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(PDF) Ultrathin Al2O3 Coating on LiNi0.8Co0.1Mn0.1O2 Cathode Material for Enhanced Cycleability at Extended Voltage Ranges
PDF | Ni-rich LiNi0.8Co0.1Mn0.1O2 oxide has been modified by ultrathin Al2O3 coatings via atomic layer deposition (ALD) at a growth rate of 1.12... | Find, read and cite all the research you need on ResearchGate
Ultrathin Al2O3 Coating on LiNi0.8Co0.1Mn0.1O2 Cathode Material for Enhanced Cycleability at Extended Voltage Ranges
DOI: 10.3390/coatings9020092
Zhiqiang Xie
Abstract and Figures
Ni-rich LiNi0.8Co0.1Mn0.1O2 oxide has been modified by ultrathin Al2O3 coatings via atomic layer deposition (ALD) at a growth rate of 1.12 Å/cycle. All characterizations results including TEM, SEM, XRD and XPS together confirm high conformality and uniformity of the resultant Al2O3 layer on the surface of LiNi0.8Co0.1Mn0.1O2 particles. Coating thickness of the Al2O3 layer is optimized at ~2 nm, corresponding to 20 ALD cycles to enhance the electrochemical performance of Ni-rich cathode materials at extended voltage ranges. As a result, 20 Al2O3 ALD-coated LiNi0.8Co0.1Mn0.1O2 cathode material can deliver an initial discharge capacity of 212.8 mAh/g, and an associated coulombic efficiency of 84.0% at 0.1 C in a broad voltage range of 2.7–4.6 V vs. Li+/Li in the first cycle, which were both higher than 198.2 mAh/g and 76.1% of the pristine LiNi0.8Co0.1Mn0.1O2 without the Al2O3 protection. Comparative differential capacity (dQ/dV) profiles and electrochemical impedance spectra (EIS) recorded in the first and 100th cycles indicated significant Al2O3 ALD coating effects on suppressing phase transitions and electrochemical polarity of the Ni-rich LiNi0.8Co0.1Mn0.1O2 core during reversible lithiation/delithiation. This work offers oxide-based surface modifications with precise thickness control at an atomic level for enhanced electrochemical performance of Ni-rich cathode materials at extended voltage ranges.
(a) Schematics illustration of the Al2O3 ALD growth at the surface of NCM811 particles; FESEM images of (b) bare NCM811, and (c) 20 Al2O3 ALD NCM811; EDS mapping of (d) 20 Al2O3 ALD NCM811; TEM images of (e) bare NCM811, (f) 20 Al2O3 ALD NCM811, and (g) 50 Al2O3 ALD NCM811; and HRTEM images of (h) bare NCM811, (i) 20 Al2O3 ALD NCM811, and (j) 50 Al2O3 ALD NCM811. …
Characteristics XPS spectra captured on the 10 Al 2 O 3 ALD NCM811, 20 Al 2 O 3 ALD NCM811, and 50 Al 2 O 3 ALD NCM811 materials compared to the bare NCM811: (a) Al 2p, (b) Ni 2p, (c) Co 2p, and (d) Mn 2p peaks. …
Figures - available via license: Creative Commons Attribution 4.0 International
160+ million publication pages
coatings
Article
Ultrathin Al 2 O 3 Coating on LiNi 0.8 Co 0.1 Mn 0.1 O 2
Cathode Material for Enhanced Cycleability at
Extended V oltage Ranges
Wenchang Zhu 1,2 , Xue Huang 1,2 , T ingting Liu 3 , Zhiqiang Xie 4 , Ying Wang 4 , Kai T ian 1,2 ,
Liangming Bu 1,2 , Haibo Wang 1,2,5 , Lijun Gao 1 , 2, * and Jianqing Zhao 1, 2, *
1 College of Energy , Soochow Institute for Energy and Materials InnovationS, Soochow University ,
Suzhou 215006, China; [email protected] (W .Z.); [email protected] (X.H.);
[email protected] (K.T.); [email protected] (L.B.); [email protected] (H.W .)
2 Key Laboratory of Advanced Carbon Materials and W earable Energy Technologies of Jiangsu Pr ovince,
Soochow University , Suzhou 215006, China
3 Suzhou University of Science and T echnology & Jiangsu Key Laboratory of Environmental Science and
Engineering, Suzhou 215001, China; [email protected]
4 Department of Mechanical & Industrial Engineering, Louisiana State University ,
Baton Rouge, LA 70803, USA; [email protected] (Z.X.); [email protected] (Y .W.)
5 Institute of Chemical Power Sources, Soochow University , Suzhou 215600, China
* Correspondence: [email protected] (L.G.); [email protected] (J.Z.);
T el.: +86-512-6522-9905 (L.G. & J.Z.)
Received: 20 December 2018; Accepted: 31 January 2019; Published: 3 February 2019
Abstract:
Ni-rich LiNi
0.8
Co
0.1
Mn
0.1
O
2
oxide has been modified by ultrathin Al
2
O
3
coatings via atomic
layer deposition (ALD) at a growth rate of 1.12 Å/cycle. All characterizations results including TEM,
SEM, XRD and XPS together confirm high conformality and uniformity of the resultant Al
2
O
3
layer
on the surface of LiNi
0.8
Co
0.1
Mn
0.1
O
2
particles. Coating thickness of the Al
2
O
3
layer is optimized at
~2 nm, corresponding to 20 ALD cycles to enhance the electrochemical performance of Ni-rich cathode
materials at extended voltage ranges. As a result, 20 Al
2
O
3
ALD-coated LiNi
0.8
Co
0.1
Mn
0.1
O
2
cathode
material can deliver an initial discharge capacity of 212.8 mAh/g, and an associated coulombic
efficiency of 84.0% at 0.1 C in a broad voltage range of 2.7–4.6 V vs. Li
+
/Li in the first cycle,
which were both higher than 198.2 mAh/g and 76.1% of the pristine LiNi
0.8
Co
0.1
Mn
0.1
O
2
without the
Al
2
O
3
protection. Comparative differential capacity (d Q /d V ) profiles and electrochemical impedance
spectra (EIS) recorded in the first and 100th cycles indicated significant Al
2
O
3
ALD coating effects
on suppressing phase transitions and electrochemical polarity of the Ni-rich LiNi
0.8
Co
0.1
Mn
0.1
O
2
core during reversible lithiation/delithiation. This work offers oxide-based surface modifications
with precise thickness control at an atomic level for enhanced electrochemical performance of Ni-rich
cathode materials at extended voltage ranges.
Keywords:
Al
2
O
3
oxide; atomic layered deposition; LiNi
0.8
Co
0.1
Mn
0.1
O
2
; Ni-rich cathode material;
lithium ion battery
1. Introduction
Lithium ion batteries have been dominantly applied in hybrid electric vehicles (HEVs) and
pure electric vehicles (EVs) [
1
,
2
], which significantly enhances our living environment. In particular
for electric transportation systems and future large-scale applications of stationary grid energy
storage, lithium ion batteries are required to provide higher ener gy and power densities, together
with excellent long-term service life and acceptable cost [
3
]. Performance of lithium ion batteries
Coatings 2019 , 9 , 92; doi:10.3390/coatings9020092 www.mdpi.com/journal/coatings
Coatings 2019 , 9 , 92 2 of 12
critically depends on the electrochemical properties and behaviors of electrode materials both in
cathodes and anodes [
4
–
6
]. Because of the rapid development of practical Si–C composite anode
materials, developing high-performance cathode materials with high specific capacity , high working
potential, excellent cycle life, reliable safety , and low cost has become an urgent requirement [
7
–
9
].
Li-excess and Ni-rich layered oxides have been extensively investigated as high-energy cathode
materials for superior lithium ion batteries [
10
,
11
]. Despite delivering an attractive discharge capacity
of ~250 mAh/g, Li-excess layered cathode materials have been suffering from two crucial issues. One is
the layered-to-spinel phase transition during prolonged electrochemical cycles, leading to continuous
voltage fading. The other is low coulombic efficiency in the first cycle that r esults from the initial
electrochemical activation of the Li
+
-inactive Li
2
MnO
3
component [
10
,
12
,
13
]. These two problems
impede practical applications of Li-excess cathode materials. Alternatively , Ni-rich layered oxides
have been considered as feasible cathode materials by offering a reversible capacity of ~200 mAh/g
and a stable working voltage at ~3.8 V vs. Li + /Li.
It is well-known that the resultant electrochemical performance of Ni-rich cathode materials is
essentially determined on the specific composition of Ni, Co, and Mn elements within these ternary
transition metal oxides, LiNi
1 − x − y
Co
x
Mn
y
O
2
( x + y < 0.5) [
11
,
14
,
15
]. Higher Ni content results in higher
lithium storage capacity of LiNi
1 − x − y
Co
x
Mn
y
O
2
, but leads to the undesired formation of Li
+
/Ni
2+
cation mixing in the layered structure; the expense of safety in material usage and more complexity in
the material preparation [
16
,
17
]. Mn and Co dopants have been demonstrated to enhance the structural
robustness and cationic ordering for LiNi
1 − x − y
Co
x
Mn
y
O
2
variants, respectively . However, the specific
capacity has to be sacrificed, when Mn and Co contents are increased. In order to rapidly promote
practical applications of Ni-rich cathode materials for superior lithium ion batteries, poor cycling
and thermal stabilities of LiNi
1 − x − y
Co
x
Mn
y
O
2
should be urgently addressed, especially for materials
with high Ni content. Capacity fading can be exacerbated, when these Ni-rich LiNi
1 − x − y
Co
x
Mn
y
O
2
cathodes are cycled at broad voltage ranges with a high upper cut-off voltage above 4.3 V vs. Li
+
/Li.
One reason is that the intensive oxidation capability of Ni
3+/4+
redox could aggravate parasitic side
reactions during lithiation/delithiation of LiNi
1 − x − y
Co
x
Mn
y
O
2
cathode materials, leading to undesired
electrolyte decomposition and solid electrolyte interphase (SEI) formation at the surface of the cathode.
The other reason is the induced phase transition from the initial layered structur e to spinel-like and/or
NiO-like rock-salt phases at the surface of LiNi
1 − x − y
Co
x
Mn
y
O
2
particles, because the formation
of Li
+
vacancies in high concentration at deep charge destabilizes the initial layered structure of
LiNi
1 − x − y
Co
x
Mn
y
O
2
[
18
]. These unfavorable structural transformations are consecutive, and gradually
overspread from the surface to bulk Ni-rich layered oxides [
17
,
19
]. In addition, the formation of
impure phases definitely brings about structural degradation and increased kinetic barrier for lithium
ion diffusion, causing capacity fading and inferior rate capability of LiNi
1 − x − y
Co
x
Mn
y
O
2
cathode
materials [ 20 , 21 ].
Surface modifications, either on particles of active cathode materials or at the surface of the
entire cathode, have been demonstrated to improve electrochemical performance for various cathode
materials even in harsh operation conditions, such as elevated working temperatures and broad
voltage ranges [
22
,
23
]. Oxides are considered common coating materials, because of their low material
cost, simple synthetic procedure, and high effectiveness in protecting internal electrode materials.
V arious examples have been reported in the literature [
24
–
28
], involving Al
2
O
3
, ZrO
2
, ZnO, TiO
2
,
Cr
2
O
3
, SnO
2
, etc. However, associated electrochemical performance of modified cathode materials is
sensitively determined by qualities of the coated oxides in terms of thickness, conformality , uniformity ,
and integrity . Oxide coatings prepared by atomic layer deposition (ALD) have been demonstrated
to considerably enhance electrochemical performance for various cathode materials, involving
layered LiCoO
2
[
29
,
30
], spinel LiMn
2
O
4
, and LiMn
1.5
Ni
0.5
O
4
[
31
,
32
]; Ni-rich LiNi
1 − x − y
Co
x
Mn
y
O
2
and
LiNi
0.8
Co
0.15
Al
0.05
O
2
[
33
,
34
]; and Li-excess Li[Li
1 − x
M
x
]O
2
oxides [
35
]. The ALD technique can result
in highly conformational and uniform oxide coating layers at the entire surface of the underlying
substrates, and thus has been considered as an effective method for surface modifications of different
Coatings 2019 , 9 , 92 3 of 12
cathode materials. Ni-rich cathode materials have been dominantly used for lithium ion batteries to
power currently-developed electric automobiles, but still suffer from poor service life, especially in
harsh operation conditions, such as at elevated working temperatures and/or in extended voltage
ranges. As reported in the literature [
33
,
34
], Al
2
O
3
ALD coatings contribute to enhanced cycling
stabilities of LiNi
0.5
Co
0.2
Mn
0.3
O
2
, LiNi
0.8
Co
0.1
Mn
0.1
O
2
, and LiNi
0.8
Co
0.15
Al
0.05
O
2
by protecting coated
Ni-rich oxide particles from parasitic side reactions at the cathode’s surface. However, the insulating
property of Al
2
O
3
material makes it is necessary to precisely control the coating’s thickness, in order to
maximize the electrochemical performance of Ni-rich cathode materials. In addition, it is also urgent
to understand structural features and chemical environments between oxide coatings and Ni-rich
oxide particles.
The ALD technique was employed in this work to coat ultrathin Al
2
O
3
onto Ni-rich
LiNi
0.8
Co
0.1
Mn
2
target material (marked as n Al
2
O
3
ALD NCM811, then responses to the number
of ALD cycles related to the thickness control of Al
2
O
3
coating layer). TEM observations were used
to examine the structural characteristics of resultant Al
2
O
3
coatings and determine the ALD growth
rate of Al
2
O
3
oxide. XPS spectra were used to study chemical environments of different n Al
3
ALD NCM811 ( n = 10, 20 and 50) materials. Electrochemical performance of three n Al
2
O
3
ALD
NCM811 cathode materials were evaluated and compared with the bare NCM811 cathode in a broad
voltage range of 2.7–4.6 V vs. Li
+
/Li. This work offers a high-quality oxide coating for Ni-rich cathode
materials by using the ALD method, which significantly contributes to improved electrochemical
performance in extended voltage ranges for superior lithium ion batteries.
2. Materials and Methods
2.1. Synthesis of Ni-Rich Layered LiNi 0.8 Co 0.1 Mn 0.1 O 2 Material
In a typ ical s ol (sol utio n)-ge l rout e, sto ichio metri c amou nts of CH
3
COOL i
·
2H
2
O, Ni( CH
2 ·
4H
2
O,
Co(CH
3
COO)
2 ·
4H
2
O, and Mn(CH
3
COO)
2 ·
4H
2
O were dissolved in 50 mL of distilled water . An extra
3 mol.% of the lithium source was used to compensate for the volatilization of lithium at high heating
temperatures. The green sol was obtained after the solvent was completely evaporated, and was then
transferred to dry in vacuum at 120
◦
C for
5 h, under pure O
2
flow at a temperature ramp of 5
◦
C/min. The resultant black LiNi
0.8
Mn
0.1
Co
0.1
O
2
(marked as NCM811) powder was collected after cooling to room temperature.
2.2. Al 2 O 3 Coating on LiNi 0.8 Co 0.1 Mn 0.1 O 2 Particles Through Atomic Layer Deposition
The atomic layer deposition of Al
2
O
3
coating on LiNi
0.8
Mn
0.1
O
2
particles was performed in
a Savannah 100 ALD system (Cambridge NanoT ech Inc., Waltham, MA, USA) at 120
◦
C, by applying
Al(CH
3
)
3
(T rimethylalumium, TMA) and H
2
O as precursors with exposure time of 0.01 s, waiting
time of 5 s, and purge time of 40 s, respectively . Nitrogen gas was used as the flow gas, and the flow
rate was set at 20 sccm. The vacuum condition in the reaction chamber was controlled at 10
− 3
–10
− 2
torr, and the overpr essure threshold for the coating processes was set at 250 torr . Two self-terminating
reactions involved in the ALD growth of Al 2 O 3 layer are described as follows:
Al-CH 3 *+H 2 O → AlOH* + CH 4 (2)
LiNi
0.8
Co
0.1
Mn
0.1
O
2
particles coated with the Al
2
O
3
layer under different ALD cycles were
marked as n Al 2 O 3 ALD NCM811 (the n corresponds to the number of ALD cycles).
2.3. Characterizations
Crystallographic structures of bare NCM811 and Al
2
O
3
-coated NCM811 materials were examined
by X-ray diffraction (XRD), using a Bruker D8 Advance automatic diffractometer (Bruker , Billerica,
MA, USA) with Cu K
α
radiation. Morphologies and energy dispersive spectroscopic (EDS) mappings
of different samples were observed by field emission scanning electron micr oscopy (FESEM) on a
Hitachi SU-8010 (Hitachi High-T ech Corp., Tokyo, Japan) and FEI Quanta FEG 250 micr oscopies (FEI,
Hillsboro, OR, USA), respectively , with an acceleration voltage at 15/20 kV in a secondary electrons (SE)
detection mode. The Everhart Thornley Detector (ETD) was used to collected electron signals. Detailed
structural features of different specimens wer e captured by transmission electron microscopy (TEM)
and high-resolution transmission electron microscopy (HR TEM) coupled with selected area electron
diffraction (SAED) on a FEI T ecnai G2 T20 equipment (FEI, Hillsboro, OR, USA), at an acceleration
voltage of 200 kV . Chemical environments and valent states of cations within different materials were
characterized by X-ray photoelectron spectroscopic (XPS) measurements on an ESCALAB 250Xi XPS
device (Thermo Fisher Scientific, W altham, MA USA). All XPS spectra were calibrated according to the
binding energy of the C 1 s peak at 284.6 eV .
2.4. Electrochemical Measurements
The working electrodes were composed of 80 wt.% active cathode materials, 10 wt.% super p
as the conductive carbon, and 10 wt.% polyvinylidenefluoride (PVDF) as the binder. These cathodes
were assembled into two-electrode CR2025-type coin cells (Shenzhen Kejing Star T echnology Co.,
LTD., Shenzhen, China), in an Ar -filled glove box (MBraun, Garching, Germany) for electrochemical
measurements, with the metallic lithium foil as the reference, and counter electrodes with the glass
microfiber (Whatman, Grade GF/B, Little Chalfont, UK) as the separator . The electrolyte was a 1 M
solution dissolved in ethylene carbonate (EC) and dimethyl carbonate (DMC) at a volumetric
ratio of 1:1. The real loading of active material was ~3.5 mg in the cathode with a diameter of 12 mm
and a thickness of ~50 mm for all electrode materials. The electrolyte volume used during the coin
cell assembly was ~0.5 mL per unit. Galvanostatic charge and discharge were performed at different
current densities in a voltage range of 2.7–4.6 V vs. Li
+
/Li on a LAND battery testing system (Jinnuo,
Wuhan, China). The current density corresponding to 1 C was 200 mA/g. Electrochemical impedance
spectroscopy (EIS) was conducted in a frequency range of 10 mHz–100 kHz with an AC amplitude
of 5 mV on the Autolab electrochemical workstation (PGST AT302N, Metrohm Autolab, Utrecht,
The Netherlands).
3. Results and Discussion
3.1. Characteristics of Al 2 O 3 Layer Deposited on NCM811 Particles via ALD Coating
As shown in the schematic illustrations in Figure 1 a, the ALD growth of Al
2
O
3
coating at the
surface of NCM811 particles was subjected to a sequence of chemisorption and self-terminating
surface reactions (Equations (1) and (2) in Section 2.2 ). Detailed deposition mechanisms for the
different oxides, involving Al
2
O
3
, ZnO and ZrO
2
, can be found in our previous work [
12
,
36
–
40
]. As a
result, ultrathin oxide coatings under ALD growth always reveal desirable conformality , uniformity ,
robustness, and pinhole-free features. Furthermore, thickness of the resultant oxide coatings can be
precisely controlled at the Angstrom or atomic monolayer level, which is determined by the number of
ALD cycles. Accordingly, morphologic and structural dif ferences of pristine NCM811, 20 Al
2
O
3
ALD
NCM811, and 50 Al
2
O
3
ALD NCM811 materials are compared in Figure 1 b–j. The pristine NCM811
material (Figure 1 b) reveals a distinct aggregation of tremendous primary nanoparticles, which have
smooth facets and sharp edges with an average particle size of ~500 nm. Such morphologic features
generally indicate the high crystallinity and purity of the prepared NCM811 particles. By contrast,
FESEM images of the 20 Al
2
O
3
ALD NCM811 particles showed apparent roughness at the entire surface
after coating the Al
2
O
3
layer in 20 ALD cycles (Figure 1 c), implying the conformal and uniform surface
modification of the NCM811 substrate. The elemental energy dispersive spectroscopic (EDS) mapping
was captured on the selected 20 Al
2
O
3
ALD NCM811 particles (Figure 1 d), which revealed even
distributions of Al, Ni, Co, Mn, and O elements, and thus again demonstrated desirable conformality
Coatings 2019 , 9 , 92 5 of 12
and uniformity of Al
2
O
3
coatings at the surface of NCM811 particles. In order to comprehensively
understand structural characteristics of the resultant Al
2
O
3
layer, 50 Al
2
O
3
ALD NCM811 particles
with increased coating thickness were examined by TEM observations, and compared to bare NCM811
and the 20 Al 2 O 3 ALD NCM811 materials. As shown in Figure 1 e, TEM images of NCM811 particles
showed consistent contrast throughout the whole observation area, revealing a single solid structur e
without any surface modifications. HRTEM images of the selected region in Figure 1 e, marked by a
blue square, showed perfect lattice fringes with a d-space of 0.47 nm (Figure 1 h), corresponding to
(003) planes in the layered structure of NCM811 oxide. By contrast, TEM images of the 20 Al
2
O
3
ALD
NCM811 and 50 Al
2
O
3
ALD NCM811 particles captured in Figure 1 f,g gave rise to distinct contrast
differences between the dark NCM811 core and light Al
2
O
3
coating shells at the surface, respectively .
It was noticeable that the ALD coating contributed to satisfactory uniformity and conformality of the
resultant Al
2
O
3
layer, which was in accor dance with that coated at the surface of different cathode
materials reported in the literature [
36
,
38
]. The precise thickness was 5.6 nm as shown in the HRTEM
image of the 50 Al
2
O
3
ALD NCM811 (Figure 1 j), corresponding to an Al
2
O
3
ALD growth rate of
1.12 Å/cycle. Accordingly, 20 ALD cycles r esulted in an Al
2
O
3
coating with 2.2 nm thickness as shown
in Figure 1 i for the 20 Al
2
O
3
ALD NCM811 materials. Furthermore, these two HRTEM observations
indicated an amorphous feature of the Al
2
O
3
coating layer, which was distinguishable fr om the internal
crystalline NCM811 particles. As a result, SEM and TEM images demonstrated the conformational and
uniform coating of the Al 2 O 3 layer for the surface modification of Ni-rich NCM811 particles through
ALD processes, together with thickness control at the sub-nano level.
Coatings 2019 , 9 FOR PEER REVIEW 5
images of the selected region in Figure 1e, marked by a blue square, showed perfect lattice fringes
with a d-space of 0.47 nm (Figure 1h), corresponding to (003) planes in the layered structure of
NCM811 oxide. By contrast, TEM images of the 20 Al 2 O 3 ALD NCM811 and 50 Al 2 O 3 ALD NCM 811
particles captured in Fi gure 1f,g gave rise to distinct contrast differences between the dark NCM811
core and light Al 2 O 3 coating shells at the surface, respectively. It was noticeable that the ALD coating
contributed to satisfactory uniformity and conformality of the resultant Al 2 O 3 layer, which was in
accordance with that coated at the surface of differe nt cathode materials reported in the literature
[36,38]. The precise thickness was 5.6 nm as shown in the HRTEM image of the 50 Al 2 O 3 ALD
NCM811 (Figure 1j), corresponding to an Al 2 O 3 ALD growth rate of 1.12 Å/cycle. Accordingly, 20
ALD cycles resulted in an Al 2 O 3 coating wi th 2.2 nm thickness as shown in Figure 1i for the 20 Al 2 O 3
ALD NCM811 materials. Furthermore, these two HRTEM observations indicated an amorphous
feature of the Al 2 O 3 coating layer, which was distinguishable fro m the i nternal crystalline NCM811
particles. As a result, SEM and TEM images demonstrated the conformational and uniform co ating
of the Al 2 O 3 layer for the surface modification of Ni- rich NCM811 particles thro ugh ALD processes,
together with thickness control at the su b-nano level.
Figure 1. ( a ) Schematics illustration of the Al 2 O 3 ALD growth at the surface of NCM811 particles;
FESEM images of ( b ) bare NCM811, and ( c ) 20 Al 2 O 3 ALD NCM811; EDS mapping of ( d ) 20 Al 2 O 3
ALD NCM811; TEM images of ( e ) bare NCM811, ( f ) 20 Al 2 O 3 ALD NCM811 , and ( g ) 50 Al 2 O 3 ALD
NCM811; and HRTEM images of ( h ) bare NCM811, ( i ) 20 Al 2 O 3 ALD NCM811, and ( j ) 50 Al 2 O 3 ALD
NCM811.
Al 2 O 3 coating ef fects on changing t he crystal structure of Ni-rich NCM811 core were evaluated
using XRD patterns of different coated materials, coupl ed with quantitati ve analyses fro m Rietveld
refinements. As shown in Figure 2a, the XRD pattern of pri stine NCM811 material was well indexed
to a layered α-NaFeO 2 structure with a R-3m space group (JCPDS No . 74-0919). It also showed a
desirable intensity rati o of characteristic 003 over 104 reflectio ns, i.e., I 003 / I 104 = 1.48 and distinct peak
Figure 1.
(
a
) Schematics illustration of the Al
2
O
3
ALD growth at the surface of NCM811 particles;
FESEM images of (
b
) bare NCM811, and (
c
) 20 Al
2
O
3
ALD NCM811; EDS mapping of (
d
) 20 Al
2
O
3
ALD NCM811; TEM images of (
e
) bare NCM811, (
f
) 20 Al
2
O
3
ALD NCM811, and (
g
) 50 Al
2
O
3
ALD
NCM811; and HRTEM images of (
h
) bare NCM811, (
2
O
3
ALD NCM811, and (
j
) 50 Al
2
O
3
ALD NCM811.
Coatings 2019 , 9 , 92 6 of 12
Al
2
O
3
coating effects on changing the crystal structure of Ni-rich NCM811 core wer e evaluated
using XRD patterns of different coated materials, coupled with quantitative analyses from Rietveld
refinements. As shown in Figure 2 a, the XRD pattern of pristine NCM811 material was well indexed to
a layered
α
-NaFeO
2
intensity ratio of characteristic 003 over 104 reflections, i.e., I
003
/ I
104
= 1.48 and distinct peak splitting of
two 006/102 and 108/110 doublets, indicating outstanding structural ordering of the layered NCM811
material. The Rietveld refinement on the XRD pattern of pristine NCM811 resulted in lattice parameters
of a = 2.8746 Å, c = 14.2102 Å, and V = 101.72 Å
3
, together with a low estimated Li
+
/Ni
2+
cation mixing
of 3.68% based on a low reliability-factor of R
wp
= 6.62% (T able 1 ). These XRD features all indicate
an excellent layered structure of the prepar ed Ni-rich NCM811 material, in accordance with HRTEM
images (Figure 1 h). XRD patterns and the associated refinement results of NCM811 particles coated
with 10, 20, and 50 Al
2
ALD layers are displayed in Figure 2 b–d, respectively . The calculated lattice
parameters and cation mixings of these three coated materials, with gradually-increasing coating
thickness of Al
2
O
3
, are summarized in T able 1 compared to bare NCM811, together with values of
standard deviations (s.d.) for the calculations. The Al
2
O
3
phase was not detectable even in the 50
Al
2
O
3
ALD NCM811 samples, owing to the amorphous phase. However, the Al
2
O
3
coating slightly
suppressed the crystal structural of the internal NCM811 host. Coatings thicker than 2 nm, i.e., 20
according to the refinement results of the 20 Al
2
O
3
ALD NCM811 sample, while the 10 Al
2
O
3
ALD
NCM811 showed little change in lattice parameters as compared with that in the pristine NCM811
(T able 1 ). Although the thick Al
2
O
3
coating reduced a and c values of the 50 Al
2
O
3
ALD NCM811
material, its c / a ratio was almost the same with the NCM811, again indicating high conformality and
uniformity of surface modifications via oxide ALD coatings. On the other hand, XRD patterns of the
O
3
-coated NCM811 materials revealed I
003
/ I
104
values equal to 1.54, 1.46, and 1.45 after 10,
20, and 50 ALD cycles (Figure 2 b–d), respectively , indicating little effects of Al
2
O
3
ALD coating on the
structural ordering of internal NCM811 material. The estimated cation mixings within the layered
structures of these three samples wre all in an acceptable range of 3%–4%, consistent with that of the
pristine NCM811 material (T able 1 ).
Coatings 2019 , 9 FOR PEER REVIEW 6
splitting of two 006/102 and 108/110 doublets, indicating outstanding structural ordering of the
layered NCM811 material. The Rietveld refinement on the XRD pattern of pristine NCM811 resulted
in lattice parameters of a = 2.8746 Å, c = 14.2102 Å, and V = 101.72 Å 3 , together wi th a low estimated
Li + /Ni 2+ cation mixing of 3.68% based on a low reliability-factor of R wp = 6.62% (Table 1). These XRD
features all indicate an excellent layered structure of the prepared Ni-rich NC M811 material, in
accordance with HRTEM images (Figure 1h). XRD patterns a nd the associated ref inement results of
respectively. The calculated lattice para meters and cation mixings of these three coated materials,
with gradual ly-increasing co ating thickness of Al 2 O 3 , are summarized in Table 1 compared to bare
NCM811, together with values of standard deviations (s.d.) for the calculations. The Al 2 O 3 phase wa s
not detectable even in the 50 Al 2 O 3 ALD NCM811 samples, owing to the amorphous phase. However,
the Al 2 O 3 coating sli ghtly suppressed the crystal structural of the inte rnal NCM811 host. Coat ings
thick er tha n 2 nm, i. e., 2 0 ALD cycles (20 cycle* 1.12 Å/cycle = 2 .24 nm), resulted in a d etectable decrease
in a , c , and V values, according to the refinement results of the 20 Al 2 O 3 ALD NCM811 sample, while
the 10 Al 2 O 3 ALD NCM811 showed little change in l attice parameters as compared wi th that in the
pristine NCM811 (Table 1). Although the thick Al 2 O 3 coating reduced a and c values of the 50 Al 2 O 3
ALD NCM811 materi al, its c / a ratio was almost the same with the NCM811, again i ndicating high
conformality and uniformity of surface modifications via oxide ALD co atings. On the other hand,
XRD patterns of the three Al 2 O 3 -coated NCM811 materials revealed I 003 / I 104 values equal to 1.54, 1.46,
and 1.45 after 10, 20, and 50 ALD cycles (Figure 2b–d), respectively, indicating little effects of Al 2 O 3
ALD coating on the structu ral ordering o f internal NCM811 material. The estimated cation mixings
within the layered structures of these three samples wre all in an acceptable range of 3%–4%,
consistent with that of the pristine NCM 811 material (Table 1).
Figure 2. XRD patterns of ( a ) bare NCM8111; ( b ) 10 Al 2 O 3 ALD NCM8111; ( c ) 20 Al 2 O 3 ALD
NCM8111; and ( d ) 50 Al 2 O 3 ALD NCM8111 materials, coupled with rietveld refinement results.
Figure 2.
XRD patterns of (
a
) 10 Al
2
O
3
ALD NCM8111; (
c
) 20 Al
2
O
3
ALD NCM8111;
and ( d ) 50 Al 2 O 3 ALD NCM8111 materials, coupled with rietveld refinement results.
Coatings 2019 , 9 , 92 7 of 12
T able 1.
Crystal parameters of different Al
2
O
3
-coated NCM811 materials in comparison to bare
NCM811, according to XRD patterns and refinement results as shown in Figure 2 .
Samples a
(Å) s.d. c
compared. As shown in Figure 3 a, 10 Al
2
O
3
ALD NCM811, 20 Al
2
O
3
ALD NCM811, and 50 Al
2
O
3
ALD NCM811 samples all showed sharp Al 2 p XPS peaks, verifying successful Al
2
O
3
coating at the
surface of NCM811 particles. These collected Al 2 p peaks slightly shifted to higher binding energies at
75.4, 75.6, and 75.7 eV , respectively, compared to 74.6 eV of pur e Al
2
O
3
Database, implying possible chemical bonding between the Al
2
O
3
coating layer and NCM811 particles.
As reported in the literature [
36
–
40
], the oxide coating and substrate in a typical ALD growth can result
in a favorable chemical bond of substrate–O–M
x
O
y
(M = Al, Zn, Zr , Sn, etc.), this process is illustrated
in Figure 1 a. However, it is unexpected to see that all the characteristic of Ni 2 p , Co 2 p , and Mn
2 p XPS peaks captured on three Al
2
O
3
-coated NCM811 particles also gave rise to higher bonding
O
3
was
gradually increased (Figure 3 b–d). These interesting XPS results may be attributed to the tr emendous
–OH groups that were left at the surface of Al
2
O
3
coating at the end of ALD growth (Figure 1 a),
which are highly electronegative, and thus probably induce reduced electr on cloud densities of Al,
Ni, Co, and Mn cations. The thicker Al
2
O
3
coating resulted in increased surface area of Al
2
O
3
-coated
NCM811 particles as well as the quantity of residual –OH groups at the most outside surface; hence,
the inductive effect was enhanced by the increased number of –OH groups, leading to binding energy
2
O
3
and NCM811, which may facilitate charge transfer and lithium ion diffusion through the oxide
coating layer.
Coatings 2019 , 9 FOR PEER REVIEW 7
Table 1. Crystal parameters of different Al 2 O 3 -coated NCM811 materials in comparison to bare
NCM811, according to XRD patterns and refinement results as shown in Figure 2.
Samples a
(Å) s.d. c
(Å) s.d. Volume
(Å 3 ) s.d. c / a Li + at
3 b Sites
s.d. R wp
(%)
R p
(%)
NCM811 2.8746 3 × 10 −5 14.2102 1.8 ×
10 −3 101.72 2.87 ×
10 −3 4.9432 0.9632 2.203 ×
10 −3 6.62 4.81
10 Al 2 O 3 ALD
NCM811 2.8745 3 × 10 −5 14.2095 3.1 ×
10 −3 101.71 3.1 ×
10 −3 4.9433 0.9634 2.351 ×
10 −3 6.09 5.12
20 Al 2 O 3 ALD
NCM811 2.8743 2 × 10 −5 14.2094 3.6 ×
10 −3 101.65 3.05 ×
10 −3 4.9436 0.9697 1.936 ×
10 −3 6.42 5.18
50 Al 2 O 3 ALD
NCM811 2.8739 4 × 10 −5 14.2071 5.2 ×
10 −3 101.49 7.93 ×
10 −3 4.9435 0.9666 7.725 ×
10 −3 7.03 5.58
In or der to confirm Al 2 O 3 coating forma tion an d its p ossible impact s on th e chemi cal environments
of transition metal catio ns at the surface o f NCM811 particles, characteristic Al 2 p , Ni 2 p , Co 2 p , and
Mn 2 p XPS peaks of bare NCM811 and three Al 2 O 3 -coated NCM811 materials were measured and
compared. As shown in Figure 3a, 10 Al 2 O 3 ALD NCM811, 20 Al 2 O 3 ALD NCM811, and 50 Al 2 O 3
ALD NCM811 samples all showed sharp Al 2 p XPS peaks, verifying successful Al 2 O 3 coating at the
surface of NCM8 11 particles. These coll ected Al 2 p peaks sl ightly shifted to higher binding energies
at 75.4, 75.6, and 75.7 eV, respectively, compared to 74.6 eV of pure Al 2 O 3 oxide reported in NIST XPS
Database, implying possible chemical bonding between the Al 2 O 3 coating layer and NCM811
particles. As reported in the literature [36–40], the ox ide coating and substrate in a typical ALD
growth can result in a favorable chemical bond of substrate–O–M x O y (M = Al, Zn, Zr, Sn, etc.), this
process is illustrated in Figure 1a. However, it is unexpected to see that all the characteristic of Ni 2 p ,
Co 2 p , an d Mn 2 p XPS peaks captured on three Al 2 O 3 -coated NCM811 particles also gave rise to
higher bonding energies compared to those of pristine NCM811 particles, when the coating thickness
of Al 2 O 3 was gradually increased (Figure 3b–d). These interesting XPS results may be attributed to
the tremendous –OH groups that were left at the surface of Al 2 O 3 coating at the end of ALD growth
(Figure 1a), which are highly el ectronegative, and thus probably induce reduced e lectron cloud
densities of Al, Ni, Co, and Mn cations. The t hicker Al 2 O 3 coa ting resulted in increased surface area of
Al 2 O 3 -coated NCM 811 particles as well as the quantity of residual –OH groups at the most outside
surface; hence, the inducti ve effect was enhanced by the increased number of –OH groups, leadi ng
to binding energy shifts of different cations to higher values. XPS results indicate a probable chemical
bonding between Al 2 O 3 and NCM811, which may facilitate charge transfer and lithium ion diffusion
through the oxide coating layer.
Figure 3. Characteristics XPS spectra captured o n the 10 Al 2 O 3 ALD NCM811, 20 Al 2 O 3 ALD NCM811,
and 50 Al 2 O 3 ALD NCM811 materials compared to the bare NCM811: ( a ) Al 2 p , ( b ) Ni 2 p , ( c ) Co 2 p ,
and ( d ) Mn 2 p peaks.
Figure 3.
Characteristics XPS spectra captured on the 10 Al
2
O
3
ALD NCM811, 20 Al
2
O
3
ALD NCM811,
and 50 Al
2
O
3
ALD NCM811 materials compared to the bare NCM811: (
a
) Al 2 p , (
b
) Ni 2 p , (
c
) Co 2 p ,
and ( d ) Mn 2 p peaks.
Coatings 2019 , 9 , 92 8 of 12
3.2. Enhanced Electrochemical Performance of Ni-Rich NCM811 Cathode Materials by Al 2 O 3 ALD Coating
Effects of Al
2
O
3
ALD coating on improving electrochemical performance of Ni-rich NCM811
cathode material are evaluated in Figure 4 , where different cathode materials were subjected to a
broad voltage range of 2.7–4.6 V vs. Li
+
/Li. Figure 4 a compares resultant cycling performance of
the Al
2
O
3
-coated NCM811 cycled at 0.1 C with bare NCM811 material. The coating thickness of
Al
2
O
3
layer was optimized at ~2 nm, corresponding to 20 ALD cycles. As a result, the 20 Al
2
O
3
ALD NCM811 cathode delivered an impressive discharge capacity of 212.8 mAh/g and an associated
initial columbic efficiency of 84.0% in the first cycle, which were both higher than 198.2 mAh/g and
76.1% of the pristine NCM811 without Al
2
O
3
protection. Accordingly , the charge/discharge curves
of these two cathode materials cycled at 1st and 100th cycles are shown in Figure 4 b. The improved
electrochemical reversibility with increased specific capacity of the 20 Al
2
O
3
ALD NCM811 in the
first cycle can be attributed to the conformal surface modification from the Al 2 O 3 coating (Figure 1 a),
which effectively suppressed detrimental side reactions even when the NCM811 cathode material was
cycled in an extended voltage range up to 4.6 V . In addition to protecting the internal Ni-rich core
material from the HF attack in electrolytes as reported in the literature [
29
,
41
], the conformational
and uniform Al
2
O
3
coating also reduced the electrolyte decomposition induced by high oxidation
of Ni
3+
/Ni
4+
redox, especially under the deeply-charged condition at a high cut-off voltage of 4.6 V .
As shown in Figure 4 a,b, the pristine NCM811 cathode material suffered from distinct capacity decay to
127.5 mAh/g after 100 electrochemical cycles, while the 20 Al
2
O
3
ALD NCM811 retained a much higher
capacity of 157.2 mAh/g in the 100th cycle. Furthermore, the NCM811 also encountered an obvious
working voltage fading from 3.80 initially to 3.76 V in the 100th cycle. By contrast, electrochemical
polarity was effectively inhibited in the 20 Al
2
O
3
ALD NCM811 cathode material, resulting in a
well-preserved working voltage from 3.84 V in the first cycle to 3.83 V after 100 cycles. The 10 Al
2
O
3
ALD NCM811 delivered moderate cycling performance as shown in Figure 4 a, between the NCM811
and 20 Al
2
O
3
ALD NCM811, which was attributed to the thinner Al
2
O
3
coating around 1 nm. On the
other hand, the much thicker coating of Al
2
O
3
layer (>5 nm) after 50 ALD cycles resulted in satisfactory
cycling stability , but the lithium storage capacity had to be sacrificed (Figure 4 a), owing to the inferior
conductivity of insulating Al
2
O
3
oxide [
42
,
43
]. According to reports in the literature [
13
,
44
], Ni-rich
cathode materials undergo inevitable phase transitions among three hexagonal (H1, H2, and H3) and
one monoclinic (M) phases in their layered structures during lithiation/delithiation, which further
aggravate undesired capacity fading in long-term electrochemical cycles. In order to examine possible
phase transitions, related differential capacity (d Q /d V ) profiles ar e shown in Figure 4 c, which were
transferred from charge/discharge curves in Figur e 4 b. The initial anodic peak of pristine NCM811
showed the much higher intensity by contrast with 20 Al
2
O
3
ALD NCM811, indicating severe parasitic
side reactions that occurred during the first phase transformation from the hexagonal H1 to monoclinic
M phases. Subsequent M to H2, and H2 to H3 took place around at 4.0 and 4.2 V as marked in
Figure 4 c, respectively , when the Ni-rich cathode materials were charged to a high cutoff voltage.
In successive discharge processes, phase transitions from H3 to H2 to M were reduced, resulting
in dominant cathodic peaks around 3.75 V both in NCM811 and 20 Al
2
O
3
ALD NCM811 cathodes.
However, two r edox pairs at higher voltages around 4.0 and 4.2 V were detected in the 100th cycle
of pristine NCM811 cathode (peak voltages of detected anodic and cathodic peaks are marked by
underlines), while the 20 Al
2
O
3
ALD NCM811 gave rise to the smoother d Q /d V curves above 3.9 V ,
revealing significantly suppressed phase transitions for its enhanced cycling stability after the optimal
Al
2
O
3
ALD coating. Furthermore, total resistance changes of these two cathodes after 100 cycles
were determined by EIS spectra as shown in Figure 4 d. These measurements were conducted on
their fully-discharged states after prolonged electrochemical cycles. EIS spectra of fresh cells were
also recorded at open circuit voltage states for the comparison. It is worth noting that two fresh cells
of NCM811 and the 20 Al
2
O
3
ALD NCM811 cathodes both showed small resistances around 25
Ω
.
However, two Nyquist cir cles with larger diameters were captured in both cathodes after 100 cycles.
The selected equivalent circuit, as the inset, was used to calculate the associated resistances based on
Coatings 2019 , 9 , 92 9 of 12
fitting solid lines. For the pristine NCM811, one Nyquist circle in high frequency may be attributed
to impure phases, such as spinel-like and/or rock-salt phases formed during prolonged cycles as
reported in the literature [
45
,
46
], and others in low frequency were assigned to the solid electrolyte
interphase (SEI) film. By contrast, two Nyquist circles in 20 Al
2
O
3
ALD NCM811 resulted from the
Al
2
O
3
coating and SEI film at the surface of cycled cathode material, respectively . It is noticeable
that introduction of 2 nm Al
2
O
3
coating led to acceptable resistance at 29
Ω
, which was smaller than
the 35
Ω
caused by the secondary impure structure that formed at the surface of NCM811 without
surface modification. Moreover, the 20 Al
2
O
3
ALD NCM811 resulted in considerable decrease (160
Ω
)
corresponding to SEI film resistance, while the pristine NCM811 brought about larger SEI r esistance
(250
Ω
). Electrochemical performance demonstrated significant effects of the optimized Al
2
O
3
ALD
coating on reducing electrochemical polarity and improving r eversibility of Ni-rich cathode materials
for superior lithium ion batteries.
Coatings 2019 , 9 FOR PEER REVIEW 9
prolonged cycles as reported in the literature [45 ,46], and others in low frequency were assigned to
the solid electrolyte interphase (SEI) film. By contrast, two Nyquist c ircles in 20 Al 2 O 3 ALD NCM811
resulted from the Al 2 O 3 coating and SEI film at the sur face of cycled cathode material, respectively.
It is noticeable that introduction of 2 nm Al 2 O 3 coating led to acceptable resistance at 29 Ω, which was
smaller than the 35 Ω c aused by the secondary impure structure that formed at the surface of
NCM811 without surface modification . Moreover, the 20 A l 2 O 3 ALD NCM811 result ed in con siderable
decrease (160 Ω) corresponding to SEI fil m resistance, while the pristine NCM811 brought about
larger SEI resistance (250 Ω) . Electrochemical performance demonstrated significant effects of the
optimized Al 2 O 3 ALD coating on reducing electrochemical polarity and improving reversi bility of
Ni-rich cathode materials for superi or lithium ion batteries.
Figure 4 Electrochemical performance of different cathode materials in a broad voltage range of 2.7–
4.6 V vs. Li + /Li: ( a ) cycling performance at 0.1 C for 100 cycles; ( b ) charge/discharge curves of bare
NCM811 and 20 Al 2 O 3 ALD NCM811 in the first and 100th cycles at 0.1 C; ( c ) d Q /d V profiles of bare
NCM811 and 20 Al 2 O 3 ALD NCM811 in the first and 100th cycles; and ( d ) EIS spectra captured on
fresh cells (solid patterns) at open circuit voltage states and after 100 cycles at fully-discharged states
(hollow patterns).
4. Conclusions
Enhanced cycling stability of Ni-rich LiNi 0.8 Co 0.1 Mn 0.1 O 2 cathode material in an extended voltage
range has been reali zed by surface modification of ultrathin Al 2 O 3 coating through atomic layer
deposition. The o xide ALD growth leads to impressive conformality and uniformity of resultant
Al 2 O 3 layer, and the coating thickness can be precisely controlled at 1.12 Å per ALD cycle. The optimal
thickness of the Al 2 O 3 coating for LiNi 0.8 Co 0.1 Mn 0.1 O 2 cathode material is in 2 nm level through
performing 20 ALD cycles. Ei ther the thicker or thinner coating thi ckness leads to decreased lithium
storage capacity together with inferior cycling performance of different Al 2 O 3 coated
LiNi 0.8 Co 0.1 Mn 0.1 O 2 cathodes. The optimized 20 Al 2 O 3 ALD modified LiNi 0.8 Co 0.1 Mn 0. 1 O 2 cathode
material di stinctly shows increased discharge capacity a nd columbic efficiency in the first cycle, as
well as improved capacity retention after successive 100 cycles in comparison with the pristine
Figure 4.
Electrochemical performance of different cathode materials in a broad voltage range of
2.7–4.6 V vs. Li
+
/Li: (
a
) cycling performance at 0.1 C for 100 cycles; (
b
) charge/discharge curves of
bare NCM811 and 20 Al
2
O
3
ALD NCM811 in the first and 100th cycles at 0.1 C; (
c
) d Q /d V profiles of
bare NCM811 and 20 Al
2
O
3
ALD NCM811 in the first and 100th cycles; and (
d
) EIS spectra captured on
fresh cells (solid patterns) at open circuit voltage states and after 100 cycles at fully-discharged states
(hollow patterns).
4. Conclusions
Enhanced cycling stability of Ni-rich LiNi
0.8
Co
0.1
Mn
0.1
O
2
cathode material in an extended
voltage range has been realized by surface modification of ultrathin Al
2
O
3
coating through atomic
layer deposition. The oxide ALD growth leads to impressive conformality and uniformity of
resultant Al
2
O
3
layer, and the coating thickness can be pr ecisely controlled at 1.12 Å per ALD cycle.
The optimal thickness of the Al
2
O
3
coating for LiNi
0.8
Co
0.1
Mn
0.1
O
2
cathode material is in 2 nm
level through performing 20 ALD cycles. Either the thicker or thinner coating thickness leads to
decreased lithium storage capacity together with inferior cycling performance of different Al
2
O
3
Coatings 2019 , 9 , 92 10 of 12
coated LiNi
0.8
Co
0.1
Mn
0.1
O
2
cathodes. The optimized 20 Al
2
O
3
ALD modified LiNi
0.8
Co
0.1
Mn
0.1
O
2
cathode material distinctly shows increased discharge capacity and columbic efficiency in the first
cycle, as well as improved capacity retention after successive 100 cycles in comparison with the
pristine material. Electrochemical features in the first and 100th cycle of cathode materials, with and
without Al
2
O
3
protection were compared, involving charge/dischar ge curves, differential capacity
profiles, and electrochemical impedance spectra. The Al
2
O
3
coating has been demonstrated to
suppress parasitic side reactions and phase transitions during prolonged lithiation/delithiation of
the LiNi
0.8
Co
0.1
Mn
0.1
O
2
cathode, resulting in reduced electrochemical polarity and enhanced cycling
stability for Ni-rich cathode materials cycled in broad voltage ranges.
Author Contributions:
Conceptualization, J.Z.; Methodology, W .Z., T.L., Z.X., and X.H.; Software, L.B.;
Data Curation, W .Z., X.H., L.B., and K.T.; W riting—Original Draft Preparation, W .Z.; Writing—Review and
Editing, Y .W., H.W ., J.Z., and L.G.; Project Administration, L.G. and J.Z.; Funding Acquisition, L.G. and J.Z.
Funding:
This research was funded by the National Natural Science Foundation of China (Nos. 21703147
and U1401248); the Jiangsu Provincial Natural Science Foundations for the Y oung Scientist (No. BK20170338);
the General Financial Grant from the China Postdoctoral Science Foundation (No. 2016M601876); and the Open
Fund of Jiangsu Key Laboratory of Materials and T echnology for Energy Conversion (No. MTEC-2017M01).
Acknowledgments:
The authors acknowledge Suzhou Key Laboratory for the Advanced Carbon Materials and
W earable Energy Technologies, Suzhou 215006, China.
Conflicts of Interest: The authors declare no conflicts of interest.
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... Al2O3 is an attractive material due to its excellent dielectric properties, good adhesion to many surfaces, and thermal and chemical stability [13][14][15]. Al2O3 ultra-thin films have many potential applications in diverse areas such as the passivation of electrical contacts, as a protective layer against corrosion by oxygen, and as a gas diffusion layer in polymers, among others [16][17]
[18]
[19][20][21][22][23][24][25][26][27]. ...
... Al 2 O 3 is an attractive material due to its excellent dielectric properties, good adhesion to many surfaces, and thermal and chemical stability [13][14][15]. Al 2 O 3 ultra-thin films have many potential applications in diverse areas such as the passivation of electrical contacts, as a protective layer against corrosion by oxygen, and as a gas diffusion layer in polymers, among others [16][17]
[18]
[19][20][21][22][23][24][25][26][27]. ...
Al2O3 Ultra-Thin Films Deposited by PEALD for Rubidium Optically Pumped Atomic Magnetometers with On-Chip Photodiode
Article
Full-text available
Florival M. Cunha
Manuel F. Silva
Nuno M. Gomes
José H. Correia
This communication shows the recipe for plasma-enhanced atomic layer deposition (PEALD) Al2O3 ultra-thin films with thicknesses below 40 nm. Al2O3 ultra-thin films were deposited by PEALD to improve the rubidium optically pumped atomic magnetometers’ (OPMs) cell lifetime. This requirement is due to the consumption of the alkali metal (rubidium) inside the vapor cells. Moreover, as a silicon wafer was used, an on-chip photodiode was already integrated into the fabrication of the OPM. The ALD parameters were achieved with a GPC close to 1.2 Å/cycle and the ALD window threshold at 250 °C. The PEALD Al2O3 ultra-thin films showed a refractive index of 1.55 at 795 nm (tuned to the D1 transition of rubidium for spin-polarization of the atoms). The EDS chemical elemental analysis showed an atomic percentage of 58.65% for oxygen (O) and 41.35% for aluminum (Al), with a mass percentage of 45.69% for O and 54.31% for Al. A sensitive XPS surface elemental composition confirmed the formation of the PEALD Al2O3 ultra-thin film with an Al 2s peak at 119.2 eV, Al 2p peak at 74.4 eV, and was oxygen rich. The SEM analysis presented a non-uniformity of around 3%. Finally, the rubidium consumption in the coated OPM was monitored. Therefore, PEALD Al2O3 ultra-thin films were deposited while controlling their optical refractive index, crystalline properties, void fraction, surface roughness and thickness uniformity (on OPM volume 1 mm × 1 mm × 0.180 mm cavity etched by RIE), as well as the chemical composition for improving the rubidium OPM lifetime.
... The survey spectrum (Figure 2a) clearly indicates similar binding energies for all species in both samples, which indicating that the chemical states of the transition metal elements in the layered NCM811 structure did not change upon coating with Ag. The Ni 2p spectrum ( Figure 2b) shows that the Ni 2p 3/2 peak appearing at BE of 855.16 eV for pristine NCM811 is slightly shifted towards higher binding energy (855.55 eV) for Ag-NCM811, which can be attributed to a decreased Ni 2+ /Ni 3+ ratio
[34]
. This result reveals that more Ni 3+ ions appear on the Ag-NCM811 electrode surface than in pristine NCM811. ...
Silver Nanocoating of LiNi0.8Co0.1Mn0.1O2 Cathode Material for Lithium-Ion Batteries
Article
Xintong Li
Kai Chang
Somia Abbas
Christian M. Julien
Surface coating has become an effective approach to improve the electrochemical performance of Ni-rich cathode materials. In this study, we investigated the nature of an Ag coating layer and its effect on electrochemical properties of the LiNi0.8Co0.1Mn0.1O2 (NCM811) cathode material, which was synthesized using 3 mol.% of silver nanoparticles by a facile, cost-effective, scalable and convenient method. We conducted structural analyses using X-ray diffraction, Raman spectroscopy, and X-ray photoelectron spectroscopy, which revealed that the Ag nanoparticle coating did not affect the layered structure of NCM811. The Ag-coated sample had less cation mixing compared to the pristine NMC811, which could be attributed to the surface protection of Ag coating from air contamination. The Ag-coated NCM811 exhibited better kinetics than the pristine one, which is attributed to the higher electronic conductivity and better layered structure provided by the Ag nanoparticle coating. The Ag-coated NCM811 delivered a discharge capacity of 185 mAh·g−1 at the first cycle and 120 mAh·g−1 at the 100th cycle, respectively, which is better than the pristine NMC811.
... Surface modification is an effective approach to improve the electrochemical performance and overcome the limitations of NCM electrode materials [13,[18][19][20]. Thus far, metal oxides, fluorides, phosphates, and other coatings, such as MgO [21], ZrO 2 [16], SiO 2 [22], Al 2 O 3 [23,
24]
, Nd 2 O 3 [25], LaFeO 3 [26], LiNbO 3 [27], LiAlO 2 [28], LBO (Li 2 O-2B 2 O 3 ) [16], Li 2 TiO 3 [29], Li 2 ZrO 3 [30], Li 2 WO 4 /WO 3 [12], Li 3 VO 4 [31], Li 4 Ti 5 O 12 [32], LiF [33], CaF 2 [34], FePO 4 [11], Li 3 PO 4 [35], polysiloxane [36], polyaniline [37], and dual coatings such as Li 3 PO 4 with polypyrrole (PPy) [38] have been applied to the surface of NCM811 to improve its electrochemical performance. Surface modification of bulk materials can segregate the bulk materials from the electrolyte, thus protecting the material surface from being attacked by the electrolyte during (de)lithiation [16]. ...
Artificial Interface Modification of Ni-rich Ternary Cathode Material to Enhance Electrochemical Performance for Li-ion Storage through RF-Plasma-assisted Technique
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CHEM ENG J
Rasu Muruganantham
Tzu-Hsin Tseng
Meng-Lun Lee
Wei-Ren Liu
Ni-rich LiNi0.8Co0.1Mn0.1O2 (NCM811) is a promising high-performance cathode material for
large-scale Li-ion storage applications. However, devices consisting of Ni-rich materials are less
thermally stable, and several factors hinder their use in practical high-energy-density applications.
Herein, an approach for plasma-modified NCM811 with TiN is proposed to effectively improve
the electrochemical performance and stabilize the cathode–electrolyte interface reaction. In
addition, the following aspects are systematically investigated using different techniques: (i)
physicochemical properties; (ii) Li storage performance, particularly, cyclic/rate capacity, kinetic
behavior of the lithium-ion diffusivities, and electrical conductivity; and (iii) key factor for
improving the electrochemical performance through ex-situ/in-situ investigations. The NCM811-
TiN/graphite pouch cell displays a high reversible capacity of 17.5 mAh and sustains over 200
cycles at 1 C. Comprehensive characterization and probes indicate that the TiN interface with the
NCM electrode enhances thermal stability, cyclic capacity, and rate stability without changing the
bulk structure and morphology. Hence, these findings facilitate the practical use of safe and high-
energy-density Li-ion batteries.
... When the content of Ni reaches to 80%, the capacity fading during cycling becomes more severe. Many researches have also reported that Al2O3 coatings on high Ni-content cathode materials can improve the capacity retention by suppressing phase transition and hydrofluoric acid-induced transition metal dissolution [130,
131,
132,133]. With the higher electrical conductivity than metal oxide, ultra-thin TiN layer was coated on LiNi0.8Co0.1Mn0.1O2 ...
Atomic-scale engineering of advanced catalytic and energy materials via atomic layer deposition for eco-friendly vehicles
Article
Full-text available
Mar 2023
Xiao Liu
Yu Su
Rong Chen
Highlights
Recent process of atomic layer deposition on catalytic and energy materials is summarized.
The enhanced catalytic and electrochemical performances are presented.
Atomic layer deposition reactors for mass production are highlighted.
The challenges on future applications of atomic layer deposition are discussed.
View
... Nano-particle coatings are effective in improving structural stability and cycling performance of micron-sized CAM particles. Different coating materials like Al 2 O 3 [91,117,
118]
, LiAlO 2 [119], CeO 2 [120], ZnO [121], ZrO 2 [121] have been coated on the surface of CAM particles through the sol-gel [119], dry mechanofusion (figure 10(b)) [122], and ALD [123,124] techniques. ALD has advantages over other coating methods in terms of regulating film thickness in the Angstrom range, allowing a uniform coating and good conformality [124]. ...
| https://www.researchgate.net/publication/330896173_Ultrathin_Al2O3_Coating_on_LiNi08Co01Mn01O2_Cathode_Material_for_Enhanced_Cycleability_at_Extended_Voltage_Ranges |
Life | Free Full-Text | L-DOPA and Droxidopa: From Force Field Development to Molecular Docking into Human & beta;2-Adrenergic Receptor
The increasing interest in the molecular mechanism of the binding of different agonists and antagonists to β2-adrenergic receptor (β2AR) inactive and active states has led us to investigate protein–ligand interactions using molecular docking calculations. To perform this study, the 3.2 Å X-ray crystal structure of the active conformation of human β2AR in the complex with the endogenous agonist adrenaline has been used as a template for investigating the binding of two exogenous catecholamines to this adrenergic receptor. Here, we show the derivation of L-DOPA and Droxidopa OPLS all atom (AA) force field (FF) parameters via quantum mechanical (QM) calculations, molecular dynamics (MD) simulations in aqueous solutions of the two catecholamines and the molecular docking of both ligands into rigid and flexible β2AR models. We observe that both ligands share with adrenaline similar experimentally observed binding anchor sites, which are constituted by Asp113/Asn312 and Ser203/Ser204/Ser207 side chains. Moreover, both L-DOPA and Droxidopa molecules exhibit binding affinities comparable to that predicted for adrenaline, which is in good agreement with previous experimental and computational results. L-DOPA and Droxidopa OPLS AA FFs have also been tested by performing MD simulations of these ligands docked into β2AR proteins embedded in lipid membranes. Both hydrogen bonds and hydrophobic interaction networks observed over the 1 μs MD simulation are comparable with those derived from molecular docking calculations and MD simulations performed with the CHARMM FF.
L-DOPA and Droxidopa: From Force Field Development to Molecular Docking into Human β 2 -Adrenergic Receptor
by Andrea Catte *,†,§ , Akash Deep Biswas ‡,§ , Giordano Mancini and Vincenzo Barone *
Scuola Normale Superiore, Piazza dei Cavalieri 7, 56126 Pisa, Italy
Authors to whom correspondence should be addressed.
‡
Current address: Department of Pharmaceutical Sciences, University of Milan, Via Mangiagalli 25, 20133 Milan, Italy.
These authors contributed equally to this work.
Life 2022 , 12 (9), 1393; https://doi.org/10.3390/life12091393
Received: 29 June 2022 / Revised: 10 August 2022 / Accepted: 1 September 2022 / Published: 6 September 2022
(This article belongs to the Special Issue Advances in G Protein-Coupled Receptors Biophysical and Medicinal Chemistry )
Abstract
:
The increasing interest in the molecular mechanism of the binding of different agonists and antagonists to
β
2
-adrenergic receptor (
β
2
AR) inactive and active states has led us to investigate protein–ligand interactions using molecular docking calculations. To perform this study, the 3.2 Å X-ray crystal structure of the active conformation of human
AR in the complex with the endogenous agonist adrenaline has been used as a template for investigating the binding of two exogenous catecholamines to this adrenergic receptor. Here, we show the derivation of L-DOPA and Droxidopa OPLS all atom (AA) force field (FF) parameters via quantum mechanical (QM) calculations, molecular dynamics (MD) simulations in aqueous solutions of the two catecholamines and the molecular docking of both ligands into rigid and flexible
β
2
AR models. We observe that both ligands share with adrenaline similar experimentally observed binding anchor sites, which are constituted by Asp113/Asn312 and Ser203/Ser204/Ser207 side chains. Moreover, both L-DOPA and Droxidopa molecules exhibit binding affinities comparable to that predicted for adrenaline, which is in good agreement with previous experimental and computational results. L-DOPA and Droxidopa OPLS AA FFs have also been tested by performing MD simulations of these ligands docked into
β
2
AR proteins embedded in lipid membranes. Both hydrogen bonds and hydrophobic interaction networks observed over the 1
μ
s MD simulation are comparable with those derived from molecular docking calculations and MD simulations performed with the CHARMM FF.
Keywords:
catecholamines
;
drugs
;
adrenergic receptors
;
L-DOPA
;
Droxidopa
;
force field parameterization
;
quantum mechanical calculations
;
molecular docking
;
molecular dynamics simulations
1. Introduction
The Guanine Nucleotide-Binding Protein Coupled Receptors (GPCRs) form the largest family of human trans-membrane proteins and take part in a wide range of critical biological functions including sight, sensation and neurological transmission [
1
,
2
,
3
]. There are several activities of the GPCRs in the body, including cognitive responses [
4
], cardiovascular functions [
5
] and the growth and development of cancer [
6
]. Thirty-five percent of all commercially available drugs in the United States and throughout the world target GPCRs because of their relevance in many human disorders [
7
,
8
,
9
]. In all GPCRs there are seven transmembrane
α
helices (TM-I-TM- VII), which are linked by extracellular (ECL1-ECL3) and intracellular (ICL1-ICL3) loops [
10
,
11
]. In addition to hormones and therapeutics, a large variety of other extracellular molecules can act as agonists or antagonist on GPCRs, with the former often causing conformational changes in proteins associated with specific activities [
12
]. Furthermore, GPCRs are being viewed as the allosteric machinery that can be triggered by ions, lipids, cholesterol and water [
13
,
14
]. Moreover, due to technological breakthroughs in crystallization technologies during the last two decades, new X-ray crystal structures of GPCRs are being reported with an exponential rate [
3
,
15
]. In addition, over 150 GPCR X-ray structures published in the
www.rcsb.org
Protein Data Bank (accessed on 5 January 2020) are in complex with ligands [
16
]. At the same time, homology models of GPCRs have provided a molecular representation of more than 10% of the GPCR super-family. Structure-based drug discovery (SBDD) relies on understanding receptor-drug interactions at the atomic level, so molecular docking and molecular dynamics simulations have become widespread tools for drug design, measuring binding affinity, revealing reaction mechanisms and protein-ligand interactions, in addition to understand the GPCR structure and dynamics [
17
,
18
,
19
,
20
,
21
,
22
].
To activate the class A GPCR
β
2
-adrenergic receptor (ADRB2 or
β
2
AR), which is found in pulmonary and cardiac myocyte tissues, hormones, such as adrenaline and noradrenaline together with the neurotransmitter dopamine, are required. There has been some progress in understanding the inactive state of adrenergic receptors thanks to the identification of the first high resolution X-ray crystal structures of
β
2
AR bound to inverse agonist (-)-carazozol (PDB ID: 2RH1) [
23
,
24
] and antagonist (-)-timolol (PDB ID: 3D4S) [
25
]. In addition,
β
2
AR stabilized with a nanobody and a nucleotide-free Gs protein heterotrimer has its first agonist-bound active-state X-ray crystal structure determined [
26
,
27
]. Moreover, the
2
AR X-ray crystal structure, released in 2013 (PDB ID: 4LDO) [
28
], has served as a structural template for the investigation of the binding conformations and affinity of several endogenous agonists and antagonists. Studies using fluorescence spectroscopy have shown that catecholamines, including adrenaline, noradrenaline and dopamine may modify the
2
AR’s conformation, leading to the formation of distinct adrenergic receptor intermediate states [
29
,
30
,
31
,
32
]. There have been more recent confirmations of the
β
2
AR’s structural heterogeneity by NMR spectroscopy, which reveals that it may exist in three different states: active, intermediate and inactive [
33
]. Human
β
2
AR structures in association with 1365 ligands, 75 of which are drugs, may be found in the biggest database of GPCR structures and mutations (
www.gpcrdb.org
(accessed on 20 December 2019)) [
7
]. Among the drugs that interact with
β
2
AR is droxidopa (L-DOPS), which is an L-serine with a 3,4-dihydroxyphenyl group replaced at the beta position [
34
]. The amino acid levodopa (L-DOPA) is structurally identical to L-DOPS and a cathecolamine L-tyrosine derivative, which is an intermediate product of the biosynthesis of dopamine [
35
]. Since the symptoms of Parkinson’s disease (PD) are related to a progressive reduction of dopamine levels in the brain, dopamine and drugs able to safely cross the blood–brain barrier have been used to increase the dopaminergic function in patients with PD. Due to the inability of dopamine to cross the blood–brain barrier, L-DOPA in combination with carbidopa, which is an inhibitor of extracerebral dopa decarboxylase (IEDD), has also been employed in the treatment of PD [
35
]. Recently, PD and neurogenic orthostatic hypotension have been both treated with droxidopa, a noradrenaline precursor, which has been authorized in Japan and is now being tested in Europe, the United States, Australia and Canada. More recently, prodrugs of L-DOPA and carbidopa, namely levodopa-4
′
-phosphate (foslevodopa) and carbidopa-4’-phosphate (foscarbidopa), have been employed in successful clinical trials on patients with advanced PD in the United States [
36
,
37
] and are going to be tested in the United States and Australia [
38
].
Here, we report the results of the force field (FF) development of L-DOPA and Droxidopa molecules, and their MD simulations in water. All FF parameters were obtained through high-level QM calculations, according to the procedure implemented in the JOYCE program [
39
]. All MD simulations were performed using an FF parameterized ad hoc for each solute of interest to increase the accuracy of the conformational sampling. In addition, we show the results of the molecular dockings of these exogenous catecholamines into the human
2
AR X-ray crystal structure released by Ring et al., in 2013 (PDB ID: 4LDO) and their comparison with observations from the full agonist adrenaline. Each wholly flexible ligand was docked into the
2
AR binding pocket following two different approaches: (1) a rigid receptor model derived from the PDB coordinates of the
2
AR X-ray crystal structure (PDB ID: 4LDO), and (2) a
2
AR receptor with flexible side chains of key amino acids in its binding site. Both approaches show and confirm that the pocket conformation is compatible with the binding of adrenaline, suggesting that a similar binding mode can be predicted for L-DOPA and Droxidopa. The characteristic network of hydrogen bonds of catecholamines is also preserved, showing the equal importance of
2
AR amino acids interacting with head (Ser203/Ser204/Ser207) and tail (Asp113/Asn312) moieties of every analyzed ligand. However, other
β
2
AR residues, such as Thr118 and Tyr316, also play a remarkable role in the binding of L-DOPA and Droxidopa. Moreover, the binding affinities calculated from the molecular docking of adrenaline are in good agreement with experimental values, allowing a more reliable comparison of this property estimated for L-DOPA and Droxidopa non-natural ligands. The findings of this article are presented in the following sections starting from the development and validation of a new FF for L-DOPA and Droxidopa, and then proceeding to a discussion of the molecular docking results.
2. Materials and Methods
2.1. Force Field Development Protocol
The FF parameter set of adrenaline, L-DOPA and Droxidopa ligands were obtained by fitting energies, gradients and Hessian to the results of Electronic Structure calculations, as described in the Joyce/Ulysses procedure [
39
,
40
]. Electronic structure calculations were carried out with the Gaussian16 suite of programs [
41
,
42
], using Density-Functional Theory (DFT) [
43
] with the hybrid Becke3LYP functional (B3LYP) [
44
] in conjunction with the jul–cc-pVDZ basis set [
45
], taking into account solvent effects by means of the Conductor-like Polarizable Continuum Model (C-PCM) [
46
,
47
] and setting water as a reference solvent (
Figure S1
). The CM5 method based on Hirschfeld partitioning [
48
] was used to determine atomic charges in view of its near invariance for different quantum chemical models, remarkable reproduction of molecular dipole moments consistence with the latest revisions of the OPLS all atom (AA) force field [
49
,
50
,
51
,
52
] used for dispersion–repulsion interactions (
Tables S1 and S2
). Dihedral angles were assigned using GaussView version 6 [
53
]. Fitting of QM torsional profiles by linear combinations of cosine functions (
Figure 1
), were performed with Grace version 5.1.25 (Paul J. Turner, Portland, OR, USA). Dihedral angles
γ
and
θ
of adrenaline,
γ
of L-DOPA and
η
of Droxidopa were refined manually after the initial estimate.
Molecular dynamics (MD) simulations of protonated adrenaline, zwitterionic L-DOPA and Droxidopa in water were performed using Gromacs [
54
,
55
,
56
]. The SPC model [
57
] was used to describe water molecule (adrenaline or L-DOPA or Droxidopa) interactions. All the systems were simulated in the NVT ensemble with periodic boundary conditions, with an integration time step of 2 fs. The temperature was kept constant at 300 K with velocity-rescaling temperature coupling [
58
]. The LINCS algorithm was used to constrain all bonds [
59
]. The Particle Mesh Ewald (PME) method was used to compute long-range electrostatic interactions with grid search and a cut-off radius of 1.1 nm [
60
]. For each molecule, 20 ns NVT MD simulations in vacuum were performed using JOYCE-derived topology. Then, MD simulation production runs of adrenaline, L-DOPA and Droxidopa in SPC water were performed for 100 ns at 300 K. The analysis of MD simulations was performed with Gromacs analytical tools (gmx angle, gmx distance etc.). Then, 20 ns structures of each ligand simulated in water were used as starting conformations for the molecular docking into rigid and flexible
β
2
AR models.
2.2.
β
2
AR Molecular Modeling
The atomistic model of the TMD of human
β
2
AR was built up from the X-ray crystal structure of the protein active state conformation (PDB ID: 4LDO) [
28
]. Amino acid residues 1–28 and 343–413, which are not present in the X-ray structure, were not included following an approach similar to the one employed by Rosenbaum et al., 2011 [
61
]. The ICL3 domain intracellular residues 232–262, which were not employed by Rosenbaum et al., in 2011 and modeled by Dror et al., 2009 [
61
,
62
], were taken from a
β
2
AR homology model built up using 2RH1 as a template and reported in the Sali Laboratory ModBase database of comparative protein structure (
Figure 2
) [
63
]. 2RH1 is an excellent template structure for
β
2
AR due to its high sequence identity (90%) and a good RMSD of C
α
s of residues 29–231 and 263–342 (2.5 Å) with respect to 4LDO. T4 lysozyme (T4L) and Nanobody 6B9 (Nb6B9) amino acids were removed, and N- and C- termini were made neutral using acetyl and methylamino groups, as reported in previous studies [
61
,
62
,
64
,
65
]. Water molecules and adrenaline ligands were not included in the AA model. The sequence of human
β
2
AR (
https://www.uniprot.org/uniprot/P07550
(accessed on 20 December 2019)) was also reproduced by mutating the four engineered mutations (Met96Thr, Met98Thr, Asn187Glu and Cys265Ala) present in the receptor’s X-ray crystal structure released by Ring et al., in 2013 to their native amino acid forms [
28
].
All lysines and arginines were protonated, while all aspartates, glutamates and histidines (HSD) were deprotonated except for Glu122 (GLH), Asp130 (ASH) and His172 (HSP) residues, as previously reported by Dror et al., in 2009 and 2011 [
62
,
64
]. Since the
β
2
AR all atom structure is in its active conformation, Asp79 was deprotonated because the protonation state has been suggested to be stable upon activation [
66
,
67
]. The cysteine residues located in ECL2 (Cys184- Cys190) and TM-III (Cys106-Cys191) domains of the
β
2
AR model were modified to form disulfide bonds by deleting hydrogens bound to SG atoms [
68
]. The building up of the final
β
2
AR all atom structure was performed using VMD 1.9.4 and its psfgen plugin [
69
].
2.3. Molecular Docking Protocol
Initially, we performed an alignment of the geometry optimized structures of L-DOPA (DAH) and Droxidopa (DRO) molecules to adrenaline (ALE) in the
2
AR X-ray crystal structure (PDB ID: 4LDO), modified as described above, to produce an improved docking grid box around the receptor’s binding pocket. The
2
AR model shown in
Figure 2
was used as a rigid receptor. In the flexible model of
β
2
AR, protein residues of the binding pocket (Asp113, Val117, Thr118, Phe193, Thr195, Ser203, Ser204, Ser207, Asn293, His296, Asn301, Tyr308, Asn312 and Tyr316: see ref. [
28
]) forming polar and apolar interactions with adrenaline were considered flexible, using a similar approach to that reported by Tosso et al., 2020 in the molecular docking of dopamine to the D
2
DR receptor [
70
]. In the case of L-DOPA, His296 and Asn301 were excluded from the list of flexible residues because the total number of torsional degrees of freedom, including those of the ligand (6), would have exceeded the maximum number allowed by AutoDock Tools 1.5.6, the graphical user interface of AutoDock 4.2.6 (AD4) for generating consistent docking results [
71
]. For Droxidopa His296, Asn301 and Val117 were not included in the list of flexible amino acids because of the additional torsional degree of freedom of this ligand as compared to L-DOPA. In both receptor models, the X-, Y-, and Z-axes dimensions of the docking box grid were 50, 50 and 50, respectively, and a resolution of 0.375 Å was employed in the active site region. The grid box size was 18.75 Å, which is more than 2.9 times the radius of gyration of both L-DOPA (2.77 Å) and Droxidopa (2.91 Å) molecules, in good agreement with recommendations by Feinstein et al., in 2015 [
72
]. Non-polar hydrogen atoms were merged into heavy atoms and Gasteiger charges were assigned to each molecule. During each docking run, all torsion angles of flexible amino acids and ligands were free to rotate. Four-hundred poses were generated using the maximum number of generations and energy evaluation of 27,000 and 5e7, respectively, for both rigid and flexible
2
AR models, as previously reported for the molecular docking of dopamine to the D
2
DR receptor [
70
]. The Virtual Screening analysis of the final docked conformations was performed with the AD4 pythonsh command using a tolerance of 2 Å root mean square deviation (RMSD) for the clustering [
73
,
74
].
The binding free energy (
Δ
G
bind
=
−
RTlnK
i
) (BFE) and inhibition constants (K
i
) of lowest energy structures, estimated by AD4 with the Virtual Screening method, were employed to calculate the binding affinities of each ligand [
73
]. Since experimental binding affinities of adrenaline and other endogenous catecholamines were measured at 310.15 K, AD4 BFEs estimated at 298.15 K were also corrected, resulting in an increase of 0.2 units for the corresponding binding affinity (pK
d
) of each ligand at the physiological temperature [
75
].
Two sets of ligand heavy atom RMSDs were calculated using the X-ray crystal structure of adrenaline as a reference: one employed the original coordinates of the ligand and the other, defined as superimposed RMSD, involved a structural alignment of the ligand with the X-ray structure of adrenaline. Superimposed RMSDs were also calculated using the lowest energy conformations derived from rigid and flexible molecular dockings for each ligand.
To validate the molecular docking protocol, adrenaline was redocked into the
β
2
AR X-ray crystal structure (PDB ID: 4LDO). Two sets of redocking experiments were performed using
2
AR rigid and flexible models. From the rigid docking set, the lowest energy structures of each cluster were selected to perform ten independent runs. The consistency of the docking results was considered achieved when at least 70% of the individual runs generated conformations clustered within an RMSD of < 0.5 Å relative to the overall best energy pose of the ligand. For both protonation states of adrenaline, rigid docking runs using the same coordinates of the receptor X-ray crystal structure produced conformations (heavy atoms superimposed RMSD of 0.2 Å) and BFEs (−6.4 kcal/mol and −8.1 kcal/mol for neutral and protonated adrenaline, respectively) similar to those of the lowest energy conformations from ten independent runs [
76
]. The BFE of adrenaline in the X-ray crystal structure was estimated with the epdb option of AD4.
In order to improve the performance of AD4 runs, the multilevel parallel version of AutoDock 4.2 was also employed to perform multiple independent runs of various ligands [ 77 ]. RMSDs of ligand heavy atoms were calculated using AutoDock Tools 1.5.7 [ 78 ].
The number of hydrogen bonds and hydrophobic interactions between a ligand and the receptor were measured using the protein–ligand interaction profiler (PLIP) [ 79 ]. Images were prepared using VMD 1.9.4, AutoDock Tools 1.5.6 and LigPlot+ version 2.2 [ 80 ].
2.4. MD Simulations of
2
AR-Catecholamine Complexes
In order to test the quality of FFs developed for the different ligands, we also performed 1
s AA MD simulations of
β
2
AR-catecholamine complexes embedded in solvated lipid bilayers composed of 260 palmitoyloleoylphosphatidylcholine (POPC) and 65 cholesterol (CHOL) molecules (20% CHOL) using the OPLS AA FFs for proteins [
52
] and lipids [
81
,
82
,
83
], following an approach similar to that reported by Biswas et al., in 2021 [
76
].
The contact maps of
β
2
AR residues with each ligand were generated with the Timeline plugin version 2.3 of VMD 1.9.4 [
69
]. A ligand-protein contact was counted only when at least one atom of each catecholamine was within 5 Å of any atom of the receptor.
BFEs of ligands were extracted from MD simulations of
β
2
AR-catecholamine complexes using Molecular Mechanics Poisson–Boltzmann Surface Area (MM-PBSA) calculations [
84
].
3. Results
3.1. Force Field Parameterization and Md Simulations of L-Dopa and Droxidopa
Following the protocol described in the methods section, the QM torsional profiles of each dihedral angle of the zwitterionic L-DOPA were accurately reproduced by the corresponding JOYCE FF functions (
Figure 3
). It is worth noting that both QM and JOYCE torsional profiles of
α
,
β
,
γ
and
δ
dihedrals were very similar to those of zwitterionic Tyrosine reported by Del Galdo et al., in 2018 [
85
]. Concerning the torsions of the charged groups (
α
and
β
dihedrals) in the zwitterionic condition, the agreement between QM and JOYCE torsional profiles was better than the already satisfactory one reported by Del Galdo et al., in 2018 for the closely related L-Tyrosine amino acid, indicating the good quality of the FF parameterization of L-DOPA [
85
].
Similar to L-DOPA, the QM torsional profiles of the dihedrals of zwitterionic Droxidopa were in good agreement with JOYCE FF functions (
Figure 4
). In particular, QM and JOYCE torsional profiles of
α
,
β
,
γ
,
δ
,
ϵ
and
η
dihedrals of Droxidopa were very similar to those observed for L-DOPA (
Figure 3
).
Moreover, we also generated OPLA AA FF parameters for adrenaline, whose QM torsional profiles were accurately reproduced by the corresponding JOYCE FF parameters for all dihedral angles. QM and JOYCE torsional profiles of
α
,
γ
,
δ
,
ϵ
and
η
dihedrals of adrenaline were very similar to those observed for L-DOPA and Droxidopa ligands (
Figure S2
). A complete list of the most representative bond lengths, bond angles and dihedral angles of each ligand is provided in the SI of this work (
Tables S1–S3, Figures S3–S11
). To test the FFs of adrenaline, L-DOPA and Droxidopa, we performed MD simulations of each parameterized ligand both in vacuum and in aqueous solution. It is worth noting that all the dihedral distributions are comparable in the gas phase and in aqueous solution for both L-DOPA and Droxidopa molecules (
Figure 5
and
Figure 6
). Similar results were also observed for adrenaline (
Figure S12
).
Additionally, we also observed a good agreement between the fittings of QM torsional energy profiles subjected to the subtraction of electrostatic and Lennard–Jones contributions (
Table S4
) and correspondent QM and JOYCE for each dihedral of adrenaline (
Figure S13
), L-DOPA (
Figure S14
) and Droxidopa (
Figure S15
). The profiles of the Helmoltz free energy variation as a function of each of the dihedral angles were also similar to the corresponding QM energy for both L-DOPA and Droxidopa (
Figure 7
and
Figure 8
). Similar behavior of Helmholtz free energy variations was also found for each dihedral of adrenaline (
Figure S16
). The Helmholtz free energy variation (
Δ
A
) was computed from the MD ensemble probability distribution of the generic
θ
dihedral coordinate, according to the equation:
Δ
A
(
θ
)
=
−
k
T
(
ρ
(
θ
)
/
ρ
0
)
where
k
is the Boltzmann constant,
T
is the temperature,
ρ
(
θ
) is the dihedral probability distribution having
ρ
0
as a maximum value (missing
A
points in the figures imply that no sampling could be found for the corresponding geometry).
Each profile obtained using as a statistical ensemble the MD simulation performed employing Joyce-derived FF parameters is also compared with the one obtained with the use of the OPLS AA FF (see Methods). The differences between QM energy and MD
A
profiles can be ascribed to the entropic contribution, which is only present in the free energy, as previously observed by Del Galdo et al., in 2018 for zwitterionic Tyrosine [
85
]. Despite these discrepancies, this comparison can be used to analyze, at least qualitatively, the accuracy of the FF for the different dihedral angles.
3.2. Validation of the
2
AR Model: Redocking of Adrenaline
In our recent work, we verified the ability of the
2
AR X-ray crystal structure (PDB ID: 4LDO) to generate biologically relevant binding conformations of adrenaline by redocking the endogenous ligand into rigid and flexible receptor models, employing a similar approach to the one reported by Katritch et al., in 2009 [
76
,
86
]. At the physiological pH of 7.4, adrenaline is mostly present in its protonated form (94.7%); however, due to an experimental pKa of 8.52, the percentage of neutral forms is not negligible (5.3%) [
87
]. The effect of the protonation state of this endogenous ligand on its interaction with
2
AR has been recently investigated by performing the redocking using both species [
76
]. We have shown that the neutral form of adrenaline is about 2 kcal/mol less stable than its more biologically relevant protonated form. This energy difference arises from the higher number of hydrogen bonds formed by the protonated species with residues in the
2
AR binding pocket as compared to the neutral form of the ligand [
76
]. Hereafter, adrenaline refers to the protonated form of the endogenous catecholamine. In particular, the redocking of adrenaline into rigid and flexible
2
AR models generates conformations different from that of the ligand in the X-ray crystal structure, exhibiting ligand heavy atoms RMSDs of 2.2 Å and 2.4 Å, respectively (
Figure 9
A,B).
Although ligand–receptor hydrogen bonds of the ethanolamine tail of the redocked adrenaline with the anchor site formed by amino acids Asp113/Asn312 are similar to those observed in the X-ray crystal structure, the catechol head of the molecule interacts with different residues, namely Ser203/Asn293 and Thr118/Ser207 in crystal and redocked structures, respectively ( Figure 9 A,B). These results mainly arise because there is a substantial energetic difference between the free energies of binding of redocked and crystal structure ligands. According to experiments, the BFE of adrenaline ranges from −8.3 kcal/mol to −8.9 kcal/mol, as calculated from binding affinities of adrenaline reported by Del Carmine et al., in 2004 and 2002, indicating that the structure of adrenaline from the rigid redocking is almost in its more energetically stable conformation [ 75 , 88 ]. Interestingly, rigid and flexible docking lowest energy conformations of adrenaline are also structurally similar, as shown by the ligand heavy atom RMSD of 0.6 Å (superimposed RMSD = 0.3 Å). However, the average BFE of adrenaline for the lowest energy structure from the Virtual Screening of the flexible docking is −12.5 kcal/mol, indicating that this conformation of the ligand is not only much more stable than the one obtained from the rigid docking but it also has a pK d better than the experimental values reported in the literature ( Table 1 ) [ 75 , 88 ].
3.3. L-DOPA Binding to the
2
AR Receptor
The docking of L-DOPA to a rigid
2
AR model generated 70% of the largest cluster conformations from ten independent runs showing an adrenaline-like interaction of catechol and ethanolamine moieties of the ligand with the binding pocket anchor sites Ser203/Ser204/Ser207 and Asp113/Asn312, respectively (
Figure 10
A and
Table 2
). These conformations of the catecholamine displayed a pK
d
of 4.7 and an average BFE of −6.4 kcal/mol, which were similar to the values we recently reported for neutral adrenaline [
76
]. Interestingly, we also observed that the docking of L-DOPA to a rigid model of the receptor also yielded the lowest energy conformations unable to form hydrogen bonds in an adrenaline-like fashion [
76
].
The molecular docking of L-DOPA into a flexible
2
AR model yielded more ligand–receptor hydrogen bonds than those observed in the lowest energy conformation of the catecholamine produced by the rigid docking (
Figure 10
B and
Table 2
). In particular, the catechol head of the ligand also formed an additional hydrogen bond with the binding site amino acid Thr118. The lowest energy conformations showed an average BFE of −12.8 kcal/mol, corresponding to a pK
d
of 9.4 and being comparable to that observed for the endogenous ligand adrenaline docked into a flexible
2
AR model (
Table 1
).
We have recently observed that Autodock Vina (Vina) [
89
] generated best conformations of L-DOPA docked into rigid and flexible
β
2
AR models displaying average BFEs of −7.3 and −7.9 kcal/mol, respectively, which were different from correspondent AD4 results (−6.4 and −12.8 kcal/mol, respectively) (
Figures S17 and S18
) [
76
]. In the flexible
β
2
AR model, this difference in the stability of the ligand is due to the higher number of hydrogen bonds formed by the best AD4 conformation as compared to the best Vina structure (
Figure S18A,B
). However, the Vina conformation, as observed in the docking to a rigid
β
2
AR model, was still structurally closer to adrenaline’s conformation in the X-ray crystal structure than the best AD4 pose (
Figure S18C
).
3.4. Droxidopa Binding to the
2
AR Receptor
The rigid docking of Droxidopa to
β
2
AR generated the lowest energy binding poses comparable to those observed for adrenaline, in which the ethanolamine moiety of the ligand was bound to the Asp113/Asn312 anchor site and its catechol moiety formed bonds only with Ser207 in the TM-V domain of the receptor (
Figure 11
A). It is worth noting that the lowest energy pose showed an average BFE of −7.4 kcal/mol (best conformations resulting from ten independent docking runs), which is very similar to the one we recently observed for noradrenaline (−7.6 kcal/mol), of which Droxidopa is a precursor, confirming the validity of the molecular docking protocol [
76
].
Moreover, the pK
d
of Droxidopa (5.4) is also in good agreement with experimental and computational values available for noradrenaline [
75
,
76
,
86
,
88
]. Similarly to L-DOPA, the best binding poses of Droxidopa docked in the flexible
2
AR model formed more hydrogen bonds with both anchor sites of the binding pocket of the receptor as compared to the ligand bound to the rigid model (
Figure 11
B). The lowest energy binding pose of Droxidopa in the flexible receptor model is associated with an average BFE of −14.0 kcal/mol, corresponding to a pK
d
of 10.3 (
Table 1
), and hydrogen bond interactions comparable to those observed in the best binding conformation of the ligand in a rigid
2
AR model (
Figure 11
A). Moreover, this structure is characterized by a hydrogen bond network showing an additional polar interaction with Asn312 in the Asp113/Asn312 anchor site (
Figure 11
B and
Table 2
). Additionally, this best binding pose of Droxidopa is likely a representative ligand’s conformation because its orientation is similar to that of catecholamines in
2
AR models reported in the literature [
76
,
86
].
In analogy with L-DOPA, the lowest energy Vina conformations of Droxidopa docked into rigid and flexible
β
2
AR models displayed less hydrogen bond contacts and average BFEs of −7.5 and −7.9 kcal/mol, respectively, corresponding to binding affinities similar to the rigid AD4 value and comparable with noradrenaline computational and experimental results (
Figures S19 and S20
) [
75
,
76
,
86
,
88
]. These results implicate that hydrophobic interactions could also play a crucial role in the stability of this catecholamine.
3.5. Hydrogen Bonds in
β
2
AR-Adrenaline Complexes
The lowest energy conformation of adrenaline from the docking into a rigid
β
2
AR model displayed a hydrogen bond network essentially similar to the one of the ethanolamine tail of the ligand in the X-ray crystal structure (
Figure 9
and
Table 2
). The ethanolamine moiety of established hydrogen bond interactions with both anchor site amino acids Asp113 and Asn312, is in good agreement with experimental and computational findings [
28
,
86
,
90
]. Moreover, hydrogen bond interactions were observed between the Asn312 side chain and the
β
-OH of the ligand, in good agreement with biochemical results [
91
]. Furthermore, the H-bond distance between Tyr316 and
β
-OH of adrenaline present in the X-ray crystal structure was partially disrupted and increased from 3.5 to 3.9 Å in the redocked adrenaline. Additionally, Tyr316 was still found to be involved in the formation of hydrogen bonds with the N amino of adrenaline. The Asn293 side chain was located too far away from acceptor and donor atoms of the catecholamine to form hydrogen bonds, which were previously proposed and reported for
β
2
AR agonists experimentally and computationally [
75
,
86
,
88
,
92
,
93
]. At the same time, this conformational model of the
β
2
AR-adrenaline complex presented marked differences in the ligand catechol head of the ligand. Hydrogen bonds of catechol hydroxyls with side chains of serines of the TM-V helical domain are considered the most specific interactions for
β
2
AR agonists [
75
,
88
,
94
,
95
,
96
,
97
]. In particular, the H-bonding of both meta-OH and para-OH hydroxyl groups with both Ser203 and Ser207 side chains was not reproduced as in the X-ray crystal structure, the only exception being represented by a decrease of the donor-acceptor Ser207-para-OH distance from 3.5 to 2.6 Å (
Table 2
). While the distance between hydroxyl groups of the catechol head and the Ser204 side chain increased, additional hydrogen bond interactions arose between both meta-OH and para-OH with Thr118 side chain (
Table 2
). The involvement of Thr118 in the
β
2
AR hydrogen bond network has been recently found in wild type and mutated (T164I) forms of the receptor bound to salbutamol using molecular docking and MD simulations [
98
]. Similar hydrogen bond interactions were essentially observed for the neutral form of the ligand, the only exception being the loss of the Tyr316-N-amino H-bond [
76
]. Moreover, the presence of hydrogen bond interactions between residue Thr118 and different
β
2
AR ligands has previously been reported in MD simulation studies [
98
,
99
,
100
,
101
,
102
].
It is worth noting that adrenaline formed more stable hydrogen bonds on average, as evidenced by shorter distances reported in
Table 2
, with both its ethanolamine tail and catechol head when docked into a flexible
2
AR model as compared to conformations of the ligand bound to a rigid model both to the X-ray crystal structure of the receptor. Moreover, two additional hydrogen bonds were found between the catechol head hydroxyls and serines S203 and S207, namely Ser203-para-OH and Ser207-meta-OH, which contributed to the observed dramatic decrease of the BFE (
Table 1
). The hydrogen bond between the meta hydroxyl group of the catechol ring of adrenaline and residue Asn293 of
2
AR reported in the X-ray crystal structure (PDB ID: 4LDO) was not reproduced in the lowest energy binding poses of protonated and neutral adrenaline docked in both receptor models [
28
,
76
].
3.6. Hydrogen Bonds in
2
AR in Complex with L-DOPA and Droxidopa
The docking of L-DOPA and Droxidopa in both flexible and rigid
2
AR models produced ligand conformations similar to the best binding poses of adrenaline. It is worth noting that the hydrogen bonds of both L-DOPA and Droxidopa docked in different
2
AR models displayed some similarities and remarkable differences with the network of polar interactions of the endogenous catecholamine (
Figure 10
,
Figure 11
,
Figure 12
A and
Table 2
).
The main similarity with polar interactions observed for the endogenous ligand was represented by a reduction in hydrogen bond distances when using flexible receptor models (
Table 2
). Both ligands formed hydrogen bonds with anchor sites Asp113 and Asn312 through their ethanolamine moieties. In Droxidopa, as observed for adrenaline, the presence of the
-OH group in the ethanolamine tail of the ligand strengthened these polar interactions, resulting in the formation of H-bonds with Asp113 and Asn312 residues in both rigid and flexible
2
AR models (
Table 2
). In both receptor models, L-DOPA also showed a hydrogen bond interaction with Asn312 through one oxygen of its carboxylic acid moiety. A similar polar interaction was only present in Droxidopa docked to a flexible
2
AR receptor (
Table 2
). In analogy with adrenaline and despite the receptor model, the ethanolamine N of both exogenous ligands developed hydrogen bonds with Tyr316, which also behaved as an anchor site interacting with the
-OH group of Droxidopa docked only in the rigid receptor model (
Table 2
).
In the rigid receptor, L-DOPA displayed hydrogen bond interactions with
2
AR residues Ser203 and Ser207 through its catechol moiety para-OH and meta-OH hydroxyls, respectively (
Table 2
). These polar interactions are different from those reported by experimental and computational studies that predict the formation of hydrogen bonds of meta-OH and para-OH hydroxyl groups of the catechol head of various catecholamines with Ser203 and Ser 207, respectively [
86
,
95
,
97
]. It is interesting to note that the docking of L-DOPA to a rigid
2
AR model also leads to hydrogen bonding with Ser204 through the para-OH of its catechol head, displaying an additional polar interaction not observed in experiments and computational investigations [
86
,
95
,
97
]. However, the hydrogen bond interaction of the para-OH hydroxyl group of L-DOPA’s catechol with Ser 207 is observed when the exogenous ligand is docked into a flexible
2
AR model, in good agreement with previous experimental and computational studies [
86
,
95
,
97
] (
Table 2
). In addition, in the flexible
2
AR model, both hydroxyl groups of L-DOPA’s catechol head formed hydrogen bonds with Thr118, as observed for the endogenous catecholamine (
Table 2
). As opposed to L-DOPA, the catechol moiety of Droxidopa was involved in hydrogen bonding only with
2
AR residues Ser207 and Thr118 in both receptor models (
Table 2
). In the case of Droxidopa, the para-OH-Ser207 hydrogen bond was found to be particularly stable in rigid and flexible
β
2
AR models. Furthermore, both hydroxyl groups of the catechol moiety of Droxidopa formed hydrogen bonds with Thr118 in the flexible
β
2
AR model (
Table 2
).
Similar to the endogenous catecholamine, both exogenous ligands did not display hydrogen bonds with Asn293, which has been found to form a stabilizing polar interaction with adrenaline bound to
β
2
AR using different experimental techniques [
28
,
93
,
96
]. In our recent work, we performed the shifting of the grid box center in order to observe the formation of this hydrogen in both endogenous and exogenous ligands [
76
]. In particular, AD4 lowest energy conformations of L-DOPA and Droxidopa obtained with the shifted grid box center did not exhibit hydrogen bond interactions of the catechol head of the ligand with residue Asn293 of flexible
β
2
AR systems, while both ligands showed polar interactions with Thr118 [
76
]. As observed with adrenaline, the hydrogen bond with residue Asn293 of
β
2
AR was instead formed in both L-DOPA and Droxidopa lowest energy binding poses docked into flexible
β
2
AR models obtained by Vina calculations [
76
].
3.7. Hydrophobic Contacts of
β
2
AR Agonists
The adrenaline ligand exhibited hydrophobic contacts with Val117 and Phe289 residues when docked to a rigid
β
2
AR model (
Figure 12
B). Phe289 was also reported to be a key residue in the formation of hydrophobic interactions with different catecholamines in a previous computational study [
86
]. When adrenaline was docked in a flexible
β
2
AR model, the endogenous ligand also exhibited hydrophobic interactions with Phe290 (
Figure 12
B). We recently found that neutral adrenaline displayed similar hydrophobic contacts with Val117 and Phe289 residues in rigid
β
2
AR models subjected to AD4 and Vina calculations [
76
]. In flexible
β
2
AR models, neutral adrenaline presented the same apolar contacts generated by Vina docking runs of the ligand docked in a rigid receptor, while AD4 calculations showed hydrophobic interactions with Val114 and Val117 residues [
76
].
Interestingly, L-DOPA exhibited hydrophobic contacts with
β
2
AR residues Val114 and Phe193 in rigid receptor models (
Figure 12
B). It is worth noting that the Vina L-DOPA’s lowest energy conformation in a rigid
β
2
AR model also displayed an additional apolar interaction with residue Val117 [
76
]. In flexible
β
2
AR models, the lowest energy binding poses of L-DOPA displayed hydrophobic contacts with Val117 and Phe289 (
Figure 12
B and
Figure 13
A). In our recent work, the Vina best binding poses showed the same hydrophobic contacts of the rigid docking approach, namely with Val114, Val117 and Phe193 residues [
76
].
In rigid
β
2
AR models, the lowest energy binding pose of Droxidopa formed hydrophobic interactions with residues Val117 and Phe289 (
Figure 12
B). We have also recently observed that the Vina best binding pose exhibited apolar contacts with Val114, Val117 and Phe193, as noted for L-DOPA [
76
]. When
2
AR binding pocket residues were flexible, the Droxidopa lowest energy conformation displayed hydrophobic contacts with Val114, Val117 and Phe289 (
Figure 12
B and
Figure 13
B). In our recent study, the Vina best binding pose of Droxidopa showed more apolar interactions with amino acids Val114, Phe193 and Phe289 [
76
].
3.8. Protein–Ligand Interactions in MD Simulations of
2
AR-Catecholamine Complexes
Additionally, we performed one microsecond-long AA MD simulations of
2
AR-catecholamine complexes embedded in POPC:CHOL lipid membranes, which allowed us to determine whether or not the lowest energy binding poses were stable. After 300 ns, the receptor C-alpha atoms RMSDs reached a plateau value of less than 4 Å in the
2
AR-adrenaline complex, indicating that the endogenous ligand provided structural stability to the entire protein (
Figure 14
A). This stability persisted until 700 ns into the simulation period, when there were fewer changes in protein conformation. When compared to
2
AR adreanline’s lower RMSD values and stability at 300 ns, Droxidopa and L-Dopa show less fluctuation after 300ns, suggesting that these exogenous ligands might induce more conformational changes within the protein than adrenaline (
Figure 14
A). The RMSDs of the ligand’s heavy atoms are shown in
Figure 14
B. It is worth noting that the stability of each ligand is achieved after 300 ns of the simulation time, which is in line with prior findings. The conformational variations in L-Dopa and Droxidopa were found to be larger than in the
2
AR-adrenaline system; however, after 300 ns, all simulations achieved stability with less changes in the conformational state of each exogenous ligand.
The hydrogen bond network of L-DOPA and Droxidopa with
2
AR residues during MD simulations was very similar to the one observed with the CHARMM FF (
Figure 15
) and comparable to that of adrenaline (
Figure S22
), supporting the results obtained with molecular docking calculations.
The contact maps illustrated in
Figure 16
for the L-Dopa and Droxidopa molecules indicate excellent interactions between ligands and the
2
AR residues. In the green to red shades, while analyzing the 1000 ns simulation, we observe that the L-Dopa forms stronger connections with V114, F193, F289, F290 and N293 and loose or fading interactions with D113, V117, S203, S204, S207, Y308 and N312, which may also include the hydrophobic interaction component of the binding site. When analyzing the Droxidopa, we found that it forms strong connections with D113, V114, V117, F289, F290, N312 and Y316, and fading bonds with T118, S203, S204, S207, W286 and N293 throughout the 1000 ns simulation time. In addition, Droxidopa has a greater affinity for binding than L-Dopa, which is convincing evidence that it may be more effective. We observed that Adrenaline’s probability contact map with
2
AR residues is comparable to L-Dopa’s (
Figure S23
), displaying excellent contacts with D113, V114, V117, F193, F289 and N312 and fading bonds for T110, T118, S203, S207, F290, N293, Y308 and Y316. Furthermore, we can see that Adrenaline’s interaction profile is extremely comparable to that of L-Dopa, while that of Droxidopa’s interaction profile is rather higher. BFE calculations using the MM-PBSA method indicate this as well. Droxidopa has a stronger interaction with the
β
2
AR receptor than L-Dopa or Adrenaline, as evidenced by its BFE reported in
Table 1
, indicating that all three interaction profiles and residue characterizations can be trusted.
Interestingly, MM-PBSA calculations over a 1
s MD simulation of the
β
2
AR-adrenaline complex yielded a BFE of −4.5 +/− 0.4 kcal/mol (pK
d
= 3.3), which was higher than the experimental value of the endogenous ligand (−8.2 kcal/mol pK
d
= 6.1–6.5) (
Table 1
). More interestingly, in the simulated receptor–ligand complex, L-DOPA displayed a BFE of −5.4 +/− 0.4 kcal/mol (pK
d
= 3.9), which was lower than the adrenaline ligand value (
Table 1
). Furthermore, MD simulations of the
2
AR-Droxidopa complex exhibited a catecholamine BFE of −12.5 +/−0.4 kcal/ mol, corresponding to a pK
d
of 9.3 (
Table 1
), better than noradrenaline experimental values (i.e., 5.0 and 5.4). On the contrary, the adrenaline and L-DOPA BFEs estimated for each ligand parameterized with the OPLS FF were more positive than not only those obtained by both rigid and flexible docking calculations, but also those from MD simulations performed with the CHARMM FF [
76
], suggesting that this FF might better reproduce the conformational space of these ligands.
We examined the contributions of
2
AR residues to the BFE of each catecholamine, in order to better understand protein–ligand interactions (
Figure 17
). For the most part, the hydrogen bond and hydrophobic interactions of the receptor residues (particularly D113, Y308, N312, S203, S204, S207, T118, N293, V114, V117 and F193) were shown to have a positive effect on adrenaline’s BFE, confirming both experimental and computational results [
75
,
76
,
86
,
88
,
94
,
97
]. Intriguingly, six negatively charged amino acids (E107, E180, E188, D192, D300, E306) and two positively charged residues (R175 and K305) had a stabilizing and destabilizing influence on the
2
AR-adrenaline complex, despite being positioned on the periphery of the
2
AR binding pocket.
Figure 17
shows that L-DOPA substantially interacted with the same residues as adrenaline and, particularly, with hydrophilic (S203, S204, T118, N293, Y308) and hydrophobic (V114, V117, F193 and F289) residues. Furthermore, we found that D113 had a poor contact with the ligand, which may have been owing to the ligand’s carboxilic group being in an unfavorable position relative to the aspartic acid equivalent moiety. The
2
AR residues that contributed more to the Droxidopa’s BFE were similar to those found for L-DOPA and adrenaline, and those that bound more strongly to the catecholamine were V114, V117 and F289, in good agreement with the interaction pattern described above and our previous findings with the CHARMM FF [
76
]. D113, similar to L-DOPA, had a modest interaction with Droxidopa, although its energetic contribution was less favorable.
4. Discussion
To study the interaction of the adrenergic receptor
2
AR with endogenous and exogenous catecholamines, we have recently used molecular docking calculations and MD simulations [
76
]. Rigid docking calculations produced the lowest energy conformations of all investigated ligands with pK
d
s similar to experimental values. In contrast, all catecholamines docked into flexible
2
AR models had pK
d
s exceeding experimental values, which were also confirmed by BFEs obtained from MM-PBSA calculations performed on MD simulations of
2
AR-catecholamine complexes.
In particular, the molecular docking of endogenous ligands, such as adrenaline, noradrenaline and dopamine, into both rigid and flexible
2
AR models led to the discovery of novel binding poses. These new conformations differ from experimental and computationally anticipated structures, indicating that catecholamines can adopt more energetically stable binding modes. The best binding poses of exogenous ligands L-DOPA and Droxidopa were similar to endogenous catecholamines dopamine and noradrenaline, respectively.
Thus, to further investigate the aforementioned binding poses of endogenous and exogenous ligands through MD simulations, we parameterized the OPLS AA FFs of these small organic molecules. The JOYCE FF functions accurately reproduce the QM torsional profiles of each dihedral angle of the zwitterionic L-DOPA. These dihedral torsional profiles resemble those of zwitterionic L-Tyrosine, as reported by Del Galdo et al., in 2018 [
85
]. The agreement between QM and JOYCE torsional profiles for charged groups in zwitterionic condition was better than that found by Del Galdo et al., in 2018 [
85
] for the comparable amino acid L-Tyrosine, confirming the excellent quality of the FF parameterization of L-DOPA. Similar to L-DOPA, the QM torsional profiles of zwitterionic Droxidopa dihedrals matched JOYCE FF characteristics. The QM and JOYCE torsional profiles of Droxidopa dihedrals are very close to those of L-DOPA. In addition, QM and JOYCE torsional profiles of protonated adrenaline were similar and in good agreement with those observed for the two exogenous ligands.
To evaluate the L-DOPA and Droxidopa FFs, we performed MD simulations of each ligand in both vacuum and aqueous solution. Notably, both L-DOPA and Droxidopa showed similar dihedral distributions in vacuum and water for each dihedral angle. The Helmholtz free energy variation patterns were identical to the QM energy profiles for both L-DOPA and Droxidopa. Each profile created using the JOYCE program as a statistical ensemble is compared to the OPLS AA FF profile. The entropic contribution is only present in the free energy, as reported by Del Galdo et al., in 2018 [
85
] for zwitterionic Tyrosine. Despite this difference, the comparison has allowed us to qualitatively assess the accuracy of the developed FFs for various dihedral angles of each ligand.
Since adrenaline is predominantly protonated at a physiological pH, we initially employed this form of the ligand to perform its redocking into rigid and flexible
2
AR models, yielding conformations distinct from that of the X-ray crystal structure (ligand heavy atom RMSDs of 2.2 and 2.4 Å, respectively) (
Figure 9
) [
28
]. While the ethanolamine tail of the redocked adrenaline binds to anchor site amino acids Asp113/Asn312, the catechol head interacts with different residues in the crystal and redocked structures, respectively. According to experimental studies, the BFE of adrenaline varies from −8.3 kcal/mol to −8.9 kcal/mol, showing that the rigid redocking structure of adrenaline is almost in its more energetically stable conformation (BFE = −8.1 kcal/mol). The lowest energy conformation of adrenaline in flexible receptor models is not only more stable than the rigid docking conformation, but also has a pK
d
better than the experimental values reported in the literature (
Table 1
) [
75
,
88
]. This remarkable result is most probably a consequence of the larger conformational space sampled by the flexible redocking as compared to the rigid docking calculation [
76
]. Taking into account the variety of
2
AR active states in physiological [
103
] and tumoral [
104
] conditions, it is plausible to predict that the endogenous catecholamine could interact with the receptor adopting conformations more similar to those described by flexible docking calculations and MD simulations.
Interestingly, the docking of L-DOPA to a rigid receptor model generated best binding poses unable to create hydrogen bonds in an adrenaline-like manner. As a consequence, the average BFE of L-DOPA docked into a rigid
2
AR model was −6.4 kcal/mol, higher than the Vina finding (−7.3 kcal/mol), corresponding to a pK
d
of 4.7 (
Figure S10
and
Table 1
) [
76
]. The docking of L-DOPA into the flexible
2
AR model induced more ligand–receptor hydrogen bond interactions than docking into the rigid receptor model. The ligand’s catechol head formed hydrogen bonds with the binding site residue Thr118. Moreover, L-DOPA docked into a flexible
2
AR model has a pK
d
of 9.4, which is comparable to the value observed for adrenaline (9.2) (
Table 1
). The lowest energy conformation of Droxidopa bound to a rigid receptor showed a BFE of −7.4 kcal/mol, which is comparable to the one we observed for noradrenaline (−7.6 kcal/mol) [
75
,
76
,
88
], demonstrating the validity of the molecular docking protocol. Droxidopa, similar to L-DOPA, docked into the flexible
β
2
AR model resulted in lowest energy conformations having stronger hydrogen bond interactions with both anchor sites of the binding pocket of the receptor (
Table 2
). Droxidopa’s lowest energy conformation in the flexible receptor model had a BFE of −14.0 kcal/mol (pK
d
= 10.3), polar interactions similar to the ligand’s best binding pose in the rigid
β
2
AR model (
Table 1
and
Table 2
) and an orientation similar to that of catecholamines in
2
AR models [
86
]. Although the contribution of hydrophobic interactions has to be taken into account, this favorable BFE is due to a hydrogen bond network larger than those observed for adrenaline and L-DOPA [
76
].
When docked into a rigid
2
AR model, the lowest energy conformation of adrenaline revealed a hydrogen bond network similar to that of the ligand’s ethanolamine tail in the X-ray crystal structure, showing polar interactions with Asp113 and Asn312. In particular, the Asn312 side chain formed hydrogen bonds with the ligand’s
-OH, as expected biochemically [
91
]. Tyr316 was also involved in the formation of hydrogen bonds with adrenaline’s ethanolamine tail (
Figure 9
and
Table 2
). However, the most specific polar interactions for
β
2
AR agonists are hydrogen bonds between catechol hydroxyls and serines in the TM-V helical domain [
94
,
95
,
96
]. We only observed the conservation of the hydrogen bond between S207 and the para-OH of the ligand, as compared to the
β
2
AR X-ray structure (
Table 2
). Interestingly, both catechol hydroxyls formed polar interactions with Thr118. Molecular docking and MD simulations have recently revealed the role of Thr118 in the
β
2
AR hydrogen bond network [
76
]. Furthermore, MD simulations studies have reported hydrogen bond interactions between residue Thr118 and several
2
AR ligands [
98
,
99
,
100
,
101
,
102
]. When docked into a flexible
β
2
AR model, adrenaline established more stable hydrogen bonds with its ethanolamine tail and catechol head, as compared to conformations of the ligand bound to a rigid receptor model or the X-ray crystal structure (
Figure 9
and
Table 2
). We observed the formation of additional hydrogen bonds between catechol head hydroxyls and serines S203 and S207 (Ser203-para-OH and Ser207-meta-OH), which contributed to the BFE decrease. The Asn293 side chain did not form hydrogen bonds with the meta-OH of adrenaline, as in Ring et al.’s X-ray structure [
28
] and a previous computational study of
β
2
AR agonists [
86
].
L-DOPA and Droxidopa conformations were similar to adrenaline’s best binding poses in both flexible and rigid
2
AR models. The tail moieties of both ligands formed hydrogen bond interactions with anchor sites Asp113 and Asn312 (
Figure 10
,
Figure 11
and
Table 2
). In the rigid
β
2
AR model, the catechol head of L-DOPA formed hydrogen bonds with Ser203 and Ser207 through its para- and meta-OH hydroxyl groups, respectively, in good agreement with experimental and computational results [
86
,
94
,
95
,
96
]. Additionally, L-DOPA docked into a rigid receptor model formed hydrogen bonds with Ser204 through the para-OH of its catechol moiety, an interesting polar interaction not supported by previous experimental and computational investigations (
Table 2
). Both hydroxyl groups of L-DOPA and Droxidopa catechol heads formed hydrogen bonds with Thr118 in flexible
β
2
AR models. In both receptor models, Droxidopa’s catechol head also displayed polar interactions with Ser207, as shown by the quite stable para-OH-Ser207 hydrogen bond (
Figure 11
and
Table 2
). Although we shifted the grid box center toward Asn293 of flexible
β
2
AR systems [
76
], the catechol heads of both L-DOPA and Droxidopa did not form hydrogen bonds with Asn293 and displayed polar interactions with Thr118 in AD4 lowest energy conformations. Interestingly, the L-DOPA and Droxidopa lowest energy binding poses docked into flexible
β
2
AR models produced by Vina simulations created a hydrogen bond with Asn293 of
β
2
AR [
76
]. It is worth noting that the hydrogen bond network of L-DOPA and Droxidopa observed through molecular docking calculations was also reproduced during MD simulations of
β
2
AR-catecholamine complexes performed with CHARMM [
76
] and OPLS AA FFs (
Figure 15
,
Table S5 and Figure S22
). The OPLS AA FF of both ligands were less successful in keeping stable hydrogen bonds with Ser203 and Ser207, but generated similar percentages of hydrogen bond formation with other key amino acids, such as Asp113, N312, Thr118 and Y316, especially in the case of Droxidopa, as compared to corresponding results obtained with the CHARMM AA FF (
Figure 15
and
Table S5
) [
76
].
In rigid and flexible
β
2
AR models, adrenaline showed hydrophobic interactions with Val117 and Phe289 residues. In recent computational studies, Phe289 has been found to be a critical residue in the formation of hydrophobic interactions with catecholamines [
76
,
86
]. However, adrenaline docked in a flexible
β
2
AR model also revealed hydrophobic interactions with Phe290. Molecular docking calculations employing rigid receptor models showed that L-DOPA had hydrophobic interactions with
β
2
AR residues Val114 and Phe193. When L-DOPA was docked into flexible
β
2
AR models, the exogenous ligand formed apolar interactions with Val117 and Phe289, the same residues were observed for the endogenous ligand. Similarly to adrenaline, Droxidopa’s lowest energy conformation interacted with Val117 and Phe289 in rigid
β
2
AR models. When
β
2
AR binding pocket residues were flexible, the Droxidopa best binding pose exhibited hydrophobic contacts with Val114, Val117 and Phe289. It is remarkable that MD simulations of
β
2
AR-catecholamine complexes performed with CHARMM and OPLS AA FFs displayed the formation of hydrophobic interactions with the same amino acids obtained by molecular docking calculations (
Figure 16
,
Figure 17
,
Figures S21 and S23
), confirming the quality of both ligands’ FFs and their ability to reproduce these important apolar interactions [
76
]. Due to the broader conformational space sampled by MD simulations, this methodology usually provides better and more reliable binding poses of ligands than lowest energy conformations obtained by flexible and rigid molecular docking using both AD4 and Vina calculations.
In order to validate the hypothesis that drugs employed in the treatment of PD could display binding conformations similar to those observed for L-DOPA and Droxidopa, we also performed the molecular docking of carbidopa, foslevodopa and foscarbidopa to a rigid
2
AR model using the latest version of Vina (v. 1.2.3) (
Figure S24
) [
105
]. The lowest energy conformations of carbidopa, foslevodopa and foscarbidopa are structurally similar to those observed for adrenaline, L-DOPA and Droxidopa, respectively, displaying BFEs of −7.5, −6.4 and −7.2 kcal/mol, respectively, comparable with the values obtained for the endogenous and exogenous ligands. Moreover, the hydrogen bond network of these drugs is also characterized by polar interactions with the same amino acids, including Thr118, observed in best binding poses of adrenaline, L-DOPA and Droxidopa (
Figure S24
). The main motivation of our study was to provide a step-by-step perspective guide for the investigation of
2
AR-catecholamine complexes, including the development of FF parameters of ligands, molecular docking calculations of each ligand to both flexible and rigid receptor models and MD simulations of lowest energy binding poses of ligands docked to protein models embedded in lipid membranes. Future objectives will include the FF parameterization of additional related drugs (see above) and MD simulations of
2
AR-drug complexes embedded in membranes with more physiological lipid composition at atomistic and coarse grained levels.
5. Conclusions
OPLS AA FFs have been developed and tested for protonated adrenaline, and zwitterionic L-DOPA and Droxidopa molecules by performing QM calculations and MD simulations in water. QM torsional profiles of all ligands resembled those of zwitterionic L-Tyrosine [
85
]. Moreover, QM and JOYCE torsional profiles of
α
,
β
,
,
δ
,
ϵ
and
η
dihedrals of Droxidopa were similar to those observed for L-DOPA.
Molecular docking calculations have highlighted that the binding of exogenous catecholamines to
2
AR is favored by the formation of hydrogen bonds between their catechol head and ethanolamine tail moieties and key amino acids, such as Ser203, Ser204, Ser207, Asp113 and Asn312, as reported in previous experimental and computational studies [
75
,
86
,
88
,
94
,
97
]. This network of polar interactions involves Tyr316 and Thr118 residues of
β
2
AR and ethanolamine and catechol moieties, respectively, increasing the stability of lowest energy binding poses of each investigated ligand. Additionally, each catecholamine also formed hydrophobic interactions with
2
AR residues Val114, Val117, Phe193, Phe289 and Phe290, previously observed to interact with similar agonists [
86
].
Furthermore, OPLS AA FF parameters of adrenaline, L-DOPA and Droxidopa were also applied in 1
s long MD simulations of
2
AR-catecholamine complexes embedded in lipid membranes. MD simulations of these
2
AR-catecholamine complexes exhibited hydrogen bond and hydrophobic interactions comparable to those derived from molecular docking calculations and MD simulations performed with the CHARMM AA FF [
76
].
Since we have recently shown how L-DOPA and Droxidopa drugs interact with
2
AR [
76
], our preliminary molecular docking and latest MD simulations findings strengthen the hypothesis that similar binding modes could also be predicted for the other drugs in use for treating patients with Parkinson’s disease.
Supplementary Materials
The following supporting information can be downloaded at:
https://www.mdpi.com/article/10.3390/life12091393/s1
, Figure S1. Geometry optimized chemical structures of protonated adrenaline, zwitterionic L-DOPA and Droxidopa. Figure S2. Torsional profiles derived from QM calculations and JOYCE for protonated adrenaline. Figure S3. OPLS AA force field parameters of adrenaline: bond lengths and force constants. Figure S4. OPLS AA force field parameters of adrenaline: bond angles and force constants. Figure S5. OPLS AA force field parameters of adrenaline: dihedral angles, force constants and multiplicity. Figure S6. OPLS AA force field parameters of L-DOPA: bond lengths and force constants. Figure S7. OPLS AA force field parameters of L-DOPA: bond angles and force constants. Figure S8. OPLS AA force field parameters of L-DOPA: dihedral angles, force constants and multiplicity. Figure S9. OPLS AA force field parameters of Droxidopa: bond lengths and force constants. Figure S10. OPLS AA force field parameters of Droxidopa: bond angles and force constants. Figure S11. OPLS AA force field parameters of Droxidopa: dihedral angles, force constants and multiplicity. Figure S12. Comparison of Dihedrals distributions in vacuum and water to torsional profiles obtained by QM calculations and JOYCE for protonated adrenaline. Figure S13. Comparison of protonated adrenaline dihedral angles torsional energy profiles from QM, JOYCE, QM after the subtraction of electrostatic and LJ energy contributions and fittings calculations. Figure S14. Comparison of zwitterionic L-DOPA dihedral angles torsional energy profiles from QM, JOYCE, QM after the subtraction of electrostatic and Lennard-Jones (LJ) energy contributions and fittings calculations. Figure S15. Comparison of zwitterionic Droxidopa dihedral angles torsional energy profiles from QM, JOYCE, QM after the subtraction of electrostatic and LJ energy contributions and fittings calculations. Figure S16. Comparison of protonated adrenaline QM torsional energy profiles with Helmholtz free energy variations obtained from MD simulations performed using JOYCE and OPLS FFs. Figure S17. Comparison of lowest energy binding poses obtained from AD4 and Vina molecular docking calculations for L-DOPA docked into rigid
2
AR models. Figure S18. Comparison of lowest energy binding poses obtained from AD4 and Vina molecular docking calculations for L-DOPA docked into flexible
2
AR models. Figure S19. Comparison of lowest energy binding poses obtained from AD4 and Vina molecular docking calculations for Droxidopa docked into rigid
2
AR models. Figure S20. Comparison of lowest energy binding poses obtained from AD4 and Vina molecular docking calculations for Droxidopa docked into rigid
2
AR models. Figure S21. Percentage of contacts of ligands with the receptor hydrophobic residues extracted from MD simulations of
2
AR-catecholamine complexes performed with CHARMM and OPLS AA FFs. Figure S22. Hydrogen bond network of adrenaline with key amino acids of
2
AR binding pocket using CHARMM and OPLS AA FFs. Figure S23. Normalized number of contacts of adrenaline with
2
AR residues. Figure S24. Comparison of lowest energy binding poses from Vina molecular docking calculations for carbidopa, foslevodopa and foscarbidopa. Table S1. Partial atomic charges and OPLS AA force field Lennard-Jones parameters of adrenaline. Table S2. Partial atomic charges and OPLS AA force field Lennard-Jones parameters of L-DOPA. Table S3. OPLS AA force field Lennard-Jones parameters of Droxidopa. Table S4. Coulomb and Lennard-Jones energies of adrenaline, L-DOPA and Droxidopa. Table S5. Percentage of hydrogen bond formation for different
β
2
AR-Ligand complexes from 1
μ
s all atom MD simulations performed with CHARMM and OPLS AA FF parameters. adrenaline.itp: OPLS AA force field parameters of adrenaline generated with JOYCE. dopa.itp: OPLS AA force field parameters of L-DOPA generated with JOYCE. droxidopa.itp: OPLS AA force field parameters of Droxidopa generated with JOYCE.
Author Contributions
Conceptualization, A.C. and V.B.; methodology, A.C. and A.D.B.; software, A.C. and A.D.B.; validation, A.C. and A.D.B.; formal analysis, A.C. and A.D.B.; investigation, A.C. and A.D.B.; resources, V.B.; data curation, A.C. and A.D.B.; writing—original draft preparation, A.C. and A.D.B.; writing—review and editing, A.C., A.D.B., G.M. and V.B.; visualization, A.C. and A.D.B.; supervision, G.M.; project administration, V.B.; funding acquisition, V.B. All authors have read and agreed to the published version of the manuscript.
Funding
This research was funded by the Italian MIUR (PRIN 2017; Project PHANTOMS - Physico-chemical Heuristic Approaches: Nanoscale Theory Of Molecular Spectroscopy; grant number 2017A4XRCA) and by the Italian Space Agency (ASI; project ‘Life in Space’, N. 2019-3-U.0).
Institutional Review Board Statement
Not applicable.
Informed Consent Statement
Not applicable.
Data Availability Statement
Data can be found with A.C.
Acknowledgments
We are grateful to Sara Del Galdo for contributing to the force field development of L- DOPA and Droxidopa molecules. We are thankful to Alberto Coduti and all the staff of the high-performance computer facilities of the SMART Laboratory ( https://smart.sns.it ) for providing assistance with software installation and computer resources.
Conflicts of Interest
The authors declare no conflict of interest.
Abbreviations
The following abbreviations are used in this manuscript: AA All Atom β 2 AR Beta2 Adrenergic Receptor pK d Binding Affinity BFE Binding Free Energy GPCR Guanine Nucleotide-Binding Protein Coupled Receptor DFT Density-Functional Theory FF Force Field L-DOPA Levodopa MD Molecular Dynamics PD Parkinson’s Disease QM Quantum Mechanical
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Figure 1. Chemical structures of protonated adrenaline and zwitterionic L-DOPA and Droxidopa ligands. Carbon, hydrogen, nitrogen and oxygen atoms are shown in cyan, white, blue and red, respectively. Non-polar hydrogens are not shown for clarity. Dihedral angles of each ligand are highlighted by green arrows.
Figure 1. Chemical structures of protonated adrenaline and zwitterionic L-DOPA and Droxidopa ligands. Carbon, hydrogen, nitrogen and oxygen atoms are shown in cyan, white, blue and red, respectively. Non-polar hydrogens are not shown for clarity. Dihedral angles of each ligand are highlighted by green arrows.
Figure 2.
(
A
) A side view of the
β
2
AR model shows the main changes applied to the 4LDO original structure with adrenaline (ALE) in its crystallographic binding site highlighted by a green square.
β
2
AR TM
α
-helices and the ICL3 domain are in gray and red, respectively. M96, M98, N187 and C265 residues, which are mutated in the X-ray crystal structure, and Q231 and K263 residues connecting 4LDO to the ICL3 domain are shown in licorice representation. (
B
)
β
2
AR residues of the binding pocket interacting with crystallographic adrenaline (green) are shown in purple without hydrogens. TM
α
-helices III, V, VI and VII are displayed in grey. (
C
) Chemical structures of protonated adrenaline and zwitterionic L-DOPA and Droxidopa molecules employed in the molecular docking to rigid and flexible
β
2
AR receptor models.
Figure 2.
) A side view of the
β
2
AR model shows the main changes applied to the 4LDO original structure with adrenaline (ALE) in its crystallographic binding site highlighted by a green square.
β
2
AR TM
α
-helices and the ICL3 domain are in gray and red, respectively. M96, M98, N187 and C265 residues, which are mutated in the X-ray crystal structure, and Q231 and K263 residues connecting 4LDO to the ICL3 domain are shown in licorice representation. (
B
)
β
2
AR residues of the binding pocket interacting with crystallographic adrenaline (green) are shown in purple without hydrogens. TM
α
-helices III, V, VI and VII are displayed in grey. (
C
) Chemical structures of protonated adrenaline and zwitterionic L-DOPA and Droxidopa molecules employed in the molecular docking to rigid and flexible
β
2
AR receptor models.
Figure 3. Torsional profiles derived from QM calculations (dots) and JOYCE (lines) for zwitterionic L-DOPA. Each panel refers to dihedral angles defined in Figure 1 . Energies are reported in kilojoules per mole (1 kJ/mol = 0.24 kcal/mol).
Figure 3. Torsional profiles derived from QM calculations (dots) and JOYCE (lines) for zwitterionic L-DOPA. Each panel refers to dihedral angles defined in Figure 1 . Energies are reported in kilojoules per mole (1 kJ/mol = 0.24 kcal/mol).
Figure 4. Torsional profiles derived from QM calculations (dots) and JOYCE (lines) for zwitterionic Droxidopa. Each panel refers to one of the dihedral angles defined in Figure 1 . Energies are reported in kilojoules per mole (1 kJ/mol = 0.24 kcal/mol).
Figure 4. Torsional profiles derived from QM calculations (dots) and JOYCE (lines) for zwitterionic Droxidopa. Each panel refers to one of the dihedral angles defined in Figure 1 . Energies are reported in kilojoules per mole (1 kJ/mol = 0.24 kcal/mol).
Figure 5. ( Top ) Dihedral distributions in vacuum (green) and water (cyan) are compared to torsional profiles obtained by QM calculations (dots) and JOYCE (lines) for zwitterionic L-DOPA. Each panel refers to one of the dihedral angles defined in Figure 1 . ( Bottom ) L-DOPA structures simulated for 20 ns and 100 ns in vacuum and water, respectively. Energies are reported in kilojoules per mole (1 kJ/mol = 0.24 kcal/mol).
Figure 5. ( Top ) Dihedral distributions in vacuum (green) and water (cyan) are compared to torsional profiles obtained by QM calculations (dots) and JOYCE (lines) for zwitterionic L-DOPA. Each panel refers to one of the dihedral angles defined in Figure 1 . ( Bottom ) L-DOPA structures simulated for 20 ns and 100 ns in vacuum and water, respectively. Energies are reported in kilojoules per mole (1 kJ/mol = 0.24 kcal/mol).
Figure 6. ( Top ) Dihedral distributions in vacuum (green) and water (cyan) compared to torsional profiles obtained by QM calculations (dots) and JOYCE (lines) for zwitterionic Droxidopa. Each panel refers to one of the dihedral angles defined in Figure 1 . ( Bottom ) Droxidopa structures simulated for 20 ns and 100 ns in vacuum and water, respectively. Energies are reported in kilojoules per mole (1 kJ/mol = 0.24 kcal/mol).
Figure 6. ( Top ) Dihedral distributions in vacuum (green) and water (cyan) compared to torsional profiles obtained by QM calculations (dots) and JOYCE (lines) for zwitterionic Droxidopa. Each panel refers to one of the dihedral angles defined in Figure 1 . ( Bottom ) Droxidopa structures simulated for 20 ns and 100 ns in vacuum and water, respectively. Energies are reported in kilojoules per mole (1 kJ/mol = 0.24 kcal/mol).
Figure 7. ( Top ) Zwitterionic L-DOPA QM torsional energy profiles (circles) compared with Helmholtz free energy variations as a function of the dihedral angle, as obtained from MD simulations performed using JOYCE (magenta dots) and OPLS (cyan dots) FFs. ( Bottom ) 100 ns structures of L-DOPA from MD simulations using JOYCE and OPLS (Fittings) FF parameters, respectively. Energies are reported in kilojoules per mole (1 kJ/mol = 0.24 kcal/mol).
Figure 7. ( Top ) Zwitterionic L-DOPA QM torsional energy profiles (circles) compared with Helmholtz free energy variations as a function of the dihedral angle, as obtained from MD simulations performed using JOYCE (magenta dots) and OPLS (cyan dots) FFs. ( Bottom ) 100 ns structures of L-DOPA from MD simulations using JOYCE and OPLS (Fittings) FF parameters, respectively. Energies are reported in kilojoules per mole (1 kJ/mol = 0.24 kcal/mol).
Figure 8.
(
Top
) Zwitterionic Droxidopa QM torsional energy profiles (circles) compared with Helmholtz free energy variations as a function of the dihedral angle, as obtained from MD simulations performed using JOYCE (magenta dots; for clarity, red dots are used for the dihedral
θ
) and OPLS AA FFs (cyan dots); (
Bottom
) 100 ns structures of Droxidopa from MD simulations using JOYCE and OPLS (Fittings) FF parameters, respectively. Energies are reported in kilojoules per mole (1 kJ/mol = 0.24 kcal/mol).
Figure 8.
(
Top
) Zwitterionic Droxidopa QM torsional energy profiles (circles) compared with Helmholtz free energy variations as a function of the dihedral angle, as obtained from MD simulations performed using JOYCE (magenta dots; for clarity, red dots are used for the dihedral
θ
) and OPLS AA FFs (cyan dots); (
Bottom
) 100 ns structures of Droxidopa from MD simulations using JOYCE and OPLS (Fittings) FF parameters, respectively. Energies are reported in kilojoules per mole (1 kJ/mol = 0.24 kcal/mol).
Figure 9.
Conformations of adrenaline from the
2
AR X-ray crystal structure (PDB ID: 4LDO) and the redocking of the ligand to rigid (
A
) and flexible (
B
) models of the receptor are shown in yellow and green, respectively. Lowest energy binding poses of adrenaline from the molecular docking to rigid (yellow) and flexible (green)
2
AR models are compared to the ligand’s conformation in the X-ray crystal structure (dark green). The protein is shown as grey ribbons and
β
2
AR side chains in contact with adrenaline are shown as sticks and balls. Carbon atoms of rigid and flexible side chains of
2
AR amino acid residues interacting with adrenaline are shown in purple and green, respectively. Hydrogen bonds are shown with cyan spheres. All non-polar hydrogens are not shown.
Figure 9.
Conformations of adrenaline from the
2
AR X-ray crystal structure (PDB ID: 4LDO) and the redocking of the ligand to rigid (
A
) and flexible (
B
) models of the receptor are shown in yellow and green, respectively. Lowest energy binding poses of adrenaline from the molecular docking to rigid (yellow) and flexible (green)
β
2
AR models are compared to the ligand’s conformation in the X-ray crystal structure (dark green). The protein is shown as grey ribbons and
2
AR side chains in contact with adrenaline are shown as sticks and balls. Carbon atoms of rigid and flexible side chains of
β
2
AR amino acid residues interacting with adrenaline are shown in purple and green, respectively. Hydrogen bonds are shown with cyan spheres. All non-polar hydrogens are not shown.
Figure 10.
Binding poses of L-DOPA obtained from the molecular docking into (
A
) rigid and (
B
) flexible models of the
β
2
AR receptor. The largest cluster conformation of L-DOPA (salmon) in a
β
2
AR rigid model displays more hydrogen bonds with anchor sites as compared to the lowest energy binding pose of the ligand in a flexible receptor. Carbon atoms of flexible side chains in the binding site are in green. View point and color code as in
Figure 9
.
Figure 10.
A
) rigid and (
B
) flexible models of the
β
2
AR receptor. The largest cluster conformation of L-DOPA (salmon) in a
β
2
AR rigid model displays more hydrogen bonds with anchor sites as compared to the lowest energy binding pose of the ligand in a flexible receptor. Carbon atoms of flexible side chains in the binding site are in green. View point and color code as in
Figure 9
.
Figure 11.
Conformations from the molecular docking of Droxidopa to (
A
) rigid and (
B
) flexible models of the
β
2
AR receptor. The lowest energy binding pose of Droxidopa (violet) in a rigid receptor displays more hydrogen bond interactions with anchor sites when compared to the lowest energy binding conformation of the ligand in a flexible
β
2
AR model. Carbon atoms of flexible side chains in the binding site are in green. View point and color code as in
Figure 9
.
Figure 11.
Conformations from the molecular docking of Droxidopa to (
A
) rigid and (
B
) flexible models of the
β
2
AR receptor. The lowest energy binding pose of Droxidopa (violet) in a rigid receptor displays more hydrogen bond interactions with anchor sites when compared to the lowest energy binding conformation of the ligand in a flexible
β
2
AR model. Carbon atoms of flexible side chains in the binding site are in green. View point and color code as in
Figure 9
.
Figure 12.
Number of (
A
) hydrogen bond and (
B
) hydrophobic contacts between
β
2
AR amino acids and different catecholamines docked into rigid and flexible receptor models obtained by molecular docking calculations.
Figure 12.
Number of (
A
) hydrogen bond and (
B
) hydrophobic contacts between
β
2
AR amino acids and different catecholamines docked into rigid and flexible receptor models obtained by molecular docking calculations.
Figure 13.
Receptor hydrophobic residues in contact with lowest energy binding poses of (
A
) L-DOPA and (
B
) Droxidopa docked into flexible
β
2
AR models are shown in yellow. View point and color code as in
Figure 9
.
Figure 13.
Receptor hydrophobic residues in contact with lowest energy binding poses of (
A
) L-DOPA and (
B
) Droxidopa docked into flexible
β
2
AR models are shown in yellow. View point and color code as in
Figure 9
.
Figure 14.
(
A
) RMSDs of
β
2
AR C
α
atoms in receptor complexes with adrenaline (green), L-DOPA (blue) and Droxidopa (red). (
B
) RMSDs of ligands heavy atoms.
Figure 14.
(
A
) RMSDs of
β
2
AR C
α
atoms in receptor complexes with adrenaline (green), L-DOPA (blue) and Droxidopa (red). (
B
) RMSDs of ligands heavy atoms.
Figure 15.
Snapshots of MD simulations of
β
2
AR-catecholamine complexes show the hydrogen bond network of (
top
) L-DOPA and (
bottom
) Droxidopa ligands with key amino acids of the receptor binding pocket using CHARMM and OPLS AA FFs. Hydrogen bonds are highlighted with dashed blue lines. View point and color code as in Figure 5 of ref. [
76
].
Figure 15.
Snapshots of MD simulations of
β
2
AR-catecholamine complexes show the hydrogen bond network of (
top
) L-DOPA and (
bottom
) Droxidopa ligands with key amino acids of the receptor binding pocket using CHARMM and OPLS AA FFs. Hydrogen bonds are highlighted with dashed blue lines. View point and color code as in Figure 5 of ref. [
76
].
Figure 16.
Normalized number of contacts of (
A
) L-DOPA and (
B
) Droxidopa with the receptor residues extracted from 1
μ
s AA MD simulations of the
β
2
AR-catecholamine complexes performed with the OPLS AA FF. Snapshots from MD simulations show
β
2
AR hydrophilic (cyan) and hydrophobic (yellow) residues interacting with (
top
) L-DOPA and (
bottom
) Droxidopa ligands. For clarity, only
β
2
AR residues displaying the largest percentages of contacts with the ligand are shown. Side chains of some residues are indicated by green arrows. This analysis was performed over the whole 1
μ
s trajectory.
Figure 16.
Normalized number of contacts of (
A
) L-DOPA and (
B
) Droxidopa with the receptor residues extracted from 1
μ
s AA MD simulations of the
β
2
AR-catecholamine complexes performed with the OPLS AA FF. Snapshots from MD simulations show
β
2
AR hydrophilic (cyan) and hydrophobic (yellow) residues interacting with (
top
) L-DOPA and (
bottom
) Droxidopa ligands. For clarity, only
β
2
AR residues displaying the largest percentages of contacts with the ligand are shown. Side chains of some residues are indicated by green arrows. This analysis was performed over the whole 1
μ
s trajectory.
Figure 17.
The mapping of energy contributions on the structure of
β
2
AR-catecholamine complexes and contribution energies of
β
2
AR residues for (
top
) adrenaline, (
middle
) L-DOPA and (
bottom
) Droxidopa ligands. Energies are reported in kilojoules per mole (1 kJ/mol = 0.24 kcal/mol).
Figure 17.
The mapping of energy contributions on the structure of
β
2
AR-catecholamine complexes and contribution energies of
β
2
) adrenaline, (
middle
) L-DOPA and (
bottom
) Droxidopa ligands. Energies are reported in kilojoules per mole (1 kJ/mol = 0.24 kcal/mol).
Table 1.
Calculated binding affinities, pK
d
, of different ligands for rigid and flexible
β
2
AR models obtained by molecular docking calculations in comparison with experimental values.
Table 1.
Calculated binding affinities, pK
d
, of different ligands for rigid and flexible
β
2
AR models obtained by molecular docking calculations in comparison with experimental values.
Ligand Calculated Binding Affinity pK d a Experimental Binding Affinity pK d Rigid Model Flexible Model Adrenaline 5.9 9.2 6.1 b –6.5 c (3.3) d L-DOPA 4.7 9.4 NA (3.9) Droxidopa 5.4 10.3 NA (9.2)
Table 2.
Hydrogen bond distances for different
β
2
AR-Ligand complexes from AD4 calculations. This analysis was performed on the following ligands: adrenaline (ALE), L-DOPA (DAH) and Droxidopa (DRO). Distances not compatible with hydrogen bonding are shown in bold characters.
Table 2.
Hydrogen bond distances for different
β
2
AR-Ligand complexes from AD4 calculations. This analysis was performed on the following ligands: adrenaline (ALE), L-DOPA (DAH) and Droxidopa (DRO). Distances not compatible with hydrogen bonding are shown in bold characters.
Hydrogen Bonds ( β 2 AR-Ligand) Donor-Acceptor Distance (Å) Rigid Model Flexible Model ALE DAH DRO ALE DAH DRO OD1 (D113)-N (amino) 3.7 ( 4.1 ) a 3.0 3.4 2.8 2.8 2.8 OD2 (D113)-N (amino) 2.7 (2.8) 2.5 2.4 2.6 2.5 2.3 OD1 (D113)-O ( β -OH) 3.0 (2.8) - c 2.7 3.1 - 2.9 OG1 (T118)-O (para) 3.3 ( 4.4 ) 6.2 3.6 3.4 3.1 3.1 OG1 (T118)-O (meta) 3.2 ( 7.0 ) 3.7 3.3 2.6 2.7 3.1 OG (S203)-O (para) 4.7 ( 3.7 ) 2.8 4.3 2.7 2.6 4.7 OG (S203)-O (meta) 7.1 (3.2) 7.1 5.1 5.1 4.9 7.5 OG (S204)-O (para) 6.5 ( 5.7 ) 3.5 6.3 6.2 5.5 6.9 OG (S204)-O (meta) 8.7 ( 4.8 ) 6.2 8.7 8.0 7.8 8.8 OG (S207)-O (para) 2.6 (3.5) 4.5 2.9 3.1 2.5 2.7 OG (S207)-O (meta) 4.0 (6.0) 2.9 4.1 2.8 3.1 3.9 OD1 (N312)-N (amino) 2.8 (2.8) 2.9 2.7 3.0 3.0 2.9 ND2 (N312)-O ( β -OH) 2.9 (2.8) - 2.8 4.9 - 3.0 ND2 (N312)-O1 (-COO − ) - b 2.7 4.6 - 2.5 3.5 ND2 (N312)-O2 (-COO − ) - 4.0 5.3 - 4.0 5.0 OH (Y316)-N (amino) 3.4 (3.5) 3.0 2.9 3.3 2.4 2.4 OH (Y316)-O ( β -OH) 3.9 (3.5) - 3.5 4.1 - 3.9
a Hydrogen bonds of adrenaline’s conformation in the β 2 AR X-ray crystal structure (PDB ID: 4LDO) are shown in parentheses. b COO− group is absent in the adrenaline ligand. c β-OH group is absent in the L-DOPA ligand.
MDPI and ACS Style
Catte, A.; Biswas, A.D.; Mancini, G.; Barone, V. L-DOPA and Droxidopa: From Force Field Development to Molecular Docking into Human β 2-Adrenergic Receptor. Life 2022, 12, 1393.
https://doi.org/10.3390/life12091393
AMA Style
Catte A, Biswas AD, Mancini G, Barone V. L-DOPA and Droxidopa: From Force Field Development to Molecular Docking into Human β 2-Adrenergic Receptor. Life. 2022; 12(9):1393.
https://doi.org/10.3390/life12091393
Chicago/Turabian Style
Catte, Andrea, Akash Deep Biswas, Giordano Mancini, and Vincenzo Barone. 2022. "L-DOPA and Droxidopa: From Force Field Development to Molecular Docking into Human β 2-Adrenergic Receptor" Life12, no. 9: 1393.
https://doi.org/10.3390/life12091393
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IJERPH | Free Full-Text | Willingness to Take COVID-19 Vaccines in Ethiopia: An Instrumental Variable Probit Approach
This paper analyzed the factors influencing the willingness of Ethiopia’s population to take COVID-19 vaccines. The data included the COVID-19 High Frequency Phone Survey of Households in Ethiopia that were collected in 2021. This paper relied on the 10th round of the survey, which was comprised of 2178 households. The Instrumental Variable Probit regression model was used to analyze the data. The results showed that majority of the respondents (92.33%) would receiveCOVID-19 vaccines, while 6.61% and 1.06% were, respectively, unwilling and unsure. Across the regions of Ethiopia, Southern Nations, Nationalities, and Peoples’ Region (SNNPR) (99.30%), Oromia (97.54%), Tigray (97.04%) and Gambela (95.42%) had the highest proportions of respondents willing to have the vaccine. Vaccine safety concern was the topmost reason for those unwilling to receive the vaccine. The results of the Instrumental Variable Probit regression showed that currently working, age, engagement with non-farm businesses and region of residence significantly influenced the population’s willingness to take the vaccine (p < 0.05). It was concluded that although the willingness be vaccinated was impressive, without everyone being receiving the COVID-19 vaccine, infection risk can still be high; this is due to the persistent mutation of the viral strains. Thus, there is a need to intensify efforts toward addressing the safety issues of COVID-19 vaccines, while efforts to enhance acceptability should focus on the youth population and those who are unemployed.
Willingness to Take COVID-19 Vaccines in Ethiopia: An Instrumental Variable Probit Approach
Int. J. Environ. Res. Public Health 2021 , 18 (17), 8892; https://doi.org/10.3390/ijerph18178892
Received: 7 July 2021 / Revised: 18 August 2021 / Accepted: 19 August 2021 / Published: 24 August 2021
Abstract
This paper analyzed the factors influencing the willingness of Ethiopia’s population to take COVID-19 vaccines. The data included the COVID-19 High Frequency Phone Survey of Households in Ethiopia that were collected in 2021. This paper relied on the 10th round of the survey, which was comprised of 2178 households. The Instrumental Variable Probit regression model was used to analyze the data. The results showed that majority of the respondents (92.33%) would receiveCOVID-19 vaccines, while 6.61% and 1.06% were, respectively, unwilling and unsure. Across the regions of Ethiopia, Southern Nations, Nationalities, and Peoples’ Region (SNNPR) (99.30%), Oromia (97.54%), Tigray (97.04%) and Gambela (95.42%) had the highest proportions of respondents willing to have the vaccine. Vaccine safety concern was the topmost reason for those unwilling to receive the vaccine. The results of the Instrumental Variable Probit regression showed that currently working, age, engagement with non-farm businesses and region of residence significantly influenced the population’s willingness to take the vaccine (
p
< 0.05). It was concluded that although the willingness be vaccinated was impressive, without everyone being receiving the COVID-19 vaccine, infection risk can still be high; this is due to the persistent mutation of the viral strains. Thus, there is a need to intensify efforts toward addressing the safety issues of COVID-19 vaccines, while efforts to enhance acceptability should focus on the youth population and those who are unemployed.
Keywords:
COVID-19
;
viral strain
;
vaccine
;
vaccination
;
Ethiopia
1. Introduction
Judging by the intensity of its morbidity and mortality, COVID-19 has proved to be one of the worst pandemics the world has recently witnessed. Having been declared as a Public Health Emergency of International Concern (PHEIC), addressing COVID-19 requires the proper administration of medical services, among which effective vaccination cannot be over-emphasized [
1
]. This is in alignment with conventional wisdom derived from the fact that, aside from access to safe drinking water, no other interventions in the history of mankind have had significant impacts on reducing incidences of morbidity and mortality as vaccinations [
2
]. The World Health Organization (WHO) is therefore advocating for speedy interventions that would ensure access of every individual to COVID-19 vaccines, as a way of securing our collective existence given the severity of the ongoing pandemic.
Generally, vaccines are meant to enhance the immune system through their extraordinary ability in responding to and remembering certain encounters with pathogenic antigens [
3
]. More importantly, over the past few decades, a number of success stories in addressing many pandemics of worrisome morbidity and fatality have been directly associated with development and effective utilization of vaccines. It has been estimated that, annually, vaccines prevent about 6 million deaths that could have resulted from vaccine-preventable diseases [
4
]. Therefore, healthcare professionals and policymakers are now advocating for development of vaccines in sufficient quantities, in order to address the ongoing COVID-19 pandemic.
Vaccines can be classified as live or non-live. Live vaccines are used with certain restrictions since they can replicate uncontrollably in individuals whose immune systems are compromised as a result of underlying medical conditions [
3
]. However, individuals with compromised immune systems can access non-live vaccines without risk, although their efficacy may be substantially sub-optimal [
5
]. However, due to several factors, addressing COVID-19 through vaccination presents some peculiar challenges. The first borders on several speculations on the emergence of the virus, many of which may influence acceptability of global efforts in addressing its spread. Specifically, there have been a number of conspiracy theories advancing the hidden international agendas throughout the COVID-19 saga, many of which are precipitating fears and vaccine hesitancy [
6
].
The emergence of social media as major platform for information-sharing has rendered an individual of the 21st century more informed, whether rightly or wrongly. Specifically, it should be reemphasized that the acceptability of polio vaccines in Nigeria, Pakistan and Afghanistan was affected by misinformation on its tendency to inhibit fertility [ 7 , 8 ]. Presently, the information around COVID-19 vaccines has been diverse, and much of this information is spreading misleading rumors [ 9 ]. There have been underlying notions that COVID-19 vaccines may contain deliberate poisons that are meant to control global population [ 10 ]. In a recent study, 91% of the information obtained from several countries on the internet was classified as rumors [ 10 ]. These include the fear of being sick or dying after receiving the COVID-19 vaccination and that the vaccine is a messenger Ribonucleic acid (mRNA) that may distort the sequence of human deoxyribonucleic acid (DNA), thereby turning them into mere prototypic beings whose genetic compositions may have been silently modified [ 10 ].
Several factors may influence an individual’s conception or belief in medical procedures for disease prevention. People also the fundamental right to decline whatever options are presented to them by healthcare professionals [ 11 ]. Except by legislative means, many countries cannot force individuals to be vaccinated against their will. More importantly, some authors have highlighted the factors that can influence the decision to comply with government’s vaccination programs. These include possession of proper education on health-related issues, an individual’s perception of the level of risk [ 10 , 12 , 13 , 14 ], race [ 15 ], perceived risk of infection [ 16 ], perceived benefits [ 17 ], age [ 15 , 18 , 19 , 20 , 21 ], educational level [ 18 ], gender [ 15 , 19 , 21 ], chronic medical condition [ 19 ], access to health insurance [ 19 ], ethnicity, income and employment [ 22 ] and previously being tested for the virus [ 18 ].
It should be emphasized that most of these studies have been conducted in the United States of America and China. There are currently very few studies on African countries and Ethiopia in particular. Studies on the willingness to partake in the COVID-19 vaccination program are not only important but essentially timely. Such studies can enhance the understanding of health policymakers on socio-economic and demographic factors that influence vaccination compliance. This is going to assist public health practitioners in evaluating the expected effectiveness of resources that are being committed to the procurement of vaccines and the expected impacts on the control and management of COVID-19 pandemic.
2. Materials and Methods
2.1. The Data
This study used the data from the COVID-19 High Frequency Phone Survey of Households in Ethiopia that commenced in 2020 [
23
]. The World Bank leveraged the Living Standards Measurement Study (LSMS) to implement this survey based on existing long-term collaboration with the Central Statistical Agency (CSA) of Ethiopia [
23
].The survey is therefore a subsample of the Ethiopia Socioeconomic Survey (ESS) that was conducted by the CSA in 2018/2019. ESS is a long-term project that is being implemented by the CSA, which is constitutionally mandated according to Ethiopia’s Proclamation No. 442/2005 to coordinate the National Statistical System (NSS) in order to provide time-responsive datasets for informed policy decisions [
24
].
The survey was telephonically conductedbetween 1st and 23rd of February 2021 and the World Bank has implemented similar collaborations between national statistical agencies of five other African countries, including Tanzania, Malawi, Nigeria, Uganda and Kenya [
23
]. The respondents were contacted through the phone numbers that were provided during the previous ESS. The sampling frame was therefore formed by the list of all the households that supplied their phone numbers, because correctly addressing the COVID-19 pandemic necessitates social distancing and intermittent lockdowns within Ethiopia [
25
].
Specifically, out of the 7527 households that formed the sampling frame for wave 4 of the 2018/2019 ESS [
26
], valid phone numbers were obtained for 5374 households, with 4626 being phone-owners and 995 providing reference phone numbers. The first round of the survey targeted 3300 households for an interview in order to ensure national representativeness. Specifically, 1300 rural households and 2000 urban households were targeted. It should also be noted that 1413 rural households had phones and 771 provided reference phone numbers. Additionally, 3213 urban households had phones and 224 could be reached through reference phone numbers.
In the first round, the survey was implemented by calling all of the phone numbers that were provided in order to account for non-response and attrition [
25
]. A household is flagged as non-response only after being called at least three times in three days [
25
]. The consent to participate in the survey was sought from those who were reached on their phones after the objectives of the survey had been clearly explained to them. Most of the respondents were the heads of the household. However, in few cases where the heads were indisposed, a representative with adequate information on the contents of the questionnaire stood for them.
The survey used the modular approach of the Computer Assisted Telephone Interview (CATI) techniques. The questionnaire was loaded with Survey CTO (Dobility, Inc., Cambridge, MA, USA). This is a CATI software that has been noted as one of the most reliable software for collecting data in offline settings [
23
]. Tablets were given to every enumerator along with sufficient data bundles which were loaded on their personal mobile phone devices. The collected data were daily sent to the central server and Senior Field Supervisors were designated to review the survey with the enumerators twice-a-day through phone calls in order to address quality concerns. Audio recordings of the interviews were also logged in order to reconcile outliers or non-response issues [
23
]. The interviews were carried out in six languages: Wolayita, Afan Oromo, Amharic, Afar, Somali and Tigrigna [
25
]. During the first round in 2020, 3249 households were successfully interviewed (2271 from urban areas and 978 from rural areas). At each round of data collection, the consents of the interviewed households were sought for inclusion in the next survey [
25
]. However, during the 10th round, only 2178 households completed the survey, with 537 from rural areas and 1641 from urban areas.
2.2. Limitations of the Data
The survey suffers from limitations because intermittent lockdowns prevented the conduction of face-to-face interviews with the respondents. In addition, using a sampling frame that was based on those whose phone numbers or references phone numbers were provided during the 2018/2019 ESS also undermines the representativeness of the data. This is a result of the low penetration of telecommunication in rural Ethiopia. This is more evidently revealed by the low proportion of rural respondents in the dataset, unlike the results from ESS that were conducted via face-to-face interviews in 2018/2019 [ 26 ]. Dropout of respondents, as characterized by panel data, is also a matter of concern. Specifically, the first round of the survey had 3249 respondents, compared to 2178 in the tenth round.
2.3. Instrumental Variable Probit Model
The Instrumental Variable Probit regression model was used to analyze the data. Conventionally, the Probit model is used when the dependent variable is binary in nature. The Probit model uses the cumulative Gaussian normal distribution function to calculate the probability of belonging to any of the categories.The standard Probit model is not applicable for this study because of the suspicion that the “currently working” variable could be endogenous, thereby implying that the estimated parameters would be biased. Therefore, an extension of the Probit model, in the form of the Instrumental Variable Probit regression, was used. The model is ideal for a situation whereby a dichotomous dependent variable, estimated as dummy variable, is suggested to be influenced by some independent variables, among which there is a variable that had been suspected to be endogenous [
27
].
(1)
1
z
X
i
k
+
π
G
i
+
ϵ
i
(2)
In Equation (1), the dependent variable (
Y
i
) was coded as 1 for willing to take COVID-19 vaccines and 0 (0) for otherwise.
X
i
k
are the explanatory variables which include urban area (yes = 1, 0 otherwise), occupation—unemployed is the base variable—[agriculture (yes = 1, 0 otherwise), industry/manufacturing (yes = 1, 0 otherwise), wholesale and retail trade (yes = 1, 0 otherwise), transport services (yes = 1, 0 otherwise), restaurant (yes = 1, 0 otherwise), public administration (yes = 1, 0 otherwise), personal service like beauty salon (yes = 1, 0 otherwise), construction (yes = 1, 0 otherwise) and education/health (yes = 1, 0 otherwise)], regional variables—Tigray is the base variable—[Afar region (yes = 1, 0 otherwise), Amhara (yes = 1, 0 otherwise), Oromia (yes = 1, 0 otherwise), Somali (yes = 1, 0 otherwise), Benishangul-Gumuz (yes = 1, 0 otherwise), SNNPR (yes = 1, 0 otherwise), Gambela (yes = 1, 0 otherwise), Harar (yes = 1, 0 otherwise), Addis Ababa (yes = 1, 0 otherwise) and Dire Dawa (yes = 1, 0 otherwise)], age of household head (years), farming income (yes = 1, 0 otherwise) and business income (yes = 1, 0 otherwise).
W
i
is the endogenous explanatory variable coded as 1 for currently working and 0 (0) otherwise. Equation (2) estimates the determinants of being currently working with gender of the respondents
(
G
i
)
, which was coded as 1 for males and 0 otherwise representing the instrumental variable. If
W
i
is not endogenous, then
C
o
v
(
X
i
ε
i
)
=
0
]. The analyses for this study were carried out with STATA 13 software. The software generated the Wald test of exogeneity statistic, which, if shown to be statistically significant, implies the adequacy of the instrumental variable(s) and the use of IV Probit is thus justified.
3. Results
3.1. Socioeconomic Characteristics of Respondents
Table 1
shows the distribution of the respondents’ socioeconomic factors based on their decision to receive the vaccination. It shows that majority of the respondents (92.33%) would get a COVID-19 vaccination if the approved vaccines are freely available. The results in the Table further reveal that respondents from urban areas accounted for 75.34% of the respondents and majority of those who were not willing to be vaccinated came from urban areas. Based on gender, 62.21% of the respondents were males, but more females were unwilling to be vaccinated. In addition, 69.65% of the respondents were working at the time of the survey. The majority of the respondents were in their active age brackets of 25 < 45 years, while 4.64% were over 59 years of age.
Table 1. Respondents’ Demographic Characteristics.
Figure 1 and Figure 2 further reveal the distribution of the respondents’ decisions to get a COVID-19 vaccine across different regions and occupational groups in Ethiopia. Figure 1 shows that SNNPR (99.30%), Oromia (97.54%), Tigray (97.04%) and Gambela (95.42%) had the highest proportions of vaccine-willing respondents while Dire Dawa (83.69%), Addis-Ababa (87.94%) and Harar (90.34%) had the lowest percentages. Figure 2 also shows that the respondents who occupied public administration positions constituted the highest frequencies of those that were willing and unwilling to be vaccinated. Figure 3 presents the reasons that were provided by the respondents for being unwilling to be vaccinated, coming from the different regions across Ethiopia. This Figure reveals that the safety of the vaccines was the topmost reason provided by the respondents across the different regions. In the Dire Dawa region, however, the second most important reason that was provided for the rejection of COVID-19 vaccine was based on side effects it might have, while second most important factor in Addis Ababa was the fear that it would not work.
Figure 1. Distribution of respondents based on willingness to get COVID-19 vaccines across the Ethiopia’s regions.
Figure 2. Frequencies of respondents willing to get COVID-19 vaccines across occupational groups in Ethiopia.
Figure 3. Frequencies of respondents’reasons for not willing to get COVID-19 vaccines across the regions in Ethiopia.
3.2. IV Probit Model Results
Table 2 presents the results of data analysis with the Instrumental Variable (IV) Probit regression approach. The model produced a good fit for the data based on the statistical significance ( p < 0.01) of the computed Chi-square statistics (101.75). Additionally, the use of the Instrumental Variable Probit was justified by the statistical significance of the computed Wald test of exogeneity ( p < 0.05). This implies that the currently working variable was truly endogenous and the instrumental variable was adequate.
Table 2. Determinants of Willingness to Take COVID-19 Vaccines.
The results further show that the parameter of the “currently working” variable is statistically significant (
p
< 0.01). This result implies that respondents who were currently working were far more likely to be willing to receive the vaccine. The parameter of age is also showed a positive sign and was statistically significant (
p
< 0.01). This also implies that old respondents were more likely to have a COVID-19 vaccine. The parameter of non-farm businesses showed a negative sign and was therefore statistically significant (
p
< 0.05). This shows that those respondents whose households opened non-farm businesses some four weeks before the survey had a significantly lower probability of receiving a COVID-19 vaccine. Additionally, the regional variables for Afar, Amhara, Somali, Harar, Addis Ababa and Dire Dawa showed a negative sign and were also statistically significant (
p
< 0.05). These results imply that compared with respondents from Tigray, residents from Afar, Amhara, Somali, Harar, Addis Ababa and Dire Dawa were less likely to have a COVID-19 vaccine.
4. Discussion
The results of data analyses show that most of the respondents (92.3%) indicated that they would be willing to have a COVID-19 vaccination if approved vaccines are available. This represents a large proportion of the population given that in some previous studies, lower proportions had been reported. Specifically, in the USA, 75% reported a willingness to be vaccinated [ 15 ]; in China, 28.7% indicated yes and 54.6% said probably [ 17 ]; in a survey in Philadelphia, 63.7% of employees indicated yes and 26.3% were unsure [ 18 ]. In Africa, 71% [ 29 ] and 59% [ 30 ] were willing to be vaccinated in South Africa and the Democratic Republic of the Congo, respectively. However, given the high-mutant property of COVID-19, a higher vaccination coverage would likely guarantee the attainment of herd immunity. This is due to a recent emergence of different variant strains of COVID-19 due to a progressive mutation that is rendering certain developed vaccines to be less effective [ 31 , 32 ].
The results further revealed that a higher proportion of urban dwellers were unwilling to be vaccinated compared to rural dwellers. However, the parameter of urban residence did not significantly influence the probability of willingness to receive a COVID-19 vaccine. This is expected because urban residents may have access to a high level of misinformation on the COVID-19 vaccine [ 9 , 12 , 13 ]. The results also show that more males were willing to be vaccinated than their female counterparts. This result reveals the gender factor that can impact efforts by government in addressing COVID-19 in Ethiopia. In some previous studies [ 15 , 19 , 21 ], gender was found to influence decisions around the COVID-19 vaccination.
Older respondents were also far more likely to be willing to have a COVID-19 vaccine. This is expected because age is one of the major factors affecting COVID-19 infection, with elderly people having weaker immune systems and thus at a higher risk of infection. A similar finding had been reported in some previous studies [ 15 , 18 , 19 , 20 , 21 ]. Furthermore, the “currently working” variable significantly increased the probability of willingness to be vaccinated. This can be explained by the desirability of good health for individuals that are working, since being sick with COVID-19 would reduce their productivity and thus their income. However, the results show that engagement with non-farm businesses reduced the probability of willingness to have a COVID-19 vaccine. This points to the fact that self-employed individuals may be less likely to see the need to get COVID-19 vaccines because they are not subjected to the operational contents of any formal contracts. The results also indicate that willingness to get vaccinated is influenced by some regional variables. This reemphasizes the need to factor in regional differences when addressing the COVID-19 pandemic in Ethiopia.
The reasons for individuals’ unwillingness to get COVID-19 vaccines were also revealed. Specifically, pertinent issues surrounding the safety and the side effects of the vaccines were of the topmost concern to the respondents. In certain previous vaccination interventions that were meant to address prior epidemic outbreaks, safety had been a fundamental determinant of acceptance. Good examples include the polio vaccination in northern Nigeria [ 10 ], the H1N1 vaccine in Sweden and Finland [ 32 ], and the measles, mumps and rubella (MMR) vaccine in the United Kingdom and United States [ 33 ].
5. Conclusions
Understanding the expected behavior of the population in relation to the uptake of COVID-19 vaccination is a vital subject demanding thorough investigations and analyses. This is now more important, given the intermittent upsurge of infections, in what have been described as viral waves in many African countries. The consensus among policymakers is that addressing COVID-19 requires adequate vaccination of the entire population, based on the speed of infections, seriousness of morbidity and mutative features of the virus that are now undermining the effectiveness of the developed vaccines.
Based on the findings of this study, some recommendations can be made. It should be emphasized that several socioeconomic variables are of fundamental relevance in addressing the willingness to have a COVID-19 vaccine. Specifically, although older people would be more willing to receive COVID-19 vaccines, efforts to address the pandemic also require younger individuals to take adequate protective responsibilities, especially because they tend to be asymptomatic. In addition, there are some gender issues that should be taken cautiously in the ongoing efforts at promoting the effective management of COVID-19. Specifically, Ethiopian women are to be targeted with information to facilitate their responsiveness to COVID-19 vaccination. It is also important to ensure that occupational factors that are relevant for promoting COVID-19 acceptance in Ethiopia are addressed, understanding that informally engaged people would need to be specifically targeted with compelling information to address their hesitancy around the vaccine.
Furthermore, ongoing research efforts and international initiatives to provide workable vaccines against COVID-19 are commendable. However, more efforts are still needed in addressing the effectiveness of vaccines with significantly minimized side effects. Meanwhile, the provision of honest communication by healthcare practitioners on effectiveness and expected side effects of available COVID-19 vaccines would go a long way in helping individuals to make informed decisions on being vaccinated.
Informed consents were obtained from all subjects involved in the study.
Data Availability Statement
Conflicts of Interest
References
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Figure 1. Distribution of respondents based on willingness to get COVID-19 vaccines across the Ethiopia’s regions.
Figure 2. Frequencies of respondents willing to get COVID-19 vaccines across occupational groups in Ethiopia.
Figure 3. Frequencies of respondents’reasons for not willing to get COVID-19 vaccines across the regions in Ethiopia.
Table 1. Respondents’ Demographic Characteristics.
Variables Not Willing/Not Sure Willing Total Sector Freq % Freq % Freq % Urban 148 6.80 1493 68.55 1641 75.34 Rural 19 0.87 518 23.78 537 24.66 Gender Female 93 4.27 730 33.52 823 37.79 Male 74 3.40 1281 58.82 1355 62.21 Currently Working No 51 2.34 610 28.01 661 30.35 Yes 116 5.33 1401 64.33 1517 69.65 Age of Respondents <20 3 0.14 38 1.74 41 1.88 20 < 25 21 0.96 183 8.40 204 9.37 25 < 30 39 1.79 366 16.80 405 18.60 30 < 35 24 1.10 342 15.70 366 16.80 35 < 40 33 1.52 321 14.74 354 16.25 40 < 45 24 1.10 371 17.03 395 18.14 45 < 50 6 0.28 132 6.06 138 6.34 50 < 55 9 0.41 96 4.41 105 4.82 55 < 60 5 0.23 64 2.94 69 3.17 >=60 3 0.14 98 4.50 101 4.64 Total 167 7.67 2011 92.33 2178 100.00
Table 2. Determinants of Willingness to Take COVID-19 Vaccines.
| https://www.mdpi.com/1660-4601/18/17/8892/xml |
Tissue expression of OR4C6 - Staining in thymus - The Human Protein Atlas
Expression of OR4C6 in thymus tissue. Antibody staining with in immunohistochemistry.
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AllGene nameProtein classUniprot keywordChromosomeExternal idTissue expression (IHC)Patient ID (IHC)Tissue category (RNA)Tissue expression cluster (RNA)Reliability score tissue (IHC)Brain region category (RNA)Mouse brain category (RNA)Pig brain category (RNA)Reliability score mouse brainCell type category (RNA)Single cell type expression cluster (RNA)Cell type enrichment (RNA)Prognostic cancerCancer category (RNA)Immune cell category (RNA)Immune cell lineage category (RNA)Immune cell expression cluster (RNA)Secretome annotationPan-cancer panelSubcellular location (ICC)Subcellular location - cell line (ICC)Subcellular Cell Cycle Peak PhaseReliability score cells (ICC)Cell line category (RNA)Cell line expression cluster (RNA)Metabolic pathwayEvidence summaryUniProt evidenceNeXtProt evidenceHPA evidenceProtein array (PA)Western blot (WB)Immunohistochemistry (IHC)Immunocytochemistry (ICC)With antibodiesProtein structuresHas protein dataSort by
Term
Gene name
Class
Blood group antigen proteinsCancer-related genesCandidate cardiovascular disease genesCD markersCitric acid cycle related proteinsDisease related genesEnzymesFDA approved drug targetsG-protein coupled receptorsHuman disease related genesImmunoglobulin genesMapped to neXtProtMapped to UniProt SWISS-PROTMetabolic proteinsNuclear receptorsPlasma proteinsPotential drug targetsPredicted intracellular proteinsPredicted membrane proteinsPredicted secreted proteinsProtein evidence (Ezkurdia et al 2014)Protein evidence (Kim et al 2014)RAS pathway related proteinsRibosomal proteinsRNA polymerase related proteinsT-cell receptor genesTranscription factorsTransportersVoltage-gated ion channels
Subclass
Class
Biological processMolecular functionDisease
Keyword
Chromosome
12345678910111213141516171819202122MTUnmappedXY
External id
Tissue
AnyAdipose tissueAdrenal glandAppendixBone marrowBreastBronchusCartilageCaudateCerebellumCerebral cortexCervixChoroid plexusColonDorsal rapheDuodenumEndometriumEpididymisEsophagusEyeFallopian tubeGallbladderHairHeart muscleHippocampusHypothalamusKidneyLactating breastLiverLungLymph nodeNasopharynxOral mucosaOvaryPancreasParathyroid glandPituitary glandPlacentaProstateRectumRetinaSalivary glandSeminal vesicleSkeletal muscleSkinSmall intestineSmooth muscleSoft tissueSole of footSpleenStomachSubstantia nigraTestisThymusThyroid glandTonsilUrinary bladderVagina
Cell type
Expression
Patient ID
Tissue
AnyAdipose tissueAdrenal glandBone marrowBrainBreastCervixChoroid plexusEndometriumEpididymisEsophagusFallopian tubeGallbladderHeart muscleIntestineKidneyLiverLungLymphoid tissueOvaryPancreasParathyroid glandPituitary glandPlacentaProstateRetinaSalivary glandSeminal vesicleSkeletal muscleSkinSmooth muscleStomachTestisThyroid glandTongueUrinary bladderVagina
Category
Tissue enrichedGroup enrichedTissue enhancedLow tissue specificityNot detectedDetected in allDetected in manyDetected in someDetected in singleIs highest expressed
Cluster
82:Adipose tissue - ECM organization17:Adrenal gland - Steroid metabolism14:B-cells - Humoral immune response75:Bone marrow - mRNA splicing & Cell cycle65:Brain - Ion transport70:Brain - Nervous system development10:Brain - Neuronal signaling73:Brain - Neuropeptide signaling6:Brain - Smell perception58:Brain - Synaptic function76:Brain & Bone marrow - Chromatin organization32:Brain & Lymphoid tissue - Unknown function27:Brain & Skin - Unknown function5:Breast - Unknown function69:Cerebellum - Gene expression regulation88:Choroid plexus - Transmembrane transport42:Ciliated cells - Cilium & Cell projection49:Ciliated cells - Cilium organization30:Epididymis - Antimicrobial activity68:Epididymis - Unknown function84:Esophagus - Epithelial cell function89:Fibroblasts - ECM organization44:Heart - Cardiac muscle contraction38:Heart - Muscle contraction16:Immune cells - Immune response45:Intestine - Brush border56:Intestine - Transmembrane transport37:Intestine - Unknown function87:Intestine & Kidney - Transmembrane transport41:Intestine & Liver - Lipid metabolism7:Kidney - Transmembrane transport81:Kidney & Liver - Metabolism62:Liver - Hemostasis60:Liver - Hemostasis & Lipid metabolism85:Liver - Metabolism86:Liver & Placenta - Transport via ER19:Lung - Lung function66:Lymphoid tissue - Immune response regulation64:Macrophages - Immune response67:Neutrophils - Humoral immune response40:Neutrophils - Inflammatory response57:Non-specific - Angiogenesis53:Non-specific - Cell cycle regulation54:Non-specific - Microtubule organization39:Non-specific - Mitochondria55:Non-specific - Mitochondria & Proteasome52:Non-specific - Ribosome72:Non-specific - Transcription59:Non-specific - Translation51:Non-specific - Unknown function29:Non-specific - Vesicular transport25:Pancreas - Digestion48:Parathyroid gland - membrane proteins26:Pituitary gland - Hormone signaling28:Placenta - Pregnancy79:Retina - Phototransduction77:Retina - Visual perception20:Retina & Lymphoid tissues - Unknown function24:Salivary gland - Salivary secretion61:Skin - Cornification31:Skin - Epidermis development12:Smooth muscle tissue - Mixed function11:Squamous epithelial cells - Epithelial cell function4:Stomach - Digestion33:Striated muscle - Muscle contraction80:Striated muscle - Unknown function63:T-cells - Adaptive immune response23:Testis - Cell cycle regulation71:Testis - DNA repair83:Testis - Spermatogenesis43:Testis - Unknown function1:Thyroid gland - Transcription
Reliability
EnhancedSupportedApprovedUncertain
Brain region
AnyAmygdalaBasal gangliaCerebellumCerebral cortexHippocampal formationHypothalamusMedulla oblongataMidbrainPonsSpinal cordThalamusWhite matter
Category
Region enrichedGroup enrichedRegion enhancedLow region specificityNot detectedDetected in allDetected in manyDetected in someDetected in singleIs highest expressed
Brain region
AnyAmygdalaBasal gangliaCerebellumCerebral cortexHippocampal formationHypothalamusMidbrainOlfactory bulbPituitary glandPons and medullaRetinaThalamusWhite matter
Category
Region enrichedGroup enrichedRegion enhancedLow region specificityNot detectedDetected in allDetected in manyDetected in someDetected in singleIs highest expressed
Brain region
AnyAmygdalaBasal gangliaCerebellumCerebral cortexHippocampal formationHypothalamusMedulla oblongataMidbrainOlfactory bulbPituitary glandPonsRetinaSpinal cordThalamusWhite matter
Category
Region enrichedGroup enrichedRegion enhancedLow region specificityNot detectedDetected in allDetected in manyDetected in someDetected in singleIs highest expressed
Reliability
SupportedApproved
Cell type
AnyAdipocytesAlveolar cells type 1Alveolar cells type 2AstrocytesB-cellsBasal keratinocytesBasal prostatic cellsBasal respiratory cellsBasal squamous epithelial cellsBipolar cellsBreast glandular cellsBreast myoepithelial cellsCardiomyocytesCholangiocytesClub cellsCollecting duct cellsCone photoreceptor cellsCytotrophoblastsDendritic cellsDistal enterocytesDistal tubular cellsDuctal cellsEarly spermatidsEndometrial ciliated cellsEndometrial stromal cellsEndothelial cellsEnteroendocrine cellsErythroid cellsExcitatory neuronsExocrine glandular cellsExtravillous trophoblastsFibroblastsGastric mucus-secreting cellsGlandular and luminal cellsGranulocytesGranulosa cellsHepatocytesHofbauer cellsHorizontal cellsInhibitory neuronsIntestinal goblet cellsIonocytesKupffer cellsLangerhans cellsLate spermatidsLeydig cellsMacrophagesMelanocytesMicroglial cellsMonocytesMucus glandular cellsMuller glia cellsNK-cellsOligodendrocyte precursor cellsOligodendrocytesPancreatic endocrine cellsPaneth cellsPeritubular cellsPlasma cellsProstatic glandular cellsProximal enterocytesProximal tubular cellsRespiratory ciliated cellsRod photoreceptor cellsSalivary duct cellsSchwann cellsSerous glandular cellsSertoli cellsSkeletal myocytesSmooth muscle cellsSpermatocytesSpermatogoniaSquamous epithelial cellsSuprabasal keratinocytesSyncytiotrophoblastsT-cellsTheca cellsThymic epithelial cellsUndifferentiated cells
Category
Cell type enrichedGroup enrichedCell type enhancedLow cell type specificityNot detectedDetected in allDetected in manyDetected in someDetected in singleIs highest expressed
Cluster
20:Airway & Pancreas - Proteolysis41:Alveolar cells - Lung function63:Astrocytes - Nervous system maintenance62:B-cells - B-cell activation70:Basal prostatic cells - Lipid metabolism35:Bipolar cells - Visual perception30:Breast - Lactation5:Bronchus - Unknown function77:Cardiomyocytes - Muscle contraction56:Ciliated cells - Cilium assembly53:Connective tissue cells - ECM organization28:Cytotrophoblasts - Unknown function57:Early spermatids - Flagellum & Golgi organization49:Early spermatids - Spermatogenesis55:Endocrine cells - Hormone signaling52:Endometrial stromal cells - ECM organization14:Endometrium - Transcription regulation66:Endothelial cells - Angiogenesis50:Enterocytes - Absorption71:Erythroid cells - Oxygen transport54:Extravillous trophoblasts - Unknown function65:Fibroblasts - ECM organization58:Gastric mucus-secreting cells - Digestion46:Granulocytes - Mast cell degranulation17:Granulosa cells - Transcription regulation29:Hepatocytes - Metabolism13:Hepatocytes - Oxidoreductase activity26:Intestinal epithelial cells - Absorption23:Langerhans cells - Immune response51:Late spermatids - Spermatogenesis33:Macrophages - Degranulation69:Macrophages - Innate immune response68:Muller glia cells - Visual perception75:Myeloid cells - Innate immune response9:Neurons - Nervous system development38:Neurons - Neuronal signaling32:Neurons - Synaptic function10:Neurons & Oligodendrocytes - Nervous system development7:NK-cells - Immune response regulation43:Non-specific - Cell proliferation12:Non-specific - Chromatin organization18:Non-specific - Mixed function16:Non-specific - RNA binding64:Non-specific - Transcription39:Non-specific - Translation8:Oligodendrocytes - Myelin sheath organization74:Pancreatic cells - Mixed function44:Photoreceptor cells - Visual perception45:Plasma cells - Humoral immune response48:Plasmacytoid dendritic cells - Unknown function4:Platelets - Platelet activation73:Prostatic glandular cells - Transcription59:Proximal enterocytes - Transmembrane transport60:Proximal tubular cells - Absorption25:Schwann cells & Melanocytes - Mixed function21:Serous glandular cells - Salivary secretion27:Skeletal myocytes - Muscle contraction72:Smooth muscle cells - ECM organization15:Smooth muscle cells - Muscle contraction36:Spermatids - Spermatogenesis24:Spermatids - Unknown function31:Spermatocytes - Spermatogenesis42:Spermatocytes & Spermatids - Spermatogenesis76:Spermatocytes & Spermatogonia - Spermatogenesis47:Spermatogonia - Spermatogenesis22:Squamous epithelial cells - Keratinization3:Suprabasal keratinocytes - Cornification67:Syncytiotrophoblasts - Pregnancy1:T-cells - Immune response2:T-cells - T-cell receptor
Tissue
Adipose subcutaneousAdipose visceralBreastColonHeart muscleKidneyLiverLungPancreasProstateSkeletal muscleSkinStomachTestisThyroid
Cell type
Enrichment
Very highHighModerate
Cancer
Breast cancerCervical cancerColorectal cancerEndometrial cancerGliomaHead and neck cancerLiver cancerLung cancerMelanomaOvarian cancerPancreatic cancerProstate cancerRenal cancerStomach cancerTestis cancerThyroid cancerUrothelial cancer
Prognosis
FavorableUnfavorable
Cancer
AnyBreast cancerCervical cancerColorectal cancerEndometrial cancerGliomaHead and neck cancerLiver cancerLung cancerMelanomaOvarian cancerPancreatic cancerProstate cancerRenal cancerStomach cancerTestis cancerThyroid cancerUrothelial cancer
Category
Cancer enrichedGroup enrichedCancer enhancedLow cancer specificityNot detectedDetected in allDetected in manyDetected in someDetected in singleIs highest expressed
Cell type
AnyBasophilClassical monocyteEosinophilGdT-cellIntermediate monocyteMAIT T-cellMemory B-cellMemory CD4 T-cellMemory CD8 T-cellMyeloid DCNaive B-cellNaive CD4 T-cellNaive CD8 T-cellNeutrophilNK-cellNon-classical monocytePlasmacytoid DCT-regTotal PBMC
Category
Immune cell enrichedGroup enrichedImmune cell enhancedLow immune cell specificityNot detected in immune cellsNot detectedDetected in allDetected in manyDetected in someDetected in singleIs highest expressed
Cell lineage
AnyB-cellsDendritic cellsGranulocytesMonocytesNK-cellsT-cells
Category
Lineage enrichedGroup enrichedLineage enhancedLow lineage specificityNot detectedDetected in allDetected in manyDetected in singleIs highest expressed
Cluster
23:Antigen presenting cells - Antigen presentation21:B-cells - Adaptive immune response43:B-cells - Humoral immune response37:B-cells - Transcription24:B-cells - Unknown function41:Basophils - Cellular respiration46:Basophils - DNA binding38:Basophils - Unknown function18:Basophils - Vesicular transport45:Eosinophils - Innate immune response52:Eosinophils - Transcription49:Eosinophils - Unknown function36:GdT-cells - Adaptive immune response5:Granulocytes - Unknown function16:MAIT-cells - Unknown function25:Monocytes - Inflammatory response51:Monocytes - Innate immune response14:Monocytes - Unknown function28:Myeloid DCs - Unknown function50:Neutrophils - Cellular senescence33:Neutrophils - Chromatin organization8:Neutrophils - Inflammatory response9:Neutrophils - Innate immune response1:Neutrophils - Mixed function15:NK-cells - Transcription48:NK-cells - Unknown function12:Non-specific - Basic cellular processes27:Non-specific - Gene expression31:Non-specific - Inflammatory response26:Non-specific - Mitochondria39:Non-specific - mRNA processing44:Non-specific - Transcription30:Non-specific - Translation47:Plasmacytoid DCs - Protein folding29:Plasmacytoid DCs - Unknown function20:T-cells - T-cell receptor32:T-cells - Unknown function4:T-regs - Cell cycle regulation35:T-regs - Unknown function
Annotation
Immunoglobulin genesIntracellular and membraneSecreted - unknown locationSecreted in brainSecreted in female reproductive systemSecreted in male reproductive systemSecreted in other tissuesSecreted to bloodSecreted to digestive systemSecreted to extracellular matrix
Disease
AnyAcute myeloid leukemiaBreast cancerCervical cancerChronic lymphocytic leukemiaColorectal cancerDiffuse large B-cell lymphomaEndometrial cancerGliomaLung cancerMyelomaOvarian cancerProstate cancer
Location
Actin filamentsAggresomeCell JunctionsCentriolar satelliteCentrosomeCleavage furrowCytokinetic bridgeCytoplasmic bodiesCytosolEndoplasmic reticulumEndosomesFocal adhesion sitesGolgi apparatusIntermediate filamentsKinetochoreLipid dropletsLysosomesMicrotubule endsMicrotubulesMidbodyMidbody ringMitochondriaMitotic chromosomeMitotic spindleNuclear bodiesNuclear membraneNuclear specklesNucleoliNucleoli fibrillar centerNucleoli rimNucleoplasmPeroxisomesPlasma membraneRods & RingsVesicles
Searches
EnhancedSupportedApprovedUncertainIntensity variationSpatial variationCCD protein mitotic structureCCD protein interphaseCell cycle dependent proteinCell cycle independent proteinCell cycle dependent transcriptCell cycle independent transcriptMultilocalizingLocalizing 1Localizing 2Localizing 3Localizing 4Localizing 5Localizing 6Main locationAdditional location
Location
AnyActin filamentsAggresomeCell JunctionsCentriolar satelliteCentrosomeCleavage furrowCytokinetic bridgeCytoplasmic bodiesCytosolEndoplasmic reticulumEndosomesFocal adhesion sitesGolgi apparatusIntermediate filamentsKinetochoreLipid dropletsLysosomesMicrotubule endsMicrotubulesMidbodyMidbody ringMitochondriaMitotic chromosomeMitotic spindleNuclear bodiesNuclear membraneNuclear specklesNucleoliNucleoli fibrillar centerNucleoli rimNucleoplasmPeroxisomesPlasma membraneRods & RingsVesicles
Cell line
AnyA-431A-549AF22ASC52teloBJ [Human fibroblast]CACO-2EFO-21FHDF/TERT166GAMGHaCaTHAP1HBEC3-KTHBF/TERT88HDLM-2HEK293HELHeLaHep-G2HTCEpiHTEC/SVTERT24-BHTERT-HME1HTERT-RPE1HTERT-RPE1 (serum starved)HUVEC/TERT2JURKATK-562LHCN-M2MCF-7NB4OE19PC-3REHRh30RPTEC/TERT1RT-4SH-SY5YSiHaSK-MEL-30SuSaTHP-1U-251MGU2OS
Type
ProteinRna
Phase
G1SG2
Reliability
EnhancedSupportedApprovedUncertain
Cancer type
AnyBile duct cancerBladder cancerBone cancerBrain cancerBreast cancerCervical cancerColorectal cancerEsophageal cancerGallbladder cancerGastric cancerHead and neck cancerKidney cancerLeukemiaLiver cancerLung cancerLymphomaMyelomaNeuroblastomaNon-cancerousOvarian cancerPancreatic cancerProstate cancerRhabdoidSarcomaSkin cancerTestis cancerThyroid cancerUncategorizedUterine cancer
Category
Cancer enrichedGroup enrichedCancer enhancedLow cancer specificityNot detectedDetected in allDetected in manyDetected in someDetected in singleIs highest expressed
Cluster
23:B-cell cancers - Adaptive immune response6:BEWO - Unknown function69:BICR 18 - Unknown function14:Bone cancer - Transcription28:Bone cancer CADO-ES1 - Glutamate signalling65:Breast cancer - Unknown function20:Connective tissue cells - ECM organization2:DU4475 - Unknown function59:Fibroblasts - Metabolism62:Granulocytes - Innate immune response3:HUVEC & TIME - Signal transduction60:Keratinocytes - Epithelial cell function68:Kidney - Mixed function50:L-1236 & L-428 - Unknown function61:Liver - Metabolism35:Liver cancer - Metabolism12:Lymphoid cancers - Adaptive immune response9:Lymphoid cancers - Immune response11:Lymphoma - Adaptive immune response54:Lymphoma - Cytokine signaling64:Lymphoma - Humoral immune response66:Myeloid cells - Innate immune response32:Myeloid leukemia - Oxygen transport51:Myeloma - Humoral immune response26:NCI-H716 - Unknown function21:Neuroblastoma - Neuronal signaling7:Neuronal cell lines - Stereocilium56:Neurons - Neuronal signaling30:Non-specific - Antiviral immune response58:Non-specific - Basic cellular processes45:Non-specific - Cell proliferation41:Non-specific - Cilium assembly40:Non-specific - Enzymes43:Non-specific - Mitochondria67:Non-specific - Mitochondria & RNA binding53:Non-specific - mRNA processing13:Non-specific - Nuclear processes1:Non-specific - Nucleosome assembly15:Non-specific - Protein binding48:Non-specific - RNA binding31:Non-specific - Transcription57:Non-specific - Translation63:Non-specific - Unknown function10:Ovarian & Endometrial cancers - Unknown function37:Ovarian cancer RMG-I - Cellular stress response24:Prostate cancer - Lipid metabolism34:Rabdoid cancer - Embryonic development47:Retina - Visual perception22:Rhabdoid cancers - Neuronal signaling17:RS4;11 - Unknown function42:Sarcoma - Muscle contraction16:Skin cancer - Melanocyte processes33:Skin cancer - Membrane components52:Spermatids - Smell perception19:Stomach & Colon cancer - Absorption27:TE 441.T - Unknown function29:TT & NCI-H1385 - Synaptic signal transduction
Pathway
Acyl-CoA hydrolysisAcylglycerides metabolismAlanine; aspartate and glutamate metabolismAmino sugar and nucleotide sugar metabolismAminoacyl-tRNA biosynthesisAndrogen metabolismArachidonic acid metabolismArginine and proline metabolismAscorbate and aldarate metabolismBeta oxidation of branched-chain fatty acids (mitochondrial)Beta oxidation of di-unsaturated fatty acids (n-6) (mitochondrial)Beta oxidation of di-unsaturated fatty acids (n-6) (peroxisomal)Beta oxidation of even-chain fatty acids (mitochondrial)Beta oxidation of even-chain fatty acids (peroxisomal)Beta oxidation of odd-chain fatty acids (mitochondrial)Beta oxidation of phytanic acid (peroxisomal)Beta oxidation of poly-unsaturated fatty acids (mitochondrial)Beta oxidation of unsaturated fatty acids (n-7) (mitochondrial)Beta oxidation of unsaturated fatty acids (n-7) (peroxisomal)Beta oxidation of unsaturated fatty acids (n-9) (mitochondrial)Beta oxidation of unsaturated fatty acids (n-9) (peroxisomal)Beta-alanine metabolismBile acid biosynthesisBile acid recyclingBiopterin metabolismBiotin metabolismBlood group biosynthesisButanoate metabolismC5-branched dibasic acid metabolismCarnitine shuttle (cytosolic)Carnitine shuttle (endoplasmic reticular)Carnitine shuttle (mitochondrial)Carnitine shuttle (peroxisomal)Cholesterol biosynthesis 1 (Bloch pathway)Cholesterol biosynthesis 2Cholesterol biosynthesis 3 (Kandustch-Russell pathway)Cholesterol metabolismChondroitin / heparan sulfate biosynthesisChondroitin sulfate degradationCoA synthesisCysteine and methionine metabolismDrug metabolismEicosanoid metabolismEstrogen metabolismEther lipid metabolismFatty acid activation (cytosolic)Fatty acid activation (endoplasmic reticular)Fatty acid biosynthesisFatty acid biosynthesis (even-chain)Fatty acid biosynthesis (odd-chain)Fatty acid biosynthesis (unsaturated)Fatty acid desaturation (even-chain)Fatty acid desaturation (odd-chain)Fatty acid elongation (even-chain)Fatty acid elongation (odd-chain)Fatty acid oxidationFolate metabolismFormation and hydrolysis of cholesterol estersFructose and mannose metabolismGalactose metabolismGlucocorticoid biosynthesisGlutathione metabolismGlycerolipid metabolismGlycerophospholipid metabolismGlycine; serine and threonine metabolismGlycolysis / GluconeogenesisGlycosphingolipid biosynthesis-ganglio seriesGlycosphingolipid biosynthesis-globo seriesGlycosphingolipid biosynthesis-lacto and neolacto seriesGlycosphingolipid metabolismGlycosylphosphatidylinositol (GPI)-anchor biosynthesisHeme degradationHeme synthesisHeparan sulfate degradationHistidine metabolismInositol phosphate metabolismIsolatedKeratan sulfate biosynthesisKeratan sulfate degradationLeukotriene metabolismLinoleate metabolismLipoic acid metabolismLysine metabolismMetabolism of other amino acidsMiscellaneousN-glycan metabolismNicotinate and nicotinamide metabolismNucleotide metabolismO-glycan metabolismOmega-3 fatty acid metabolismOmega-6 fatty acid metabolismOxidative phosphorylationPantothenate and CoA biosynthesisPentose and glucuronate interconversionsPentose phosphate pathwayPhenylalanine metabolismPhenylalanine; tyrosine and tryptophan biosynthesisPhosphatidylinositol phosphate metabolismPool reactionsPorphyrin metabolismPropanoate metabolismProstaglandin biosynthesisProtein assemblyProtein degradationProtein modificationPurine metabolismPyrimidine metabolismPyruvate metabolismRetinol metabolismRiboflavin metabolismROS detoxificationSerotonin and melatonin biosynthesisSphingolipid metabolismStarch and sucrose metabolismSteroid metabolismSulfur metabolismTerpenoid backbone biosynthesisThiamine metabolismTransport reactionsTricarboxylic acid cycle and glyoxylate/dicarboxylate metabolismTryptophan metabolismTyrosine metabolismUbiquinone synthesisUrea cycleValine; leucine; and isoleucine metabolismVitamin A metabolismVitamin B12 metabolismVitamin B2 metabolismVitamin B6 metabolismVitamin C metabolismVitamin D metabolismVitamin E metabolismXenobiotics metabolism
Category
Evidence at protein levelEvidence at transcript levelNo human protein/transcript evidence
Score
Evidence at protein levelEvidence at transcript levelNo human protein/transcript evidence
Score
Evidence at protein levelEvidence at transcript levelNo human protein/transcript evidence
Score
Evidence at protein levelEvidence at transcript levelNo human protein/transcript evidence
Validation
SupportedApprovedUncertain
Validation
Enhanced - CaptureEnhanced - GeneticEnhanced - IndependentEnhanced - OrthogonalEnhanced - RecombinantSupportedApprovedUncertain
Validation
Enhanced - IndependentEnhanced - OrthogonalSupportedApprovedUncertain
Validation
Enhanced - GeneticEnhanced - IndependentEnhanced - RecombinantSupportedApprovedUncertain
Antibodies
YesNo
Protein structure
ExperimentalPrediction
In atlas
TissueCellPathologyBrainBlood - conc. immunoassayBlood - conc. mass spectrometryBlood - detected peaDisease - peaDisease - mass spectrometry
Column
GenePositionTissue specific scorePrognosticReliability (IF)Reliability (IH)
| https://www.proteinatlas.org/ENSG00000181903-OR4C6/tissue/thymus |
Institute for Poverty, Land and Agrarian Studies (PLAAS)
Institute for Poverty, Land and Agrarian Studies (PLAAS)
TheInstitute for Poverty, Land and Agrarian Studies (PLAAS)engages in research, training, policy development and advocacy in relation to land and agrarian reform, rural governance and natural resource management. It is committed to social change that empowers the poor, builds democracy and enhances sustainable livelihoods.
Lockdown, resilience and emergency statecraft in the Cape Town food system
Kroll, Florian ; Adelle, Camilla ( Cities , 2022 )
Well before the Covid-19 pandemic, rapidly growing cities of the global South were at the epicenter of multiple converging crises affecting food systems. Globally, government lockdown responses to the disease triggered ...
Life on the land: New lives for agrarian questions
Shattuck, Annie ; Grajales, Jacobo ; Hall, Ruth ( Taylor and Francis Group , 2023 )
The politics of food, climate, energy, and the yet unfinished work ofending colonialism run square through questions of land. Theclassical agrarian question has taken on new forms, and a newintensity. We look at four ...
Intra-party cohesion in Zimbabwe’s ruling party after Robert Mugabe
Zamchiya, Phillan ( Journal of Asian and African Studies , 2023 )
Some mainstream political scientists apply the trilogy of exit, voice and loyalty in studying intra-party cohesion. This approach applies more neatly in liberal than in repressive contexts. I therefore make three modifications ...
Smallholder views on Chinese agricultural investments in Mozambique and Tanzania in the context of VGGTS
Pointer, Rebecca ; Sulle, Emmanuel ; Ntauazi, Clemente ( MDPI , 2023 )
Based on a case study in each country, this study documents the views of Mozambican and
Tanzanian smallholders regarding Chinese agricultural investments and the extent to which investors
abide by their legitimate land ...
Resisting agrarian neoliberalism and authoritarianism: Struggles towards a progressive rural future in Mozambique
Monjane, Boaventura ( Wiley , 2022 )
After nearly two and a half decades with a Land Law widely
considered progressive, Mozambique is preparing to revise
its legal framework for land. Land activists accuse the government
of pursuing an authoritarian approach, ...
Covid-19 Impacts: Household Food Production, Agroecology, Rural Livelihoods and Alternative Food Systems
Building leaders for the UN Ocean Science Decade: A guide to supporting early career women researchers within academic marine research institutions
Shellock, Rebecca J ; Cvitanovic, Christopher ; Isaacs, Moenieba ( Oxford University Press , 2023 )
Diverse and inclusive marine science is now recognized as
essential for addressing the complex and accelerating challenges facing marine social-ecological systems (Blythe and
Cvitanovic, 2020; Lawless et al., 2021). The ...
Changing customary land tenure regimes in Zambia, implications for women’s land rights
Zamchiya, Phillan ; Musa, Chilombo ( Institute for Poverty Land and Agrarian Studies (PLAAS) , 2023-03 )
This paper argues that the formalisation of customary land through a rural certification programme in Nyimba District, Zambia, has triggered the establishment of a new tenure regime that transcends the dualism between ...
Securing Tenure for Customary Land Rights Holders in Southern Africa
Zamchiya, Phillan ( Institute for Poverty Land and Agrarian Studies (PLAAS) , 2023-02 )
The Land and Its People: the land question and the South African political order
Du Toit, Andries ( Institute for Poverty Land and Agrarian Studies (PLAAS) , 2023-03 )
This paper examines the disjuncture between the discourses of policy deliberation and
contentious politics in debates about ‘the land question’ in South Africa. It argues that the South
African land debate as it unfolds ...
Gender, generation and the experiences of farm dwellers resettled in the Ciskei Bantustan, South Africa, ca 1960–1976
Evans, Laura ( Wiley , 2013 )
This paper examines the experiences of farm dwellers resettled in rural townships in theCiskei Bantustan during the decades of the 1960s and 1970s. Drawing on the oraltestimonies of elderly residents ...
South Africa’s Bantustans and the dynamics of “decolonisation”: Reflections on writing histories of the homelands
Evans, Laura ( Taylor and Francis Group , 2012 )
From the late 1950s, as independent African polities replaced formal colonialrule in Africa, South Africa’s white minority regime set about its own policy ofmimicry in the promotion of self-governing homelands, which ...
Zambia’s Customary Landholding Certificate and Tenure Options for Women
Zamchiya, Phillan ; Musa, Chilombo ( Institute for Poverty Land and Agrarian Studies (PLAAS) , 2023-02 )
Women’s Lived Realities Under Customary Tenure in Rural South Africa and Policy Implications
Zamchiya, Phillan ; Lebepe, Shula ( Institute for Poverty Land and Agrarian Studies (PLAAS) , 2023-02 )
Securing Land Tenure for Women and Men Living on Customary Land in Zimbabwe
This policy brief reports on findings from a study investigating the impact of the formalisation of customary land on tenure relations and livelihoods for women and men living in rural Zimbabwe. The research was conducted ...
Securing Land Tenure for Women Under Mozambique’s Land Administration Programme (Terra Segura)
Musa, Chilombo ; Zamchiya, Phillan ; Ntauazi, Clemente ; Noyes, Joana ( Institute for Poverty Land and Agrarian Studies (PLAAS) , 2023-01 )
This policy brief reports findings from a study undertaken by researchers at the Institute for Poverty, Land and Agrarian Studies (PLAAS) at the University of the Western Cape (UWC) investigating the formalisation of ...
More than socially embedded: The distinctive character of ‘communal tenure’ regimes in South Africa and its implications for land policy
Cousins, Ben ( Wiley , 2007 )
This article analyzes debates over tenure reform policy in post-apartheid South Africa, with a particular focus on the controversial Communal Land Rights Act of 2004. Land tenure systems in the ...
The next great Trek? South African commercial farmers move north
Hall, Ruth ( Taylor and Francis Group , 2012 )
This paper analyses the shifting role of South African farmers, agribusiness andcapital elsewhere in the Southern African region and the rest of the continent. Itexplores recent trends in this expansion, and investigates ...
Smallholder Aagriculture and land reform in South Africa
Lahiff, Edward ; Cousins, Ben ( Institute of Development Studies , 2005 )
How canland reformcontribute toa revitalisationof smallholder agriculture inSouthernAfrica?Thisquestion remains important despitenegativeperceptions of land reformas a result of the impactofZimbabwe’s “fast-track” resettlement ...
Institutions and Co-Management in East African Inland and Malawi Fisheries: A Critical Perspective
Nunan, Fiona ; Hara, Mafaniso ; Onyango, Paul ( Elsivier , 2015 )
Institutions matter within natural resource management. While there are many examples of analyses of the nature and influence of institutions within fisheries, there are fewer examples of how institutions inform the practice ...
| https://repository.uwc.ac.za/handle/10566/18 |
Observational study of the development and evaluation of a fertility preservation patient decision aid for teenage and adult women diagnosed with cancer: the Cancer, Fertility and Me research protocol | BMJ Open
Observational study of the development and evaluation of a fertility preservation patient decision aid for teenage and adult women diagnosed with cancer: the Cancer, Fertility and Me research protocol
G L Jones 1 ,
J Hughes 1 ,
N Mahmoodi 1 ,
D Greenfield 2 ,
G Brauten-Smith 3 ,
J Skull 4 ,
J Gath 5 ,
D Yeomanson 6 ,
E Baskind 7 ,
J A Snowden 8 , 9 ,
http://orcid.org/0000-0001-6710-5403 R M Jacques 10 ,
G Velikova 11 ,
K Collins 12 ,
D Stark 13 ,
R Phillips 14 ,
S Lane 15 ,
H L Bekker 16
(On behalf of the Cancer, Fertility and Me research team)
1 Department of Psychology, School of Social Sciences, Leeds Beckett University, City Centre Campus , Leeds , UK
3 Breast Cancer Care , London , UK
4 Jessop Wing, Sheffield Teaching Hospitals NHS Foundation Trust , Sheffield , UK
5 Independent Cancer Patients’ Voice , London , UK
6 Sheffield Children's Hospital NHS Foundation Trust , Sheffield , UK
7 Seacroft Hospital, Leeds Teaching Hospitals , Leeds , UK
8 Department of Haematology, Sheffield Teaching Hospitals NHS Foundation Trust, Royal Hallamshire Hospital, Sheffield
9 Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK
10 School of Health and Related Research, University of Sheffield , Sheffield , UK
11 University of Leeds, St James Hospital, Leeds Teaching Hospitals , Leeds , UK
12 Centre for Health and Social Care Research, Sheffield Hallam University , Sheffield , UK
13 University of Leeds, St James Hospital, Leeds Teaching Hospitals , Leeds , UK
14 Center for Review and Dissemination, University of York, Leeds General Infirmary, Leeds Teaching Hospitals , York , UK
15 Oxford Radcliffe Hospitals NHS Trust , Oxford , UK
16 Leeds Institute of Health Sciences, School of Medicine, University of Leeds , Leeds , UK
Correspondence to Professor GL Jones; [email protected]
Abstract
IntroductionWomen diagnosed with cancer and facing potentially sterilising cancer treatment have to make time-pressured decisions regarding fertility preservation with specialist fertility services while undergoing treatment of their cancer with oncology services. Oncologists identify a need for resources enabling them to support women's fertility preservation decisions more effectively; women report wanting more specialist information to make these decisions. The overall aim of the ‘Cancer, Fertility and Me’ study is to develop and evaluate a new evidence-based patient decision aid (PtDA) for women with any cancer considering fertility preservation to address this unmet need.
Methods and analysisThis is a prospective mixed-method observational study including women of reproductive age (16 years +) with a new diagnosis of any cancer across two regional cancer and fertility centres in Yorkshire, UK. The research involves three stages. In stage 1, the aim is to develop the PtDA using a systematic method of evidence synthesis and multidisciplinary expert review of current clinical practice and patient information. In stage 2, the aim is to assess the face validity of the PtDA. Feedback on its content and format will be ascertained using questionnaires and interviews with patients, user groups and key stakeholders. Finally, in stage 3 the acceptability of using this resource when integrated into usual cancer care pathways at the point of cancer diagnosis and treatment planning will be evaluated. This will involve a quantitative and qualitative evaluation of the PtDA in clinical practice. Measures chosen include using count data of the PtDAs administered in clinics and accessed online, decisional and patient-reported outcome measures and qualitative feedback. Quantitative data will be analysed using descriptive statistics, paired sample t-tests and CIs; interviews will be analysed using thematic analysis.
Ethics and disseminationResearch Ethics Committee approval (Ref: 16/EM/0122) and Health Research Authority approval (Ref: 194751) has been granted. Findings will be published in open access peer-reviewed journals, presented at conferences for academic and health professional audiences, with feedback to health professionals and program managers. The Cancer, Fertility and Me patient decision aid (PtDA) will be disseminated via a diverse range of open-access media, study and charity websites, professional organisations and academic sources. External endorsement will be sought from the International Patient Decision Aid Standards (IPDAS) Collaboration inventory of PtDAs and other relevant professional organisations, for example, the British Fertility Society.
Trial registration numberNCT02753296; pre-results.
Fertility preservation
Cancer
Decision-making
Decision aid
Protocol
This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:http://creativecommons.org/licenses/by-nc/4.0/
http://dx.doi.org/10.1136/bmjopen-2016-013219
Fertility preservation
Cancer
Decision-making
Decision aid
Protocol
Strengths and limitations of this study
To the best of our knowledge, this research will develop the first, open access, evidence-based fertility preservation decision aid that is suitable for women of reproductive age (16 years+) and diagnosed with anycancer.
The research will provide evidence of its acceptability and utility to women and healthcare professionals in usual practice across cancer and fertility care pathways.
The research will provide evidence for the causal assumptions of its effectiveness and issues for implementation in usual care practice.
This research will not provide evidence of its effectiveness on healthcare outcomes. However, our findings will provide the evidence to inform the study design for evaluating the effectiveness of this complex intervention on health outcomes in the future.
Introduction
The impact of cancer treatment on female fertility
Approximately 50% of people in the UK will be diagnosed with cancer at some point in their lifetime.1Owing to rising survival rates, the importance of addressing the late effects of cancer treatment, such as the risk of infertility, has increased.2Chemotherapy, radiotherapy, hormonal, medical and surgical interventions may all affect female fertility. Although, the degree to which chemotherapy and radiotherapy impacts on gonadal function depends on the treatment agent administered, the dose, as well as the woman's age and levels of ovarian reserve at the time,3–5loss of fertility is considered one of the most significant late effects of cancer treatment3and cancer survivors often report it as one of the most distressing outcomes of their cancer treatment.6
The rationale for the study
Women diagnosed with cancer have to make time-pressured decisions about fertility preservation while simultaneously planning their cancer treatment. These decisions are stressful as women are having to trade-off the immediate consequences of starting cancer treatment with the long-term chances of having a biological child in the future, post cancer treatment. For those contemplating fertility preservation, women are required to move between two medical services (oncology and fertility services) to make care planning decisions collaboratively with fertility preservation and cancer teams.
In the initial stages of treatment for cancer, the American Society of Clinical Oncology and the American Society for Reproductive Medicine recommend options to preserve fertility which are discussed with each patient of reproductive age about to undergo cancer treatment which may affect their fertility.7 ,8The current National Institute for Clinical Excellence (NICE) pathway for preserving fertility in people diagnosed with cancer presents similar guidelines for the UK.9However, the evidence suggests that many women do not feel well supported in their choices, with many missing out on having fertility preservation at this crucial time. A recent UK survey by Breast Cancer Care found that as little as 12% of 170 women were referred to a fertility consultant, with many being unaware that infertility was a consequence following chemotherapy.10
Evidence from the medical and psychological literature examining aspects of fertility, pregnancy and decision-making following a cancer diagnosis have identified a range of factors which may hinder decision-making for this patient population.11–25The barriers identified are diverse including financial concerns (especially in those countries where fertility preservation is not covered by insurance), fear associated with aggravating a hormone-sensitive cancer or a future pregnancy (in terms of a cancer recurrence and/or implications for the health of a future child) and lack of referral to fertility services (eg, due to reasons such as the oncologist prioritising cancer survival).
However, lack of fertility preservation information is also a key reason cited. The need for more evidence-based information that is integrated into the cancer care pathway early, and prior to transition to fertility services, has been identified as an important factor to facilitate women's decision-making at this time.26 ,27It has been found that oncologists lack specific fertility preservation information for patients, and have only moderate confidence in their knowledge about fertility and the preservation options available.28Therefore, they have also expressed the need for more evidence-based fertility preservation information to enable them to support women's decision-making more effectively.29
Patient decision aids
Patient decision aids (PtDAs) are information resources supporting people to make decisions between healthcare options.30They are evidence-based resources, drawing on clinical effectiveness of healthcare options data, studies of patients' decision-making and illness experiences and evidence from the decision sciences on how people make healthcare choices.31PtDAs support people to make reasoned decisions, that is, ones based on accurate information about the consequences of all options, in accordance with their beliefs, and trade-offs between their treatment preferences.32–34Compared with usual care, receiving a PtDA helps people participate with their health professionals in making personalised choices between healthcare options.32 ,33They have been shown to improve patients' knowledge of the risks and benefits of options, value of consequences to their lives and efficacy in making informed decisions.30
While there are many fertility preservation resources publically available for women with cancer,35few exist to support the fertility preservation decision process in women of reproductive age.35Of those publishing their development studies, two PtDAs were designed for women with breast cancer specifically, and none for women in the UK,36 ,37despite women with a range of different cancers facing fertility preservation treatment decisions. It is therefore likely a new PtDA supporting women diagnosed with anycancer to make fertility preservations decisions will meet patient, service and practice needs.25 ,26 ,35
Aims and objectives
The aim of this research is to develop a fertility preservation PtDA enabling cancer and fertility services to support effectively women's fertility preservation decisions following a diagnosis of any cancer type.
Our objectives are to:
develop a PtDA for use by oncology and haematology teams to support women making fertility preservation choices, while having a recent cancer diagnosis;
assess the face validity of the PtDA to support women making informed decisions about fertility preservation before starting their cancer treatment and
evaluate the acceptability of the PtDA using qualitative and quantitative methods to 1) women making fertility preservation decisions while planning their cancer treatment and 2) oncology, haematology and fertility health professionals supporting women's cancer and fertility treatment choices.
Evaluation of the PtDA should enable us to determine whether the provision of a PtDA early in the cancer care pathway better supports women, especially in the stressful intervening period between planning their cancer treatment and referral to the fertility expert. We also anticipate that the provision of this PtDA will enable women to make more informed fertility preservation treatment decisions, have more focused consultations with the fertility experts and a better opportunity to ask the right questions for them at the right time.
Methods and analysis
All aspects of the research are discussed with the steering group, and all stakeholders comment on all the materials. There has been patient and public involvement in the development of the research protocol and initial needs assessment. The PtDA is being developed across two regional cancer (adult, and teenage and young adult services) and fertility centres in Yorkshire. Ethics approval was granted on 5 April 2016.
Design
The Cancer, Fertility and Me PtDA was developed over a year using systematic and evidence-based methods (table 1—stages 1 and 2).33 ,38 ,39A prospective, observational study using interview and questionnaire methods to evaluate the PtDA will be conducted (table 1—stage 3) informed by Medical Research Council Guidance for Developing Complex Interventions.40
Table 1
The three stages of the Cancer, Fertility and Me study
Stage 1: Development of the PtDA (November 2015—July 2016)
Stage 1 has used evidence to develop a PtDA supporting women to make informed decisions about fertility preservation options before starting cancer treatment. This will be for use alongside usual cancer and fertility care pathways.
The PtDA has used guidance from the International Patient Decision Aid Standards (IPDAS) collaboration34on balance of options,41 ,42risk presentation,43–45eliciting values,46 ,47use of patient stories,30enabling readability48and understanding illness.49 ,50The guidance helps information to be structured so that it encourages people to evaluate all decision options, and their consequences, in accordance with their values and without bias, thus, enabling decision-making to be based on their trade-offs between these evaluations, that is, to make a reasoned decision.34
The aim is for women to receive the PtDA from their cancer health care professionals as part of usual care during the patient's first consultation to discuss cancer and/or fertility treatment options (this could be at cancer diagnosis), before referral to fertility services. The PtDA is being disseminated as a leaflet and PDF on a website, and evaluated accordingly. The content of the PtDA will be informed by evidence from the following:
Clinical guidelines on infertility and cancer prognosis, risks and benefits of cancer and fertility preservation treatment.8–9 ,35
Systematic narrative review of women's values, treatment preferences and decision-making experiences about fertility preservation when diagnosed with cancer, completed in June 2016. This was carried out as part of the previous PreFer study which was a 3-year mixed-methods prospective study exploring fertility preservation decision-making and quality of life in women with cancer.25
Environmental scan using systematic methods to synthesise evidence about open access resources for women with cancer about fertility preservation (patient information and clinical guidelines) and critically evaluate their ability to support informed decision-making, completed in May 2016.35
Observations of local service delivery, referral pathways within and across services and integration of research practices across regional National Health Service (NHS) centres for cancer and infertility services, completed by June 2016.
Regular meetings with the study steering group to decide the content and design of the PtDA. During this time web and graphic designers were involved in developing the PtDA's identity for use in health and patient forums, completed by July 2016.
Stage 2: Face validity study (July 2016–December 2016)
Stage 2 assesses the face validity of the PtDA for stakeholders. During the development of decision aids, this process is sometimes referred to as Learner Verification (LV).51The aim is to assess the PtDA across stakeholders for attractiveness, comprehension, cultural acceptability, self-efficacy and persuasion.52 ,53
Sample
A purposive sample of eligible women and health professionals will be invited to participate from the study sites. All women of reproductive age (16 years +), diagnosed with any cancer and undergoing or has undergone cancer treatment(s) which may impact fertility will be eligible. The sample of health professionals will consist of adult and paediatric oncologists and haematologists, cancer surgeons, cancer nurse specialists and fertility specialists (clinicians, nurses and counsellors).
There is no statistical guidance for undertaking LV methods using qualitative methods. Prior literature and our research experience suggest a sample size of 20 participants in total across both sites to be appropriate.54Therefore, 10 women and 10 health professionals from the two clinical centres will be invited to participate. In addition to the 20 participants, women and key health professionals will be invited to participate from relevant user groups/forums and professional organisations identified by the Cancer, Fertility and Me steering group and our systematic reviews (eg, National Cancer Research Initiative, Breast Cancer Care and British Fertility Society among others).
Recruitment
To recruit the women to stage 2, the nurses/clinicians will make the initial approach (for those women recruited from the two clinical centres). For the women recruited through the service user groups/forums, the lead contacts for the service user groups will make the initial approach. Following this, the contact details of the interested women will be passed to a trained researcher and those willing to participate will be sent the PtDA and associated documents to review by post. Recruitment of health professionals will be obtained from the study sites and through purposive and snowball sampling for the key stakeholders. The PtDA will be sent by post or via a PDF online depending on the request of the health professional. Appropriate consenting procedures and guidelines prescribed by the British Psychological Society55and NHS research protocols will be followed.
Data collection
All the women and health professionals will be asked to complete a study questionnaire which includes the LV questionnaire, and the Preparation for Decision-making questionnaire.56The LV questionnaire will consist of four items taken from the QQ-10,57but will also comprise of three open-ended questions relating to the acceptability and utility of the PtDA from women's and health professional's perspective. The Preparation for Decision-making scale56is a 10-item measure which assesses an individual's perception of how useful a PtDA is in preparing the respondent to communicate with their practitioner at a consultation focused on making a health decision. High scores on the overall scale (range 0–100) indicate higher perceived levels of preparation for decision-making.
Second, all the health professionals and women who completed the questionnaire and consent form, will be asked to take part in a follow-up telephone interview. An interview schedule will be used to seek their feedback and understanding of the purpose of the PtDA and study measures.51 ,53Interviews will be audio recorded, digitalised and transcribed for analysis.
Data analysis
Telephone interviews will be coded and managed using NVivo 10 qualitative data analysis software. Analysis will use a practical, thematic approach outlined by Braun and Clarke58using a systematic five-step approach: familiarisation, generating initial codes, searching for themes, reviewing themes and defining and naming themes.
Stage 3: Evaluation study (January 2017–May 2018)
Stage 3 evaluates the acceptability, feasibility and usefulness of the PtDA in clinical practice with women and health professionals. The study design employs mixed methods, using quantitative (stage 3a) and qualitative methods (stage 3 b).
Stage 3a Quantitative sample
All women receiving a new diagnosis of cancer from two regional centres will be eligible for participation. Inclusion criteria are women of a reproductive age (16 years +) with a new diagnosis of any cancer, and facing cancer treatment(s) with curative intent, which may impact fertility. We anticipate that the majority will be women with breast cancer, although women with lymphoma and leukaemia, head and neck cancers and cervical cancers are also likely to be represented in this research. From the results of our previous PreFer study,13we have found that ∼90 women, across both hospital sites, aged between 16 and 40 years are diagnosed with cancer and face chemotherapy treatment annually and are eligible to receive the new PtDA. We identified around 17% of women from this group do not wish to consider fertility preservation as they already have children or never wanted children. During the 12-month period we hope to recruit ∼78 women in total, taking into account a 20% non-response rate from our previous data. Using a paired t-test to compare the outcome measures before and after the implementation of the PtDA, with 78 participants, we have 80% power at 5% two-sided significance to detect a minimum standardised effect size of 0.32.
Stage 3a Quantitative recruitment
We will adopt the ‘referral model’ for implementing the PtDA59that is, the PtDA will be mentioned and discussed by their healthcare professional with any woman fitting the eligibility criteria during the patient's first consultation to discuss treatment options. The referral model proposes that these tools are ‘adjuncts’ that support decision-making, when used ahead of visits, or shortly afterwards.59Eligible women will be invited to participate by the researchers working with the clinical care team, immediately following this consultation.
Stage 3a Quantitative data collection
Quantitative data will be collected at three time-points (figure 1). Questionnaire packs will be given to women at the same time as the PtDA (baseline); the timing of their attendance at the fertility clinic or cancer treatment starting point if not going to fertility services (time 1) and after their first session of chemotherapy (time 2a). The measures chosen for this study have been decided on following recommended guidance from the Patient Decision Aid International Research Group,60and will assess the use of the PtDA and decisional preparedness.
Figure 1
Process flow chart for stage 3 evaluation study.
Baseline: questionnaire pack includes: The State Trait Anxiety Inventory—STAI-6,61the EuroQol five dimensions questionnaire (EQ-5D),62the Stage of Decision-making63and the Decisional Conflict Scale.64Women are instructed not to open and read the PtDA (or access it online) until they have completed the questionnaires.
The State Trait Anxiety Inventory—6 item45is a brief 6-item version used to measure of state anxiety. All items are rated on a 4-point scale (1-Almost never, 4-Almost always). Higher scores indicate greater anxiety. The EQ-5D62is a standardised instrument for use as a measure of health outcome. It consists of five dimensions: mobility, self-care, usual activities, pain/discomfort and anxiety/depression. Each dimension has three levels: no problems, some problems and extreme problems. The Stage of Decision-making63is a 6-category tool to assess the individual's readiness to engage in decision-making, progress in making a choice and receptivity to considering or reconsidering options. The tool is rated on a 6-point scale (1-not thinking about it at all; 6-considered the options). The Decisional Conflict Scale64is a 16-item scale which measures the patient's reported experience of making a reasoned and/or conflicted decision.
Scores >37.5 on the overall scale (range 0–100) indicate high decisional conflict, which is characterised by decision delay and/or uncertainty about decision.
Time 1: Questionnaire pack includes: the STAI-6,45the Stage of Decision-making63and the Preparation for Decision-making.56
Time 2a: Questionnaire pack includes: the STAI-6,45the Stage of Decision-making63and the Decisional Conflict Scale.64
Stage 3a Quantitative data analysis
We will report summary statistics for the count data and other service indicators. For the decisional outcome measures and other patient-reported outcomes we will use paired sample t-tests to calculate mean change in scores from baseline to time 1 and from baseline to time 2. 95% CIs for the mean changes will also be calculated. All statistical tests will be two-tailed with significance determined at p≤0.05.
Stage 3b Qualitative sample
Qualitative, semistructured interviews with a purposive sample of ∼30 women from the stage 3a evaluation (15 women from each site) and 30 health professionals including cancer surgeons, adult and paediatric oncologists and haematologists, nurse specialists and fertility experts (15 from each site) will be carried out. The purpose of the interviews are to gain a deeper sight into service user and healthcare professionals experiences of using the PtDA and its impact on the decision- making process and clinical care, within the context of this complex intervention.40Although a total of ∼30 interviews are estimated, this will be guided by data saturation, following established protocols in qualitative research.58 ,65 ,66
Stage 3b Qualitative recruitment
The sample will consist of the women recruited into the stage 3 quantitative study, and the clinical sample will be obtained through snowball sampling methods. Women and health professionals will be issued with a study pack, including a study information sheet and the PtDA. On the day of the interview, an interview consent form will be completed. As shown in
Figure 1, the interview with women and the health professionals will be carried out after the first round of chemotherapy has been completed (time 2b) at a place that is most preferred.
Stage 3b Qualitative data collection
The interview schedule will comprise of the telephone interview LV schedule used in stage 2, with additional open-ended questions to add depth and breadth to the interpretation of the quantitative results enabling further insight into their experiences. It will also focus on LV and the PtDAs clarity and usefulness in planning care and making decisions between treatment options. However, additional areas we will explore include the PtDAs likelihood of use, barriers to use in practice, whether or not the women and health professionals benefit from their delivery, usefulness of the PtDA in aiding service transition and how the women used the PtDA.
All interviews will be audio-recorded and transcribed verbatim for analysis. Following the interview, the women will be given a final study pack questionnaire to complete, which comprises of the EQ-5D62and the Decisional Regret Scale.67The Decisional Regret Scale is a brief five-item scale which measures ‘distress or remorse after a health care decision’ using a 5-point Likert scale (1- strongly agree; 5- strongly disagree). A score of 0 on the overall scale (range 0–100) indicates no regret; scores of 100 mean high regret.
Stage 3b Qualitative data analysis
Interviews will be coded and managed using NVivo 10. Framework analysis will be carried out to identify recurrent themes which have been specifically developed for applied health and policy research.68Independent analysis of the transcribed data by members of the study team and steering group will take place. Interdisciplinary analysis meetings will include critical appraisal of the literature, systematic data and coding framework verification and challenging of interpretive analysis. We will map the data against the themes identified from the existing literature as well as allow new themes to emerge. We will adhere to established quality criteria for qualitative research.58 ,65 ,66
Other questionnaires and outcome measures
Demographic information about women's age, ethnicity, employment and treatment status will be collected through a questionnaire during stage 2 (face validity) and at stage 3 baseline. Demographic information about health professionals will also be collected through a questionnaire, during stage 2 and at stage 3 (time 2b). Details of patients' cancer treatment(s) will be recorded at the end of the study using a study ‘cancer treatment proforma’. This proforma has been ethically approved and used to record the cancer treatment details in the previously mentioned PreFer Study.26
Count data will be collected of the number of PtDAs given to women and health professionals, counts of use and number of clicks on the ‘Cancer, Fertility and Me’ website and downloads of the online PDF version will be recorded. In addition, we will record length of oncology, haematology and fertility consultations and length of time to fertility and cancer treatment. Using count data is a common method for evaluating a decision aid.69
Ethics and dissemination
Ethical considerations
Written, signed consent will be obtained from all participants. Issues particularly pertinent to this study will include participants' right to withdraw from the research process, informed consent and their right to confidentiality and anonymity. Usual NHS care will be provided by the health professionals involved, which includes referral to support and counselling services available within the oncology, haematology and fertility services at the NHS study sites, if any of the women wish. In line with good practice, across both sites, the young women aged 16–17 years and their parents/guardians will be asked to sign for consent.
Dissemination
This research will involve rigorous methods and evaluation in a clinical context.40The multidisciplinary and collaborative nature of this proposal will enable us to disseminate the research and its milestones to the study participants and into the NHS and wider healthcare community through a variety of local, national and international channels regularly throughout the duration of this research.
During the development and evaluation phases of the research, we are engaging with patients and the public through the North Trent Consumer Research Panel group, NHS England's Patient Involvement Team, International Cancer Patient Voices, the service user
research partnership of Breast Cancer Care as well as presenting our findings at INVOLVE national conferences. A study website is currently under development (http://www.leedsbeckett.ac.uk/cancerfertilityandme.ac.uk).
It will be used to provide an evidence-based portal on the study, team and links with our international partners. It will enable access to the web-based version of the instrument and provide two-way links into other relevant organisations, charities signposted on our webpage and the other social media planned to be used in the study, for example, twitter/blogs. We plan to impact the academic and clinical community more widely through conference presentations and publications in peer-reviewed journals that are open access.
Findings on the quality of the PtDA and study outcomes will be used to provide feedback to health professionals and programme managers. Audit and feedback is an effective intervention for changing the behaviour of health professionals (Cochrane Effective Practice and Organisation of Care Group). The study will be widely and regularly disseminated throughout its duration.
We will develop links with NHS England patient information teams and other UK and international bodies who endorse patient education materials for use/dissemination by service teams. We will also seek assessment by the international criteria of PtDAs to be included in their A to Z inventory.60
The primary output of this study will be the final version of the PtDA. Once evaluated, it will be promoted widely and made available free through a diverse range of media (ie, social and print), charity websites, professional organisations, academic sources and posted to all key stakeholders and participants.
Discussion
It is anticipated that this research will provide evidence about the effectiveness of a PtDA to support cancer patients' decision-making in relation to fertility preservation. Currently, fertility preservation PtDAs for women of reproductive age only exist to support women with breast cancer. A unique feature of this research is that we hope to provide evidence that one open-access PtDA can be used effectively across a range of women's cancer types. Another strength of this research is that it will be administered early into the cancer care pathway, thus providing clinical cancer care teams with an evidence-based resource to provide to all women diagnosed with cancer, therefore meeting a current unmet need. It is anticipated that this will encourage more cancer specialists to have fertility related discussions with women, help raise fertility awareness and provide a resource that will improve the care, support and management of the women.
While this might result in more women choosing to see the fertility expert (Breast Cancer Care alone estimated that around 5000 women per year who should be having this consultation are missing out), it should also reduce the number of women with cancer who are inappropriately referred for fertility preservation and unsuitable for this treatment.
In trying to create a resource that is suitable for women with any cancer, this undoubtedly creates a number of challenges (in terms of synthesising the evidence on cancer treatment on female reproduction and the fertility preservation choices available). We have tried to prepare for this and included an extensive face validity stage during which the PtDA will undergo review from a large number of patients, service users and key stakeholders from a variety of oncology and fertility specialities.
The overall aim of the ‘Cancer, Fertility and Me’ study is to develop and evaluate a new evidence-based PtDA for women with any cancer considering fertility preservation. The data generated as part of this study should help us identify factors associated with its implementation in practice, and/or integration in care. During its evaluation, the cancer care clinical teams will hand out information about the study and the PtDA. We will capture data on the acceptability of this method of integration within care from the clinical teams. It may be our clinical teams think a short skills training session on using our PtDA within cancer and fertility services will support its implementation in usual practice. It is likely future research evaluating our PtDA's impact on health outcomes may therefore also need to include an assessment of shared decision-making training within an implementation study's process evaluation.
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Footnotes
ContributorsGLJ conceived the idea, secured funding and is the chief investigator. The first REC approval was made by GLJ. GLJ, JH, HLB, KC, DG, JAS, GV, GB-S, RMJ, JG provided intellectual input into the protocol for the grant application. GLJ, JH, HLB, NM, KC, DG, GV, GB-S, RMJ, JAS, EB, DY, SL, DS, JG, SL, RP provided intellectual input and study design for the final protocol of the study.
FundingThis work is funded by Yorkshire Cancer Research, grant number (S391).
Competing interestsNone declared.
Ethics approvalThe study protocol was approved by the East Midlands NHS Research Ethics for the Protection of Persons of Bordeaux University (approval number 2015-A00778-41). It was also approved by the National Commission for Data Processing and Freedoms (approval number 1838811).
Provenance and peer reviewNot commissioned; externally peer reviewed.
| https://bmjopen.bmj.com/content/7/3/e013219 |
v>>VV>LLi`V>i*> >`- *]>ivi>>iV>
with the SHBP vendor or change drug stores. U
iVii`i}>`}L>>iV>
24
important notice
decision guide 2008
October 1, 2007
Two Peachtree Street Atlanta, GA 30303 {{xUnn
Important Notice from the SHBP for Medicare
Eligible Members
About Your Prescription Drug Coverage with BlueChoice HMO, BlueCross BlueShield Lumenos HRA, Kaiser Permanente, Indemnity, PPO, UnitedHealthcare Choice HMO, UnitedHealthcare Definity HRA and Medicare
For Plan Year: January 1December 31, 2008
Please read this notice carefully and keep it where you can find it. This notice has information about your current prescription drug coverage with the SHBP and about your options under Medicare's prescription drug coverage. This information can help you decide whether or not you want to join a Medicare drug plan. Information about where you can get help to make decisions about your prescription drug coverage is at the end of this notice.
1. Medicare prescription drug coverage became available in 2006 to everyone with Medicare. You can get this coverage if you join a Medicare Prescription Drug Plan or join a Medicare Advantage Plan (like an HMO or PPO) that offers prescription drug coverage. All Medicare drug plans provide at least a standard level of coverage set by Medicare. Some plans may also offer more coverage for a higher monthly premium.
2. The SHBP has determined that the prescription drug coverage offered by BlueChoice HMO, i
i-i`i,]>i*i>ii]`i]**"]1i`i>V>i
Choice HMO and UnitedHealthcare Definity HRA Options under SHBP are, on average for all plan participants, expected to pay out as much as standard Medicare prescription drug coverage pays and is considered Creditable Coverage.
Because your existing coverage is, on average, at least as good as standard Medicare prescription drug coverage, you can keep this coverage and not pay a higher premium (a penalty) if you later decide to join a Medicare drug plan.
You can join a Medicare drug plan when you first become eligible for Medicare and each year from November 15th through December 31st. This may mean that you may have to wait to join a Medicare drug plan and that you may pay a higher premium (a penalty) if you join later. You may pay that higher premium (a penalty) as long as you have Medicare prescription drug coverage. However, if you lose creditable prescription drug coverage, through no fault of your own, you will be eligible for a sixty (60) day Special Enrollment Period (SEP) because you lost creditable coverage to join a Part D plan. In addition if you lose your SHBP coverage, you will be eligible to join a Part D plan at that time using an Employer Group Special Enrollment Period. You should compare your current coverage, including which drugs are covered at what cost, with the coverage and costs of the plans offering Medicare prescription drug coverage in your area.
If you decide to join a Medicare drug plan, your SHBP coverage will be affected. See below for more information about what happens to your current coverage if you join a Medicare drug plan.
If you elect Part D and keep your SHBP coverage under BlueChoice HMO, BlueCross BlueShield i,]>i*i>ii]`i]**"]1i`i>V>i
Vi">` UnitedHealthcare Definity HRA Options, these plans will coordinate with Part D coverage.
important notice
25
decision guide 2008
If you do decide to join a Medicare drug plan and drop your BlueChoice HMO, BlueCross i-i`i,]>i*i>ii]`i]**"]1i`i>V>i
Vi"
UnitedHealthcare Definity HRA coverage, be aware that you and your dependents will not be able to get your SHBP coverage back. You should also know that if you drop or lose your coverage with SHBP and don't join a Medicare drug plan within 63 continuous days after your current coverage ends, you may pay a higher premium (a penalty) to join a Medicare drug plan later.
If you go 63 continuous days or longer without prescription drug coverage that's at least as good as Medicare's prescription drug coverage, your monthly premium may go up by at least 1% of the base beneficiary premium per month for every month that you did not have that coverage. For example, if you go nineteen months without coverage, your premium may consistently be at least 19% higher than the base beneficiary premium. You may have to pay this higher premium (a penalty) as long as you have Medicare prescription drug coverage. In addition, you may have to wait until the following November to join.
For More Information about this Notice or Your Current Prescription Drug Coverage...
Contact the SHBP Call Center at (404) 656-6322 or (800) 610-1863 for further information. NOTE: You'll get this notice each year. You will also get it before the next period you can join a Medicare drug plan, and if your SHBP coverage changes. You also may request a copy.
For More Information about Your Options under Medicare Prescription Drug Coverage...
More detailed information about Medicare plans that offer prescription drug coverage is in the Medicare & You handbook. You will get a copy of the handbook in the mail every year from Medicare. You may also be contacted directly by Medicare drug plans. For more information about Medicare prescription drug coverage:
U6i`V>i}
U
>->ii>>Vi>Vi*}>iii`iL>VVivVvi Medicare & You handbook for their telephone number) for personalized help
U
>n
, n{//9i`V>n{n{n
If you have limited income and resources, extra help paying for Medicare prescription drug coverage is available. For information about this extra help, visit Social Security on the web at www.socialsecurity.gov, or call them at 1-800-772-1213 (TTY 1-800-325-0778).
Remember: Keep this Creditable Coverage notice. If you decide to join one of the Medicare drug plans, you may be required to provide a copy of this notice when you join to show whether or not you have maintained creditable coverage and whether or not you are required to pay a higher premium (a penalty).
Date: October 1, 2007 Name of Entity/Sender: State Health Benefit Plan Office: Call Center Address: P. O. Box 38342, Atlanta, GA 30334 Phone Number: (404) 656-6322 or (800) 610-1863
26
important notice
decision guide 2008
Two Peachtree Street Atlanta, GA 30303 {{xUnn
October 1, 2007
Important Notice from the SHBP for
Medicare Eligible Members
About Your Prescription Drug Coverage with the High Deductible Health Plan and Medicare
For Plan Year: January 1December 31, 2008
Please read this notice carefully and keep it where you can find it. This notice has information about your current prescription drug coverage with the State Health Benefit Plan (SHBP) and about your options under Medicare's prescription drug coverage. This information can help you decide whether you want to join a Medicare drug plan. Information about where you can get help to make decisions about your prescription drug coverage is at the end of this notice.
1. Medicare prescription drug coverage became available in 2006 to everyone with Medicare. You can get this coverage if you join a Medicare Prescription Drug Plan or join a Medicare Advantage Plan (like an HMO or PPO) that offers prescription drug coverage. All Medicare drug plans provide at least a standard level of coverage set by Medicare. Some plans may also offer more coverage for a higher monthly premium
2. The SHBP has determined that the prescription drug coverage under the High Deductible Health Plan (HDHP) Option, is, on average for all plan participants, NOT expected to pay out as much as standard Medicare prescription drug coverage pays and is considered NonCreditable Coverage. This is important, because most likely, you will get more help with your drug costs if you join a Medicare drug plan, than if you only have prescription drug coverage through the HDHP offered by the SHBP
3. You have decisions to make about Medicare prescription drug coverage that may affect how much you pay for that coverage, depending on if and when you join. Read this notice carefully as it explains your options
Consider joining a Medicare drug plan. You can keep your HDHP coverage offered by the SHBP. You can keep the coverage regardless of whether it is as good as Medicare drug plan. However, because your existing coverage is, on average, NOT at least as good as standard Medicare prescription drug coverage, you may pay a higher premium (a penalty) if you later decide to join a Medicare drug plan.
You can join a Medicare drug plan when you first become eligible for Medicare and each year from November 15th through December 31st. This may mean that you may have to wait to join a Medicare drug plan and that you may pay a higher premium (a penalty) if you join later. You may pay that higher premium (a penalty) as long as you have Medicare prescription drug coverage. However, if you lose *Vi>}i`ii- *Lii}Li>*> >>>i}> Employer Group Special Enrollment Period.
You Need to Make a Decision
When you make your decision, you should compare your current coverage, including which drugs are covered, with the coverage and cost of the plans offering Medicare prescription drug coverage in your area. If you decide to join a Medicare drug plan, your HDHP coverage under SHBP will be affected. See below for more information about what happens to your current coverage if you join a Medicare drug plan.
important notice
27
decision guide 2008
Uvii`V>i*> iLiVii}Livi`V>i*> ]V>ii your HDHP coverage even if you elect Part D and the HDHP will coordinate benefits with Part D coverage.
Uv``iV`i>i`V>i`}>>`` *Vi>}i`i- *]Li aware that you and your dependents will not be able to get your SHBP coverage back.
U9`>>v`i *Vi>}i- *>``> Medicare drug plan within 63 continuous days after your current coverage ends, you may pay a higher premium (a penalty) to join a Medicare drug plan later.
Uv}V`>}iiV`}Vi>}i>>i>>}`> Medicare's prescription drug coverage, your monthly premium may go up by at least 1% of the base beneficiary premium per month for every month that you did not have that coverage. For example, if you go nineteen months without coverage, your premium may consistently be at least 19% higher than the base beneficiary premium. You may have to pay this higher premium (penalty) as long as you have Medicare prescription drug coverage. In addition, you may have to wait until the following November to join.
For More Information about this Notice or Your Current Prescription Drug Coverage...
Contact the SHBP Call Center at (404) 656-6322 or (800) 610-1863 for further information. NOTE: You will get this notice each year. You will also get it before the next period you can join a Medicare drug plan, and if your SHBP coverage changes. You also may request a copy.
For More Information about Your Options under Medicare Prescription Drug Coverage...
More detailed information about Medicare plans that offer prescription drug coverage is in the Medicare & You handbook. You will get a copy of the handbook in the mail every year from Medicare. You may also be contacted directly by Medicare drug plans. For more information about Medicare prescription drug coverage:
U6i`V>i}
U
>->ii>>Vi>Vi*}>iii`iL>VVivVvi Medicare & You handbook for their telephone number) for personalized help
U
>n
, n{//9i`V>n{n{n
If you have limited income and resources, extra help paying for Medicare prescription drug coverage is available. For information about this extra help, visit Social Security on the web at www.socialsecurity.gov, or call them at 1-800-772-1213 (TTY 1-800-325-0778).
Date: October 1, 2007 Name of Entity/Sender: State Health Benefit Plan Office: Call Center Address: P. O. Box 38342, Atlanta, GA 30334 Phone Number: (404) 656-6322 or (800) 610-1863
decision guide 2008
28
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decision guide 2008
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Health Insurance Portability And Accountability Act (HIPAA) Annual Notice
This section describes certain rights available to you under the Health Insurance Portability and Accountability Act (HIPAA) when you add a dependent to your SHBP coverage.
The PPO, PPO CCO and Indemnity Options contain a pre-existing condition (PEC) limitation. Specifically, the Health Plan will not pay charges that are over $1,000 for the treatment of any pre-existing condition during the first 12 months of a patient's coverage, unless the patient gives satisfactory documentation that he or she has been free of treatment or medication for that condition for at least six consecutive calendar months. However, a preexisting condition limitation does not apply to coverage for:
U*i}>V
U iLV`i`i>}in>i>`i`>Vi`v>`]viV` becomes covered within 31 days after birth, adoption or placement for adoption.
In certain situations, SHBP dependents can reduce the 12-month pre-existing condition limitation period. The reduction is possible by using what is called "creditable coverage" to offset a pre-existing condition period. Creditable coverage generally includes the health coverage a family member had immediately prior to joining the SHBP. Coverage under most group health plans, as well as coverage under individual health policies and governmental health programs, qualifies as creditable coverage.
To reduce the pre-existing condition limitation period for your dependents (including your spouse), you must provide the SHBP with a certificate of creditable coverage stating when coverage started and ended for each dependent that you want to cover. Any period of prior coverage for that dependent will reduce the 12-month limitation period if no more than 63 days have elapsed between the dependent's loss of prior coverage and the first day of coverage under the SHBP.
If your dependent (including a spouse) had any break in coverage lasting more than 63 days, your dependent will receive creditable coverage only for the period of time after the break ended.
Within two years after your dependent's former coverage terminated, he or she has the right to obtain a certificate of creditable coverage from his or her former employer(s) to offset the preexisting condition limitation period under the SHBP. The SHBP will evaluate the certificate of creditable coverage or other documentation to determine whether any of the pre-existing condition limitation period will be reduced or eliminated. After completing the evaluation, the SHBP will notify you as to how the pre-existing condition limitation period will be reduced or eliminated.
Please submit the certificate of creditable coverage to the Plan with your dependent's enrollment paperwork.
decision guide 2008
32
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Helping Georgians Stay Healthy | https://dlg.usg.edu/record/dlg_ggpd_y-ga-bc900-pe4-bs1-bh4-b2008-belec-p-btext/fulltext.text |
(PDF) Impacts of Hurricanes Irma and Maria on Aedes aegypti Populations, Aquatic Habitats, and Mosquito Infections with Dengue, Chikungunya, and Zika Viruses in Puerto Rico
PDF | Puerto Rico was severely impacted by Hurricanes Irma and Maria in September 2017. The island has been endemic for dengue viruses (DENV) and... | Find, read and cite all the research you need on ResearchGate
Impacts of Hurricanes Irma and Maria on Aedes aegypti Populations, Aquatic Habitats, and Mosquito Infections with Dengue, Chikungunya, and Zika Viruses in Puerto Rico
June 2019
The American journal of tropical medicine and hygiene 100(6):1413-1420
DOI: 10.4269/ajtmh.19-0015
CC BY 4.0
Authors:
Veronica Acevedo
Abstract and Figures
Puerto Rico was severely impacted by Hurricanes Irma and Maria in September 2017. The island has been endemic for dengue viruses (DENV) and recently suffered epidemics of chikungunya (CHIKV 2014) and Zika (ZIKV 2016) viruses. Although severe storms tend to increase the number of vector and nuisance mosquitoes, we do not know how they influence Aedes aegypti populations and arboviral transmission. We compared the abundance of female Ae. aegypti in autocidal gravid ovitraps (AGO traps), container habitats, and presence of RNA of DENV, CHIKV, and ZIKV in this vector before and after the hurricanes in Caguas city and in four communities in southern Puerto Rico. Two of these communities were under vector control using mass AGO trapping and the other two nearby communities were not. We also investigated mosquito species composition and relative abundance (females/trap) using Biogents traps (BG-2 traps) in 59 sites in metropolitan San Juan city after the hurricanes. Mosquitoes sharply increased 5 weeks after Hurricane Maria. Ensuing abundance of Ae. aegypti was higher in Caguas and in one of the southern communities without vector control. Aedes aegypti did not significantly change in the two areas with vector control. The most abundant mosquitoes among the 26 species identified in San Juan were Culex (Melanoconion) spp., Culex quinquefasciatus, Culex nigripalpus, and Ae. aegypti. No arboviruses were detected in Ae. aegypti following the hurricanes, in contrast with observations from the previous year, so that the potential for Aedes-borne arboviral outbreaks following the storms in 2017 was low.
Number of female pupae of Aedes aegypti collected from containers in houses (A) and number of positive containers of each type per 100 houses (Breteau container index) (B) before and after Hurricanes Irma and Maria in Caguas city, Puerto Rico in 2017. …
Average number of female Aedes aegypti per sentinel autocidal gravid ovitraps per week and accumulated rainfall (mm) during the third and second weeks before each mosquito-sampling week in 2016, and comparable results observed in 2017 after Hurricanes Irma and Maria in Caguas city, Puerto Rico. Rainfall was lag-forwarded 1.5 weeks to facilitate visual comparisons with mosquito numbers. …
Map of the metropolitan area of San Juan city showing the average number of mosquitoes per BG-S trap per day of the four more abundant mosquito species across major landscape elements (forests, high-density housing, low-density housing, non-forested vegetation, and wetlands) after Hurricanes Irma and Maria hit Puerto Rico in 2017. …
Am. J. Trop. Med. Hyg. , 100(6), 2019, pp. 1413 – 1420
doi:10.4269/ajtmh.19-0015
Impacts of Hurricanes Irma and Maria on Aedes aegypti Populations, Aquatic Habitats, and
Mosquito Infections with Dengue, Chikungunya, and Zika Viruses in Puerto Rico
Roberto Barrera,
1
* Gilberto Felix,
1
Veronica Acevedo,
1
Manuel Amador,
1
Damaris Rodriguez,
1
Luis Rivera,
1
Orlando Gonzalez,
1
Nicole Nazario,
2
Marianyoly Ortiz,
2
Jorge L. Muñoz-Jordan,
3
Stephen H. Waterman,
1
and Ryan R. Hemme
1
1
Entomology and Ecology Team, Dengue Branch, Centers for Disease Control and Prevention, San Juan, Puerto Rico;
2
Vector Control Unit of
Puerto Rico, Puerto Rico Science Trust, San Juan, Puerto Rico;
3
Molecular Diagnostic Laboratory, Dengue Branch, Centers for Disease Control
and Prevention, San Juan, Puerto Rico
Abstract. Puerto Rico was severely impacted by Hurricanes Irma and Maria in September 2017. The island has been
endemic for dengue viruses (DENV) and recently suffered epidemics of chikungunya (CHIKV 2014) and Zika (ZIKV 2016)
viruses. Although severe storms tend to increase the number of vector and nuisance mosquitoes, we do not know how
they in fl uence Aedes aegypti populations and arboviral transmission. We compared the abundance of female Ae. aegypti
in autocidal gravid ovitraps (AGO traps), container habitats, and presence of RNA of DENV, CHIKV, and ZIKV in this vector
before and after the hurricanes in Caguas city and in four communities in southern Puerto Rico. Two of these communities
were under vector control using mass AGO trapping and the other two nearby communities were not. We also investigated
mosquito species composition and relative abundance (females/trap) using Biogents traps (BG-2 traps) in 59 sites in
metropolitan San Juan city after the hurricanes. Mosquitoes sharply increased 5 weeks after Hurricane Maria. Ensuing
abundance of Ae. aegypti was higher in Caguas and in one of the southern communities without vector control. Aedes
aegypti did not signi fi cantly change in the two areas with vector control. The most abundant mosquitoes among the 26
species identi fi ed in San Juan were Culex ( Melanoconion ) spp., Culex quinquefasciatus , Culex nigripalpus , and Ae.
aegypti . No arboviruses were detected in Ae. aegypti following the hurricanes, in contrast with observations from the
previous year, so that the potential for Aedes -borne arboviral outbreaks following the storms in 2017 was low.
INTRODUCTION
Severe storms disturb aquatic habitats where mosquitoes
undergo immature development and affect the spatial dis-
persal of both mosquitoes and vertebrate hosts, including
displacement of people. New aquatic habitats for vector or
nuisance mosquitoes appear after severe storms, such as the
thousands of abandoned swimming pools in New Orleans
following Hurricane Katrina.
1
Increases in the relative abun-
dance of several mosquito species that develop in ground-
water habitats after hurricanes have been reported, including
important vectors of arboviruses, such as West Nile, Saint
Louis encep halitis, and Ea stern equin e encephalit is viruses.
2 – 8
Communicable diseases are generally not common after
natural disasters, with the exception of events resulting in the
displacement of people without adequate sanitation, access
to shelter, and primary health care.
9
Nasci and Moore
4
reviewed the impact of storms and fl oods in the continental
United States from 1975 to 1997 and concluded that with
one exception, these natural events did not increase trans-
mission of arboviruses to humans or domestic animals. No
signi fi cant increases of arboviral diseases after storms and
fl oods were observed in other studies despite heightened
mosquito abundance
2,10
or the presence of arboviruses in
mosquitoes.
11,12
The Pan American Health Organization
13
reported that neither dengue nor malaria cases increased over
previous values after Hurricane Mitch swept through Central
America. Hurricane Georges hit Puerto Rico as a category
3 hurricane in 1998 in the midst of a large dengue epidemic, yet
the storm did not exacerbate the epidemic.
14
Similarly, Hur-
ricane Hortense hit Puerto Rico on September 10, 1996,
causing heavy rains and fl ooding, but did not change the usual
seasonal pattern of dengue transmission.
15
Nevertheless, several reports do account for increased risk
of arbovirus transmission after severe storms or fl ooding.
Surges in West Nile neuro-invasive disease cases were re-
ported during the 3 weeks following Hurricane Katrina in areas
directly impacted by the hurricane in Louisiana and Mis-
sissippi.
16
These authors also suggested that increased in-
cidence of the disease the following year was possibly caused
by increased exposure to mosquito bites where people had
substandard living conditions and during reconstruction ac-
tivities. Increased dengue and leptospirosis incidence was
reported after a severe fl ood in southern Thailand,
17
although
the mechanism how the fl ood caused an increase in dengue
incidence was not investigated. An association between in-
creased dengue incidence and high river levels in Bangladesh
was explained by accumulation of garbage, including plastic
containers along water bodies.
18
Although hur ricanes are freq uent in many tropic al countrie s
where dengueviruses (DENV) are endemic , no previous studi es
assessed ho w hurrican es affect the m ain dengue ve ctor Aedes
aegypti (L.) . Here, we inv estigated c hanges in ad ult Ae. aegypt i
and its aquatic habi tats, abund ance of other urbanmosquitoes,
and the prese nce of chiku ngunya, den gue, and Zika v iruses in
Ae. aegypti fol lowing the im pacts of cat egory 4 Hurric anes Irma
and Maria in Septem ber 2017 in Puerto Ric o. Maria, which ha s
been the thir d costliest h urricane in th e U.S. histor y, traverse d
the island on Se ptember 20 , 2017. Wind s near 250 km/ho urs,
heavy rains, and fl oods devast ated the islands .
19
METHODS
We compared adult Ae. aegypti populations before and
immediately following the hurricanes in two areas where
we have been conducting vector surveillance and control
activities: the city of Caguas, Caguas municipality, and four
* Address correspondence to Roberto Barrera, Entomology and
Ecology Team, Dengue Branch, Centers for Disease Control and
Prevention, 1324 Calle Canada, San Juan 00920, Puerto Rico. E-mail:
[email protected]
1413
communities in southern Puerto Rico. We also initiated adult
mosquito surveillance of other mosquito species, including
Ae. aegypti , in the metro area of San Juan city 1 month after
Hurricane Maria. Immature surveys in Caguas city before and
after the hurricanes were conducted to understand how the
storms affected the composition and abundance of con-
tainers producing Ae. aegypti .
Caguas city study. We compared female Ae. aegypti per trap
per week in 360 surveillance autocidal gravid ovitraps (SAGO
traps) placed at fi xed stations throughout the city from the second
week of October to December 2016 (non-hurricane year) and f rom
the second week of October to De cember 2017 (hurricane year).
Hurricanes Irma and Maria interrupted weekly sampling from the
fi rst week in September to the fi rst week in October 2017. In-
tegrated vector management, including community awareness,
source reduction, larviciding, and mass trapping using three
autocidal gravid ovitraps (AGO traps)per building in most of the
buildings, slowly started in late November 2016 and continued
through August 2017, when control traps began to be withdrawn
(CDC, unpublished data). Results fr om that investigation are being
published elsewhere (CDC, unpublished data). We conducted
pupal surveys in 395 and 677 buildings in June/July 20 17 (before)
and November/December 2017 (after hurricanes), respectively.
The sites selected for the pupal surveys were areas around SAGO
traps with above average numbers of female Ae. aegypti .W e
searched for all containers with water per building to record the
abundance of Ae. aegypti pupae and identi fi ed the most pro-
ductive types of containers. Co llected pupae were preserved in
80% ethanol and taken to the laboratory for identi fi cation under a
stereoscopic microscope. We also calculated the house index (HI;
percentage of houses with at least one container with immature
Ae. aegypti ), container index (CI; percentage of containers with
water that had immatures), Breteau index (BI; no. of positive
containers per 100 houses), and container Breteau index (no. of
positive containers of each type per 100 houses).
Southern Puerto Rico study. We have been conducting
Ae. aegypti surveillance in four communities (241 – 397 houses
each) in Salinas and Guayama municipalities for several
years.
20
Two communities (La Margarita and Villodas) were
initially treated with source reduction and larvicing, and La
Margarita received three AGO traps per home in most homes
in December 2011. In February 2013, we treated Villodas with
three AGO traps per home and simultaneously we started
monitoring two untreated, nearby communities (Arboleda and
Playa) to compare Ae. aegypti populations with the two
treated areas. Mosquito surveillance has been conducted
using 28 – 44 SAGO traps per community since then. We
compared the abundance of Ae. aegypti in the study areas
from August 2016 through January 2017 (non-hurricane year)
with data from August 2017 through January 2018 (hurricane
year). Weekly sampling was interrupted for 2 weeks (last week
in September and fi rst week in October 2017) in all four areas
following Hurricane Maria. Hurricane Irma did not signi fi cantly
affect surveillance or control in these southern areas.
San Juan city study. We deployed 59 BG-2 Sentinel (BG-S)
traps throughout San Juan city from October 17 to November
17, 2017. Most BG-S traps were operated for four consecutive
days for o ne or two con secut ive week s per site . The samp ling
sites were selected based on a previous study in 2005, where
we trapped in various types of land covers within the city (for-
ests, high-density housing, low-density housing, non-forested
vegetation, and wetlands).
21
W e d i dn o tu s eC D Cm i n i a t u r el i g h t
traps as in the previous study because our CDC light traps used
D-batteries, which were in short supply immediately after the
hurricane, and because no dry ice was available. BG-S traps
were operated with BS-lure using rechargeable batteries that we
had in stock (sealed lead-acid 12V 18 ampere hour). Collected
mosquitoes were transported to the laboratory and stored
at − 20 ° C until they were enumerated and identi fi ed.
Weather. Meteorological stations (HOBO data loggers;
Onset Computer Corporation, Boume, MA) during these
studies recorded rainfall, air temperature, and relative hu-
midity in Caguas city (eight stations) and in the southern
Puerto Rico communities (three stations). We calculated ac-
cumulated rainfall during the third and second weeks before
mosquito sampling because rainfall during the preceding
week should not contribute to new adult Ae. aegypti at the time
of sampling. We used average temperature and relative hu-
midity during 3 weeks before sampling because these pa-
rameters could in fl uence the number of adult mosquitoes
present at the moment of sampling, assuming that mosqui-
toes do not live longer than 3 weeks. To compare weather
between years, we used average weekly rainfall, average daily
air temperature, and average daily relative humidity. Hurricane
Maria knocked down most of our weather stations, and it took
us several weeks to obtain spare parts to fi x them (January
2018). We obtained missing weather data from nearby weather
stations th at kept record ing during tha t time in Cagu as
(HSWHQ ICAGU ASC5 Station 18 ° 22 3 9 N, − 66 ° 044 9 W), Sa linas
(Camp Santia go Station 18 ° 00 4 9 N, − 66.283 9 W), and Guay ama
(Jobos Bay Stati on 17 ° 956 9 N, − 66 ° 223 9 W).
Arbovirus detections in Ae. aegypti . To understand if in-
creased mosquito abundance following the 2017 hurricanes
were associated with increased arbovirus transmission, we
used a trioplex real time, reverse transcription polymerase
chain reaction (RT-PCR) to simultaneously detect RNA of
DENV, CHIKV, and ZIKV in pools (1 – 20 specimens per vial) of
female Ae. aegypti collected in SAGO traps in Caguas city and
in the four communities in southern Puerto Rico.
22,23
Pools of
female Ae. aegypti from Caguas were collected, analyzed, and
compared for the following periods: October – December 2016
and October – December 2017. Pools from the four southern
communities were collected, analyzed, and compared for
October 2016 – January 2017 and October 2017 – January
2018. Data collected during 2016 on arbovirus detections in
the four southern communities were recently published.
22
Statistical methods. We compared females of Ae. aegypti
per trap per week during similar periods (October – December
or January) between the year before (2016) and after the hur-
ricanes (2017) using generalized estimating equations (GEE).
We used the following weather parameters as covariates:
accumulated rainfall 2 – 3 weeks before mosquito sampling,
and average temperature and relative humidity for 3 weeks,
including the sampling week. A negative binomial model with
log link was used for the analyses and a fi rst-order autore-
gressive function as the covariance structure for repeated
measures. We reported results as means and standard errors.
Statistical analyses were carried out with IBM SPSS Statistics
25 software (IBM Corporation, Armonk, NY).
RESULTS
Caguas city. We found 441 Ae. aegypti pupae in 35 of 395
buildings (1.1 pupae/building) in the pupal survey before the
1414 BARRERA AND OTHERS
hurricanes (June/July 2017) and 1962 pupae in 140 of 677
buildings (2.9 pupae/building) after the hurricanes (November/
December 2017). The containers producing more Ae. aegypti
pupae during the fi rst survey were discarded tires, other dis-
carded containers, 19-L pails, 10-L buckets, and fl ooded
water meters (Figure 1). After the hurricanes, the most pro-
ductive containers were cavities in building structures (e.g.,
inundated fl oors of houses with damaged or missing roofs,
hollow bricks, and tubes), discarded containers (damaged
appliances, rubble, and trash), plant pots (trivets), fl ooded
water meters, 19-L pails, 10-L buckets, and discarded tires
(Figure 1). The BI per type of container (positive containers per
100 houses) indicated that the most common containers with
Ae. aegypti immatures before the hurricanes were fl ooded
F IGURE 1. Number of female pupae of Aedes aegypti collected from containers in houses ( A ) and number of positive containers of each type per
100 houses (Breteau container index) ( B ) before and after Hurricanes Irma and Maria in Caguas city, Puerto Rico in 2017.
IMPACT OF HURRICANES ON AEDES AEGYPTI 1415
water meters, discarded containers, 19-L pails and 10-L
buckets, discarded tires, and plant pots (Figure 1). After the
hurricanes, the most common positive containers were dis-
carded containers, plant pots, containers for water storage
(drums, 19-L pails, 10-L buckets, and pail lids), water meters,
and cavities in structures (Figure 1). The HI, CI, and BI (HI =
14%, CI = 3%, BI = 19) before the hurricanes were lower than
those after the hurricanes (HI = 33%, CI = 12, BI = 62).
The average number of female adults of Ae. aegypti per
AGO trap per week after the hurricanes in October – December
2017 (16.8 ± 0.2; N = 4,242 trap × weeks) was signi fi cantly
different (Wald χ
1
2
= 220; P < 0.001) from the previous, non-
hurricane year (October – December 2016; 8.4 ± 0.1; N =
4,309). There were signi fi cant effects of the covariates: ac-
cumulated rainfall (Wald χ
1
2
= 380; P < 0.001), average tem-
perature (Wald χ
1
2
= 30; P < 0.001), and average relative
humidity (Wald χ
1
2
=2 4 ; P < 0.001). The number of female mos-
quit oes peaked in October and by the end of November 2017
(Figure 2). The rela tive ab unda nce of Ae. aegypti (1.4 – 2.1 ±
0.04; CDC, unpublished data) prevailing in Caguas city a few
months (May – August 2017) before removing the control traps
in August – September 2017 was several times lower than that
observed in October – December 2017 (16.8 ± 0.2), showing
that the population of Ae. aegypti rapidly recovered after re-
moving control measures and following the hurricanes.
Average weekly rainfall from the second week in October –
December 2016 (37.8 ± 8.1 mm) was similar to that registered
for the same time interval in 2017 (41.5 ± 9.1; Figure 2) in
Caguas city. Weekly rainfall distribution varied between years,
with one peak in November 2016 and two peaks in October
and November 2017 (Figure 2). Average temperature and
relative humidity in 2016 (25.9 ± 0.3 ° C; 85.2 ± 0.6%) and 2017
(26.2 ± 0.2 ° C; 80.8 ± 1.1%) were comparable.
We found one DENV-, three CHIKV-, and 44 ZIKV-positive
pools of female Ae. aegypti in October – December 2016, the
year of the Zika epidemic in Puerto Rico (4,385 pools). No
arboviruses were detected in Ae. aegypti in Caguas city after
the hurricanes in October – December 2017 (5,257 pools).
Southern Puerto Rico. Hurricane Maria directly affected all
four study sites, bringing down power lines and trees, and
partially or totally destroying many buildings. Yet, few control
AGO traps were lost (20 – 37) in the two communities under
mass trapping, but many were toppled or dry (95 of 498 in
Villodas and 145 of 568 in La Margarita). There were simulta-
neous sharp increases in Ae. aegypti in all four communities
5 weeks after Hurricane Maria (Figure 3). Average Ae. aegypti
abundance at each of the four sites during the fi fth week after
the hurricane was the largest ever recorded for those sites
since 2013 (CDC, unpublished data). Abundance of Ae.
aegypti in the two communities with control AGO traps (Vil-
lodas and La Margarita) has been small and steady for several
years,
22
at or below two females per trap per week. These low
numbers were observed for most of 2016/2017 and 2017/
2018 (Figure 3A and B), except following Hurricane Maria
when abundance increased to 10 – 14 mosquitoes per trap per
week. Despite these temporary abundance peaks, the GEE
analyses showed lack of signi fi cant differences (Wald χ
1
2
= 0.4;
P > 0.05) in the average abundance of Ae. aegypti per trap per
week for the months of the study between years (non-
hurricane 1.7 ± 0.1 versus hurricane 2.21 ± 0.1) and a signi fi -
cant effect of rainfall (Wald χ
1
2
= 88.4; P < 0.001) in Villodas.
Similarly, average mosquito numbers in La Margarita did not
signi fi cantly (Wald χ
1
2
= 0.4; P < 0.001) change between years
(1.3 ± 0.1 versus 2.2 ± 0.1). Covariates rainfall (Wald χ
1
2
=
155.9; P < 0.001) and temperature (Wald χ
1
2
= 117.6; P < 0.001)
were signi fi cant.
Mosquito abundance after the hurricanes in one of the two
communities without vector control (Arboleda 10.0 ± 0.3
females/trap/week; Figure 3C) was steadily more than ob-
served levels in the previous year from October to December
(6.5 ± 0.2). The GEE analysis showed signi fi cant differences
between years (Wald χ
1
2
= 39.1; P < 0.001) and signi fi cant
F IGURE 2. Average number of female Aedes aegypti per sentinel autocidal gravid ovitraps per week and accumulated rainfall (mm) during the third
and second weeks before each mosquito-sampling week in 2016, and comparable results observed in 2017 after Hurricanes Irma and Maria in
Caguas city, Puerto Rico. Rainfall was lag-forwarded 1.5 weeks to facilitate visual comparisons with mosquito numbers.
1416 BARRERA AND OTHERS
effects of rainfall (Wald χ
1
2
= 155.3; P < 0.001) and temperature
(Wald χ
1
2
= 6.6; P < 0.05). Average mosquito abundance in the
other community without vector control (Playa 13.8 ± 0.6) was
actually lower than in the previous, non-hurricane year (16.6 ±
0.6). Results from the GEE analysis showed that those differ-
ences were signi fi cant (Wald χ
1
2
= 20.0; P < 0.001) despite the
fact that the peak in mosquito abundance that was observed
5 weeks after the hurricane reached its largest value ever (42
females/trap/week; Figure 3D). Effects of covariates rainfall
(Wald χ
1
2
= 122.6; P < 0.001) and temperature (Wald χ
1
2
= 29.1;
P < 0.001) were signi fi cant.
Average weekly rainfall for all sites after the hurricanes from
August 2017 to January 2018 (40.4 ± 6.5 mm) was double than
that registered for August 2016 – January 2017 (19.5 ± 2.5;
Figure 3). Overall, average temperature and relative humidity in
August 2016 – January 2017 (26.9 ± 0.2 ° C; 76.3 ± 0.5%) and
August 2017 – January 2018 (26.8 ± 0.1 ° C; 76.5 ± 0.6%) were
similar.
No pools of Ae. aegypti females tested positive for DENV,
CHIKV, or ZIKV in either August 2016 – January 2017 or August
2017 – January 2018 in the two communities treated with AGO
traps (La Margarita 213 pools and Villodas 148 pools). We
found fi ve and eight positive pools of female Ae. aegypti with
ZIKV in the untreated communities (Arboleda 265 pools and
Playa 626 pools, respectively), in August 2016 – January 2017,
and no arboviruses were detected in Ae. aegypti from these
communities in August 2017 – January 2018 (382 and 480
pools, respectively). Thus, no arbovirus activity was evident in
Ae. aegypti in any of these communities following Hurricanes
Irma and Maria in 2017.
San Juan city. We placed BG-S traps at 59 locations in the
following municipalities of the metro area of San Juan city:
Bayam ´ on, Carolina, Cataño, Guaynabo, San Juan, and Trujillo
Alto (Figure 4). We collected 11,797 females of 26 species of
mosquitoes in 451 trap days (Table 1). There were 17 trap
failures, including some stolen batteries or traps, wire prob-
lems, and ants. The most common female adult mosquito
species in the traps were Culex atratus , Culex quinque-
fasciatus , Ae. aegypti , and Culex nigripalpus . More Cx. atratus
were captured in non-forest vegetation areas and in forests.
Culex quinquefasciatus was more abundant in wetland areas
followed by low-density housing areas. Aedes aegypti was
F IGURE 3. Comparing average numbers of female Aedes aegypti and accumulated rainfall (mm) during the third and second weeks before each
mosquito-sampling week in four communities in southern Puerto Rico. Two communities ( A and B ) were under vector control interventions using
three autocidal gravid ovitraps per house in most houses in 2016 and in 2017 when the Hurricanes Irma and Maria hit Puerto Rico. The other two
communities ( C and D ) were nearby sites without vector-control interventions. Rainfall was forwarded 1.5 weeks to facilitate comparisons with
mosquito numbers.
IMPACT OF HURRICANES ON AEDES AEGYPTI 1417
more common in low-density housing areas, but like Cx.
quinquefasciatus , this species was widely distributed across
landscapes in the metro area. Culex nigripalpus was more
abundant in wetlands and forests (Table 1). The average
numbers of Ae. aegypti per trap per day in the various land-
scapes were as follows: low-density housing 9.8 ± 1.1, high-
density housing 3.4 ± 0.4097, non-forest vegetation 2.7 ± 0.5,
forests 2.6 ± 1.0, and wetlands 2.1 ± 0.3.
DISCUSSION
Severe storms are expected to increase the number of
mosquitoes by increasing or decreasing the edge surface of
groundwater habitats, fi lling cavities/containers with rainwa-
ter, and generating additional container aquatic habitats in
destroyed or abandoned properties (damaged appliances,
inundated fl oors/roofs, and rubble). The latter two events are
relevant to the ecology of Ae. aegypti because this species
does not use groundwaters but used water- fi lled containers
for immature development. This study showed large numbers
of containers and pupae of Ae. aegypti in the weeks following
Hurricane Maria in Caguas city, including highly productive,
fl ooded fl oors and rubble resulting from wind/ fl ood damage.
Adult female of Ae. aegypti doubled in numbers after the
hurricanes in this city. Surprisingly, the amount of rainfall from
October to December in 2016 and 2017 was similar in Caguas,
which may indicate that the increase in the number of adult
mosquitoes was mainly a result of more containers holding
water. Year 2016 was a rather wet year itself.
22
The numeric response of the Ae. aegypti population to in-
creased rainfall in 2017 as compared with 2016 in southern
Puerto Rico was heterogeneous, although mosquito numbers
in all four study sites sharply increased exactly 5 weeks after
Hurricane Maria. The only signi fi cant average increase in
adults of Ae. aegypti from October 2017 through January 2018
in comparison with the same period in 2016/2017 was ob-
served in one of the two locations without vector control. The
other location without vector control actually showed signi fi -
cantly lower mosquito numbers than in the previous year when
rainfall was about half. Contributing to the heterogeneity of
responses, the two sites with vector control (three AGO traps
per home in most homes plus surveillance AGO traps) did not
F IGURE 4. Map of the metropolitan area of San Juan city showing the average number of mosquitoes per BG-S trap per day of the four more
abundant mosquito species across major landscape elements (forests, high-density housing, low-density housing, non-forested vegetation, and
wetlands) after Hurricanes Irma and Maria hit Puerto Rico in 2017.
1418 BARRERA AND OTHERS
show any signi fi cant difference in mosquito captures in
comparison with the previous year. We were able to continue
vector surveillance in the four southern areas 3 weeks after
Maria and to reset or replace lost AGO control traps within
5 weeks in the two communities with vector control, despite
pervasive limited living conditions at the time. Wherever sig-
ni fi cant increases in Ae. aegypti captures were observed after
the hurricanes, they returned to pre-hurricane levels during
December 2017 or shortly thereafter.
Although monitoring unusual increases in mosquitoes after
natural disasters is important, some areas may already con-
tain enough mosquitoes to cause local arbovirus outbreaks
without any additional increases caused by the storms. For
example, average Ae. aegypti captures before or after the
hurricanes in Caguas city and in the two sites without vector
control in southern Puerto Rico were several times higher than
two female Ae. aegypti per trap per day; the relative abun-
dance associated with 50% less prevalence of anti-
chikungunya IgG antibodies in areas with mass-trapping
vector control.
24
Whether vector control needs to be applied after natural
disasters, such as after severe storms, should be decided
based on assessments of abundance of key vector or nui-
sance mosquito species, virus infection rates in mosquitoes,
and seroprevalence in sentinel or wild vertebrate hosts.
4
Emergency vector control has been practiced in the United
States after severe storms due to signi fi cant increases in
ground-water mosquitoes.
3,5,6,8
Our study of mosquito cap-
tures in the metro area of San Juan could not be directly
compared with a previous study
21
because we did not have
the same traps available after the hurricanes. However, we
obtained similar results to the previous study conducted
during a wette r than normal year (20 05) when we used CDC
miniature li ght traps with CO
2
: high numbers of Cu lex ( Mela-
noconion ) spp. mosqui toes in less d isturbed a reas with ta ll or
short vegeta tion and wetlands, 26 mosqu ito species ve rsus 28
in 2005, and wide spread distr ibution of Cx. nigripalpus ;a ni m -
portant West Ni le virus vector .
25
The two other wi despread
species fou nd were Ae. aegy pti and Cx. quinq uefascia tus ,b o t h
of which were mor e abundant in are as with low-de nsity hous-
ing. People in the metro area we re mostly exposed to thes e
urban mosqu ito species an d to a lesser extent to Cx. ni g-
ripalpus . Because of lack of power, pi ped water, dama ged
houses, and re construc tion activ ities, the peop le in Puerto Rico
were expos ed to increa sed mosqui to bites aft er the hurric anes.
Dengue, chikungunya, and Zika viruses were not detected
in Ae. aegypti in Caguas city or in the four southern commu-
nities after the hurricanes. In contrast, we detected all of these
viruses in Ae. aegypti the previous year in Caguas city and in
two of the communities without vector control in southern
Puerto Rico. No viruses were found during comparable pe-
riods before or after the hurricanes in the two communities
under vector control with mass AGO trapping. Because
Ae. aegypti adults do not fl y far, the presence of arboviruses in
these mosquitoes indicates the presence of local infectious
persons.
26
Our results suggest that these arboviruses were
not being actively transmitted in the study areas. Lack of
arboviruses in Ae. aegypti after the hurricanes in 2017 is
consistent with the paucity of human cases during the same
periods. For example, less than 20 Zika cases per week were
reported from Puerto Rico from October 2017 to January
2018, whereas up to 1,000 cases per week were reported
during the same time period during the Zika outbreak in
2016/2017.
27,28
Thus, the potential for outbreaks after the
T ABLE 1
Composition and abundance of female adult mosquitoes collected in BG-S traps in the metro area of San Juan city, Puerto Rico, after Hurricanes
Irma and Maria (October – November 2017)
Mosquito species Forest High-density housing Low-density housing Non-forest vegetation Wetlands Total
Culex (Mel.) atratus Theo. 1.302 1 11 3.884 137 5.335
... This study provides the opportunity to examine how interannual climate variability may impact domestic populations of Ae. aegypti that were managed by applying sustained, area-wide mass trapping. We previously reported on the effectiveness of mass trapping with sticky gravid ovitraps on reductions of Ae. aegypti populations and arbovirus prevalence in both mosquitoes and people (Barrera et al. 2014a, 2019a
, 2019b
. Data from 2014 and 2016 during the outbreaks of chikungunya and Zika viruses, respectively were previously analyzed to compare mosquito densities, weather, and infection rates of Ae. aegypti (Barrera et al. 2019a). ...
... We also reported on the impact of category 4 hurricanes Irma and Maria that hit Puerto Rico in September 2017 on Ae. aegypti populations and arbovirus circulation in the study areas. These results showed heterogeneity of impacts on Ae. aegypti density in unmanaged study sites, limited effects in managed sites, and absence of arboviruses in Ae. aegypti before and after the hurricanes in 2017
(Barrera et al. 2019b
). This study expands published knowledge by examining long term trends in mosquito populations and the impact of climate in managed and unmanaged scenarios. ...
... The impact of major hurricanes during La Niña conditions (Hurricanes Irma and Maria, September 2017) on mosquito populations in various municipalities in Puerto Rico that included data from the 4 study sites was previously published
(Barrera et al. 2019b
). There was a sharp increase in Ae. aegypti populations 5 weeks after the hurricanes in the 4 study sites and in a city in central Puerto Rico. ...
El Niño Southern Oscillation (ENSO) effects on local weather, arboviral diseases, and dynamics of managed and unmanaged populations of Aedes aegypti (Diptera: Culicidae) in Puerto Rico
Roberto Barrera
Veronica Acevedo
Manuel Amador
Gabriela Paz-Bailey
We investigated the effects of interannual El Niño Southern Oscillation (ENSO) events on local weather, Aedes aegypti populations, and combined cases of dengue (DENV), chikungunya (CHIKV), and Zika (ZIKV) viruses in 2 communities with mass mosquito trapping and 2 communities without mosquito control in southern Puerto Rico (2013–2019). Gravid adult Ae. aegypti populations were monitored weekly using Autocidal Gravid Ovitraps (AGO traps). Managing Ae. aegypti populations was done using 3 AGO traps per home in most homes. There were drought conditions in 2014–2015 concurrent with the emergence of a strong El Niño (2014–2016), wetter conditions during La Niña (2016–2018), a major hurricane (2017), and a weaker El Niño (2018–2019). The main factor explaining differences in Ae. aegypti abundance across sites was mass trapping. Populations of Ae. aegypti reached maximum seasonal values during the wetter and warmer months of the year when arbovirus epidemics occurred. El Niño was significantly associated with severe droughts that did not impact the populations of Ae. aegypti. Arbovirus cases at the municipality level were positively correlated with lagged values (5–12 mo.) of the Oceanic El Niño Index (ONI), droughts, and abundance of Ae. aegypti. The onset of strong El Niño conditions in Puerto Rico may be useful as an early warning signal for arboviral epidemics in areas where the abundance of Ae. aegypti exceeds the mosquito density threshold value.
... In the Caribbean region, events of heavy rainfall may occur repeatedly in the same year, increasing the risk of epidemics of new and emerging VBZD [29]. The occurrence of adverse events, such as hurricanes and storms, poor infrastructure and population mobility also influence mosquito population and dengue transmission [13,
[30]
[31][32]. The relationship between population mobility, relative to space/distance and time, and the implications for dengue and other infectious diseases transmission need to be better studied, particularly, within the context of Caribbean societies. ...
Climate and dengue transmission in Grenada for the period 2010–2020: Should we be concerned?
Kinda Francis
Odran Edwards
Lindonne Telesford
The impacts of climate change on vector-borne and zoonotic diseases (VBZD) are well founded in some countries but remain poorly understood in Caribbean countries. VBZD impose significant burdens on individuals and healthcare systems, heightening the need for studies and response measures to address epidemics and persistent high prevalence of these diseases in any region. This study analyses the pattern of dengue case distribution in Grenada between 2010–2020 and investigates the relationship between rainfall and cases. The total number of dengue cases in the wet seasons (June to December) and dry seasons (January to May) were 1741 and 458, respectively, indicating higher prevalence of the disease in wet periods. The data also shows that rainfall was not consistently higher during the typical rainy season months. The observed patterns in 2013, 2018 and 2020 show, while these were the driest years, the number of cases were higher than in other years. Two factors may explain high number of cases in the drier years (1) frequent sporadic heavy rainfall and (2) poor water storage practices in dry season. With each 30 mm unit decrease in annual rainfall, the incidence rate ratio of dengue was reduced by a factor of .108 (89.2%). The work of the Vector Control Unit is shown to be effective in managing dengue in Grenada. The study highlights the need for year-round surveillance and interventions to control the mosquito population and dengue transmission.
... Flooding events due to Hurricanes Maria and Irma (both made landfall on USVI in September 2017) did not increase ZIKV disease cases in USVI (Fig. 1). In neighboring Puerto Rico, increased mosquito populations were observed 5 weeks after Hurricanes Maria and Irma, but there was no increased detection of dengue, chikungunya, or ZIKV in mosquitoes
(Barrera et al, 2019)
. Other hurricane-or flood-related disasters have not been shown to increase transmission of arboviruses to humans or domestic animals in the United States, with the exception of the Red River flood of 1975 (Nasci and Moore, 1998). ...
Spatial, Sociodemographic, and Weather Analysis of the Zika Virus Outbreak: U.S. Virgin Islands, January 2016–January 2018
A. Springer Browne
David S. Rickless
C. Reed Hranac
Esther Ellis
Background: The first Zika virus outbreak in U.S. Virgin Islands identified 1031 confirmed noncongenital Zika disease (n = 967) and infection (n = 64) cases during January 2016-January 2018; most cases (89%) occurred during July-December 2016. Methods and Results: The epidemic followed a continued point-source outbreak pattern. Evaluation of sociodemographic risk factors revealed that estates with higher unemployment, more houses connected to the public water system, and more newly built houses were significantly less likely to have Zika virus disease and infection cases. Increased temperature was associated with higher case counts, which suggests a seasonal association of this outbreak. Conclusion: Vector surveillance and control measures are needed to prevent future outbreaks.
... lifespan, extrinsic incubation period, positive rate of dengue virus), thus hindering the inference of the association mechanism between tropical cyclones and dengue incidence. A study in Puerto Rico found that the abundance of Aedes aegypti did not increase significantly in vector-controlled communities after the hurricane, and dengue virus was not detected in Aedes aegypti, while dengue virus was detected in communities without vector control
[42]
. It explicitly supports vector control as the primary public health intervention for reducing dengue transmission at the community level [43]. ...
Short-term effects of tropical cyclones on the incidence of dengue: a time-series study in Guangzhou, China
Chuanxi Li
Zhe Zhao
Yu Yan
Wei Ma
Background
Limited evidence is available about the association between tropical cyclones and dengue incidence. This study aimed to examine the effects of tropical cyclones on the incidence of dengue and to explore the vulnerable populations in Guangzhou, China.
Methods
Weekly dengue case data, tropical cyclone and meteorological data during the tropical cyclones season (June to October) from 2015 to 2019 were collected for the study. A quasi-Poisson generalized linear model combined with a distributed lag non-linear model was conducted to quantify the association between tropical cyclones and dengue, controlling for meteorological factors, seasonality, and long-term trend. Proportion of dengue cases attributable to tropical cyclone exposure was calculated. The effect difference by sex and age groups was calculated to identify vulnerable populations. The tropical cyclones were classified into two levels to compare the effects of different grades of tropical cyclones on the dengue incidence.
Results
Tropical cyclones were associated with an increased number of dengue cases with the maximum risk ratio of 1.41 (95% confidence interval 1.17–1.69) in lag 0 week and cumulative risk ratio of 2.13 (95% confidence interval 1.28–3.56) in lag 0–4 weeks. The attributable fraction was 6.31% (95% empirical confidence interval 1.96–10.16%). Men and the elderly were more vulnerable to the effects of tropical cyclones than the others. The effects of typhoons were stronger than those of tropical storms among various subpopulations.
Conclusions
Our findings indicate that tropical cyclones may increase the incidence of dengue within a 4-week lag in Guangzhou, China, and the effects were more pronounced in men and the elderly. Precautionary measures should be taken with a focus on the identified vulnerable populations to control the transmission of dengue associated with tropical cyclones.
Graphical Abstract
View
... Although our results suggest that DENV-1 and DENV-2 lineages that emerged in the country could have originated in Veracruz, we do not have samples prior to 2012, and we cannot exclude an origin in another location. Veracruz was affected by hurricane Ernest in 2012, creating favorable conditions for vector development
(Barrera et al., 2019)
. Concurrently, a significant increase in the number of confirmed DF cases (12,572 in total) was reported (Salud, 2022), thus a higher representation, compared to those from other sites, was reflected in our sampling. ...
Genetic diversity and spatiotemporal dynamics of DENV-1 and DENV-2 infections during the 2012–2013 outbreak in Mexico
Eduardo D. Rodríguez-Aguilar
Jesús Martinez Barnetche
Lilia Juarez
Mario Henry Rodríguez
Dengue fever is caused by four related dengue virus serotypes, DENV-1 to DENV-4, where each serotype comprises distinct genotypes and lineages. The last major outbreak in Mexico occurred during 2012 and 2013, when 112,698 confirmed cases were reported (DENV-1 and DENV-2 were predominant). Following partial E, NS2A and NS5 gene sequencing, based on the virus genome variability, we analyzed 396 DENV-1 and 248 DENV-2 gene sequences from serum samples from dengue acute clinical cases from 13 Mexican states, Mutations were identified, and their genetic variability estimated, along with their evolutionary relationship with DENV sequences sampled globally. DENV-1 genotype V and DENV-2 Asian-American genotype V were the only genotypes circulating during the outbreak. Mutations in NS2A and NS5 proteins were widely disseminated and suggested local emergence of new lineages. Phylogeographic analysis suggested viral spread occurred from coastal regions, and tourist destinations, such as Yucatan and Quintana Roo, which played important roles in disseminating these lineages.
... Culex quinquefasciatus takes advantage of improper disposal of sewage water above-or belowground in urban areas to oviposit and undergo immature development (Barrera et al. 2008, Chaves et al. 2009, Mackay et al. 2009, Burke et al. 2010, Correia et al. 2012. Culex quinquefasciatus and Aedes aegypti (L.) have widespread distribution in urban areas and some studies have shown that the abundance of these species is correlated , Ng et al. 2018,
Barrera et al. 2019)
. Given the public health importance of these mosquitoes and the need to monitor their presence and abundance, it would be advantageous to use the same monitoring device that could efficiently track both species. ...
Surveillance and Control of Culex quinquefasciatus Using Autocidal Gravid Ovitraps
Roberto Barrera
Veronica Acevedo
Manuel Amador
We monitored trap captures of Culex quinquefasciatus using an interrupted time-series study to determine if autocidal gravid ovitraps (AGO traps) were useful to control the population of this mosquito species in a community in southern Puerto Rico. Data for this report came from a previous study in which we used mass trapping to control Aedes aegypti, resulting in a significant 79% reduction in numbers of this species. The AGO traps used to monitor and control Ae. aegypti also captured numerous Cx. quinquefasciatus. Culex quinquefasciatus was monitored in surveillance AGO traps from October 2011 to February 2013, followed by a mosquito control intervention from February 2013 to June 2014. Optimal captures of this mosquito occurred on the 2nd wk after the traps were set or serviced, which happened every 8 wk. Changes in collection numbers of Cx. quinquefasciatus were positively correlated with rainfall and showed oscillations every 8 wk, as revealed by sample autocorrelation analyses. Culex quinquefasciatus was attracted to and captured by AGO traps, so mass trapping caused a significant but moderate reduction of the local population (31.2%) in comparison with previous results for Ae. aegypti, possibly resulting from female mosquitoes flying in from outside of the study area and decreased attraction to the traps past the 2nd wk of trap servicing. Because Ae. aegypti and Cx. quinquefasciatus are frequently established in urban areas, mass trapping to control the former has some impact on Cx. quinquefasciatus. Control of the latter could be improved by locating and treating its aquatic habitats within and around the community.
... Nevertheless, after interviewing cancer patients and health providers in this research, a fair assumption would be to consider the combination of stressors, including environmental factors promoting unhealthy and unpleasant conditions not only to cancer patients but also for many vulnerable communities in the aftermath of Hurricane María. Such conditions are solar radiation (in a warm-humid tropical environment), elevated air surface temperature + relative humidity (increasing heat index), floods, deforestation and canopy destruction, the lack of electricity and essential services, poor air quality (due to portable electric generators), vector-borne diseases and rodents, (rats and mosquitos
[39]
), potable water accessibility and water sanitation. ...
Environmental Stressors Suffered by Women with Gynecological Cancers in the Aftermath of Hurricanes Irma and María in Puerto Rico
Int J Environ Res Publ Health
Pablo A. Mendez-Lazaro
Yanina M. Bernhardt
William A Calo
Ana P. Ortiz-Martinez
Background:
Hurricanes are the immediate ways that people experience climate impacts in the Caribbean. These events affect socio-ecological systems and lead to major disruptions in the healthcare system, having effects on health outcomes. In September 2017, Puerto Rico (PR) and the United States Virgin Islands (USVI) experienced one of the most catastrophic hurricane seasons in recent history (Hurricane Irma was a Category 5 and Hurricane María was a Category 4 when they hit PR).
Objective:
This study examines environmental stressors experienced by women with gynecologic (GYN) cancers from PR and USVI who received oncologic cancer care in PR, in the aftermath of the hurricanes.
Methods:
A descriptive qualitative study design was used to obtain rich information for understanding the context, barriers, knowledge, perspectives, risks, vulnerabilities, and attitudes associated to these hurricanes. We performed focus groups among GYN cancer patients (n = 24) and key-informant interviews (n = 21) among health-care providers and administrators. Interviews were conducted from December 2018-April 2019.
Results:
Environmental health stressors such as lack of water, heat and uncomfortable temperatures, air pollution (air quality), noise pollution, mosquitos, and rats ranked in the top concerns among cancer patients and key-informants.
Conclusions:
These findings are relevant to cancer patients, decision-makers, and health providers facing extreme events and disasters in the Caribbean. Identifying environmental secondary stressors and the most relevant cascading effects is useful for decision-makers so that they may address and mitigate the effects of hurricanes on public health and cancer care.
Outbreaks of Vector-borne Infectious Disease Following a Natural Disaster
Norma Quintanilla
Introduction
Over the past century, global disaster deaths have averaged approximately 45,000 people annually. Vector-borne pathogens are susceptible to climatic conditions influencing vector survival, gonotrophic cycle, and transmission efficiency in human hosts. However, the literature has not collectively analyzed the relationship between natural disasters and vector-borne disease (VBD) outbreaks over decades.
Objective
This literature review identifies and examines published papers documenting VBD outbreaks associated with natural disasters. Additionally, information was gathered about the kinds of natural disasters commonly associated with VBD outbreaks and which diseases typically occur post- disasters.
Methods
A literature review was performed using two search strategies with terms for natural disasters and vector-borne infectious diseases as identified in the title, keywords, or abstract. Observational studies and systematic review papers were screened on the occurrence of a VBD post-disaster.
Results
A total of 30 studies were captured. Eight disaster types were captured: flood, hurricane, tropical cyclone, typhoon, tsunami, drought, monsoon, and earthquake. Floods (n=21), hurricanes (n=20), tsunamis (n=8), and drought (n=8) account for the top four disaster events commonly associated with VBDs. Of the VBDs identified, malaria outbreaks were identified in 16 papers, while dengue outbreaks were captured in 11.
Conclusion
The literature reveals a predominance of floods, malaria and dengue. While there is increasing acknowledgment that disasters can lead to outbreaks of VBDs, there is limited research and consistent data available. Future research should rely on well-defined, consistent case detection and enrollment procedures, preferably at various lag periods following a disaster event.
Background:
Climate change is expected to increase the frequency of flooding events. Although rainfall is highly correlated with mosquito-borne diseases (MBD) in humans, less research focuses on understanding the impact of flooding events on disease incidence. This lack of research presents a significant gap in climate change-driven disease forecasting.
Objectives:
We conducted a scoping review to assess the strength of evidence regarding the potential relationship between flooding and MBD and to determine knowledge gaps.
Methods:
PubMed, Embase, and Web of Science were searched through 31 December 2020 and supplemented with review of citations in relevant publications. Studies on rainfall were included only if the operationalization allowed for distinction of unusually heavy rainfall events. Data were abstracted by disease (dengue, malaria, or other) and stratified by post-event timing of disease assessment. Studies that conducted statistical testing were summarized in detail.
Results:
From 3,008 initial results, we included 131 relevant studies (dengue n=45, malaria n=61, other MBD n=49). Dengue studies indicated short-term (<1 month) decreases and subsequent (1-4 month) increases in incidence. Malaria studies indicated post-event incidence increases, but the results were mixed, and the temporal pattern was less clear. Statistical evidence was limited for other MBD, though findings suggest that human outbreaks of Murray Valley encephalitis, Ross River virus, Barmah Forest virus, Rift Valley fever, and Japanese encephalitis may follow flooding.
Discussion:
Flooding is generally associated with increased incidence of MBD, potentially following a brief decrease in incidence for some diseases. Methodological inconsistencies significantly limit direct comparison and generalizability of study results. Regions with established MBD and weather surveillance should be leveraged to conduct multisite research to a) standardize the quantification of relevant flooding, b) study nonlinear relationships between rainfall and disease, c) report outcomes at multiple lag periods, and d) investigate interacting factors that modify the likelihood and severity of outbreaks across different settings. https://doi.org/10.1289/EHP8887.
| https://www.researchgate.net/publication/333657654_Impacts_of_Hurricanes_Irma_and_Maria_on_Aedes_aegypti_Populations_Aquatic_Habitats_and_Mosquito_Infections_with_Dengue_Chikungunya_and_Zika_Viruses_in_Puerto_Rico |
Latest content added for The Portal to Texas History Title: The Groom News (Groom, Carson County, Tex.) 1926-current
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Latest content added for The Portal to Texas History Title: The Groom News (Groom, Carson County, Tex.) 1926-current
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This is a custom feed for browsing The Portal to Texas History Title: The Groom News (Groom, Carson County, Tex.) 1926-current
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The Groom News (Groom, Tex.), Vol. 25, No. 27, Ed. 1 Thursday, September 27, 1951
</title>
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<p><a href="https://texashistory.unt.edu/ark:/67531/metapth1532257/"><img alt="The Groom News (Groom, Tex.), Vol. 25, No. 27, Ed. 1 Thursday, September 27, 1951" title="The Groom News (Groom, Tex.), Vol. 25, No. 27, Ed. 1 Thursday, September 27, 1951" src="https://texashistory.unt.edu/ark:/67531/metapth1532257/small/"/></a></p><p>Weekly newspaper from Groom, Texas that includes local, state, and national news along with extensive advertising.</p>
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<entry>
<title>
The Groom News (Groom, Tex.), Vol. 23, No. 47, Ed. 1 Thursday, February 16, 1950
</title>
<link href=" https://texashistory.unt.edu/ark:/67531/metapth1532256/" rel=" alternate"/>
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<p><a href="https://texashistory.unt.edu/ark:/67531/metapth1532256/"><img alt="The Groom News (Groom, Tex.), Vol. 23, No. 47, Ed. 1 Thursday, February 16, 1950" title="The Groom News (Groom, Tex.), Vol. 23, No. 47, Ed. 1 Thursday, February 16, 1950" src="https://texashistory.unt.edu/ark:/67531/metapth1532256/small/"/></a></p><p>Weekly newspaper from Groom, Texas that includes local, state, and national news along with extensive advertising.</p>
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<title>
The Groom News (Groom, Tex.), Vol. 21, No. 42, Ed. 1 Thursday, December 25, 1947
</title>
<link href=" https://texashistory.unt.edu/ark:/67531/metapth1532252/" rel=" alternate"/>
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<p><a href="https://texashistory.unt.edu/ark:/67531/metapth1532252/"><img alt="The Groom News (Groom, Tex.), Vol. 21, No. 42, Ed. 1 Thursday, December 25, 1947" title="The Groom News (Groom, Tex.), Vol. 21, No. 42, Ed. 1 Thursday, December 25, 1947" src="https://texashistory.unt.edu/ark:/67531/metapth1532252/small/"/></a></p><p>Weekly newspaper from Groom, Texas that includes local, state, and national news along with extensive advertising.</p>
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<title>
The Groom News (Groom, Tex.), Vol. 20, No. 22, Ed. 1 Thursday, September 26, 1946
</title>
<link href=" https://texashistory.unt.edu/ark:/67531/metapth1532249/" rel=" alternate"/>
<id>
https://texashistory.unt.edu/ark:/67531/metapth1532249/
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<p><a href="https://texashistory.unt.edu/ark:/67531/metapth1532249/"><img alt="The Groom News (Groom, Tex.), Vol. 20, No. 22, Ed. 1 Thursday, September 26, 1946" title="The Groom News (Groom, Tex.), Vol. 20, No. 22, Ed. 1 Thursday, September 26, 1946" src="https://texashistory.unt.edu/ark:/67531/metapth1532249/small/"/></a></p><p>Weekly newspaper from Groom, Texas that includes local, state, and national news along with extensive advertising.</p>
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<title>
The Groom News (Groom, Tex.), Vol. 20, No. 25, Ed. 1 Thursday, October 17, 1946
</title>
<link href=" https://texashistory.unt.edu/ark:/67531/metapth1532250/" rel=" alternate"/>
<id>
https://texashistory.unt.edu/ark:/67531/metapth1532250/
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<p><a href="https://texashistory.unt.edu/ark:/67531/metapth1532250/"><img alt="The Groom News (Groom, Tex.), Vol. 20, No. 25, Ed. 1 Thursday, October 17, 1946" title="The Groom News (Groom, Tex.), Vol. 20, No. 25, Ed. 1 Thursday, October 17, 1946" src="https://texashistory.unt.edu/ark:/67531/metapth1532250/small/"/></a></p><p>Weekly newspaper from Groom, Texas that includes local, state, and national news along with extensive advertising.</p>
</summary>
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<title>
The Groom News (Groom, Tex.), Vol. 55, No. 17, Ed. 1 Thursday, July 10, 1980
</title>
<link href=" https://texashistory.unt.edu/ark:/67531/metapth1517777/" rel=" alternate"/>
<published> 2022-10-29T05:19:00-05:00 </published>
<id>
https://texashistory.unt.edu/ark:/67531/metapth1517777/
</id>
<summary type=" html">
<p><a href="https://texashistory.unt.edu/ark:/67531/metapth1517777/"><img alt="The Groom News (Groom, Tex.), Vol. 55, No. 17, Ed. 1 Thursday, July 10, 1980" title="The Groom News (Groom, Tex.), Vol. 55, No. 17, Ed. 1 Thursday, July 10, 1980" src="https://texashistory.unt.edu/ark:/67531/metapth1517777/small/"/></a></p><p>Weekly newspaper from Groom, Texas that includes local, state, and national news along with extensive advertising.</p>
</summary>
<media:thumbnail url=" https://texashistory.unt.edu/ark:/67531/metapth1517777/small/"/>
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<entry>
<title>
The Groom News (Groom, Tex.), Vol. 56, No. 42, Ed. 1 Thursday, December 31, 1981
</title>
<link href=" https://texashistory.unt.edu/ark:/67531/metapth1517814/" rel=" alternate"/>
<published> 2022-10-28T22:54:40-05:00 </published>
<id>
https://texashistory.unt.edu/ark:/67531/metapth1517814/
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<p><a href="https://texashistory.unt.edu/ark:/67531/metapth1517814/"><img alt="The Groom News (Groom, Tex.), Vol. 56, No. 42, Ed. 1 Thursday, December 31, 1981" title="The Groom News (Groom, Tex.), Vol. 56, No. 42, Ed. 1 Thursday, December 31, 1981" src="https://texashistory.unt.edu/ark:/67531/metapth1517814/small/"/></a></p><p>Weekly newspaper from Groom, Texas that includes local, state, and national news along with extensive advertising.</p>
</summary>
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<entry>
<title>
The Groom News (Groom, Tex.), Vol. 56, No. 40, Ed. 1 Thursday, December 17, 1981
</title>
<link href=" https://texashistory.unt.edu/ark:/67531/metapth1517813/" rel=" alternate"/>
<id>
https://texashistory.unt.edu/ark:/67531/metapth1517813/
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<p><a href="https://texashistory.unt.edu/ark:/67531/metapth1517813/"><img alt="The Groom News (Groom, Tex.), Vol. 56, No. 40, Ed. 1 Thursday, December 17, 1981" title="The Groom News (Groom, Tex.), Vol. 56, No. 40, Ed. 1 Thursday, December 17, 1981" src="https://texashistory.unt.edu/ark:/67531/metapth1517813/small/"/></a></p><p>Weekly newspaper from Groom, Texas that includes local, state, and national news along with extensive advertising.</p>
</summary>
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<entry>
<title>
The Groom News (Groom, Tex.), Vol. 56, No. 39, Ed. 1 Thursday, December 10, 1981
</title>
<link href=" https://texashistory.unt.edu/ark:/67531/metapth1517812/" rel=" alternate"/>
<published> 2022-10-28T22:54:23-05:00 </published>
<id>
https://texashistory.unt.edu/ark:/67531/metapth1517812/
</id>
<summary type=" html">
<p><a href="https://texashistory.unt.edu/ark:/67531/metapth1517812/"><img alt="The Groom News (Groom, Tex.), Vol. 56, No. 39, Ed. 1 Thursday, December 10, 1981" title="The Groom News (Groom, Tex.), Vol. 56, No. 39, Ed. 1 Thursday, December 10, 1981" src="https://texashistory.unt.edu/ark:/67531/metapth1517812/small/"/></a></p><p>Weekly newspaper from Groom, Texas that includes local, state, and national news along with extensive advertising.</p>
</summary>
<media:thumbnail url=" https://texashistory.unt.edu/ark:/67531/metapth1517812/small/"/>
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<entry>
<title>
The Groom News (Groom, Tex.), Vol. 56, No. 38, Ed. 1 Thursday, December 3, 1981
</title>
<link href=" https://texashistory.unt.edu/ark:/67531/metapth1517811/" rel=" alternate"/>
<published> 2022-10-28T22:54:12-05:00 </published>
<id>
https://texashistory.unt.edu/ark:/67531/metapth1517811/
</id>
<summary type=" html">
<p><a href="https://texashistory.unt.edu/ark:/67531/metapth1517811/"><img alt="The Groom News (Groom, Tex.), Vol. 56, No. 38, Ed. 1 Thursday, December 3, 1981" title="The Groom News (Groom, Tex.), Vol. 56, No. 38, Ed. 1 Thursday, December 3, 1981" src="https://texashistory.unt.edu/ark:/67531/metapth1517811/small/"/></a></p><p>Weekly newspaper from Groom, Texas that includes local, state, and national news along with extensive advertising.</p>
</summary>
<media:thumbnail url=" https://texashistory.unt.edu/ark:/67531/metapth1517811/small/"/>
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<entry>
<title>
The Groom News (Groom, Tex.), Vol. 56, No. 37, Ed. 1 Thursday, November 26, 1981
</title>
<link href=" https://texashistory.unt.edu/ark:/67531/metapth1517810/" rel=" alternate"/>
<published> 2022-10-28T22:54:04-05:00 </published>
<id>
https://texashistory.unt.edu/ark:/67531/metapth1517810/
</id>
<summary type=" html">
<p><a href="https://texashistory.unt.edu/ark:/67531/metapth1517810/"><img alt="The Groom News (Groom, Tex.), Vol. 56, No. 37, Ed. 1 Thursday, November 26, 1981" title="The Groom News (Groom, Tex.), Vol. 56, No. 37, Ed. 1 Thursday, November 26, 1981" src="https://texashistory.unt.edu/ark:/67531/metapth1517810/small/"/></a></p><p>Weekly newspaper from Groom, Texas that includes local, state, and national news along with extensive advertising.</p>
</summary>
<media:thumbnail url=" https://texashistory.unt.edu/ark:/67531/metapth1517810/small/"/>
</entry>
<entry>
<title>
The Groom News (Groom, Tex.), Vol. 56, No. 36, Ed. 1 Thursday, November 19, 1981
</title>
<link href=" https://texashistory.unt.edu/ark:/67531/metapth1517809/" rel=" alternate"/>
<published> 2022-10-28T22:54:03-05:00 </published>
<id>
https://texashistory.unt.edu/ark:/67531/metapth1517809/
</id>
<summary type=" html">
<p><a href="https://texashistory.unt.edu/ark:/67531/metapth1517809/"><img alt="The Groom News (Groom, Tex.), Vol. 56, No. 36, Ed. 1 Thursday, November 19, 1981" title="The Groom News (Groom, Tex.), Vol. 56, No. 36, Ed. 1 Thursday, November 19, 1981" src="https://texashistory.unt.edu/ark:/67531/metapth1517809/small/"/></a></p><p>Weekly newspaper from Groom, Texas that includes local, state, and national news along with extensive advertising.</p>
</summary>
<media:thumbnail url=" https://texashistory.unt.edu/ark:/67531/metapth1517809/small/"/>
</entry>
<entry>
<title>
The Groom News (Groom, Tex.), Vol. 56, No. 35, Ed. 1 Thursday, November 12, 1981
</title>
<link href=" https://texashistory.unt.edu/ark:/67531/metapth1517808/" rel=" alternate"/>
<published> 2022-10-28T22:54:02-05:00 </published>
<id>
https://texashistory.unt.edu/ark:/67531/metapth1517808/
</id>
<summary type=" html">
<p><a href="https://texashistory.unt.edu/ark:/67531/metapth1517808/"><img alt="The Groom News (Groom, Tex.), Vol. 56, No. 35, Ed. 1 Thursday, November 12, 1981" title="The Groom News (Groom, Tex.), Vol. 56, No. 35, Ed. 1 Thursday, November 12, 1981" src="https://texashistory.unt.edu/ark:/67531/metapth1517808/small/"/></a></p><p>Weekly newspaper from Groom, Texas that includes local, state, and national news along with extensive advertising.</p>
</summary>
<media:thumbnail url=" https://texashistory.unt.edu/ark:/67531/metapth1517808/small/"/>
</entry>
<entry>
<title>
The Groom News (Groom, Tex.), Vol. 56, No. 33, Ed. 1 Thursday, October 29, 1981
</title>
<link href=" https://texashistory.unt.edu/ark:/67531/metapth1517806/" rel=" alternate"/>
<published> 2022-10-28T22:53:46-05:00 </published>
<id>
https://texashistory.unt.edu/ark:/67531/metapth1517806/
</id>
<summary type=" html">
<p><a href="https://texashistory.unt.edu/ark:/67531/metapth1517806/"><img alt="The Groom News (Groom, Tex.), Vol. 56, No. 33, Ed. 1 Thursday, October 29, 1981" title="The Groom News (Groom, Tex.), Vol. 56, No. 33, Ed. 1 Thursday, October 29, 1981" src="https://texashistory.unt.edu/ark:/67531/metapth1517806/small/"/></a></p><p>Weekly newspaper from Groom, Texas that includes local, state, and national news along with extensive advertising.</p>
</summary>
<media:thumbnail url=" https://texashistory.unt.edu/ark:/67531/metapth1517806/small/"/>
</entry>
<entry>
<title>
The Groom News (Groom, Tex.), Vol. 56, No. 34, Ed. 1 Thursday, November 5, 1981
</title>
<link href=" https://texashistory.unt.edu/ark:/67531/metapth1517807/" rel=" alternate"/>
<published> 2022-10-28T22:53:46-05:00 </published>
<id>
https://texashistory.unt.edu/ark:/67531/metapth1517807/
</id>
<summary type=" html">
<p><a href="https://texashistory.unt.edu/ark:/67531/metapth1517807/"><img alt="The Groom News (Groom, Tex.), Vol. 56, No. 34, Ed. 1 Thursday, November 5, 1981" title="The Groom News (Groom, Tex.), Vol. 56, No. 34, Ed. 1 Thursday, November 5, 1981" src="https://texashistory.unt.edu/ark:/67531/metapth1517807/small/"/></a></p><p>Weekly newspaper from Groom, Texas that includes local, state, and national news along with extensive advertising.</p>
</summary>
<media:thumbnail url=" https://texashistory.unt.edu/ark:/67531/metapth1517807/small/"/>
</entry>
<entry>
<title>
The Groom News (Groom, Tex.), Vol. 56, No. 32, Ed. 1 Thursday, October 22, 1981
</title>
<link href=" https://texashistory.unt.edu/ark:/67531/metapth1517805/" rel=" alternate"/>
<published> 2022-10-28T22:53:42-05:00 </published>
<id>
https://texashistory.unt.edu/ark:/67531/metapth1517805/
</id>
<summary type=" html">
<p><a href="https://texashistory.unt.edu/ark:/67531/metapth1517805/"><img alt="The Groom News (Groom, Tex.), Vol. 56, No. 32, Ed. 1 Thursday, October 22, 1981" title="The Groom News (Groom, Tex.), Vol. 56, No. 32, Ed. 1 Thursday, October 22, 1981" src="https://texashistory.unt.edu/ark:/67531/metapth1517805/small/"/></a></p><p>Weekly newspaper from Groom, Texas that includes local, state, and national news along with extensive advertising.</p>
</summary>
<media:thumbnail url=" https://texashistory.unt.edu/ark:/67531/metapth1517805/small/"/>
</entry>
<entry>
<title>
The Groom News (Groom, Tex.), Vol. 56, No. 31, Ed. 1 Thursday, October 15, 1981
</title>
<link href=" https://texashistory.unt.edu/ark:/67531/metapth1517804/" rel=" alternate"/>
<published> 2022-10-28T22:53:25-05:00 </published>
<id>
https://texashistory.unt.edu/ark:/67531/metapth1517804/
</id>
<summary type=" html">
<p><a href="https://texashistory.unt.edu/ark:/67531/metapth1517804/"><img alt="The Groom News (Groom, Tex.), Vol. 56, No. 31, Ed. 1 Thursday, October 15, 1981" title="The Groom News (Groom, Tex.), Vol. 56, No. 31, Ed. 1 Thursday, October 15, 1981" src="https://texashistory.unt.edu/ark:/67531/metapth1517804/small/"/></a></p><p>Weekly newspaper from Groom, Texas that includes local, state, and national news along with extensive advertising.</p>
</summary>
<media:thumbnail url=" https://texashistory.unt.edu/ark:/67531/metapth1517804/small/"/>
</entry>
<entry>
<title>
The Groom News (Groom, Tex.), Vol. 56, No. 30, Ed. 1 Thursday, October 8, 1981
</title>
<link href=" https://texashistory.unt.edu/ark:/67531/metapth1517803/" rel=" alternate"/>
<published> 2022-10-28T22:53:16-05:00 </published>
<id>
https://texashistory.unt.edu/ark:/67531/metapth1517803/
</id>
<summary type=" html">
<p><a href="https://texashistory.unt.edu/ark:/67531/metapth1517803/"><img alt="The Groom News (Groom, Tex.), Vol. 56, No. 30, Ed. 1 Thursday, October 8, 1981" title="The Groom News (Groom, Tex.), Vol. 56, No. 30, Ed. 1 Thursday, October 8, 1981" src="https://texashistory.unt.edu/ark:/67531/metapth1517803/small/"/></a></p><p>Weekly newspaper from Groom, Texas that includes local, state, and national news along with extensive advertising.</p>
</summary>
<media:thumbnail url=" https://texashistory.unt.edu/ark:/67531/metapth1517803/small/"/>
</entry>
<entry>
<title>
The Groom News (Groom, Tex.), Vol. 56, No. 29, Ed. 1 Thursday, October 1, 1981
</title>
<link href=" https://texashistory.unt.edu/ark:/67531/metapth1517802/" rel=" alternate"/>
<published> 2022-10-28T22:53:09-05:00 </published>
<id>
https://texashistory.unt.edu/ark:/67531/metapth1517802/
</id>
<summary type=" html">
<p><a href="https://texashistory.unt.edu/ark:/67531/metapth1517802/"><img alt="The Groom News (Groom, Tex.), Vol. 56, No. 29, Ed. 1 Thursday, October 1, 1981" title="The Groom News (Groom, Tex.), Vol. 56, No. 29, Ed. 1 Thursday, October 1, 1981" src="https://texashistory.unt.edu/ark:/67531/metapth1517802/small/"/></a></p><p>Weekly newspaper from Groom, Texas that includes local, state, and national news along with extensive advertising.</p>
</summary>
<media:thumbnail url=" https://texashistory.unt.edu/ark:/67531/metapth1517802/small/"/>
</entry>
<entry>
<title>
The Groom News (Groom, Tex.), Vol. 56, No. 28, Ed. 1 Thursday, September 24, 1981
</title>
<link href=" https://texashistory.unt.edu/ark:/67531/metapth1517801/" rel=" alternate"/>
<published> 2022-10-28T22:53:08-05:00 </published>
<id>
https://texashistory.unt.edu/ark:/67531/metapth1517801/
</id>
<summary type=" html">
<p><a href="https://texashistory.unt.edu/ark:/67531/metapth1517801/"><img alt="The Groom News (Groom, Tex.), Vol. 56, No. 28, Ed. 1 Thursday, September 24, 1981" title="The Groom News (Groom, Tex.), Vol. 56, No. 28, Ed. 1 Thursday, September 24, 1981" src="https://texashistory.unt.edu/ark:/67531/metapth1517801/small/"/></a></p><p>Weekly newspaper from Groom, Texas that includes local, state, and national news along with extensive advertising.</p>
</summary>
<media:thumbnail url=" https://texashistory.unt.edu/ark:/67531/metapth1517801/small/"/>
</entry>
<entry>
<title>
The Groom News (Groom, Tex.), Vol. 56, No. 27, Ed. 1 Thursday, September 17, 1981
</title>
<link href=" https://texashistory.unt.edu/ark:/67531/metapth1517800/" rel=" alternate"/>
<published> 2022-10-28T22:53:07-05:00 </published>
<id>
https://texashistory.unt.edu/ark:/67531/metapth1517800/
</id>
<summary type=" html">
<p><a href="https://texashistory.unt.edu/ark:/67531/metapth1517800/"><img alt="The Groom News (Groom, Tex.), Vol. 56, No. 27, Ed. 1 Thursday, September 17, 1981" title="The Groom News (Groom, Tex.), Vol. 56, No. 27, Ed. 1 Thursday, September 17, 1981" src="https://texashistory.unt.edu/ark:/67531/metapth1517800/small/"/></a></p><p>Weekly newspaper from Groom, Texas that includes local, state, and national news along with extensive advertising.</p>
</summary>
<media:thumbnail url=" https://texashistory.unt.edu/ark:/67531/metapth1517800/small/"/>
</entry>
<entry>
<title>
The Groom News (Groom, Tex.), Vol. 56, No. 26, Ed. 1 Thursday, September 10, 1981
</title>
<link href=" https://texashistory.unt.edu/ark:/67531/metapth1517799/" rel=" alternate"/>
<published> 2022-10-28T22:52:50-05:00 </published>
<id>
https://texashistory.unt.edu/ark:/67531/metapth1517799/
</id>
<summary type=" html">
<p><a href="https://texashistory.unt.edu/ark:/67531/metapth1517799/"><img alt="The Groom News (Groom, Tex.), Vol. 56, No. 26, Ed. 1 Thursday, September 10, 1981" title="The Groom News (Groom, Tex.), Vol. 56, No. 26, Ed. 1 Thursday, September 10, 1981" src="https://texashistory.unt.edu/ark:/67531/metapth1517799/small/"/></a></p><p>Weekly newspaper from Groom, Texas that includes local, state, and national news along with extensive advertising.</p>
</summary>
<media:thumbnail url=" https://texashistory.unt.edu/ark:/67531/metapth1517799/small/"/>
</entry>
<entry>
<title>
The Groom News (Groom, Tex.), Vol. 56, No. 25, Ed. 1 Thursday, September 3, 1981
</title>
<link href=" https://texashistory.unt.edu/ark:/67531/metapth1517798/" rel=" alternate"/>
<published> 2022-10-28T22:52:47-05:00 </published>
<id>
https://texashistory.unt.edu/ark:/67531/metapth1517798/
</id>
<summary type=" html">
<p><a href="https://texashistory.unt.edu/ark:/67531/metapth1517798/"><img alt="The Groom News (Groom, Tex.), Vol. 56, No. 25, Ed. 1 Thursday, September 3, 1981" title="The Groom News (Groom, Tex.), Vol. 56, No. 25, Ed. 1 Thursday, September 3, 1981" src="https://texashistory.unt.edu/ark:/67531/metapth1517798/small/"/></a></p><p>Weekly newspaper from Groom, Texas that includes local, state, and national news along with extensive advertising.</p>
</summary>
<media:thumbnail url=" https://texashistory.unt.edu/ark:/67531/metapth1517798/small/"/>
</entry>
<entry>
<title>
The Groom News (Groom, Tex.), Vol. 56, No. 24, Ed. 1 Thursday, August 27, 1981
</title>
<link href=" https://texashistory.unt.edu/ark:/67531/metapth1517797/" rel=" alternate"/>
<published> 2022-10-28T22:52:38-05:00 </published>
<id>
https://texashistory.unt.edu/ark:/67531/metapth1517797/
</id>
<summary type=" html">
<p><a href="https://texashistory.unt.edu/ark:/67531/metapth1517797/"><img alt="The Groom News (Groom, Tex.), Vol. 56, No. 24, Ed. 1 Thursday, August 27, 1981" title="The Groom News (Groom, Tex.), Vol. 56, No. 24, Ed. 1 Thursday, August 27, 1981" src="https://texashistory.unt.edu/ark:/67531/metapth1517797/small/"/></a></p><p>Weekly newspaper from Groom, Texas that includes local, state, and national news along with extensive advertising.</p>
</summary>
<media:thumbnail url=" https://texashistory.unt.edu/ark:/67531/metapth1517797/small/"/>
</entry>
<entry>
<title>
The Groom News (Groom, Tex.), Vol. 56, No. 23, Ed. 1 Thursday, August 20, 1981
</title>
<link href=" https://texashistory.unt.edu/ark:/67531/metapth1517796/" rel=" alternate"/>
<published> 2022-10-28T22:52:31-05:00 </published>
<id>
https://texashistory.unt.edu/ark:/67531/metapth1517796/
</id>
<summary type=" html">
<p><a href="https://texashistory.unt.edu/ark:/67531/metapth1517796/"><img alt="The Groom News (Groom, Tex.), Vol. 56, No. 23, Ed. 1 Thursday, August 20, 1981" title="The Groom News (Groom, Tex.), Vol. 56, No. 23, Ed. 1 Thursday, August 20, 1981" src="https://texashistory.unt.edu/ark:/67531/metapth1517796/small/"/></a></p><p>Weekly newspaper from Groom, Texas that includes local, state, and national news along with extensive advertising.</p>
</summary>
<media:thumbnail url=" https://texashistory.unt.edu/ark:/67531/metapth1517796/small/"/>
</entry>
<entry>
<title>
The Groom News (Groom, Tex.), Vol. 56, No. 22, Ed. 1 Thursday, August 13, 1981
</title>
<link href=" https://texashistory.unt.edu/ark:/67531/metapth1517795/" rel=" alternate"/>
<published> 2022-10-28T22:52:14-05:00 </published>
<id>
https://texashistory.unt.edu/ark:/67531/metapth1517795/
</id>
<summary type=" html">
<p><a href="https://texashistory.unt.edu/ark:/67531/metapth1517795/"><img alt="The Groom News (Groom, Tex.), Vol. 56, No. 22, Ed. 1 Thursday, August 13, 1981" title="The Groom News (Groom, Tex.), Vol. 56, No. 22, Ed. 1 Thursday, August 13, 1981" src="https://texashistory.unt.edu/ark:/67531/metapth1517795/small/"/></a></p><p>Weekly newspaper from Groom, Texas that includes local, state, and national news along with extensive advertising.</p>
</summary>
<media:thumbnail url=" https://texashistory.unt.edu/ark:/67531/metapth1517795/small/"/>
</entry>
<entry>
<title>
The Groom News (Groom, Tex.), Vol. 56, No. 21, Ed. 1 Thursday, August 6, 1981
</title>
<link href=" https://texashistory.unt.edu/ark:/67531/metapth1517794/" rel=" alternate"/>
<published> 2022-10-28T22:52:14-05:00 </published>
<id>
https://texashistory.unt.edu/ark:/67531/metapth1517794/
</id>
<summary type=" html">
<p><a href="https://texashistory.unt.edu/ark:/67531/metapth1517794/"><img alt="The Groom News (Groom, Tex.), Vol. 56, No. 21, Ed. 1 Thursday, August 6, 1981" title="The Groom News (Groom, Tex.), Vol. 56, No. 21, Ed. 1 Thursday, August 6, 1981" src="https://texashistory.unt.edu/ark:/67531/metapth1517794/small/"/></a></p><p>Weekly newspaper from Groom, Texas that includes local, state, and national news along with extensive advertising.</p>
</summary>
<media:thumbnail url=" https://texashistory.unt.edu/ark:/67531/metapth1517794/small/"/>
</entry>
<entry>
<title>
The Groom News (Groom, Tex.), Vol. 56, No. 20, Ed. 1 Thursday, July 30, 1981
</title>
<link href=" https://texashistory.unt.edu/ark:/67531/metapth1517793/" rel=" alternate"/>
<published> 2022-10-28T22:52:11-05:00 </published>
<id>
https://texashistory.unt.edu/ark:/67531/metapth1517793/
</id>
<summary type=" html">
<p><a href="https://texashistory.unt.edu/ark:/67531/metapth1517793/"><img alt="The Groom News (Groom, Tex.), Vol. 56, No. 20, Ed. 1 Thursday, July 30, 1981" title="The Groom News (Groom, Tex.), Vol. 56, No. 20, Ed. 1 Thursday, July 30, 1981" src="https://texashistory.unt.edu/ark:/67531/metapth1517793/small/"/></a></p><p>Weekly newspaper from Groom, Texas that includes local, state, and national news along with extensive advertising.</p>
</summary>
<media:thumbnail url=" https://texashistory.unt.edu/ark:/67531/metapth1517793/small/"/>
</entry>
<entry>
<title>
The Groom News (Groom, Tex.), Vol. 56, No. 7, Ed. 1 Thursday, April 30, 1981
</title>
<link href=" https://texashistory.unt.edu/ark:/67531/metapth1517792/" rel=" alternate"/>
<published> 2022-10-28T22:52:10-05:00 </published>
<id>
https://texashistory.unt.edu/ark:/67531/metapth1517792/
</id>
<summary type=" html">
<p><a href="https://texashistory.unt.edu/ark:/67531/metapth1517792/"><img alt="The Groom News (Groom, Tex.), Vol. 56, No. 7, Ed. 1 Thursday, April 30, 1981" title="The Groom News (Groom, Tex.), Vol. 56, No. 7, Ed. 1 Thursday, April 30, 1981" src="https://texashistory.unt.edu/ark:/67531/metapth1517792/small/"/></a></p><p>Weekly newspaper from Groom, Texas that includes local, state, and national news along with extensive advertising.</p>
</summary>
<media:thumbnail url=" https://texashistory.unt.edu/ark:/67531/metapth1517792/small/"/>
</entry>
<entry>
<title>
The Groom News (Groom, Tex.), Vol. 55, No. 50, Ed. 1 Thursday, February 26, 1981
</title>
<link href=" https://texashistory.unt.edu/ark:/67531/metapth1517791/" rel=" alternate"/>
<published> 2022-10-28T22:52:02-05:00 </published>
<id>
https://texashistory.unt.edu/ark:/67531/metapth1517791/
</id>
<summary type=" html">
<p><a href="https://texashistory.unt.edu/ark:/67531/metapth1517791/"><img alt="The Groom News (Groom, Tex.), Vol. 55, No. 50, Ed. 1 Thursday, February 26, 1981" title="The Groom News (Groom, Tex.), Vol. 55, No. 50, Ed. 1 Thursday, February 26, 1981" src="https://texashistory.unt.edu/ark:/67531/metapth1517791/small/"/></a></p><p>Weekly newspaper from Groom, Texas that includes local, state, and national news along with extensive advertising.</p>
</summary>
<media:thumbnail url=" https://texashistory.unt.edu/ark:/67531/metapth1517791/small/"/>
</entry>
<entry>
<title>
The Groom News (Groom, Tex.), Vol. 55, No. 40, Ed. 1 Thursday, December 18, 1980
</title>
<link href=" https://texashistory.unt.edu/ark:/67531/metapth1517789/" rel=" alternate"/>
<published> 2022-10-28T22:51:53-05:00 </published>
<id>
https://texashistory.unt.edu/ark:/67531/metapth1517789/
</id>
<summary type=" html">
<p><a href="https://texashistory.unt.edu/ark:/67531/metapth1517789/"><img alt="The Groom News (Groom, Tex.), Vol. 55, No. 40, Ed. 1 Thursday, December 18, 1980" title="The Groom News (Groom, Tex.), Vol. 55, No. 40, Ed. 1 Thursday, December 18, 1980" src="https://texashistory.unt.edu/ark:/67531/metapth1517789/small/"/></a></p><p>Weekly newspaper from Groom, Texas that includes local, state, and national news along with extensive advertising.</p>
</summary>
<media:thumbnail url=" https://texashistory.unt.edu/ark:/67531/metapth1517789/small/"/>
</entry>
| https://texashistory.unt.edu/explore/titles/t00495/feed/?sort=added_d&t=untl_agent |
Italy's Pilgrim Route-La Via Francigena [Archive] - Eupedia Forum
Well, it's one of them. It's the ancient pilgrim route from France, hence the name, or more broadly, northern Europe, to Rome. It was analogous, I think, with the pilgrim route to Santiago de Compostela. See: https://en.wikipedia.org/wiki/Via_Francigena " The name Via Francigena is first mentioned in the Actum Clusio, a parchment of 876 in the Abbey of San Salvatore al Monte Amiata (Tuscany).At the end of the 10th century Sigeric the Serious, the Archbishop of Canterbury, used the Via
Angela
28-08-17, 16:49
Well, it's one of them. It's the ancient pilgrim route from France, hence the name, or more broadly, northern Europe, to Rome. It was analogous, I think, with the pilgrim route to Santiago de Compostela.
See:
https://en.wikipedia.org/wiki/Via_Francigena
"The name Via Francigena is first mentioned in the Actum Clusio, a parchment of 876 in the Abbey of San Salvatore (https://en.wikipedia.org/wiki/Abbey_of_San_Salvatore) al Monte Amiata (https://en.wikipedia.org/wiki/Monte_Amiata) (Tuscany (https://en.wikipedia.org/wiki/Tuscany)).[2] (https://en.wikipedia.org/wiki/Via_Francigena#cite_note-2)At the end of the 10th century Sigeric the Serious (https://en.wikipedia.org/wiki/Sigeric_the_Serious), the Archbishop of Canterbury (https://en.wikipedia.org/wiki/Archbishop_of_Canterbury), used the Via Francigena to and from Rome in order to receive his pallium (https://en.wikipedia.org/wiki/Pallium);[3] (https://en.wikipedia.org/wiki/Via_Francigena#cite_note-3) he recorded his route and his stops on the return journey,[4] (https://en.wikipedia.org/wiki/Via_Francigena#cite_note-4) but nothing in the document suggests that the route was then new.
Later itineraries to Rome include the Leiðarvísir og borgarskipan (https://en.wikipedia.org/wiki/Lei%C3%B0arv%C3%ADsir_og_borgarskipan) of the Icelandic (https://en.wikipedia.org/wiki/Iceland) traveller Nikolás Bergsson (https://en.wikipedia.org/w/index.php?title=Nikol%C3%A1s_Bergsson&action=edit&redlink=1) (in 1154) and the one from Philip Augustus (https://en.wikipedia.org/wiki/Philip_Augustus) of France (in 1191).[5] (https://en.wikipedia.org/wiki/Via_Francigena#cite_note-5) Two somewhat differing maps of the route appear in manuscripts of Matthew Paris (https://en.wikipedia.org/wiki/Matthew_Paris), Historia Anglorum, from the 13th century."
http://www.goodwalkingbooks.com/images/assets/via%20fran/vf%20map%20walk.gif
I initially became interested in it because it passed quite literally in front of the house where I was born, and in later years I've walked parts of it myself. Unfortunately, stretches of it have been overlaid by modern roads, which is the case in the part that goes past my door, and no side paths have been provided, and parts of it aren't very well marked. Also, unlike the better known pilgrimage route to Santiago de Compostela, convenient accommodations don't exist everywhere, which means hikers have to camp out, but as it is getting more and more known, and more people are hiking it, I think it may change.
"Due to the scarcity of dedicated pilgrims' accommodation along the Via Francigena, pilgrims often camp out rather than staying in hotels or pensions (https://en.wikipedia.org/wiki/Pension_(lodging)), both options which would turn out expensive when used for weeks on end. However increasingly in Italy, some monasteries and religious houses offer dedicated pilgrim's accommodation. These are called spedali and — like the refugios found on the Way of St. James (https://en.wikipedia.org/wiki/Way_of_St._James) in France and Spain — they offer cheap and simple dormitory-style accommodation. Spedali accept pilgrims who bear a valid credenziale (pilgrim's passport), usually for one night only. Some places offer meals as well.
Only a few decades ago, interest in the Via Francigena was limited to scholars. This began to change in recent years when many who, after travelling the
Way of St.James (https://en.wikipedia.org/wiki/Way_of_St._James)
in Spain, wanted to make the pilgrimage to Rome on foot as well. In Italy, this gave birth to a network of lovers of the Via Francigena, who with paint and brush, began to mark its trails and paths. These people were joined by religious and local government agencies who also tried to recover the original route. Where possible today's route follows the ancient one but sometimes it deviates from the historical path in favour of paths and roads with low traffic."
http://ac4fa7708134a70c34d3-66da2307b23609a8f8a6d8a13d2f16e2.r38.cf1.rackcdn.c om/1241/2/default.jpg
http://www.gonews.it/wp-content/uploads/2014/03/via_francigena.jpg
Sigerico, Archbishop of Canterbury, stayed here, in Aulla, my municipal center, around 990 AD, and the Abbey and guest house are part of the very little of ancient Aulla which remains following the destruction during World War II.
https://upload.wikimedia.org/wikipedia/commons/d/db/Pic-VF4-IT23_Ponteromli-Aulla_08_%28abad%C3%ADa_San_Caprasio%29.JPG
People do it following guides, and there are also starting to be guided excursions.
http://www.viefrancigene.org/en/ | https://www.eupedia.com/forum/archive/index.php/t-34500.html?s=68570bdd38a314f7c3475865624a5e4b |
Luke 13:3 (AFV) - Robertson's Book Notes (NT)
No, I tell you; but if you do not repent, you shall all likewise perish.
Luke 13:3 ( A Faithful Version )
A.F.VA.S.V.Amplified®DarbyI.S.V.K.J.V.N.A.S.B.NASB E-PrimeYoung'sCompare all
Book Notes:
Robertson's Book Notes (NT) Luke
There is not room here for a full discussion of all the interesting problems raised by Luke as the author ofthe Gospeland Acts. One can find them ably handled in the Introduction to Plummer's volume on Luke's Gospel in the International and Critical Commentary, in the Introduction to Ragg's volume on Luke's Gospel in the Westminster Commentaries, in the Introduction to Easton's Gospel According to St. Luke, Hayes' Synoptic Gospels and the Book of Acts, Ramsay's Luke the Physician, Harnack's Date of the Acts and the Synoptic Gospels, Foakes-Jackson and Kirsopp Lake's Beginnings of Christianity, Carpenter's Christianity According to St. Luke, Cadbury's The Making of Luke-Acts, McLachlan's St. Luke: The Man and His Work, Robertson's Luke the Historian in the Light of Research, to go no further. It is a fascinating subject that appeals to scholars of all shades of opinion.
The Same Author For Gospel And ActsThe author of Acts refers to the Gospel specifically as "the first treatise," \ton pr"ton logon\, (Acts 1:1) and both are addressed to Theophilus (Luke 1:3;Acts 1:1). He speaks of himself in both books as "me" (\kamoi\,Luke 1:3) and (I made) (\epoiˆsamˆn\,Acts 1:1). He refers to himself with others as "we" and "us" as inActs 16:10, the "we" sections of Acts. The unity of Acts is here assumed until the authorship of Acts is discussed in Volume III. The same style appears in Gospel and Acts, so that the presumption is strongly in support of the author's statement. It is quite possible that the formal Introduction to the Gospel (Luke 1:1-4) was intended to apply to the Acts also which has only an introductory clause. Plummer argues that to suppose that the author of Acts imitated the Gospel purposely is to suppose a literary miracle. Even Cadbury, who is not convinced of the Lucan authorship, says: "In my study of Luke and Acts, their unity is a fundamental and illuminating axiom." He adds: "They are not merely two independent writings from the same pen; they are a single continuous work. Acts is neither an appendix nor an afterthought. It is probably an integral part of the author's original plan and purpose."
The Author Of Acts A Companion Of PaulThe proof of this position belongs to the treatment of Acts, but a word is needed here. The use of "we" and "us" inActs 16:10and fromActs 20:6to the end of chapter Acts 28 shows it beyond controversy if the same man wrote the "we" sections and the rest of the Acts. This proof Harnack has produced with painstaking detail in his Date of the Acts and the Synoptic Gospelsand in his volume The Acts of the Apostlesand in his Luke the Physician.
This Companion Of Paul A PhysicianThe argument for this position lies in the use of medical terms throughout the Gospel and the Acts. Hobart in his Medical Language of St. Lukeproves that the author of both Gospel and Acts shows a fondness for medical terms best explained by the fact that he was a physician. Like most enthusiasts he overdid it and some of his proof does not stand the actual test of sifting. Harnack and Hawkins in his Horae Synopticaehave picked out the most pertinent items which will stand. Cadbury in his Style and Literary Method of Lukedenies that Luke uses Greek medical words more frequently in proportion than Josephus, Philo, Plutarch, or Lucian. It is to miss the point about Luke merely to count words. It is mainly the interest in medical things shown in Luke and Acts. The proof that Luke is the author of the books does not turn on this fact. It is merely confirmatory. Paul calls Luke "the beloved physician" (\ho iatros ho agapˆtos\,Colossians 4:14), "my beloved physician." Together they worked in the Island of Malta (Acts 28:8-10) where many were healed and Luke shared with Paul in the appreciation of the natives who "came and were healed (\etherapeuonto\) who also honoured us with many honours." The implication there is that Paul wrought miracles of healing (\iasato\), while Luke practised his medical art also. Other notes of the physician's interest will be indicated in the discussion of details like his omitting Mark's apparent discredit of physicians (Mark 5:26) by a milder and more general statement of a chronic case (Luke 8:43).
This Companion And Author LukeAll the Greek manuscripts credit the Gospel to Luke in the title. We should know that Luke wrote these two books if there was no evidence from early writers. Irenaeus definitely ascribes the Gospel to Luke as does Clement of Alexandria, Tertullian, the Muratorian Fragment. Plummer holds that the authorship of the four great Epistles of Paul (I and II Corinthians, Galatians, Romans) which even Baur accepted, is scarcely more certain than the Lukan authorship of the Gospel. Even Renan says: "There is no very strong reason for supposing that Luke was not the author of the Gospel which bears his name."
A Sketch Of LukeHis name is not a common one, and is probably a shortened form of \Lukios\ and \Lukanos\. Some of the manuscripts of the Gospel actually have as the title \Kata Lukanon\. Dean Plumptre suggests that the Latin poet Lucanus was named after Luke who probably was the family physician when he was born. That is conjecture as well as the notion of Hayes that, since the brothers Gallio and Seneca were uncles of Lucanus they were influenced by Luke to be friendly toward Paul both in Corinth and in Rome. It is probable that Luke was a Greek, certainly a Gentile, possibly a freedman. So this man who wrote more than one-fourth of the New Testament was not a Jew. It is not certain whether his home was in Antioch or in Philippi. It is also uncertain whether he was already converted when Paul met him at Troas. The Codex Bezae has a "we" passage afterActs 11:27which, if genuine, would bring Luke in contact with Paul before Troas. Hayes thinks that he was a slave boy in the family of Theophilus at Antioch, several conjectures in one. We do not know that Theophilus lived at Antioch. It may have been Rome. But, whether one of Paul's converts or not, he was a loyal friend to Paul. If he lived at Antioch, he could have studied medicine there and the great medical temple of Aesculapius was at Aegae, not far away. As a Greek physician, Luke was a university man and in touch with the science of his day. Greek medicine is the beginning of the science of medicine as it is known today. Tradition calls him a painter, but of that we know nothing. Certainly he was a humanist and a man of culture and broad sympathies and personal charm. He was the first genuine scientist who faced the problem of Christ and of Christianity. It must be said of him that he wrote his books with open mind and not as a credulous enthusiast.
The Date Of The GospelThere are two outstanding facts to mark off the date of this Gospel by Luke. It was later than the Gospel of Mark since Luke makes abundant use of it. It was before the Acts of the Apostles since he definitely refers to it inActs 1:1. Unfortunately the precise date of both terminiis uncertain. There are still some scholars who hold that the author of the Acts shows knowledge of the Antiquitiesof Josephus and so is after AD85, a mistaken position, in my opinion, but a point to be discussed when Acts is reached. Still others more plausibly hold that the Acts was written after the destruction of Jerusalem and that the Gospel of Luke has a definite allusion to that event (Luke 21:20f.), which is interpreted as a prophecy post eventuminstead of a prediction by Christ a generation beforehand. Many who accept this view hold to authorship of both Acts and Gospel by Luke. I have long held the view, now so ably defended by Harnack, that the Acts of the Apostles closes as it does for the simple and obvious reason that Paul was still a prisoner in Rome. Whether Luke meant the Acts to be used in the trial in Rome, which may or may not have come to pass, is not the point. Some argue that Luke contemplated a third book which would cover the events of the trial and Paul's later career. There is no proof of that view. The outstanding fact is that the book closes with Paul already a prisoner for two years in Rome. If the Acts was written about AD63, as I believe to be the case, then obviously the Gospel comes earlier. How much before we do not know. It so happens that Paul was a prisoner a little over two years in Caesarea. That period gave Luke abundant opportunity for the kind of research of which he speaks inLuke 1:1-4. In Palestine he could have access to persons familiar with the earthly life andteachings of Jesusand to whatever documents were already produced concerning such matters. Luke may have produced the Gospel towards the close of the stay of Paul in Caesarea or during the early part of the first Roman imprisonment, somewhere between AD59 and 62. The other testimony concerns the date of Mark's Gospel which has already been discussed in volume I. There is no real difficulty in the way of the early date of Mark's Gospel. All the facts that are known admit, even argue for a date by AD60. If Mark wrote his Gospel in Rome, as is possible, it would certainly be before AD64, the date of the burning of Rome by Nero. There are scholars, however, who argue for a much earlier date for his gospel, even as early as AD50. The various aspects of the Synoptic problem are ably discussed by Hawkins in his Horae Synopticae, by Sanday and others in Oxford Studies in the Synoptic Problem, by Streeter in his The Four Gospels, by Hayes in his The Synoptic Gospels and the Book of Acts, by Harnack in his Date of the Acts and the Synoptic Gospels, by Stanton in his The Gospels as Historical Documents, and by many others. My own views are given at length in my Studies in Mark's Gospeland in Luke the Historian in the Light of Research.
The Sources Of The GospelIn his Preface or Prologue (Luke 1:1-4) the author tells us that he had two kinds of sources, oral and written, and that they were many, how many we have no way of telling. It is now generally accepted that we know two of his written sources, Mark's Gospel and Q or the Logia of Jesus (written by Matthew, Papias says). Mark is still preserved and it is not difficult for any one by the use of a harmony of the Gospels to note how Luke made use of Mark, incorporating what he chose, adapting it in various ways, not using what did not suit his purposes. The other source we only know in the non-Markan portions of Matthew and Luke, that is the material common to both, but not in Mark. This also can be noted by any one in a harmony. Only it is probable that this source was more extensive than just the portions used by both Matthew and Luke. It is probable that both Matthew and Luke each used portions of the Logia not used by the other. But there is a large portion of Luke's Gospel which is different from Mark and Matthew. Some scholars call this source L. There is little doubt that Luke had another document for the material peculiar to him, but it is also probable that he had several others. He spoke of "many." This applies especially to chapters 9 to 21. But Luke expressly says that he had received help from "eye-witnesses and ministers of the word," in oral form this means. It is, then, probable that Luke made numerous notes of such data and used them along with the written sources at his command. This remark applies particularly to chapters 1 and 2 which have a very distinct Semitic (Aramaic) colouring due to the sources used. It is possible, of course, that Mary the mother of Jesus may have written a statement concerning these important matters or that Luke may have had converse with her or with one of her circle. Ramsay, in his volume, Was Christ Born at Bethlehem?shows the likelihood of Luke's contact with Mary or her circle during these two years at Caesarea. Luke handles the data acquired with care and skill as he claims in his Prologue and as the result shows. The outcome is what Renan called the most beautiful book in the world.
The Character Of The BookLiterary charm is here beyond dispute. It is a book that only a man with genuine culture and literary genius could write. It has all the simple grace of Mark and Matthew plus an indefinable quality not in these wonderful books. There is a delicate finish of detail and proportion of parts that give the balance and poise that come only from full knowledge of the subject, the chief element in a good style according to Dr. James Stalker. This scientific physician, this man of the schools, this converted Gentile, this devoted friend of Paul, comes to the study of the life of Christ with a trained intellect, with an historian's method of research, with a physician's care in diagnosis and discrimination, with a charm of style all his own, with reverence for and loyalty toJesus Christas Lord and Saviour. One could not afford to give up either of the Four Gospels. They each supplement the other in a wonderful way. John's Gospel is the greatest book in allthe world, reaching the highest heights of all. But if we had only Luke's Gospel, we should have an adequate portrait of Jesus Christ as Son ofGodand Son of Man. If Mark's is the Gospel for the Romans and Matthew's for the Jews, the Gospel of Luke is for the Gentile world. He shows the sympathy of Jesus for the poor and the outcast. Luke understands women and children and so is the universal Gospel of mankind in all phases and conditions. It is often called the Gospel of womanhood, of infancy, of prayer, of praise. We have in Luke the first Christian hymns. With Luke we catch some glimpses of the child Jesus for which we are grateful. Luke was a friend and follower of Paul, and verbal parallels with Paul's Epistles do occur, but there is no Pauline propaganda in the Gospel as Moffatt clearly shows ( Intr. to Lit. of the N.T., p. 281). The Prologue is in literary Koin‚and deserves comparison with those in any Greek and Latin writers. His style is versatile and is often coloured by his source. He was a great reader of the Septuagint as is shown by occasional Hebraisms evidently due to reading that translation Greek. He has graciousness and a sense of humour as McLachlan and Ragg show. Every really great man has a saving sense of humour as Jesus himself had. Ramsay dares to call Luke, as shown by the Gospel and Acts, the greatest of all historians not even excepting Thucydides. Ramsay has done much to restore Luke to his rightful place in the estimation of modern scholars. Some German critics used to citeLuke 2:1-7as a passage containing more historical blunders than any similar passage in any historian. The story of how papyri and inscriptions have fully justified Luke in every statement here made is carefully worked out by Ramsay in his various books, especially in The Bearing of Recent Discovery on the Trustworthiness of the New Testament. The main feature of this proof appears also in my Luke the Historian in the Light of Research. So many items, where Luke once stood alone, have been confirmed by recent discoveries that the burden of proof now rests on those who challenge Luke in those cases where he still stands alone.
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Exodus 35:3 (RSV) - Forerunner Commentary
you shall kindle no fire in all your habitations on the sabbath day."
Exodus 35:3 ( Revised Standard Version )
Exodus 35:1-3
Even though the Israelites were constructing an important edifice devoted to the worship ofGod, they were not to desecrate this holy time by working on it.
John W. RitenbaughThe Fourth Commandment
Exodus 35:3
There is an interesting example in the way Orthodox Jews keep theSabbathand the 39 forbidden Sabbath activities ( melachot) that they have come up with. Rather than learn the principles involved in Sabbath-keeping, the attitude seems to be, “Let's just have a rule to cover every conceivable development.” The command inExodus 35:3directly follows a command not to workon the Sabbath, so in saying not to kindle a fire,Godwas speaking of a fire employed in work, such as one used by a smith to shape metal, not a home heating fire.
However, the Orthodox Jews take it to an extreme, teaching that it includes the modern analogy of moving electricity through a circuit. If a person opens his refrigerator door on the Sabbath and the light inside comes on, in their judgment, he has “kindled a fire.” So, the Orthodox Jewish solution is to unscrew the bulb in the refrigerator on the Preparation Day so that no light comes on when the door is opened on the Sabbath.
On the Sabbath, a Jew cannot turn the lights on in the house or the burner on the stove. To get around this, Jews use timers. Note that they do these things to “get around” the law. To this end, their sages have come up with the concept of grama, and this has nothing to do with the nice older lady who gave you cookies as a child.
In Jewish law, there is a difference in direct and indirect action on the Sabbath. For instance, a Jew cannot intentionally extinguish a flame, but if he opens a window and the wind blows out the candle, he has not violated Sabbath law. Such an indirect action, whose result is not guaranteed, is called grama, which comes from the Hebrew root meaning “to cause [something to happen].” If a fire breaks out on the Sabbath, a Jew cannot put it out, but he can fill water jugs and place them in the path of the fire. When—or if—the heat bursts the jugs, the water may put the fire out. There are more subtleties to grama, but that is the short explanation.
So, in this modern, technological world, the Jews use the grama principle in numerous ways. Opening and closing electrical circuits would be work. But if the switch has a delay so that, when a Jew presses or turns it, nothing immediately happens, yet a few seconds later something does happen, that is not considered work.
Some manufacturers have installed “Sabbath” modes on their appliances. On some new refrigerators, unscrewing the light bulb is not so easy. So now, more than 300 types of ovens, stoves, and refrigerators can be set to “Sabbath” mode, which, when enabled, means lights stay off, displays are blank, tones are silenced, fans are stilled, compressors slowed, etc. To quote WIREDmagazine's Michael Erard in “The Geek Guide to Kosher Machines”:
In a kosher fridge, there's no light, no automatic icemaker, no cold-water dispenser, no warning alarm for spoiled food, no temperature readout. Basically, [Sabbath mode] converts your fancy—and expensive—appliance into the one your grandma bought after World War II.
If we have to jump through these mental and physical hoops to follow God's laws, have we really learned the principles involved?
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Social Sciences | Free Full-Text | Do Data from Large Personal Networks Support Cultural Evolutionary Ideas about Kin and Fertility?
The fertility decline associated with economic development has been attributed to a host of interrelated causes including the rising costs of children with industrialization, and shifts in family structure. One hypothesis is that kin may impart more pro-natal information within their networks than non-kin, and that this effect may be exacerbated in networks with high kin-density where greater social conformity would be expected. In this study, we tested these ideas using large personal networks (25 associates of the respondent) collected from a sample of Dutch women (N = 706). Kin (parents) were perceived to exert slightly more social pressure to have children than non-kin, although dense networks were not associated with greater pressure. In contrast, women reported talking to friends about having children to a greater extent than kin, although greater kin-density in the network increased the likelihood of women reporting that they could talk to kin about having children. Both consanguineal and affinal kin could be asked to help with child-care to a greater extent than friends and other non-kin. Overall, there was mixed evidence that kin were more likely to offer pro-natal information than non-kin, and better evidence to suggest that kin were considered to be a better source of child-care support.
Do Data from Large Personal Networks Support Cultural Evolutionary Ideas about Kin and Fertility?
by Gert Stulp 1,* and Louise Barrett 2,3
1
Department of Sociology & Inter-University Center for Social Science Theory and Methodology, Grote Rozenstraat 31, 9712 TS Groningen, The Netherlands
2
Department of Psychology, Science Commons, University of Lethbridge, 4401 University Drive, Lethbridge, AB T1K 3M4, Canada
3
Applied Behavioral Ecology and Ecosystems Research Unit, University of South Africa, Private Bag X6, Florida 1710, South Africa
*
Author to whom correspondence should be addressed.
Soc. Sci. 2021 , 10 (5), 177; https://doi.org/10.3390/socsci10050177
Received: 14 April 2021 / Revised: 11 May 2021 / Accepted: 13 May 2021 / Published: 18 May 2021
(This article belongs to the Special Issue The Behavioral Ecology of the Family )
Abstract
The fertility decline associated with economic development has been attributed to a host of interrelated causes including the rising costs of children with industrialization, and shifts in family structure. One hypothesis is that kin may impart more pro-natal information within their networks than non-kin, and that this effect may be exacerbated in networks with high kin-density where greater social conformity would be expected. In this study, we tested these ideas using large personal networks (25 associates of the respondent) collected from a sample of Dutch women (
N
= 706). Kin (parents) were perceived to exert slightly more social pressure to have children than non-kin, although dense networks were not associated with greater pressure. In contrast, women reported talking to friends about having children to a greater extent than kin, although greater kin-density in the network increased the likelihood of women reporting that they could talk to kin about having children. Both consanguineal and affinal kin could be asked to help with child-care to a greater extent than friends and other non-kin. Overall, there was mixed evidence that kin were more likely to offer pro-natal information than non-kin, and better evidence to suggest that kin were considered to be a better source of child-care support.
Keywords:
kin
;
affinal kin
;
density
;
personal network
;
social support
;
social pressure
;
fertility
1. Introduction
Why do (post)industrial humans have so few children? This question has occupied economists, demographers, quite a few historians, and many evolutionarily-minded social scientists (see Sear et al. 2016 ). Over time, it has become clear that any explanation must combine both individual level and societal factors, and that industrial societies cannot be treated as monolithic, but have their own distinct reproductive ecologies ( Stulp et al. 2016 ; Sear 2015 ; Burger and DeLong 2016 ). Identifying how and why reproductive decision-making shifts across space and time thus requires consideration of the diverse range of changes associated with economic development—from increased mobility to improved hygiene, and from ideas on contraception to child labor laws—any number of which could influence family size, whether alone or through potentially complex intersections ( Newson et al. 2005 ).
Evolutionary approaches to the issue of fertility decline have included both individual-level explanations concerning the costs and benefits of producing children (see Lawson and Mulder ( 2016 ) for review) as well as more complex models that consider how cultural norms evolve, both within and outside the reproductive domain (see Colleran ( 2016 ) for review). With respect to behavioral ecology-inspired, individual-based models, early work by Turke ( 1989 ), for example, suggested that reductions in the size of extended kin networks during modernization meant that people could no longer call on kin for help with child-care (and/or their perceptions of the likelihood of such help declined), which served to raise the relative costs of children; family size therefore shifted downward to reflect the number of children that could be raised adequately by a smaller family unit. In this view, family size limitation reflects a rational, potentially adaptive response to ecological circumstances. Other authors, in contrast, have suggested that family size decline resulted from the misperception of child-rearing cues in a novel environment ( Kaplan 1996 ); specifically, parents assume that greater investment per child is required than is strictly necessary to promote offspring survival and success. As a result, parents engage in an extreme quality–quantity trade-off that accords with life history considerations, but is functionally maladaptive. Although these individually-oriented optimality models offer genuine insight into how and why reproductive decision-making may have shifted with modernization, such models cannot account for why particular social norms regarding family size arise and take hold in ways that continue to influence behavior independently of changes in an individual’s ecological circumstances (see e.g., Lesthaeghe and Surkyn 1988 ). There has, therefore, been an enduring interest in developing models that consider fertility decline from a cultural evolutionary perspective (see Colleran ( 2016 ) for review).
Models that incorporate social norms in addition to individual cost-benefit analyses have often considered how particular kinds of learning biases can shape decision-making such as imitating highly successful or prestigious individuals. An early example is
Boyd and Richerson
’s (
1985
) suggestion that fertility decline is a culturally evolved process that reflects shifts in prestige and who people imitate. Under non-industrial conditions,
Boyd and Richerson
(
1985
) argued that prestige and success would be associated with high reproductive success, as individuals afforded prestige would likely be the matriarchs or patriarchs of large families. Modernization then generated new forms of success and associated prestige, often in roles associated with education and work outside the domestic sphere, such as teachers. As such high-investment social roles were likely to cause the individuals fulfilling these roles to limit family size, this would then result in smaller family sizes among those imitating high-prestige individuals, thus creating new reproductive norms.
As
Newson et al.
(
2005
) point out, however, the manner by which prestige is determined is itself a product of social values and group norms. Thus, this prestige influence model leaves unexplained why norms of social prestige should have changed to favor “the exotic expertise” of school teachers and the like. Newson and colleagues thus suggest we also need to incorporate
teaching
biases into cultural evolutionary models in order to generate a more complete explanation. Specifically, they suggest that kin and non-kin are likely to differ in the kinds of information they convey, with kin more likely to encourage behavior that leads to reproductive success. If modernization leads to shifts in the composition of networks, possibly along the lines
Turke
(
1989
) suggested, then this, in itself, would be sufficient to explain why family limitation took hold as pro-natal kin influence waned, and new cultural norms for small family sizes could develop.
Newson et al.
(
2005
) offer evidence in favor of their hypothesis from the ethnographic literature, and also by reference to close-knit religious sects like the Amish and Hutterites. They offer further suggestive evidence from a study of family planning in Mozambique, where conversations about family limitation were more likely to occur between friends than relatives. More specific tests of their model require attention to the following two hypotheses: (a) among individuals in the same culture, those with more kin-based networks should be more inclined to behave in ways likely to lead to reproductive success, and (b) in conversations about reproduction, relatives should be more likely to condone or encourage pro-natal behavior. Of course, one has to keep in mind that the hypothesis is concerned with the kinds of teaching biases that serve to initiate a demographic transition and it is possible that these may have changed over time, such that kin and non-kin may converge much more closely in the present day. This is an empirical issue, however, and so it remains valid to test whether different kinds of teaching biases are conveyed via kin versus non-kin.
Here, we use data on the personal networks of Dutch women to investigate (i) whether kin-rich networks are associated with higher levels of social pressure to reproduce, and whether women feel they can talk to kin about having children to a greater extent than the non-kin members of their networks (that is, kin-related teaching bias may come about through both unsolicited and solicited advice). This speaks directly to
Newson et al.
’s (
2005
) ideas regarding teaching biases. We also consider (ii) whether people perceive kin as more likely to help with child-care than non-kin, as this may also increase receptiveness to pro-natal information, and so factor into kin-based influences on reproductive success (more in line with
Turke
’s (
1989
) behavioral ecological approach).
In addition, we consider network density (i.e., the proportion of all possible ties between alters in the network that are present) as this has the potential to influence both the degree to which novel information is transmitted, and the extent to which social norms are adhered to and policed ( Montgomery and Casterline 1996 ; Marsden 1987 ; Kohler et al. 2001 ). If kin-rich networks are also denser, this could amplify the influence of kin as proposed by Newson et al. ( 2005 ), because close kin relationships within the network could potentially enable close monitoring and maintenance of pro-natal norms and resist outside influence. This adds a further twist to Newson et al.’s ideas, as kin influence could potentially weaken with modernization due to changes in internal network structure in addition to changes in network composition. In line with this, Colleran ( 2020 ), using data from a large sample of Polish women across 22 villages, found that greater market integration was associated with a loosening of kin ties in women’s networks (i.e., the proportion of all possible ties that were kin-based was lower), even though network size did not change.
Interestingly, in an earlier study on the same population,
Colleran et al.
(
2014
) found that less educated women, when living among more highly educated neighbors, had fewer children than expected and more highly educated social networks. This effect was not due to a greater presence of non-kin in the network, nor to horizontal transmission between strong ties in the network; rather, it seemed to reflect more frequent interactions with highly educated women. This suggests that reproductive decision-making was partly driven by cultural dynamics beyond the individual (i.e., women’s personal circumstances alone could not fully account for their reproductive decisions). Taken together, these findings suggest either that prestige-based copying of educated women may, in fact, drive decision-making
contra
Newson et al., and/or greater contact with highly educated women combined with reduced kin density allows new social norms to diffuse more easily due to a reduced capacity for personal networks to resist change. One limitation of this earlier work is that, despite an impressive sample size in general, ego-networks were small, with respondents asked to name up to five other women to whom they could talk about important personal matters (mean network size was 3.11 individuals); such small networks may not be fully representative. Women in our sample were asked to name 25 alters (of either sex, kin and non-kin).
In what follows, we therefore begin by establishing whether network density relates to the proportion of kin in large networks, and whether network structure in our sample varies in ways that would reinforce or undermine Newson et al. ’s ( 2005 ) hypotheses concerning kin-related teaching biases. We then go on to test our two main hypotheses. In our analyses, we consider the influence of both consanguineal and affinal kin, in line with Bogin et al. ’s ( 2012 ) characterization of human reproduction as biocultural, rather than as cooperative per se; that is, unlike non-human cooperative breeders, the provision of care and resource transfers among humans is often decoupled from genetic relatedness—a distinction that is worth making explicit. In addition, the blood relatives of an individual’s partner obviously have a vested interest in the reproduction of the couple ( Burton-Chellew and Dunbar 2011 ; Hughes 1988 ). In our view, then, support, information, and pressure are likely to be exerted by both consanguineal and affinal kin in similar fashion (although it should be remembered that the interests of kin and affinal kin may diverge: Sear et al. 2003 ).
2. Results
2.1. Descriptives
Overall, we obtained data from 706 Dutch women between the ages of 18 and 41. Each woman reported on exactly 25 alters with whom they had been in contact within the last year and with whom they would be able to communicate if needed. This gave us information on 17,650 alters. On average, respondents reported seven kin in their personal networks, which equates to 28% (SD = 15%), although there was substantial variation with 16 respondents reporting no kin and five reporting 80% or more (
Figure 1
). The proportion of affinal kin was considerably lower at 10% (SD = 11%) (if we exclude women’s partners this declines to 7% (SD = 10%) for those women who named their partner as an alter). This implies that, on average, networks consisted mostly of non-kin (62%; SD = 18%). Those who reported more kin reported slightly fewer affinal kin (
r
= −0.05), but many fewer non-kin (
r
= −0.80). Similarly, reporting more affinal kin meant reporting fewer non-kin (
r
= −0.56).
Figure 1. The number of people in the network that are consanguineal kin; affinal kin; non-kin; that can help you with child-care; or that you could talk to about having children. % refers to percentage of respondents ( N = 706).
2.2. Are More Kin-Heavy Networks More Densely Connected?
Respondents were asked to indicate whether each alter in their network was in contact with each of the other alters, where contact referred to both face-to-face interactions as well as other forms of contact. This meant that respondents had to evaluate 300 alter-alter-ties. The nature of our question means that it need not be the case that all kin are connected (e.g., divorced parents may not be in contact) as is often assumed in kin networks (e.g., Colleran 2020 ; David-Barrett 2019 ). The average density of the network across respondents was 24% (SD = 11%), which means that, on average, 24% of the possible 300 ties between all 25 alters exist ( Figure 2 ). Density was positively but weakly associated with the number of consanguineal kin that people reported in their network ( r = 0.30; Figure 2 ), and even more weakly with the number of affinal kin ( r = 0.16). A linear regression predicted a density of 23% with five kin alters in the network, which increased to 27% with 10 kin alters in the network. The number of non-kin was negatively associated with density ( r = −0.35; Figure 2 ; combining the number of consanguineal and affinal kin would lead to an identical, but positive correlation with density of r = 0.35).
Figure 2. ( a ) The association between the number of consanguineal kin in the network and density ( r = 0.30); ( b ) The association between the number of non-kin in the network and density ( r = −0.35); ( c ) histogram of density (binwidth = 2.5%). Shaded band is 95% confidence interval around linear regression line.
2.3. Are Kin More Supportive with Respect to Child-Care and Communication?
For each alter, respondents were asked whether they could (i) ask the alter for help with child-care, and (ii) talk to the alter about having children. On average, 35% (SD = 21%) of alters were available for help with child-care and respondents stated they could talk to 28% (SD = 24%) of alters about having children.
Respondents reported that approximately 55% of consanguineal and affinal kin could help with child-care ( Figure 3 ), but only 24% of non-kin. Non-kin were further broken down into those that were or were not considered friends: 37% of friends were able to help with child-care, whereas this was true for only 7% of non-friends.
Figure 3. Percentage of kin, affinal kin, and non-kin (which are divided into friends and not friends) that respondents can ask for help with child-care or talk to about having children. Estimates presented in white are those for affinal kin excluding the respondent’s partner ( N = 1316).
Approximately 40% of affinal kin were reported as approachable for discussions about having children, compared to approximately 25% for consanguineal kin and non-kin. However, when partners were excluded from affinal kin, this percentage dropped to 21%. Thus, for kin beyond the potential reproductive partnership, respondents talk to affinal kin to the same degree that they talk to consanguineal kin or non-kin. Again, if we split non-kin into friends and non-friends, talking about children was more likely with friends (41%) than non-friends (9%). Thus, respondents were likely to speak to friends about having children to a greater extent than both kin categories, and most unlikely to talk about such things with non-friends.
We modeled these data with a binomial mixed model, controlling for respondent age, partnership status, and whether the respondent had children, and corroborated these results (
Appendix A
,
Table A1
). Compared to non-kin, non-friend alters, the odds of being able to ask for help with child-care was 10.2 (95% CI: 8.8–11.8) times higher for friends, 32.9 (95% CI: 28.3–38.3) times higher for consanguineal kin, and 36.6 (95% CI: 30.7–43.8) times higher for affinal kin. When examining whether respondents could talk to the alter about having children, weaker but still strong patterns emerged: compared to non-kin, non-friend alters, the odds of talking about children were 6.0 (95% CI: 5.2–6.9) times higher for consanguineal kin, 11.6 (95% CI: 9.7–13.7) for affinal kin, and 12.4 (95% CI: 10.8–14.2) for friends.
We then considered both the composition and density of the network on respondent perceptions. In order to do so, we needed to consider ties between groups of alters, and among kin in particular. We therefore modeled the four alter categories separately (i.e., consanguineal kin, affinal kin, friends, and non-friends). With respect to network composition (i.e., the number of alters in the network belonging to a given category), an increase in the number of consanguineal kin, affinal kin, and non-friends decreased the probability of being able to ask an alter to help with child-care (
Figure 4
;
Table A2
; controlling for the density among that group, the age of the respondent, partnership status, and whether the respondent has children). Specifically, the predicted odds of being able to ask an alter to help with child-care decreased by 8.1 (95% CI: 5.4–12.1) for consanguineal kin as we moved from no consanguineal kin alters in the network (composition of 0%) to all individuals in the network being consanguineal kin (composition of 100%). For affinal kin, the odds declined by 3.7 (95% CI: 1.5–9.5), and for non-kin/non-friend alters, the odds declined by 11.6 (95% CI: 5.6–24.1). For non-kin friends, in contrast, the odds increased very slightly by 1.4 (95% CI: 1.1–1.9).
Figure 4.
Predicted percentages (95% confidence band based on binomial regressions; see
Table A2
) of responses to the questions “can ask alter for help with child-care” and “can talk to alter about having children” depending on composition for consanguineal kin (
N
= 676 respondents), affinal kin (
N
= 339), friends (
N
= 668), and non-friend alters (
N
= 606). Composition refers the percentage of alters in the network belonging to that particular group. Darker shades represent the middle 50% of data. Sample sizes vary because density (which is included in the models) could only be calculated for particular groups when the respondent listed at least two of that group. An increase of 4% in composition means one extra alter is listed in the network of 25. Models were evaluated for 29 year-old women with a partner and children, and average density among the particular groups. On top of the panels, histograms of composition for each group are displayed (binwidth = 4%).
Reporting more consanguineal and affinal kin in the network also decreased the probability of being able to talk to these categories of alters about having children, whereas this was less pronounced for friends and non-friends (
Figure 4
). For consanguineal kin, the predicted odds of talking to an alter about children decreased by 11.1 (95% CI: 6.8–18.0) when moving from no consanguineal kin alters in the network (composition of 0%) to all individuals being consanguineal kin (composition of 100%). For affinal kin, the odds decreased by 4.4 (95% CI: 1.7–11.5), and for non-friend alters by 1.5 (95% CI: 0.8–2.7). The number of friends in the network produced no change in the odds of talking to an alter about having children (i.e., the predicted odds had a value of 1.0 (95% CI: 0.8–1.4),
Table A2
).
With respect to density, we also found a strong impact on whether an individual could be asked for help with child-care but, in this case, the relationship was positive for both kin categories in addition to friends (controlling for the number of alters in the network of that particular group, the age of the respondent, partnership status, and whether the respondent has children). That is, for consanguineal kin, affinal kin, and non-kin friends, increased network density was associated with a higher probability of women being able to ask for help with child-care, but there was no such relationship for non-friend alters (
Figure 5
). The predicted odds of being able to ask an alter to help with child-care increased by 5.6 (95% CI: 4.2–7.4) for consanguineal kin as we moved from no ties between the alters (density of 0%) to all ties existing between the alters (density of 100%), while for affinal kin, the odds increased by 10.7 (95% CI: 6.2–18.6). For friends, the odds increased by 2.0 (95% CI: 1.5–2.5), and for non-friends, the odds increased by only 1.1 (95% CI: 0.7–1.6) (
Table A2
).
Figure 5. Predicted percentages (95% confidence band based on binomial regressions; see Table A2 ) of responses to the questions “can ask alter for help with child-care” and “can talk to alter about having children” depending on density for consanguineal kin ( N = 676 respondents), affinal kin ( N = 339), friends ( N = 668), and non-friend alters ( N = 606). Darker shades represent middle 50% of data. Sample sizes vary because density could only be calculated for particular groups when the respondent listed at least two of that group. Models were evaluated for 29 year-old women with a partner and children, and average composition among the particular groups. On top of the panels, histograms of density for each group are displayed (binwidth = 5%).
Different patterns, however, emerged for talking about having children. With respect to consanguineal and affinal kin, increased density was associated with being able to talk about children, whereas the relationship was reversed and weaker for friends (
Figure 5
): higher friend-density was associated with a lower probability that women could talk about having children. Density had little impact among non-kin/non-friend alters. The predicted odds of talking to an alter about children were raised by 3.0 (95% CI: 2.2–4.2) for consanguineal kin and 2.6 (95% CI: 1.5–4.4) affinal kin, when moving from no ties between the alters (density of 0%) to all ties existing between the alters (density of 100%), while they decreased by 1.3 (95% CI: 1.0–1.6) for friends, and by 1.1 (95% CI: 0.7–1.6) for non-friend alters (
Table A2
).
2.4. Do Women with Kin-Heavy Networks Feel More Pressure to Have Children?
In order to assess whether kin and non-kin differed in the kinds of information they passed to respondents, we investigated the extent to which respondents reported feeling pressure from their parents (or caretakers) and the pressure they felt from friends to have children (on a 7-point scale; ranging from strongly disagree to strongly agree). Excluding women that responded with “I don’t know” (
N
= 92 for pressure from parents and
N
= 162 for pressure from friends) and “not applicable” (
N
= 38 for pressure from parents), respondents reported slightly higher levels of pressure to reproduce from parents (mean = 4.21; SD = 2.19;
N
= 576) than from friends (mean = 3.97; SD = 2.12;
N
= 544;
t
-test: t(1118) = 1.92;
p
= 0.056;
d
= 0.11; paired
t
-test: mean difference = 0.14;
t
(510) = 3.00;
p
= 0.0028;
d
= 0.13) (
Figure 6
). About half (53%) of respondents felt at least some pressure to reproduce from parents—defined as those responding with “somewhat agree”, “agree”, and “strongly agree”—whereas the rest (47%) did not (i.e., those responding with “neither agree/disagree” up to “strongly disagree”). Slightly less than half of respondents (46%) felt at least some pressure from friends.
Figure 6. Do you feel pressure to have (more) children from parents and friends? Each stacked bar chart is of equivalent width, covering all responses, and centered on the response “neither agree/disagree”. Responses “I don’t know” and “not applicable” were excluded from the counts.
Perceived pressure was very different for women with and without children (
Figure 6
). Among those with children, only 25% felt some pressure to reproduce from parents and only 22% reported pressure from friends, whereas this increased to 67% and 59% among those women without children. Moreover, the most frequent response among those with children was “completely disagree”, whereas for women without children it was “agree”. The overall pattern of responses to pressure from parents and friends was very similar within women with children and within women without children (
Figure 6
). This resemblance is also apparent from the strong correlation between the pressure felt from friends and from parents (
r
= 0.88;
N
= 511).
Neither the number of kin nor the density among kin had a substantive impact on the degree of pro-natal pressure that women reported (
Figure 7
;
Table A3
). The strongest effect was observed for the number of kin, but the effect was negligible (and the 95% confidence interval included zero): more than 20 extra kin were predicted to be required to move the scale up by one point up (e.g., from somewhat agree to agree). Adding the number of kin to the model increased the explained variance by 0.5% in perceived pressure from parents, whereas kin-density increased this by 0.001%. Density among friends had a negative effect on perceived pressure from friends, but again, the effect was negligible (again, the 95% confidence interval included zero): moving from no ties between friends (density of 0%) to all friends being connected (density of 100%) decreased the perceived pressure on average by about half a point. Adding density to the model increased the explained variance by 0.4% in perceived pressure from friends, whereas the number of friends increased this by 0.002%.
Figure 7. ( a ) The association between network composition (percentage of kin) (top) and density among kin (bottom) and the pressure felt to have children by parents. ( b ) The association between network composition (percentage of friends) (top) and density among friends and the pressure felt to have children by friends. The shaded band is the 95% confidence interval around predictions from linear regressions (see Table A3 ). Darker shades represent middle 50% of data. Models were evaluated for 29 year-old women with a partner and without children, and for average composition or density.
3. Discussion
Overall, we did not find strong support for the idea that kin and non-kin differ in the level of pro-natal information they impart and the degree of social pressure they exert. Although women, on average, experienced slightly more pressure from parents than from friends, the similarity in response was more striking than the differences. There were, however, stark differences in perceived pressure from both family and friends for women with and without children, with the latter reporting higher levels of pressure. This is no doubt to be expected: the decision to have any children at all is likely to be seen as more consequential from the point of view of parents, and so most pressure may be felt at this point in the life course. We found a negligible influence of overall network composition (proportion of kin and friends in the network) and structure (kin-density and friend-density) on the extent to which respondents reported experiencing social pressure. When we considered respondents themselves seeking advice on having children, we found that women reported that they could talk about having children with their friends to a greater extent than either their consanguineal or affinal kin. In this case, there was an effect of network density: for both kin categories, denser networks meant that women could talk more to their kin about having children compared to those with sparser networks. This was not the case for friends, where more ties between friends reduced the probability of talking to friends about children.
One limitation of our study is that we asked only about pressure from parents, rather than from all categories of kin. Thus, we did not capture how other categories of kin may reinforce pro-natal pressure received from parents—it may be that pro-natal social influence is a form of complex contagion (e.g.,
Hodas and Lerman 2014
), and asking about parents alone fails to pick up on this. However, our findings showed a positive (if weak) relationship between density and the number of kin and a negative relationship with the number of non-kin. This implies that kin-dense networks should show more social conformity and relay more similar information than the more diffuse networks associated with larger numbers of non-kin, but we found no evidence that this was the case.
It could also be true that the norms transmitted and sustained within kin networks relate to the support and encouragement of any expressed desire to reproduce on the part of respondents, or a general emphasis on the happiness and fulfilment that children bring, rather than exerting a pressure to have children per se; the particular phrasing of our question cannot distinguish between different kinds of pro-natal sentiment, plus the word “pressure” may have been interpreted in wholly negative terms. The idea that density among kin increased women’s perceptions that kin could help with child-care and that they could talk to kin about having children gives some support to this idea. Overall, then, we cannot rule out the possibility that a more fine-grained analysis would identify kin-based teaching biases, but our current analyses offer no consistent evidence that, in this sample at least, kin and non-kin differ in the kinds of information they are likely to pass on and circulate within networks. We should also note that
Newson et al.
’s (
2005
) hypothesis focuses on the origins of low fertility norms, which are potentially distinct from the processes that maintain such norms in the population once established.
More generally, our data show that, even in a low-fertility population like the Netherlands, personal networks contain a substantial number of kin: on average, seven consanguineal kin are reported plus an additional 2.5 affinal kin. This means that some 40% of people’s self-reported personal networks can be considered kin. This reinforces the idea that, while the size of (extended) kin networks may have diminished ( Murphy 2011 ), kin nevertheless remain important social contacts in contemporary populations (e.g., Marsden 1987 ; Höllinger and Haller 1990 ; Allan 2008 ). Again, it is worth noting that our findings come from much larger personal networks than is often the case. This is important because structural and compositional aspects of networks are only reliably estimated with a large number of alters (>15–20; McCarty et al. 2007a , 2007b ; Stadel and Stulp 2021 ). With 25 alters, we can thus be fairly confident that we have reliable estimates of the density and the composition of the networks, and that we are tapping into weak links, meaning that people are not simply calling to mind the most readily available members of their network. Of course, 25 alters remains a low number compared to people’s total social network size, and our estimates of density are thus confined to respondents’ personal networks and will not hold for entire sociocentric networks.
These findings raise the further question of whether this level of kin representation would be sufficient to resist the influence of new norms being introduced into the network by non-kin and weak ties, and whether it would be sufficient to provide the level of support needed to act as an incentive for women to reproduce rather than postpone birth (or produce a smaller family size than they desire). With respect to the first issue, our answer is only speculative, but we consider this unlikely, given our finding that women talk to their friends about having children much more than their kin; if kin are not sought out for their advice, then their ability to influence decisions will be reduced, no matter how well they are represented (although, as noted above, density may need to be factored in here). With respect to the latter question, consanguineal kin and affinal kin were equally likely to contribute to child-care if needed, and did so at a higher level than non-kin friends and non-friends, which corroborates the idea that networks with many kin are able to ease the burden of child-rearing in ways that might open up opportunities for further reproduction (
Turke 1989
). The fact that women also reported a substantial likelihood of asking friends for help with child-care means that kin-based help is likely to be augmented by that from friends, and confirms that human reproduction should be considered to be biocultural (
Bogin et al. 2012
), where affinal kin and non-kin are important for raising children, in addition to biological kin.
One surprising finding was that women reported that they could ask for support from their consanguineal and affinal kin to a much greater extent than they could talk to them about having children. Compared to both categories of kin, friends were somewhat less likely to be asked for help, but they were spoken to about children to a greater extent. This suggests that there are certain social expectations around kin-based help with child-care, which makes it easy to request such help from a large proportion of kin, but that conversations about having children may be limited to network members with whom one shares a close relationship. This is supported to some degree by our findings on network composition: as the number of consanguineal and affinal kin in the network increased, women reported being less likely to ask for help and to talk about children, which suggests that we are perhaps capturing more distantly related kin, who are less approachable for help. Overall, these findings are in line with the notion that kin can be asked for more practical support, while people turn to friends for emotional support (e.g.,
Allan 2008
;
Voorpostel and Lippe 2007
).
Modernization has dramatically changed personal networks, and people in contemporary populations experience greater freedom in their choice of interaction partners. Friends have taken a prominent role in people’s social environment, but this does not mean that kin have lost their importance. The strong reciprocity that is considered important for (maintaining) friendships, does not hold to the same extent for family relations. Novel information and norms may spread more freely in a world with fewer kin, but help with raising children—a service that is not easily reciprocated—seemingly continues to fall predominantly on kin.
4. Materials and Methods
4.1. Participants
Here, we make use of data from the LISS (Longitudinal Internet Studies for the Social sciences) panel administered by CentERdata (Tilburg University, The Netherlands). This is a representative sample of Dutch individuals who participate in monthly Internet surveys. The panel is based on a true probability sample of households drawn from the population register by Statistics Netherlands (CBS). Households that could not otherwise participate are provided with a computer and Internet connection. Only households in which at least one household member spoke Dutch are included. A longitudinal study consisting of 10 core surveys are fielded in the panel every year, covering a large variety of topics. The representativeness of the LISS-panel is similar to those from traditional surveys based on probability sampling (
Knoef and de Vos 2009
;
Scherpenzeel and Bethlehem 2011
). Initial selection biases were substantially corrected by refreshment samples, and further refreshment samples were planned for attrition biases (
Scherpenzeel 2011
). The LISS-panel has information on over 10,000 individuals.
4.2. Social Networks and Fertility Survey
The LISS-panel allows researchers to do their own survey within the panel. We added a study named the Social Networks and Fertility survey (for further details see
Stulp 2021
;
Buijs and Stulp 2019
). This research involves investigating social influences on fertility desires and outcomes (i.e., how many children people have or would like to have). All women in the LISS panel between the ages of 18 and 40 (
N
= 1332) were invited to participate in this survey between 20 February and 27 March 2018. Due to constraints on our budget for renumerating respondents and concerns about statistical power, we focused on women only, rather than collecting data on smaller samples for both men and women. In total, 758 women completed the survey with a mean age of 29.2 (SD = 6.5). Respondents were similar to non-respondents based on a comparison of a range of measures that are collected for all respondents and are continuously updated including birth year, position in household, number of children, marital status, region of living, income, educational level, and (migration) background (
Stulp 2021
).
For this study, we only selected respondents that listed 25 alters. We excluded respondents that gave problematic responses to alter relationship questions, who did the survey on their phone (against explicit instructions), that had more than 10 missing values, and the one respondent that reported no alter-alter-ties (see Stulp 2021 ). This led to a final sample of 706 respondents.
Ethical approval for this particular study was obtained through the ethical committee of sociology at the University of Groningen (ECS-170920). For information on the ethical approval on the LISS-panel as a whole, see
https://www.lissdata.nl/faq-page#n5512
(accessed on 17 May 2021). The survey was in Dutch. For the full survey in Dutch, an English translation of the questionnaire, further description of the survey, and code to clean and correct the LISS survey data, please visit:
https://doi.org/10.34894/EZCDOA
(accessed on 17 May 2021). R-code to produce the results in the current manuscript can be found here:
https://doi.org/10.34894/DTCZWA
(accessed on 17 May 2021). Data will become available on
https://www.lissdata.nl
(accessed on 17 May 2021).
4.3. Procedure
Respondents were invited to participate in a study on “social networks and fertility” and instructed that the survey would probably take around 25–30 min and that they would receive €12.50 for completing the survey. The first block of questions was about the fertility intentions and desires of the respondents and their partners if they had one.
The second part of the questionnaire involved generating 25 names. Respondents were asked: “Please list 25 names of individuals 18 years or older with whom you have had contact in the last year. This can be face-to-face contact, but also contact via phone, Internet, or email. You know these people and these people also know you by your name or face (think of friends, family, acquaintances, etcetera). You could reach out to these people if you would have to. Please name your partner in case you have one. The names do not have to match perfectly; you can also use nicknames. It is important that you would recognize these names in a future survey. For this research, it is important that you actually name 25 individuals!”. This phrasing was based on the studies by McCarty and colleagues ( McCarty et al. 2007a , 2007b ). When a respondent proceeded with the questionnaire without listing 25 names, a pop-up screen appeared, reminding respondents that listing 25 alters was important for this study, and that if they had difficulties coming up with names, they could use a contact list. They were also informed that if they still wanted to continue without listing 25 names, that this was also possible. The choice to ask respondents to list exactly 25 names, rather than allowing respondents to freely name as many network members as they liked, was deliberate: allowing respondents a free choice of how many alters to report could lead to variation in network size that reflects motivation to complete the questionnaire and/or differences in how the question was interpreted. Some respondents may have found listing 25 alters hard, others may have found it easy, and this will be reflected in the characteristics of the alters. It is this latter kind of variation that is of interest to network researchers ( McCarty et al. 2019 ). We chose 25 alters because people can easily do so ( McCarty 2002 ; McCarty and Govindaramanujam 2005 ), because this size of the network is large enough to consist of weak(er) ties, and because networks smaller than 25 individuals reduce the reliability of estimates of the composition and structure of the network ( McCarty et al. 2007b ; Stadel and Stulp 2021 ). In total, 738 respondents (97%) listed exactly 25 alters, and 632 of those (90%) came up with the names from memory ( Stulp 2021 ).
Subsequently, 16 alter characteristics were asked about (see
Stulp 2021
). Here we only list those relevant for this study: (i) type of relationship, with the choice of partner, parent, siblings, other relative, relative of partner, acquaintance/friend of partner, from primary school, from high school, from college/university, from work, from a social activity, through a mutual acquaintance/friend, from the neighborhood, and other. These categories were reduced to kin, affinal kin, and non-kin; (ii) whether the alter was considered a friend; (iii) which of these individuals could the respondent ask for help with the care of the child; and (iv) with whom of these individuals did the respondent discuss having children. Nineteen alters were not given a relationship and we assumed these to be non-kin.
The final question about the alters concerned ties between alters. The following question was asked: “With whom does the alter have contact? With contact, we meant all forms of contact including face-to-face contact, contact via (mobile) phone, letters, emails, texts, and other forms of online and offline communication”.
The survey ended with some additional questions among which two were about the pressure felt to have children. Respondents were asked to state their agreement with the statement “Most of my friends think that I should have (more) children” (scale from completely agree (1) to completely disagree (7) and a “I don’t know” option). They were then asked the same but for parents/caretakers (similar answer options except the possibility “Not applicable” was also added).
4.4. Data Analysis
In all our models, we control for respondent age (centered on 29), whether the respondent has a partner, and whether the respondent has children, all of which are important predictors for network composition and structure, and fertility behavior. For analyses where the dependent variable is a characteristic of the alter (e.g., can talk to this alter about having children, or can ask this alter for help with child-care), we presented results from binomial mixed models to accommodate the nested structure of the data (alters nested in ego;
van Duijn et al. 1999
). We performed linear regressions in the case of the pressure felt to reproduce from parents and friends. To examine the effects of composition and density on the probability of talking to alters about having children or being able to ask them for help with child-care, we used binomial models.
We used R ( R Core Team 2018 ) for cleaning, transforming, analyzing, and visualizing all data and to write the manuscript. We made use of the following R-packages: ggplot2 ( Wickham 2016 ), tidyverse ( Wickham 2017 ), patchwork ( Pedersen 2017 ), ggtext ( Wilke 2020 ), rmarkdown ( Xie et al. 2018 ), broom ( Robinson et al. 2021 ), and kableExtra ( Zhu 2019 ). We report on how we determined our sample size, all data exclusions (if any), all manipulations, and all measures in the study.
The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.
Appendix A
Table A1. Binomial mixed model parameter estimates (95% CI) for the effect of type of alter on whether alter can help with child-care or can be talked to about having children while controlling for age, partnership status, and parenthood.
Table A1. Binomial mixed model parameter estimates (95% CI) for the effect of type of alter on whether alter can help with child-care or can be talked to about having children while controlling for age, partnership status, and parenthood.
Estimate Can Help with Child-Care Can Talk to about Children Intercept −3.069 (−3.298; −2.839) −3.126 (−3.386; −2.865) Age −0.024 (−0.043; −0.005) 0.018 (−0.004; 0.041) Has partner −0.055 (−0.284; 0.175) 0.139 (−0.138; 0.416) Has child −0.091 (−0.353; 0.172) −0.102 (−0.417; 0.212) Friend 2.321 (2.177; 2.465) 2.517 (2.377; 2.656) Affinal kin 3.601 (3.423; 3.779) 2.447 (2.275; 2.618) Consanguineal kin 3.495 (3.343; 3.646) 1.786 (1.644; 1.929) SD random intercept 1.180 1.443
Age was centered around 29; women without partners or children were the reference category. Alters ( N = 17,650) are nested within respondents ( N = 706).
Table A2. Binomial regression estimates (95% confidence interval) for the effect of density on whether alters can help with child-care or can be talked to about having children while controlling for age, partnership status, and parenthood.
Table A2. Binomial regression estimates (95% confidence interval) for the effect of density on whether alters can help with child-care or can be talked to about having children while controlling for age, partnership status, and parenthood.
Outcome Estimate Consanguineal Kin Affinal Kin Friends Non-Friends Can help with child-care Intercept −0.415 (−0.739; −0.090) −1.441 (−2.567; −0.315) −0.723 (−0.914; −0.531) −1.676 (−2.076; −1.276) Age −0.034 (−0.046; −0.023) −0.065 (−0.088; −0.042) 0.005 (−0.006; 0.016) 0.039 (0.017; 0.061) Has partner 0.067 (−0.074; 0.209) 0.050 (−0.964; 1.065) −0.201 (−0.321; −0.081) −0.273 (−0.549; 0.002) Has child −0.107 (−0.268; 0.053) −0.112 (−0.373; 0.149) −0.043 (−0.199; 0.113) 0.231 (−0.063; 0.525) Composition −0.084 (−0.100; −0.068) −0.053 (−0.090; −0.015) 0.015 (0.003; 0.026) −0.098 (−0.127; −0.069) Density 1.721 (1.439; 2.004) 2.372 (1.823; 2.922) 0.672 (0.411; 0.933) 0.061 (−0.365; 0.488) Can talk to about having children Intercept −1.218 (−1.599; −0.836) −2.028 (−3.393; −0.663) −0.238 (−0.426; −0.050) −2.259 (−2.62; −1.898) Age 0.001 (−0.012; 0.014) −0.011 (−0.034; 0.012) 0.026 (0.015; 0.037) 0.023 (0.004; 0.042) Has partner 0.163 (0.004; 0.323) 0.988 (−0.281; 2.256) −0.065 (−0.184; 0.055) 0.119 (−0.121; 0.360) Has child 0.014 (−0.165; 0.193) −0.120 (−0.388; 0.147) 0.104 (−0.047; 0.255) 0.054 (−0.201; 0.308) Composition −0.096 (−0.116; −0.077) −0.059 (−0.098; −0.020) −0.001 (−0.013; 0.011) −0.016 (−0.040; 0.008) Density 1.101 (0.771; 1.431) 0.937 (0.390; 1.484) −0.240 (−0.500; 0.020) −0.078 (−0.469; 0.314) # respondents 676 339 668 606 # in group 4891 1624 5961 4915 # help 2649 899 2232 329 # talk 1276 561 2454 445
Age was centered around 29; women without partners or children were the reference category. Composition refers to the number of alters in the network for that particular group (e.g., affinal kin). Density refers to the density among the particular group. The number of respondents vary, because density can only be calculated when respondents list at least two alters of that particular group. “# in group” refers to the number of alters in that group, “# help” refers to how many alters in that group can help with child-care, and “# talk” refers to how many alters in that group can be talked to about having children.
Table A3. Linear regression parameter estimates (95% CI) for the number of kin/friends and density among alters on the pressure felt to reproduce by parents and friends while controlling for age, partnership status, and parenthood.
Table A3. Linear regression parameter estimates (95% CI) for the number of kin/friends and density among alters on the pressure felt to reproduce by parents and friends while controlling for age, partnership status, and parenthood.
Estimate Pressure from Parents Pressure from Friends Intercept 4.044 (3.100; 4.989) 4.266 (3.677; 4.854) Age −0.045 (−0.076; −0.013) −0.064 (−0.096; −0.031) Has partner 0.581 (0.190; 0.973) 0.583 (0.175; 0.991) Has child −1.948 (−2.386; −1.511) −1.546 (−1.991; −1.102) Composition 0.049 (0.000; 0.097) −0.002 (−0.040; 0.036) Density 0.036 (−0.769; 0.840) −0.562 (−1.237; 0.113) N 557 521 R 2 24 22
Age was centered around 29; women without partners or children were the reference category. “Composition” and “Density” refer to number of kin and density among kin in the model on pressure felt from parents and the number of friends and density among friends in the model on pressure felt from friends. Analysis samples include respondents with minimally two kin or friends in their networks.
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Figure 1. The number of people in the network that are consanguineal kin; affinal kin; non-kin; that can help you with child-care; or that you could talk to about having children. % refers to percentage of respondents ( N = 706).
Figure 2. ( a ) The association between the number of consanguineal kin in the network and density ( r = 0.30); ( b ) The association between the number of non-kin in the network and density ( r = −0.35); ( c ) histogram of density (binwidth = 2.5%). Shaded band is 95% confidence interval around linear regression line.
Figure 4. Predicted percentages (95% confidence band based on binomial regressions; see Table A2 ) of responses to the questions “can ask alter for help with child-care” and “can talk to alter about having children” depending on composition for consanguineal kin ( N = 676 respondents), affinal kin ( N = 339), friends ( N = 668), and non-friend alters ( N = 606). Composition refers the percentage of alters in the network belonging to that particular group. Darker shades represent the middle 50% of data. Sample sizes vary because density (which is included in the models) could only be calculated for particular groups when the respondent listed at least two of that group. An increase of 4% in composition means one extra alter is listed in the network of 25. Models were evaluated for 29 year-old women with a partner and children, and average density among the particular groups. On top of the panels, histograms of composition for each group are displayed (binwidth = 4%).
Figure 5. Predicted percentages (95% confidence band based on binomial regressions; see Table A2 ) of responses to the questions “can ask alter for help with child-care” and “can talk to alter about having children” depending on density for consanguineal kin ( N = 676 respondents), affinal kin ( N = 339), friends ( N = 668), and non-friend alters ( N = 606). Darker shades represent middle 50% of data. Sample sizes vary because density could only be calculated for particular groups when the respondent listed at least two of that group. Models were evaluated for 29 year-old women with a partner and children, and average composition among the particular groups. On top of the panels, histograms of density for each group are displayed (binwidth = 5%).
Figure 6. Do you feel pressure to have (more) children from parents and friends? Each stacked bar chart is of equivalent width, covering all responses, and centered on the response “neither agree/disagree”. Responses “I don’t know” and “not applicable” were excluded from the counts.
Figure 7. ( a ) The association between network composition (percentage of kin) (top) and density among kin (bottom) and the pressure felt to have children by parents. ( b ) The association between network composition (percentage of friends) (top) and density among friends and the pressure felt to have children by friends. The shaded band is the 95% confidence interval around predictions from linear regressions (see Table A3 ). Darker shades represent middle 50% of data. Models were evaluated for 29 year-old women with a partner and without children, and for average composition or density.
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My dogs brought home a chicken... | Page 2 | BackYard Chickens - Learn How to Raise Chickens
Yes, I'm aware of this mentality and am trying to avoid it. Is it advisable to go talk to other surrounding farms to find out where the flocks are and to...
My dogs brought home a chicken...
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grammaC said:
Yes, I'm aware of this mentality and am trying to avoid it. Is it advisable to go talk to other surrounding farms to find out where the flocks are and to explain that we're not purposely letting our dogs roam? Let them know to call us and we'll come get the dogs if they end up in a neighbor's yard? We are new (6 months) to the "neighborhood" and I want to be on friendly terms.
Yes on all accounts. Give them your phone number and get them to associate your name and face with your dogs. Still folks with threatened stock will vary wildly in respect to how they will react. With repeated visits by problem causing dogs, virtually all will take action against your dogs and in most areas killing your dogs will be within their rights. You gotta confine your dogs until they have been proven to not be a threat to livestock. Some folks will kill dogs regardless of threat presented. Remember livestock can include other animals.
I have 18 acres and dog does not restrict his activities to it. He also patrols neighbors place where geese and ducks are kept. Scoob is not a threat to those birds but something(s); coyotes, bobcats, other dogs have been taking a few. As a result those birds get stressed when Scoob visits which concerns me.
grammaC said:
Yes, I'm aware of this mentality and am trying to avoid it. Is it advisable to go talk to other surrounding farms to find out where the flocks are and to explain that we're not purposely letting our dogs roam? Let them know to call us and we'll come get the dogs if they end up in a neighbor's yard? We are new (6 months) to the "neighborhood" and I want to be on friendly terms.
Nothing wrong with that mentality, what is "not purposely letting our dogs roam"? You don't fence them, you let them roam full stop. We're on 14 acres, all fenced with multiple layers. Any dogs manage to walk/ sneak/ climb/ squeeze itself in here either will be greeted with by my dogs or if they're lucky, shot by me. We don't take chances with our animals, and we don't believe in any excuses offered for roaming dogs.
As a farmer and dog lover it bothers me that multiple neighbors allow their dogs to roam. I love dogs and the neighbors all have very friendly non-aggressive dogs, but my rat terrier (who loves people) will attack intruding animals. I also have many small farm animals from chickens to rabbits that are fair game to most dogs. I have been lucky so far that a few gun shots in the air seem to have caused the roamers to bypass us, but if they do come back as mutch as I love dogs they will be shot. It's not really a "mentality" as much as a necessity.
I have in the past had to put down two of my own dogs who I could not break from chasing (not killing) chickens and cows I sure as heck am not going to tolerate someone elses animal doing it.
grammaC said:
Yes, I'm aware of this mentality and am trying to avoid it. Is it advisable to go talk to other surrounding farms to find out where the flocks are and to explain that we're not purposely letting our dogs roam? Let them know to call us and we'll come get the dogs if they end up in a neighbor's yard? We are new (6 months) to the "neighborhood" and I want to be on friendly terms.
There are several things that you need to think about here.
1. You want to be on "Friendly " terms - Strong fences make good neighbors, no kidding. Fence an acre to turn them out in.
2. You don't want to have to worry about your dogs getting hurt - your neighbor does not want to have to worry that he may not be home when your dogs come to call, that he may find them to late or come home to find birds missing and wonder if your dogs have been there.
3. You say you are not "purposely letting our dogs roam"- If your dogs go out the door and you are not supervising them at ALL times while they are outside then you ARE letting them roam. You know that your dogs are not Boundry Trained, fenced, chained or otherwise restrained. It would be like your neighbor letting his goats run loose and eat your wifes prize roses or jump up on your car. (call me if you come out to find my goat standing on your car)
4. An ounce of prevention is worth a pound of cure - If you don't allow your dogs to roam you don't have to worry about them harrassing someones stock, so the neighbor doesn't have to worry about his stock and you don't have to worry about your dogs getting shot.
This makes for some very "Friendly" neighbors. By all means visit and get to know your neighbors, take your well behaved leashed dogs with you so your neighbors will know who they belong to "IF" they happen to see them out. Do not make your neighbors responsible for your dogs.
Least you think I don't like dogs. I raise and show a large mastiff breed and have 5 to 8 at any one time. We also do lots of rescue of large and small dogs, we own 3 chi mix rescues, and 2 Cavaliers, several fixed barn cats, 2 horses, about 70 free range chickens, a few guineas, and boarded dogs in training. Our back pastures are field/livestock fence and kennel/training areas are fenced. Our front is not fenced at all and several of our personal dogs run loose at any given time, they are boundry trained and here to protect our stock. Livestock fence won't stop the big or small dogs, ours or yours.
You say you are "aware of this mentality". Are you refering to protecting ones property from a dangerous intruder? (FYI in a rural area any dog off it's property and in proximity to someone else's stock could legally be considered just that, especially ones found with dead chickens in their mouths.)
nzpouter said:
Nothing wrong with that mentality, what is "not purposely letting our dogs roam"? You don't fence them, you let them roam full stop. We're on 14 acres, all fenced with multiple layers. Any dogs manage to walk/ sneak/ climb/ squeeze itself in here either will be greeted with by my dogs or if they're lucky, shot by me. We don't take chances with our animals, and we don't believe in any excuses offered for roaming dogs.
if you haven't confined your dogs, then you ARE letting them roam. Sorry, but dogs, especially a pack of dogs, are always going to be a danger. Even if you train them to never touch YOUR flock, they will be a danger to other farmers' livestock. Dogs know the difference between "their" animals and everyone elses. Not to mention, that even if they are innocently passing through a farm, it's very likely that a farmer will view them as a threat and employ the popular SSS.
Fence your dogs, allow them outside only with supervision, whatever it takes to insure that they stay at home 100% of the time.
If you want to be on friendly terms, then this is the way to do it.
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grammaC said:
Thought about a fence, but it's not practical to fence in the 11 acres.
Invisible fencing is not all that expensive. Trust me when I tell you that it has saved the life of my neighbor's pit/chessie X -- 'nough said. Regardless of whther or not your dogs killed the chicken if they are visiting other farms they will be shot. Sorry, but that is just a fact.
Need to fence them in, get rid of them or at least chain them up. I know too many people, myself included, that have lost numerous livestock due to dogs at large. If hubby let his hunting dogs roam, eventually they would get into trouble. Maybe they wouldn't kill livestock, they never have, but to just be let loose, there would be trouble. Even if your dogs just happened to find that chicken as a carcass, they will probably become a problem over time. Good luck.
No to mention if you have intact dogs, males are very good at getting other dogs pregnant, even through a fence. It has happened to use a few times and having to put down an entire littler of puppies is no fun. It also trashes prized hunting stock. Every unwanted pregnancy costs us money and time. I hate dogs that run loose and mess with our contained animals.
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Quote: If you're still turning them loose, and they are not fenced, then you ARE "purposely" letting them roam, since you already know they do it
Talking to the neighbors doesn't do anything to solve the actual problem
If your dogs showed up at myhouse, and were killing my chickens, I'd only be calling you to come pick up the bodies
I feel certain the owner of the Rottweiler that killed my neighbor's goats is still wondering why his dog never came home
Quote:
Invisible fencing is not all that expensive.
No to mention if you have intact dogs, males are very good at getting other dogs pregnant, even through a fence.
Jeeze, you guys are scaring me. I'm always amazed by the "shoot first ask questions later" line of thinking. I understand if there are repeated issues, but dogs/goats/cows/horses/chickens/sheep do get loose unintentionally sometimes. What if I shot the sheep in the middle of the road or ran them over instead of calling the deputies to help round them up for the farmer? Or the goat that gets into my garden? Seems a bit extreme to me. But anyway...
The invisible fence won't work, because we already have a shock collar on the dog and if he's chasing a squirrel, he'll run right through the zap. Typically, he comes back with just the vibration, but he can take a lot of zap if he's otherwise engaged. The neighbor dogs come over almost every day and my dogs will run across the road and romp with them if I don't nip it in the bud.
I guess we'll have to think about a fenced area for the dogs as well as a fenced run for the chickens.
And, I highly agree with spaying/neutering. Both our dogs are neutered and, the barn cat who was already living here, we took to the vet and vaccinated and dewormed.
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STATE v. BERWALD | 186 S.W.3d 349 (2005) | sw3d3491512 | Leagle.com
Motion for Rehearing and or Transfer to Supreme Court Denied January 31 2006. JOSEPH M. ELLIS Judge. Appellant Allen B. Berwald...sw3d3491512
STATE v. BERWALD
No. WD 64445.
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Cited Cases
Citing Case
186 S.W.3d 349 (2005)
STATE of Missouri, Respondent,
v.
Allen B. BERWALD, Appellant.
Missouri Court of Appeals, Western District. https://leagle.com/images/logo.png
December 27, 2005.
Motion for Rehearing and/or Transfer Denied January 31, 2006.
Application for Transfer Denied April 11, 2006.
Attorney(s) appearing for the Case
Jeremy S. Weis, Kansas City, MO, for appellant.
Shaun J. Mackelprang, Assistant Attorney General, Jefferson City, MO, for respondent.
Before RONALD R. HOLLIGER, Presiding Judge, ROBERT G. ULRICH, Judge and JOSEPH M. ELLIS, Judge.
Missouri Court of Appeals, Western District.
Motion for Rehearing and/or Transfer to Supreme Court Denied January 31, 2006.
[186 S.W.3d 353]
JOSEPH M. ELLIS, Judge.
Appellant, Allen B. Berwald, was convicted by a Bates County jury of one count of statutory rape in the first degree and one count of statutory sodomy in the second degree, both of which concerned N.B., his adopted minor daughter. Mr. Berwald was sentenced to concurrent terms of imprisonment in the custody of the Missouri Department of Corrections of twenty-five years and seven years, respectively. We reverse his convictions and remand for a new trial.
Before stating the facts of this case, it is helpful to review its relevant procedural history. On October 20, 2003, Mr. Berwald was charged by information with three counts of statutory rape in the first degree (section 566.032); 1one count of statutory rape in the second degree (section 566.034); two counts of statutory sodomy in the first degree (section 566.062); two counts of statutory sodomy in the second degree (section 566.064); and three counts of endangering the welfare of a child in the first degree (section 568.045). He entered pleas of not guilty to all eleven charges.
Pursuant to Rule 23.04, Mr. Berwald subsequently moved for an order directing the State to file a bill of particulars, which was granted after a hearing. On June 29, 2004 (the morning of the first day of trial), the State filed an amended information dismissing both counts of first-degree statutory sodomy, leaving nine charges intact. These nine charges were as follows.
In Count I, the State alleged that in the summer or fall of 2000, when N.B. was less than fourteen years old, Mr. Berwald committed the crime of statutory rape in the first degree by having sexual intercourse with N.B. in front of the television in the living room of the Berwald family home. Count II alleged that Mr. Berwald committed statutory rape in the first degree by having sexual intercourse with N.B., who was then less than fourteen years old, by the fireplace in the living room of the Berwald family home in winter 2000 or spring 2001, while Count III alleged that Mr. Berwald committed statutory rape in the first degree by having sexual intercourse with N.B., who was then less than fourteen years old, on her bed in the Berwald family home in summer 2001. In Count IV, the State alleged that in winter 2002, when N.B. was less than seventeen years old, Mr. Berwald committed statutory rape in the second degree by having sexual intercourse with N.B. on her bed in the Berwald family home. In Count V, the State alleged that sometime in winter 2002, when N.B. was less than seventeen years old, Mr. Berwald committed statutory sodomy in the second degree by having deviate sexual intercourse with N.B. in the Berwald family home, during which he inserted his fingers into N.B.'s vagina. Count VI was similar to Count V, and alleged that sometime in 2003, Mr. Berwald committed statutory sodomy in the second degree by having deviate sexual intercourse with N.B., who was then less than seventeen years old, in the Berwald family home, during which he inserted his fingers into N.B.'s vagina. Finally, in Counts VII, VIII, and IX, the State alleged that in summer 2001, winter 2002, and sometime in 2003, respectively, when N.B. was less than seventeen years old and he was her parent, Mr. Berwald committed endangerment of the welfare of a child in the first degree by having deviate sexual intercourse with N.B. in the Berwald family home, during which he inserted his fingers into N.B.'s vagina.
The State's case-in-chief was presented over the course of a day and a half. At
[186 S.W.3d 354]
the conclusion of the State's case, Mr. Berwald filed a Motion for Judgment of Acquittal at the Close of the State's Evidence. The trial court entered a directed verdict of acquittal on one of the second-degree statutory sodomy counts against Mr. Berwald (Count V), but denied his motion as to the other eight counts. Mr. Berwald's case-in-chief also required a day and a half to present. At the close of all the evidence, Mr. Berwald filed a Motion for Judgment of Acquittal at the Close of all the Evidence. The trial court entered a directed verdict of acquittal on two of the three counts of endangering the welfare of a child in the first degree (Counts VII and VIII), but denied his motion as to the remaining six counts, which were submitted to the jury. 2 The jury found Mr. Berwald guilty on Counts III and VI, but found him not guilty on Counts I, II, IV, and IX. His motion for new trial was overruled, and he was sentenced to concurrent terms of imprisonment in the custody of the Missouri Department of Adult Institutions of twenty-five years on Count III and seven years on Count VI. This appeal followed.
Set forth in the light most favorable to the State, the State's evidence showed the following as to Counts III and VI. N.B., who was born on November 24, 1987, was a sixteen-year-old junior at Butler High School at the time of trial. She is the natural child of Kelly Berwald, who married Mr. Berwald in 1991. In 1992, Mr. Berwald, who was sixty-seven years old at the time of trial, adopted N.B. and her brother M.B. The Berwald family resided in a home located in rural Bates County, Missouri.
In the summer of 2001, N.B. was thirteen years old. Mr. Berwald came into her room one night while she was lying on her bed. He pulled N.B. over to the edge of the bed, so that she was lying across the bed with her legs hanging over the edge. He pulled off her jeans, stood between her legs, and used his hands to open the "folds" around her vagina. Mr. Berwald then rubbed his flaccid penis on N.B.'s vagina and attempted to insert his penis into her vagina, penetrating it slightly. On one occasion in 2003, prior to the end of March, while N.B. was less than seventeen years old and he was her parent, Mr. Berwald inserted his finger into N.B.'s vagina while they were in the Berwald family home. N.B. and only N.B. was the source of all this testimony.
On March 21, 2003, Mr. and Ms. Berwald separated, and Ms. Berwald moved out of the family home to live in the offices of Mr. Berwald's business. N.B. continued living in the Berwald family home for a week or two, and then went to stay with her mother. On or about April 29, 2003, N.B., who feared that her mother was going to get back together with Mr. Berwald, told Ms. Berwald for the first time about being sexually abused by Mr. Berwald, and further revealed, for the first time as well, that she was also involved in a sexual relationship with a boyfriend, B.I. Shortly after hearing these allegations, which were consistent with a "dream sequence" she had experienced a few months earlier during which she dreamed that Mr. Berwald was sexually abusing N.B. while N.B. was asleep, Ms. Berwald used a microcassette tape recorder she had found in the office to audiotape N.B.'s initial account of the abuse. Ms. Berwald then
[186 S.W.3d 355]
took N.B. to the circuit clerk's office to obtain a child protection order. A hotline call was placed to the Division of Family Services, and N.B. was subsequently interviewed by various law enforcement, juvenile justice, and family services personnel about the abuse prior to Mr. Berwald's eventual arrest.
The rest of the State's evidence against Mr. Berwald (in fact, the vast majority of the evidence against him) did not relate directly to the criminal acts with which he had been charged. Instead, it pertained to other instances of alleged sexual contact between Mr. Berwald and either N.B. or other persons at various other times, all of which were uncharged offenses. That evidence, all of which was admitted over Mr. Berwald's objections in a motion in limine and during trial as it was introduced, was as follows.
N.B. testified that when she was ten or eleven years old and in the fifth grade, Mr. Berwald told her that her legs were "sexy" when she "would stand on [her] tippy toes." N.B. also testified that a few years later, while she was in the seventh and eighth grades, Mr. Berwald began touching her breasts and/or rubbing her vagina with his hand about four to five times a week. She testified that, when he would rub her breasts, he would rub them just above the nipple and tell her that he was doing that to make them grow faster and mature more quickly.
N.B. further testified about one time during her seventh-grade year, when Mr. Berwald placed her hand in his pants and had her touch his penis and masturbate him. N.B. also testified that, at least on one occasion in the summer following her eighth-grade year, Mr. Berwald had her lie on a counter and spread her legs, then used his hands to open her vagina so that he could examine it, claiming to be checking to see if she was still a virgin, if she was pregnant, and if tampons were hurting her. She said that, during her ninth-grade year, he would also hide in her closet and watch her getting dressed. According to N.B., these acts continued through her ninth-grade year, and Mr. Berwald would often come into her room at night to molest her. Finally, N.B. testified that during 2002 and 2003, while she was in ninth grade, Mr. Berwald did not have any sexual contact with her involving his penis, but did touch her breasts and rub her vagina with his hand between two and four times a week. When Mr. Berwald touched her during this time, N.B. testified, he would tell her that he was "working her hormones."
The State also presented testimony from Jane Howe and Vicki Twedt, two of Mr. Berwald's adult children from his first marriage. Ms. Howe was forty-five years old at the time of trial and Ms. Twedt was forty-three. Ms. Howe testified that, during the nine-year period when she was six to fifteen years old, Mr. Berwald touched her vagina thirty or more times. According to Howe, he would have her get on the bed with her panties off, lie on her stomach, and raise her buttocks in the air with her legs spread apart. Ms. Howe testified that he would insert his fingers "[j]ust inside the lips" of her vagina "a little bit" and would look into her vagina, claiming he was doing that to check for hernias, to see if she was pregnant, or to see if she had begun having sex yet. Ms. Twedt testified that she was scared of Mr. Berwald and that on numerous occasions between the fifth and eleventh grades, he rubbed her breasts, telling her that if she rubbed the muscle above her breasts, they would get larger. On two occasions, said Ms. Twedt, Mr. Berwald told her to get in the bathtub so that he could check her for a hernia, and when she did so, he opened her vagina with his fingers and looked
[186 S.W.3d 356]
inside it. The events described by Ms. Howe and Ms. Twedt had allegedly occurred from twenty to thirty years prior to the charged offenses, and their testimony was admitted over specific and continuing objections by counsel for Mr. Berwald both before trial (in a motion in limine) and during trial that it was inadmissible under State v. Bernard, 849 S.W.2d 10 (Mo. banc 1993), and its progeny.
The State also presented the testimony of four witnesses regarding various incriminating statements they purportedly heard Mr. Berwald make in their presence. Ralph Manuel, who had once worked for Mr. Berwald's trucking company as a driver before being fired by him in August 2001, testified that Mr. Berwald told Manuel on one occasion that Berwald had "felt [N.B.'s] breasts for knots." Manuel further testified that Mr. Berwald was always "giddish" [sic] about N.B., not like a proud parent, but like a teenage kid who was "satiated" with her.
Kim Abney, Ms. Berwald's sister, testified that Mr. Berwald called her on April 30, 2003, to tell her that N.B. and Ms. Berwald had accused him of molesting N.B., and that the only thing he could think of that might have led to their accusations was that he "used to rub her buttocks to help her develop more fully." When she asked him what that meant, Mr. Berwald told Abney that "it loosens the muscles, tendons and ligaments, and it makes their — them develop more fully into a woman as he had done with his own children."
Bates County Chief Deputy Sheriff Gary Martin testified that, after criminal charges had been filed against Mr. Berwald, he went to Berwald's home and spoke with him about the accusations. According to Martin, during the course of their hour-long conversation, Berwald denied the allegations but told Martin that once, while he and N.B. were lying on the floor watching television together, he was rubbing a cramp on N.B.'s leg and his hand had gone too far up her leg, prompting her to say, "Dad, that's not my leg."
The State also presented the testimony of Roger Farrell, Ms. Berwald's former stepfather. Farrell testified that, on one occasion in July 2003 when they were talking together at Farrell's business, Mr. Berwald told Farrell that N.B. would "wake up when she wanted me to stop." According to Farrell, Mr. Berwald did not offer any additional details regarding the meaning of that statement, and Farrell conceded on cross-examination that it was possible that Mr. Berwald was merely repeating some of the allegations that had been made against him.
Since there was a conviction, we normally would not present a detailed summary of the evidence presented by the defendant. However, we do so here because, as will soon be seen infra,it is important in establishing whether Mr. Berwald suffered sufficient prejudice to be entitled to reversal and remand for a new trial. See State v. Driscoll,55 S.W.3d 350, 357-58 (Mo. banc 2001) (conducting detailed review of defendant's evidence to assist in determining whether the jury would likely have convicted the defendant absent the inadmissible evidence adduced by the State).
Mr. Berwald presented a vigorous defense, during which he and fourteen other witnesses testified in support of his theory of the case, which was that the charged acts of sexual abuse never actually occurred (in whole or in part), but had been fabricated by N.B. and her mother. Mr. Berwald adamantly denied all of the charged (and uncharged) allegations of sexual abuse that had been leveled against him and insisted that he had never touched N.B. in an inappropriate way. He presented numerous witnesses to support
[186 S.W.3d 357]
his defense theory, including: (1) expert medical evidence to show that due to his various health problems (including, as acknowledged at trial by N.B. herself) impotence, congestive heart disease, and knee replacement surgery, he was physically incapable of performing some of the sexual acts alleged by N.B. and was out of the home in the hospital during part of the charged time frames; (2) evidence that N.B. was involved in a forbidden sexual relationship with her boyfriend B.I. and was motivated to fabricate the abuse charges "so that her mom wouldn't be so mad at her" for having sex with B.I. and to be able to keep seeing him; (3) evidence that he was often on the road or working late as a truck driver and was not home often enough for him to have molested N.B. nearly as often as she claimed he did; (4) evidence that Ms. Berwald was motivated to fabricate the allegations against him to gain leverage in her pending divorce action against him and to draw attention from the fact that she and several of the State's witnesses against him had been involved in stealing or concealing several thousand dollars in company funds from his business after they separated (including Mr. Manuel and Ms. Abney, who admitted their complicity in Ms. Berwald's scheme at trial); and (5) evidence that Ms. Berwald had started to plant the idea of the molestation in people's minds well before leaving him for another employee of his business, John Freed, with whom she had had an affair during the marriage.
Mr. Berwald also presented substantial impeachment evidence, including: (1) testimony from a female friend of N.B.'s who said N.B. had told her that Mr. Berwald never molested her; (2) testimony from N.B.'s brother to the effect that he never observed anything that would corroborate N.B.'s testimony, never saw Mr. Berwald and N.B. alone and never saw him in her bedroom, that N.B.'s story kept changing when he communicated with her about the allegations, and that he felt pressured by a State Technical Assistance Team (STAT) investigator, Larry Wyrick, to "help his sister out" by confirming her allegations; (3) testimony that N.B. kept in close contact with Mr. Berwald after leaving the family home to live with her mother and attended a birthday dinner for Mr. Berwald at the Berwald family home on April 9, 2003; (4) testimony that Ms. Howe told a detective that she was concerned the information from N.B. about the claimed molestations was fabricated; (5) testimony that there were often various overnight guests at the family home, making N.B.'s allegations as to the pervasive scope and extent of the alleged sexual abuse unlikely to be true; (6) testimony from Ms. Berwald that on one occasion before N.B. first told her she had been sexually abused by Mr. Berwald, when Ms. Berwald had asked N.B. if Mr. Berwald had sexually abused her, N.B. said "no"; (7) testimony from DFS investigator Rhonda Talley that, during N.B.'s initial interview with Talley, N.B. told Talley that Mr. Berwald had never put his penis into her vagina; (8) a stipulation that the SAFE exam performed on N.B. at Children's Mercy Hospital revealed no physical signs of sexual abuse; and (9) testimony from several different witnesses to attempt to impeach or discredit the accounts of Ms. Howe and Ms. Twedt.
As noted
supra,
at the close of the evidence, instructions, and arguments of counsel, Mr. Berwald was found guilty of one count of first-degree statutory rape and one count of second-degree statutory sodomy, and not guilty of the two remaining counts of first-degree statutory rape, one count of second-degree statutory sodomy, and one count of endangering the welfare of a child. Jury sentencing having been waived by Mr. Berwald, on August 6,
[186 S.W.3d 358]
2004, the trial court, after overruling his motion for new trial, sentenced Mr. Berwald to concurrent terms of twenty-five years' imprisonment for first-degree statutory rape and seven years' imprisonment for second-degree statutory sodomy in the custody of the Department of Corrections. This appeal followed. Any additional facts necessary to the disposition of the appeal will be supplied as needed later in this opinion.
In his first point, Mr. Berwald contends that the trial court prejudicially erred and abused its discretion in admitting the trial testimony of Jane Howe and Vicki Twedt regarding uncharged acts of sexual abuse he purportedly committed against them as children some twenty to thirty years before trial because it was neither logically nor legally relevant to the issues before the jury in that their testimony did not relate to any criminal offense for which he was on trial and its prejudicial effect far outweighed its probative value.
"A trial court typically has broad discretion in deciding whether to admit evidence and, as such, its decision will not be disturbed unless a clear abuse of discretion is shown." State v. Danikas,11 S.W.3d 782, 788 (Mo.App. W.D.1999). It has long been established, though, that "a defendant has the right to be tried only for the offense for which he is on trial, and that evidence of other crimes committed by [the] defendant is normally inadmissible." State v. Edwards,116 S.W.3d 511, 533 (Mo. banc 2003). Such uncharged crimes evidence carries with it several significant risks, including:
(1) that the introduction of evidence of other crimes will mislead or confuse the jury, (2) that the jury will give undue weight to the if he did it once, he'll do it again inference, (3) that the defendant will be made to defend, not just against the charges brought, but against all of his prior, similar behavior which, for whatever reason, was not prosecuted by the State, and (4) that the jury, in its rush to punish the defendant for his past acts — which the jury must infer have gone unpunished — may overlook the fact that the State has failed to prove the defendant was guilty of the charges brought.
State v. Bernard,849 S.W.2d 10, 22 (Mo. banc 1993) (Robertson, C.J., concurring in part).
"If, however, evidence of prior misconduct is both logically and legally relevant to prove the charged crime, it is admissible." State v. Barriner,34 S.W.3d 139, 144 (Mo. banc 2000). "Evidence is logically relevant if it has some legitimate tendency to establish directly the accused's guilt of the charges for which he is on trial." Id.In this regard, "[e]vidence of prior uncharged misconduct generally has a legitimate tendency to prove the specific crime charged when it tends to establish motive, intent, the absence of mistake or accident, a common scheme or plan, or the identity of the person charged with the commission of the crime on trial." Id.at 145.
With regard to identity as a basis for logical relevance, in
State v. Bernard,
849 S.W.2d 10
(Mo. banc 1993), the Missouri Supreme Court expressly recognized a closely-related exception for certain prior uncharged misconduct that falls within the "signature
modus operandi
/corroboration" category.
Id.
at 17. "The signature
modus operandi
/corroboration exception approximates the long established, well recognized exception that allows evidence of prior uncharged misconduct for the purpose of proving the identity of the wrongdoer."
Id.
"In the context of corroboration, evidence of prior crimes is logically relevant [if] it has a legitimate tendency to
[186 S.W.3d 359]
prove a material fact in the case by corroborating the testimony of the victim as to the sexual assault." Id. Nevertheless:
For the prior conduct to fall within the identity exception, there must be more than mere similarity between the crime charged and the uncharged crime. The charged and uncharged crimes must be nearly identical and their methodology so unusual and distinctive that they resemble a signature of the defendant's involvement in both crimes.
Id(internal quotation marks omitted); see also State v. Frey,897 S.W.2d 25, 31 (Mo. App. W.D.1995) (holding that the uncharged crime must be "so unusual and distinctive as to be a `signature' (similar to a fingerprint) of the defendant's conduct.") "This is a threshold requirement that must be met before the trial court can proceed to weigh any additional factors in determining the question of admissibility." Bernard,849 S.W.2d at 17.
Of course, to be admissible, evidence must also be legally relevant. Id.Evidence is legally relevant if its probative value outweighs its costs. State v. Barriner,111 S.W.3d 396, 401 (Mo. banc 2003). This determination "involves a process through which the probative value of the evidence (its usefulness) is weighed against the dangers of unfair prejudice, confusion of the issues, misleading the jury, undue delay, waste of time or needless presentation of cumulative evidence (the cost of the evidence)." State v. Sladek,835 S.W.2d 308, 314 (Mo. banc 1992).
Since Bernardwas decided, the appellate courts of this state have been quite reluctant to sanction the admission of evidence relating to a defendant's prior uncharged misconduct under the signature modus operandi/corroboration exception to the general rule of exclusion. As our Supreme Court observed in State v. Gilyard,979 S.W.2d 138, 141 (Mo. banc 1998), "[b]ecause of the stringent standard for legal relevance, however, most cases addressing the corroboration exception have held the evidence of prior uncharged misconduct inadmissible." In particular, "the passage of time between incidents [may be] so lengthy that the prejudice or other `cost' of the evidence outweighs the probative value of the signature modus operandi." Bernard,849 S.W.2d at 19. Indeed, this court has held that "[b]ecause evidence of other crimes is highly prejudicial, such evidence should be admitted only when there is `strict necessity.'" State v. Pennington,24 S.W.3d 185, 190 (Mo.App. W.D.2000).
In admitting the trial testimony of Jane Howe and Vicki Twedt, the trial court found it to be both logically and legally relevant. As to logical relevance, the trial court ruled that because the allegations they planned to make if allowed to testify were "so similar to what occurred, or what [N.B.] has said," their testimony "goes to motive, to intent, to absence of mistake or accident, and to a, potentially, a common scheme or plan." As to legal relevance, the trial court ruled, without any further explanation: "Of course, this is prejudicial. I believe its probative value outweighs its prejudicial effect."
The State does not even attempt to defend the trial court's ruling on the logical relevance of the testimony of Ms. Howe and Ms. Twedt on the grounds that it was probative as to motive, intent, the absence of mistake or accident, or a common scheme or plan. Instead, the State argues solely that the evidence was logically relevant to identify Mr. Berwald as the person who committed the charged crimes under the signature modus operandi/corroboration exception recognized in Bernard.
While formally recognizing the signature
modus operandi
/corroboration exception
[186 S.W.3d 360]
in Missouri, the Court in Bernard cautioned against the indiscriminate admission of such evidence at trial, noting that it was "`particularly important that the requirement for a signature modus operandi be strictly enforced'" to ensure that the exception does not "`become so broad that it swallows up the underlying rule of exclusion.'" Bernard, 849 S.W.2d at 16, 17 (quoting Sladek, 835 S.W.2d at 315 (Thomas, J., concurring)). Thus, the Court required that any evidence of prior uncharged sexual misconduct that corroborates the testimony of the victim "be nearly identical to the charged crime and so unusual and distinctive as to be a signature of the defendant's modus operandi. " Id. at 17.
Although both are threshold requirements "that must be met before the trial court can proceed to weigh any additional factors in determining the question of admissibility," id.,such as assessing whether the evidence's probative value exceeds its costs, including "the dangers of unfair prejudice, confusion of the issues, misleading the jury, undue delay, waste of time or needless presentation of cumulative evidence," Sladek,835 S.W.2d at 314, the factual summary provided supramakes it clear that, with regard to the trial testimony of Ms. Howe and Ms. Twedt, the State did not make the first of these two essential showings — namely, that the charged and uncharged crimes were "nearly identical."
Mr. Berwald went to trial accused of nine separate criminal offenses alleged to have been committed against N.B. between the fall of 2001 and the spring of 2003. Counts I-IV were all statutory rape charges involving allegations of sexual intercourse between Mr. Berwald and N.B., including actual penetration of her vagina by Mr. Berwald's penis. However, neither Ms. Howe nor Ms. Twedt alleged that Mr. Berwald ever had sexual intercourse of any kind with them, with or without successful penetration. And while Counts V-IX all charged that Mr. Berwald had deviate sexual intercourse with N.B. during which he inserted his fingers into N.B.'s vagina, the record shows that the testimony of Ms. Howe and Ms. Twedt clearly did not involve uncharged sexual misconduct which was "nearly identical" to one or more of those charged crimes, as both women described digital-vaginal contact during which Mr. Berwald spread the lips of their vaginas and peered inside, either to check for hernias, to see if they were pregnant, or to see if they had begun having sex yet. In stark contrast, N.B.'s trial testimony pertaining to the crimes charged in Counts V-IX described overtly sexual digital-vaginal contact which did notinvolve any such distinctive conduct by Mr. Berwald. Finally, Ms. Twedt's testimony that Mr. Berwald rubbed her breasts, telling her that if she rubbed the muscle above her breasts, they would get larger, also had no relationship whatsoever to any of the criminal conduct alleged in Counts I-IX, in that none of the counts contained allegations that Mr. Berwald rubbed N.B.'s breasts.
The State nevertheless insists that the trial testimony of Ms. Howe and Ms. Twedt was logically relevant since it had a legitimate tendency to prove a material fact in the case by corroborating the testimony of N.B. as to the sexual abuse Mr. Berwald had inflicted on her. Pointing to N.B.'s trial testimony that, during the summer after she completed the eighth grade, Mr. Berwald had her lie on a counter and spread her legs, then used his hands to open her vagina so that he could examine it (claiming to be checking to see if she was still a virgin, if she was pregnant, and if tampons were hurting her), and that Mr. Berwald would "work her hormones" by rubbing her breasts just
[186 S.W.3d 361]
above the nipple to make them grow faster and mature more quickly, the State argues that Mr. Berwald's practice of allegedly conducting bogus do-it-yourself medical examinations in order to overcome his daughters' concerns about inappropriate sexual contact was "so unusual and distinctive as to be a signature of the defendant's modus operandi. " Bernard, 849 S.W.2d at 17.
Had the trial testimony of N.B. cited by the State concerned a charged offenseagainst Mr. Berwald, we might consider entertaining the State's argument. However, it did not. Rather, it concerned unchargedcriminal acts alleged by N.B. which were supposedly "corroborated" by the testimony of Ms. Howe and Ms. Twedt regarding events which allegedly occurred some two or three decades before. Since the narrow signature modus operandi/corroboration exception to the general rule of inadmissibility recognized in Bernardrequires that "[t]he similarity must be between the prior uncharged act and the present crime," Frey,897 S.W.2d at 31 (emphasis added); see also Bernard,849 S.W.2d at 17 (emphasis added) (noting that "[f]or corroboration evidence to be of sufficiently increased probative value so as to outweigh its prejudicial effect, the evidence must be more than merely similar in nature to the sexual assault for which the defendant is charged."), the trial testimony of Ms. Howe and Ms. Twedt was logically irrelevant in that it did not corroborate the testimony of N.B. as to any of the criminal offenses for which Mr. Berwald was on trial. Accordingly, that testimony was inadmissible and the trial court erred and abused its discretion in admitting it over repeated objections by Mr. Berwald. 3We now proceed to the question of prejudice. "With regard to trial court errors that have been preserved, we review for prejudice, not mere error, and will reverse only if the error was so prejudicial that it deprived the defendant of a fair trial." State v. Hutchison,957 S.W.2d 757, 761 (Mo. banc 1997). This rule is generally applicable when we review issues pertaining to the admission of evidence. See, e.g., State v. Churchill,98 S.W.3d 536, 538 (Mo. banc 2003) (internal quotation marks omitted) ("When this Court is asked to review the admissibility of evidence, it reviews for prejudice, not mere error, and will reverse only if the error was so prejudicial that it deprived the defendant of a fair trial."); State v. Anderson,76 S.W.3d 275, 277 (Mo. banc 2002) (same). In particular, our Supreme Court has held that it is to be applied in cases where, as here, a criminal defendant alleges on direct appeal that a trial court erred in admitting evidence of prior uncharged crimes over timely and specific objection that "the offenses were not logically relevant nor necessary to prove the charged crimes." State v. Morrow,968 S.W.2d 100, 105, 106 (Mo. banc 1998). 4
[186 S.W.3d 362]
In criminal cases involving the improper admission of evidence, the test for prejudice "is whether the improper admission was outcome-determinative." State v. Black, 50 S.W.3d 778 , 786 (Mo. banc 2001).
When the prejudice from the improper admission of evidence is outcome-determinative, reversal is required. A finding of outcome-determinative prejudice expresses a judicial conclusion that the erroneously admitted evidence so influenced the jury that, when considered with and balanced against all evidence properly admitted, there is a reasonable probability that the jury would have acquitted but for the erroneously admitted evidence.
Id.(internal citation omitted); see also State v. Bell,950 S.W.2d 482, 484 (Mo. banc 1997); Case,140 S.W.3d at 87. In judicially determining whether "there is no reasonable probability that the jury would have acquitted but for the erroneously admitted evidence," Black,50 S.W.3d at 786, we must keep in mind that the State is "not entitled to the benefit of all reasonable inferences from the evidence, as in a review for the sufficiency of the evidence." Driscoll,55 S.W.3d at 357.
In Bernard,the Court held that the prior uncharged crimes evidence which did not meet the narrow signature modus operandi/corroboration exception to the general rule of inadmissibility because it bore "no similarity to the conduct with which [the defendant] is charged in the present case ... is prejudicial, and its admission requires reversal and remand for a new trial." 849 S.W.2d at 20. Moreover, "[t]he amount of evidence that was erroneously admitted and the extent to which the evidence was referred during the trial" may also be considered in determining the existence of reversible, outcome-determinative error. Barriner,34 S.W.3d at 151.
In this regard, the record shows that the evidence in question (considered together with that which Mr. Berwald was forced to present in an attempt to rebut the allegations of Ms. Howe and Ms. Twedt) was extensive, covering well over 200 printed pages of the transcript. The transcript also demonstrates that the prosecutor
[186 S.W.3d 363]
took full advantage of the trial court's erroneous rulings permitting the State to present the testimony of Ms. Howe and Ms. Twedt over proper objection by Mr. Berwald. The prosecutor actually began his closing argument to the jury by specifically referring to that evidence, and also repeatedly mentioned it throughout his rebuttal argument, claiming that Ms. Howe and Ms. Twedt were especially credible witnesses since, unlike some of the other witnesses the jury had heard testify, "[t]heir stories are consistent" and "[t]hey never had their stories rehearsed." The prosecutor also contended that what happened to N.B. was "a recreation of what happened" to Ms. Howe and Ms. Twedt, even though that was clearly not the case as to any of the crimes with which Mr. Berwald was charged and for which he was on trial. The transcript further shows that the prosecutor's last words to the jury before it retired to begin its deliberations were: "And Jane [Twedt] and Vicki Howe came into this courtroom and testified that they still loved him [Mr. Berwald]. They still loved him. They still love him. Man, if you ever saw raw emotion and a family in hurt and turmoil, this is it. There's something going on here." Thus, the State's belated claim on appeal that this evidence did not contribute to the jury's guilty verdicts on Counts III and VI in any way is totally inconsistent with what it argued to the jury at trial. "Because of the volume of testimony devoted to the improperly admitted evidence, as well as the number of references highlighting the improperly admitted evidence, the likelihood that this evidence had a lasting impact on the jury is great." Id.
Nevertheless, the State maintains that there was no outcome-determinative prejudice. First, the State argues that Mr. Berwald was not prejudiced since the jury was given a limiting instruction, which stated:
If you find and believe from the evidence that the defendant was involved in offenses other than the one [sic] for which he is now on trial and other than the offenses mentioned in Instructions Nos. 9, 11, 13, 15, 17, and 195 you may consider that evidence on the issues of motive, intent and absence of mistake or accident. You may not consider such evidence for any other purpose.
This argument is disingenuous, because as noted supra,the State does not even attempt to justify the admission of the testimony of Ms. Howe and Ms. Twedt on the grounds that it was probative as to Mr. Berwald's motive, intent, or the absence of mistake or accident. Furthermore, even if it had any such evidentiary value, it would still have been inadmissible because where, as here, "evidence of other crimes is unnecessary because motive, intent,... or absence of mistake were not issues, the probative value of such evidence is far outweighed by its prejudicial effect." State v. Conley,938 S.W.2d 614, 621 (Mo.App. E.D.1997). Since the challenged testimony was inadmissible for any purpose, the limiting instruction was wholly ineffective to protect Mr. Berwald's right to be tried only for the offenses with which he had been charged and for which he was on trial.
Second, the State claims Mr. Berwald was not prejudiced because, if the testimony of Ms. Howe and Ms. Twedt had played a decisive role in its deliberations, "the jury would likely have convicted [him] on all possible counts." As illustrated by the cases cited
supra,
that is not the appropriate
[186 S.W.3d 364]
inquiry to determine the existence of outcome-determinative prejudice. Instead, the appropriate inquiry is whether there is a substantial likelihood that the jury would have acquitted Mr. Berwald on five or all six charges (rather than on only four) had the trial court properly excluded the highly prejudicial testimony of Ms. Howe and Ms. Twedt, which undoubtedly (but impermissibly) bolstered the rest of the State's case against Mr. Berwald. Given the overall weakness of the State's case against Mr. Berwald and the large amount of defense evidence he presented tending to show his innocence, 6 this is not a particularly close call. We therefore reject the State's speculative claim that the erroneously admitted evidence played little or no role in producing the jury's guilty verdicts on Counts III and VI due to his acquittal by the jury on Counts I, II, IV, and XI.
To summarize, after thoroughly reviewing the record and the law, we can only conclude that the trial court erred and abused its discretion in admitting the evidence in question. Moreover, Mr. Berwald has demonstrated to our satisfaction that when considered with and balanced against all evidence properly admitted, there is a reasonable probability that the jury would have acquitted Mr. Berwald on Counts III and VI but for the error committed by the trial court in admitting the testimony of Ms. Howe and Ms. Twedt. Accordingly, the point is granted, and Mr. Berwald's convictions on Counts III and VI must be reversed and the case remanded for a new trial.
In his second point, Mr. Berwald argues that the trial court prejudicially erred and abused its discretion in admitting the trial testimony of N.B. herself regarding multiple uncharged acts of sexual abuse he purportedly committed against her because it was neither logically nor legally relevant to the issues before the jury in that her testimony as to those acts did not relate to any criminal offense for which he was on trial and its prejudicial effect far outweighed its probative value.
Since Mr. Berwald has been granted a new trial on Counts III and VI and it is unclear whether and how such other crimes evidence from N.B. will be introduced in a retrial not involving Counts I, II, IV, V, VII, VIII, and IX, we need not decide the point in this appeal. The same applies to Mr. Berwald's fourth point, in which he argues that, due to the trial court's erroneous admission of N.B.'s vague and overlapping trial testimony concerning a host of similar charged and uncharged criminal sexual acts which she said took place at or around the time of the events charged in Count VI, the jury was unable to reasonably distinguish between the charged and uncharged acts and he was effectively denied his constitutional right to a unanimous verdict of guilt by all twelve jurors on Count VI. Should either or both of these issues arise on retrial, in deciding whether to admit or exclude N.B.'s uncharged crimes testimony (in whole or in part), the trial court is to be guided by the applicable portions of our analysis supra,as well as the proper exercise of its sound discretion.
In his third and final point, Mr. Berwald argues the trial court abused its discretion in denying his motion to dismiss all charges against him or to grant him a new trial based on the State's failure to preserve a microcassette audiotape of N.B.'s initial allegations which had been
[186 S.W.3d 365]
recorded by Ms. Berwald. We disagree, because, although the State's handling of this evidence was sloppy and perhaps negligent, Mr. Berwald has not shown that the audiotape in question was exculpatory or that the State acted in bad faith in failing to preserve it.
To properly understand this contention, it is necessary to set forth some additional facts. As mentioned supra,Ms. Berwald created the audiotape in question on or about April 29, 2003, when N.B. told Ms. Berwald for the first time about being sexually abused by Mr. Berwald. On March 15, 2004, Mr. Berwald took the deposition of his estranged wife. While testifying regarding the initial allegations lodged by her daughter, Ms. Berwald let slip the fact that she had audiotaped her conversation with N.B.
The record shows that, although Mr. Berwald was not, the State was well aware of the existence of the tape before Ms. Berwald's deposition, because, as conceded by the State in its brief, it had been delivered by her to five different state investigators involved in the criminal investigation a few days after she recorded it, including DFS investigator Rhonda Talley, Bates County Chief Deputy Juvenile Officer Deborah Powell, STAT investigator Larry Wyrick, and two members of the Bates County Sheriff's Department (Justin Moreland and Gary Martin), none of whom preserved or attempted to electronically enhance the tape before giving it back to Ms. Berwald.
Mr. Berwald subsequently filed a motion to dismiss the amended information in its entirety, seeking to establish a violation of Arizona v. Youngblood,488 U.S. 51, 109 S.Ct. 333, 102 L.Ed.2d 281 (1988), based on his claim that the State failed to preserve potentially exculpatory evidence. In particular, Mr. Berwald alleged that the State had acted in bad faith by (1) failing to preserve the tape; and (2) failing to attempt to have the audio electronically enhanced to determine if it contained any exculpatory evidence before returning it to Ms. Berwald, "a woman who is actively engaged in divorce proceedings from Mr. Berwald and has an interest in seeing him sentenced to prison." The motion further alleged that Mr. Berwald had retained an audio expert who believed that "the tape could, in all likelihood, have been enhanced to obtain the complete statements" from N.B. and Ms. Berwald.
During a brief hearing on the motion a few days before the start of trial, the prosecutor stated that Ms. Berwald had advised him she could not find the tape and that she may have discarded it. The prosecutor also stated that Talley and Powell both explained to him that they gave the tape back to Ms. Berwald because it "is of no use to us, or you can't hear it, or some words to the effect that this isn't any good," explaining: "That may be negligence, but I don't see that as bad faith. And it's just like police not taking fingerprints at the scene of a crime. I mean, you know, if they — if they are sloppy and don't do it, I think it's more akin to that than it is a discovery violation." The trial court postponed ruling on the motion, waiting to see if the tape would be found before trial began, but made a preliminary finding of no bad faith on the State's part. Immediately before swearing the jury, the trial court overruled Mr. Berwald's motion to dismiss.
At trial, seven witnesses testified about the tape. N.B. testified that when she had listened to it, "you couldn't hardly understand very much." Ms. Berwald testified that she made the tape, which she subsequently "got rid of" or misplaced, so N.B. wouldn't have to repeat her allegations against Mr. Berwald, but that the various
[186 S.W.3d 366]
law enforcement officials she took it to "couldn't understand it."
Powell, for whom Ms. Berwald evidently played the tape first, testified that the first three minutes of the tape were "inaudible," stating that she could not hear anyone's voices and that there was "absolutely not one word that I could understand on the tape." She further stated that all she heard on the tape was "scratching and banging" and that the tape was "completely useless as any kind of tool." However, Powell acknowledged that she'd never fast-forwarded the tape to check to see if the quality improved later on. Talley also heard the first few minutes of the tape, describing it as "inaudible," stating that the voices were "muddled" and "muffled." Like Powell, Talley acknowledged that she never attempted to fast-forward through the tape to see if other portions were audible.
Detective Justin Moreland of the Bates County Sheriff's Department testified that he was given the tape by Ms. Berwald, but that he "couldn't understand anything on it," because all he could hear was "mumbling." He testified that he made no report about the tape because it had no apparent evidentiary value and was of no benefit to either party. Deputy Martin testified that he hardly remembered the tape and did not recall listening to it, but said that Detective Moreland had told him that it was inaudible. Finally, STAT investigator Wyrick testified that he was given the tape by Ms. Berwald and tried to play it, but couldn't understand what was being said because "it wasn't a very good recording." Although he could hear voices, testified Wyrick, they were "staticky" and "garbley" [sic] so he gave the tape back to Ms. Berwald, explaining that because he found the tape to be a "fairly insignificant" piece of evidence, he didn't bother to mention it in his written report. Asked whether he attempted to fast-forward through the tape to see if other portions were audible, Wyrick stated that he couldn't remember. Wyrick further testified that he did not have the tape analyzed by an audio expert to try to filter out the static and background noise because he relied on the Missouri State Highway Patrol laboratory for such services, which had been unable to successfully filter tapes that were "a lot better than" this tape.
A trial court's refusal to dismiss a charging instrument is reviewed for abuse of discretion. See State v. Burns,112 S.W.3d 451, 454 (Mo.App. W.D.2003). "Whatever duty the Constitution imposes on the States to preserve evidence, that duty must be limited to evidence that might be expected to play a significant role in the suspect's defense." California v. Trombetta,467 U.S. 479, 488, 104 S.Ct. 2528, 2534, 81 L.Ed.2d 413, 422 (1984). Therefore, in assessing whether a trial court abused its discretion in refusing to impose dismissal as a sanction for the State's failure to preserve evidence that is potentially useful to the defense, this court must determine "whether the evidence was of such significance to create a reasonable likelihood that the outcome of the trial would be affected." Burns,112 S.W.3d at 454-55.
Moreover, even if the evidence might be expected to play such a role in the outcome of the trial, a defendant must also show that "the State acted in bad faith in destroying the evidence or that the exculpatory value of the evidence was apparent before it was destroyed."
at 455. "Absent a showing of bad faith on the part of the police or prosecutor, the failure to preserve even potentially useful evidence does not constitute a denial of due process."
State v. Ferguson,
20 S.W.3d 485
, 504 (Mo. banc 2000). In this context, bad
[186 S.W.3d 367]
faith is the destruction of the evidence by a state actor "for the purpose of depriving the defendant of exculpatory evidence[.]" State v. Armentrout, 8 S.W.3d 99 , 110 (Mo. banc 1999). Thus, to merit relief on a claim of failure to preserve evidence, the defendant must also show that the evidence had an exculpatory value that was apparent to the State before it was destroyed. Trombetta, 467 U.S. at 489, 104 S.Ct. at 2534, 81 L.Ed.2d at 422. Accordingly, for due process purposes, bad faith turns on law enforcement's "`knowledge of the exculpatory value of the evidence at the time it was lost or destroyed.'" State v. Smith, 157 S.W.3d 687 , 691 (Mo.App. W.D.2004) (quoting Youngblood, 488 U.S. at 56 n.*, 109 S.Ct. at 336 n.*, 102 L.Ed.2d at 288 n.*).
The trial testimony recited supramakes it abundantly clear that Mr. Berwald failed to show that the tape in question contained exculpatory evidence significant enough to create a reasonable likelihood that the outcome of the trial would have been affected. Indeed, in his brief, he articulates no specific basis for doing anything more than speculating that something exculpatory might possibly have been found had the tape been electronically enhanced to filter out the static and background noise. Furthermore, even if the evidence was potentially useful, Mr. Berwald also failed to make a showing that the State acted in bad faith in failing to preserve the evidence since he did not demonstrate that its exculpatory value was apparent to the State before the tape was lost or destroyed or that the tape was not preserved for the purpose of depriving him of access to exculpatory evidence. Point denied.
Mr. Berwald's convictions on Count III (statutory rape in the first degree, section 566.032) and Count VI (statutory sodomy in the second degree, section 566.064) are reversed and the case is remanded for a new trial.
All concur.
FootNotes
1. All statutory references are to RSMo 2000.
2. Because Counts VI and IX charged essentially the same underlying conduct, the trial court required the State to submit Count IX in the alternative to Count VI. Therefore, Mr. Berwald could have been convicted on either none or one of those two counts, but not both of them.
3. Since evidence must be both logically and legally relevant to be admissible, we need not decide the issue of its legal relevance. We note, however, that the events described by Ms. Howe and Ms. Twedt had allegedly occurred from twenty to thirty years prior to the charged offenses and that several hundred pages of the transcript were devoted either to their testimony or the related testimony of Mr. Berwald's opposing witnesses. During all this, the jury no doubt focused its attention more on the stale sexual abuse allegations of Mr. Berwald's adult daughters than on the allegations of N.B. herself, thereby setting the stage for possible confusion of the issues, misleading the jury, undue delay, and waste of time.
4. "In most cases of trial court error, the issue is whether the evidence was `outcome determinative,' that is, whether `the erroneously admitted evidence so influenced the jury that, when considered with and balanced against all the evidence properly admitted, there is a reasonable probability that the jury would have reached a different conclusion but for the erroneously admitted evidence.'"
Driscoll,
55 S.W.3d at 356 (quoting
Barriner,
34 S.W.3d at 150). However, when a properly preserved error is so serious that it rises to the magnitude of a federal or state constitutional violation, including "due process, confrontation clause, right to present a defense, right to access justice through the courts of Missouri, right to a reliable verdict and sentencing, [or] cruel and unusual punishment,"
State v. Wolfe,
13 S.W.3d 248
, 263 (Mo. banc 2000), it is
presumed
to be prejudicial and "the judgment of guilt can be affirmed only if it is shown [by the State] that the error was harmless beyond a reasonable doubt" in accordance with the "heightened standard" of review set forth in
Chapman v. California,
386 U.S. 18
, 87 S.Ct. 824, 17 L.Ed.2d 705 (1967) and
Neder v. United States,
527 U.S. 1
, 119 S.Ct. 1827, 144 L.Ed.2d 35 (1999).
Driscoll,
55 S.W.3d at 356;
State v. Case,
140 S.W.3d 80
, 87 (Mo.App. W.D.2004) (noting that when the error complained of rises to the level of a constitutional violation, "[t]he State must prove beyond a reasonable doubt that [it] did not contribute to the verdict obtained.")
See also State v. Whitfield,
107 S.W.3d 253
, 262 (Mo. banc 2003) (internal quotation marks omitted) ("Under this test, the beneficiary of a constitutional error, the State, must prove beyond a reasonable doubt that the error complained of did not contribute to the verdict obtained.") Although there is some older Missouri authority to the contrary, as demonstrated by
Morrow,
in which our Supreme Court employed the general test for prejudice when the defendant alleged trial court error in the admission of evidence of prior uncharged crimes over his timely and specific objection at trial, this case does not involve a federal or state constitutional violation, so the harmless-beyond-a-reasonable-doubt standard of
Chapman
and
Neder
does not apply here.
5. These instructions were the verdict directors on Counts I, II, III, IV, VI, and IX, respectively.
6. The State dropped two of the original eleven charges against Mr. Berwald immediately prior to trial and he was acquitted on seven of the nine remaining charges, either by the trial court or the jury.
Comment
| https://www.leagle.com/decision/2005535186sw3d3491512 |
Ruptured pulmonary hydatid cyst | Changeset | Radiopaedia.org
Ruptured pulmonary hydatid cyst
Diagnosis almost certain
Updates to Study Attributes
Findings was changed:
There is extensive air density seen in the soft tissues of the anterior, lateral and posterior chest wall, dissecting into the deep soft tissue and muscle planes, and which extends superiorly and inferiorly to involve the left neck and left lateral abdominal wall, respectively. The emphysema even crosses over to the right side at the level of the thoracic inlet.
Within the lung fields, there is a large, well defined, cystic lesion measuring 16 cm (AP) x 9 cm (Trans) x 19 cm (CC) seen in the left lung, occupying almost the entire lung field. Within the dependant portion of this lesion, there is a heterogeneous,
serpinginous
serpiginous
or onion peel like nodule density. This is representative of the
spin
or
cumbo Cumbo sign
of detached or ruptured hydatid cyst membranes.
Pleural reaction posteriorly, as well as lung atelectasis medial to the cyst, are also seen, in keeping with the rupture.
Surrounding the hydatid cyst there are multiple smaller cystic cavities interspersed with areas of severe panlobular interstitial emphysema. Midline shift to the right is also seen, likely secondary to mass effect.
The right lung field is unaffected.
Updates to Case Attributes
Body was changed:
Subcutaneous or
Surgical
surgical
emphysema often occurs in the chest wall secondary to a malpositioned chest tube. This is not a life threatening complication and will resolve given time. Clinically may be perceived as crepitus of the soft tissues on the affected side. It is also known as surgical emphysema due to the dissection of the air into the deep soft tissues and intramuscular planes.
In this case, the underlying pulmonary pathology is that of a ruptured (complicated) cyst from a pulmonary hydatid infection. This is the second most common site of hydatid disease after the liver (hepatic hydatid cyst), and may infect the lungs through either transdiaphragmatic or haematogenous spread. Concurrent infection in both the liver and the lungs however, is rare. In this case, the liver is visualized and has normal parenchyma.
These hydatid cysts can grow very large and can be uni or multiloculated. They can also have odd shapes and rupture (as in this case) due to pressures from adjacent broncho-vascular structures, as well as the continuous production of hydatid fluid and increase in intracystic pressure. The imaging characteristics of these cysts include various radiological signage devised to help with its diagnosis, including the Cumbo/ Onion peel/ Double arch sign seen here.
It is worth noting that patients with underlying pleural pathology (such as in this case where the adjacent hydatid cyst causes pleural reaction) may be prone to malpositioning of a chest tube due to the chronic pleural inflammation.
- <p>Subcutaneous or Surgical emphysema often occurs in the chest wall secondary to a malpositioned chest tube. This is not a life threatening complication and will resolve given time. Clinically may be perceived as crepitus of the soft tissues on the affected side. It is also known as surgical emphysema due to the dissection of the air into the deep soft tissues and intramuscular planes.</p><p>In this case, the underlying pulmonary pathology is that of a ruptured (complicated) cyst from a pulmonary hydatid infection. This is the second most common site of hydatid disease after the liver (hepatic hydatid cyst), and may infect the lungs through either transdiaphragmatic or haematogenous spread. Concurrent infection in both the liver and the lungs however, is rare. In this case, the liver is visualized and has normal parenchyma. </p><p>These hydatid cysts can grow very large and can be uni or multiloculated. They can also have odd shapes and rupture (as in this case) due to pressures from adjacent broncho-vascular structures, as well as the continuous production of hydatid fluid and increase in intracystic pressure. The imaging characteristics of these cysts include various radiological signage devised to help with its diagnosis, including the Cumbo/ Onion peel/ Double arch sign seen here.</p><p>It is worth noting that patients with underlying pleural pathology (such as in this case where the adjacent hydatid cyst causes pleural reaction) may be prone to malpositioning of a chest tube due to the chronic pleural inflammation.</p><p> </p><p> </p>
+ <p>Subcutaneous or surgical emphysema often occurs in the chest wall secondary to a malpositioned chest tube. This is not a life threatening complication and will resolve given time. Clinically may be perceived as crepitus of the soft tissues on the affected side. It is also known as surgical emphysema due to the dissection of the air into the deep soft tissues and intramuscular planes.</p><p>In this case, the underlying pulmonary pathology is that of a ruptured (complicated) cyst from a pulmonary hydatid infection. This is the second most common site of hydatid disease after the liver (hepatic hydatid cyst), and may infect the lungs through either transdiaphragmatic or haematogenous spread. Concurrent infection in both the liver and the lungs however, is rare. In this case, the liver is visualized and has normal parenchyma. </p><p>These hydatid cysts can grow very large and can be uni or multiloculated. They can also have odd shapes and rupture (as in this case) due to pressures from adjacent broncho-vascular structures, as well as the continuous production of hydatid fluid and increase in intracystic pressure. The imaging characteristics of these cysts include various radiological signage devised to help with its diagnosis, including the Cumbo/ Onion peel/ Double arch sign seen here.</p><p>It is worth noting that patients with underlying pleural pathology (such as in this case where the adjacent hydatid cyst causes pleural reaction) may be prone to malpositioning of a chest tube due to the chronic pleural inflammation.</p>
References changed:
1. Al Mosa AFH, Ishaq M, Ahmed MHM. Unusual Malposition of a Chest Tube, Intrathoracic but Extrapleural. (2018) Case reports in radiology. 2018: 8129341. <a href="https://doi.org/10.1155/2018/8129341">doi:10.1155/2018/8129341</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/30174979">Pubmed</a> <span class="ref_v4"></span>
2. R. Morar, C. Feldman. Pulmonary echinococcosis. (2003) European Respiratory Journal. 21 (6): 1069. <a href="https://doi.org/10.1183/09031936.03.00108403">doi:10.1183/09031936.03.00108403</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/12797504">Pubmed</a> <span class="ref_v4"></span>
3. Peter M. Jones, Robert D. Hewer, Hugh D. Wolfenden, Paul S. Thomas. Subcutaneous emphysema associated with chest tube drainage. (2001) Respirology. 6 (2): 87. <a href="https://doi.org/10.1046/j.1440-1843.2001.00317.x">doi:10.1046/j.1440-1843.2001.00317.x</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/11422886">Pubmed</a> <span class="ref_v4"></span>
4. Sarkar M, Pathania R, Jhobta A, Thakur BR, Chopra R. Cystic pulmonary hydatidosis. (2016) Lung India : official organ of Indian Chest Society. 33 (2): 179-91. <a href="https://doi.org/10.4103/0970-2113.177449">doi:10.4103/0970-2113.177449</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/27051107">Pubmed</a> <span class="ref_v4"></span>
Al Mosa AFH, Ishaq M, Ahmed MHM. Unusual Malposition of a Chest Tube, Intrathoracic but Extrapleural. (2018) Case reports in radiology. 2018: 8129341. <a href="https://doi.org/10.1155/2018/8129341">doi:10.1155/2018/8129341</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/30174979">Pubmed</a> <span class="ref_v4"></span>
R. Morar, C. Feldman. Pulmonary echinococcosis. (2003) European Respiratory Journal. 21 (6): 1069. <a href="https://doi.org/10.1183/09031936.03.00108403">doi:10.1183/09031936.03.00108403</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/12797504">Pubmed</a> <span class="ref_v4"></span>
Peter M. Jones, Robert D. Hewer, Hugh D. Wolfenden, Paul S. Thomas. Subcutaneous emphysema associated with chest tube drainage. (2001) Respirology. 6 (2): 87. <a href="https://doi.org/10.1046/j.1440-1843.2001.00317.x">doi:10.1046/j.1440-1843.2001.00317.x</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/11422886">Pubmed</a> <span class="ref_v4"></span>
Sarkar M, Pathania R, Jhobta A, Thakur BR, Chopra R. Cystic pulmonary hydatidosis. (2016) Lung India : official organ of Indian Chest Society. 33 (2): 179-91. <a href="https://doi.org/10.4103/0970-2113.177449">doi:10.4103/0970-2113.177449</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/27051107">Pubmed</a> <span class="ref_v4"></span>
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(PDF) The Digital Divide Among College Students: Lessons Learned From the COVID-19 Emergency Transition
PDF | This report examines the meaning and impact of the digital divide-the gap between those who can and cannot access the Internet-on college students... | Find, read and cite all the research you need on ResearchGate
Research
The Digital Divide Among College Students: Lessons Learned From the COVID-19 Emergency Transition
Abstract and Figures
This report examines the meaning and impact of the digital divide-the gap between those who can and cannot access the Internet-on college students during the COVID-19 emergency shift to remote learning. The assessment is based on several national surveys conducted in the spring or summer of 2020, as well as results from a large-scale survey the authors conducted at Indiana University and The Ohio State University during the same time period. Key findings of the report are previewed below. Prevalence of Inadequate Technology Approximately 16%-19% of college students reported technology barriers (inadequate computer hardware or Internet connection) that inhibited participation in online learning. Higher rates of technology inadequacy were observed among lower-income students (20%-30%) than higher-income students (10%-12%); Black (17%-29%) and Hispanic (23%-28%) students relative to White students (12%-17%); and students living in a rural area (14%-25%) compared to those living in a suburban (16%) or urban area (16%-20%). Inadequate Technology and Student Success Compared to students with robust Internet access and reliable devices, college students with inadequate technology struggled more with the transition to remote learning. For example, they reported a sharper increase in difficulty meeting deadlines and a steeper decline in their sense of success as college students. In addition, regardless of their academic or demographic background, students with inadequate technology were substantially more likely to opt for a "Pass / No-Pass" grade in spring 2020, which signaled that students were struggling with their online coursework. Institutional and State Approaches In order to support students with inadequate technology during the emergency transition, most colleges across the U.S. loaned laptops or hotspots to students who needed them or negotiated with vendors to provide free or discounted equipment. At the same time, states leveraged recent legislation or passed new legislation to help bridge the digital divide, particularly in terms of broadband access. Four types of recent broadband policy are evident in the Midwest: streamlining bureaucratic and regulatory models, supporting community and private sector engagement and training, leveraging state resources, and making other financial investments in broadband access.
Percentage of Indiana-Ohio Respondents with Inadequate Technology by Race/Ethnicity, Residence, Class Standing, and Institutional Type …
Figures - uploaded by
The Digital Divide Among
Coll ege Students:
L essons L earned F r om
the CO VID- 19 E merg ency
T ransition
The Ohio State University
Benjamin A . Motz
Indiana University
Marcos D. Rivera
The Ohio State University
Andrew Heckler
The Ohio State University
Joshua D. Quick
Indiana University
Elizabeth A . Hance
The Ohio State University
Caroline Karwisch
The Ohio State University
EDITOR
Aaron Horn
Associate Vice President of
Research, MHEC
[email protected]
( * )
Recommended Citation
Jaggars, S. S., Motz, B. A., Rivera, M. D ., Heckler , A., Quick, J.D., Hance, E. A., & Karwischa,
C. (2021). The Digital Divide Among Colleg e Students: Lessons Learned F rom the
1
The Digital Divide Among College Students
This report examines the meaning and impact of the digital
divide — the gap between those who can and cannot access
the Internet — on college students during the COVID- 19
emergency shift to remote learning. The assessment is
based on several national surveys conducted in the spring
or summer of 2020, as well as results from a large-scale
survey the authors conducted at Indiana University and
The Ohio State University during the same time period. Key
findings of the report are previewed below.
Prevalence of Inadequate T echnolog y
Approximately 16% - 19% of college students reported
technology barriers (inadequate computer hardware or
Internet connection) that inhibited participation in online
learning. Higher rates of technology inadequacy were
observed among lower-income students (20%-30%) than
higher-income students (10%-12%); Black (17%-29%) and
Hispanic (23%-28%) students relative to White students
(12%-17%); and students living in a rural area (14%- 25%)
compared to those living in a suburban (16%) or urban area
(16%-20%).
Inadequate T echnology and Student
Success
Compared to students with robust Internet access and
reliable devices, college students with inadequate
technology struggled more with the transition to remot e
learning. For example, they reported a sharper increase
in difficulty meeting deadlines and a steeper decline in
their sense of success as college students. In addition,
regardless of their academic or demographic background,
students with inadequate technology were substantially
more likely to opt for a “Pass / No-P ass” grade in spring
2020, which signaled that students were struggling with
their online coursework.
Institutional and State Approaches
In order to support students with inadequate technology
during the emergency transition, most colleges across
the U.S. loaned laptops or hotspots to students who
needed them or negotiated with vendors to provide fr ee or
discounted equipment. At the same time, states lever aged
recent legislation or passed new legislation to help bridge
the digital divide, particularly in terms of broadband
access. Four types of recent broadband policy are e vident
in the Midwest: streamlining bureaucratic and regulatory
models, supporting community and private sector
engagement and training, leveraging stat e resources, and
making other financial investments in broadband access.
EXECUTIVE SUMMARY
POLICY OPTIONS
u Support community and private sector engagement and training, by bolstering the efforts of Community Anchor
Institutions and creating broadband certifications and trainings for communities.
u Leverage state administration t o strategically allocate indirect feder al funding to support technology access and
to streamline, coordinate, and support the administration of broadband progr ams through a centralized state
office.
u Invest directly in broadband through programs that inc entivize or match private and local investment.
u In broadband expansion efforts, place a particular emphasis on wireless broadband in order to maximize ac cess
for students who rely on portable wireless devices.
u Incentivize or support colleges in efforts to provide tablets, lapt ops, and wireless access to students who would
otherwise have inadequate technology .
2 The Digital Divide Among College Students
The Digital Divide Among Coll ege Students: Lessons L earned
Fr om the COVID- 19 Emergency T ransition
D uring spring 2020, the entirety of U.S. higher
education moved online in response to the
COVID-19 pandemic. V er y quickly, c olleges
learned that the “digital divide” is a real
challenge for their students. The digital divide refers to the gap
between those who can readily access and use the Internet
versus those who cannot. In particular, about 2 7% of U.S. adults
do not have broadband Internet at home and thus may find it
difficult to conduct critical activities online, such as shopping,
seeking employment, or doing academic work (Pew Research
Center , 2019). College students might be assumed to be on
the “good side” of the digital divide and to enjoy seamless
technology access; however , the emergency transition to online
learning quickly called that assumption into question.
This report first provides background on the extent of the
digital divide within the U.S. in general, and within American
colleges and universities in specific, prior to the emergency
shift to online learning in spring 2020. T o understand the
meaning and impact of the digital divide on college students
during the emergency shift, results are presented from sever al
national surveys conducted in the spring or summer of 2020,
as well as a large-scale survey at Indiana University and The
Ohio State University. Using these national and Midw estern-
specific data, digital inequities are linked with college
students’ academic experiences and outcomes during the
COVID- 19 period. Finally, an analysis of recent state legislation
in the Midwest highlights key policy approaches to bridge the
digital divide for college students and their communities.
BACKGROUND ON THE U.S. DIGITAL
DIVIDE
The digital divide is defined as the “gap between individuals,
households, businesses and geographic areas at different
socio-economic levels with regard to both their opportunities
to access information and communication technologies (ICT s)
and to their use of the Internet for a wide variety of activities”
(OECD, 2006). An important indicator of the digital divide is
the extent to which individuals from different income, r acial/
ethnic, and geographical groups lack broadband internet
at home. The higher speeds of a broadband connection do
not just provide greater convenienc e and efficiency relative
to a dial-up connection; many data-intensive applications
require broadband capability to function properly , such as
videoconferencing and live streaming. Nationally , survey
data collected in 2019 indicates that 27 percent of adults
lack a broadband connection at home (Pew Research
Center , 2019). Moreover , as F igure 1 illustrates, lo w-income,
underrepresented minority, and rur al populations in the
United States are most likely to lack at-home broadband
Internet. For example, only 63% of rural r esidents have
broadband, in comparison to 79% of suburban residents.
In order to use the Internet effectively , individuals need
not only robust Internet access but also devices which can
connect to the Internet and efficiently manage the task
at hand (Fernandez et al., 2019; OECD, 2006). Howev er, 17%
of U.S. adults are “cellphone dependent”: they rely on a
mobile phone for activities such as shopping, finding health
information, seeking employment, or doing academic work.
Users may turn to cellular data when they lack reliable high-
speed Internet or do not have a reliable larger-format device
such as a tablet, laptop, or desktop computer (Fernandez et
al., 2019; Perrin, 2019; Perrin & T urner, 2019). As Figure 2 shows,
cellphone dependency levels are highest among low-income,
Black or Hispanic, and rural populations. While smartphones
are helpful with basic online tasks, they are inadequate for
complex tasks such as completing homework (Fernandez et
al., 2019). For example, in a large-scale study of 8th to 11th
graders in Michigan, cellphone dependency substantially
hindered students’ academic progress and success (Hampton
et al., 2020). 1
When a cellphone is insufficient, users without at-home
Internet turn to the homes of friends and family, coff ee shops
and restaurants, libraries, and community center s (Perrin &
Turner , 2019). However, in c ommunities without widespread
broadband infrastructure, public and private alternatives
to at-home access are scarce (Hampton et al., 2020). 2 Rural
residents may be most likely to suffer from a conv ergence
of limited at-home broadband, spotty cell phone cover age,
and lack of nearby alternative access locations. Indeed, 24%
of rural adults say access to high-speed Internet is a “major
problem” in their local community , compared to 13% of urban
and 9% of suburban adults (Anderson, 2018).
3
The Digital Divide Among College Students
Source: Pew Research Center . (2019). Internet/Broadband Fact Sheet.
I FIGURE 1. Percentage of U.S. Adults Who are Home Broadband Users, by
Family Income, R ace/Ethnicity, and Residential Setting
92%
87%
72%
56%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
By income
$75K+ $50K-$75K $30K-$50K < $30K
79%
66%
61%
By race
White Black Hispanic
79% 75%
63%
By residential setting
Suburban Urban Rural
Source: Pew Research Center . (2019). Internet/Broadband Fact Sheet.
I FIGURE 2. Percentage of Cellphone-Dependent Adults in the U.S. by Family Income,
Race/Ethnicity, and Residential Setting
6% 10%
20%
26%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
By income
$75K+ $50K-$75K $30K-$50K < $30K
12%
23% 25%
By race
White Black Hispanic
13% 17% 20%
By residential setting
Suburban Urban Rural
4 The Digital Divide Among College Students
DIGITAL DIVIDES IN COLLEGE
Although the overall U.S. digital divide was clearly observable
and widely discussed prior to COVID- 19, college students were
rarely mentioned in the digital divide research because most
colleges offer robust Internet access acr oss campus libraries,
classrooms, and residence halls, and many off-campus
students live in highly-wired neighborhoods near campus
(Galanek et al., 2018; Gierdowski, 2019). For students who
cannot afford well-performing laptops or desktops, campus
computer labs and libraries also provide free ac cess to these
devices (e.g., see Regalado & Smale, 2014).
Despite these advantages, some college students remained
“underconnected. ” For example, among college students
who commuted in 2018, 28% reported having subpar Internet
access (Galanek et al., 2018). Other studies found that some
college students had difficulty paying their Internet bill
on time, struggled with data caps or outdated connection
hardware, or could not complete academic work due t o
computer performance issues (Gonzalez et al., 2020; Rideout
& Katz, 2016). These studies suggested that having reliable
high-speed Internet and a well-performing tablet, laptop,
or desktop is critical to college students’ academic success
(Gonzalez et al., 2020; Reisdorf et al., 2020). For example, a
study of students at a Midwestern university found that, after
controlling for socioeconomic status and other demographic
factors, students with more poorly-functioning laptops had
lower GP As (Gonzalez et al., 2020).
The potential for growing digital divides in college became
evident as institutions responded to the COVID- 19 pandemic.
In March 2020, colleges across the country pivoted to r emote
learning for students in traditionally face-to-face cour ses. In
a nationally-representative survey of undergraduate students
who experienced the online transition (Means & Neisler , 2020),
students described several features of their online courses
which require robust Internet access, including live discussion
sessions (67%), recorded lectures (65%), frequent quizzes
(64%), live lectures (60%), pre-recorded videos (55%), and live
breakout groups (25%). At the same time, students lost access
to several key sourc es of broadband Internet and desktop
computing, as campus libraries, computer labs, and residence
halls were emptied, and coffee shops, public libraries, and
community centers closed their doors.
To under stand the extent and impact of the digital divide on
college students during this period, multi-institutional surveys
of colleges or their students are reviewed and discussed
below. T o provide a lens specific to the Midwest, results are
also presented from a survey of over 9 ,500 undergraduates
and over 2,300 instructors across all 14 campuses of Indiana
University and The Ohio State University (the “Indiana-Ohio”
survey), which was conducted from April to June 2020. 3 T aken
together , the survey results indicate that many students had
inadequate technology – including poor Internet access or
lack of access to a device necessary to complet e academic
work online – which thwarted students’ academic experience
and success. T echnology use statistics are disaggregated by
race/ ethnicity, family income, and residential setting when
possible.
Prevalence of Inadequate T echnolog y
National and Midwestern surveys of technology use among
college students suggest that inadequate technology has been
a common barrier during the COVID- 19 pandemic. In May 2020,
the Congressionally-authorized non-profit organization Digital
Promise conducted a nationwide survey of around a thousand
undergraduates, including both two- and four-year colleg e
students (Means & Neisler , 2020). Digital Promise found that
16% of undergraduates had Internet connectivity issues which
“often” or “very often” hindered their ability to participate
in coursework. These rates were higher among Black and
Hispanic students (17% and 23%, respectively) than among
White students (12%). Connectivity problems were also higher
among students from households earning under $50,000
(20%) than from households earning over $100,000 (12%) but
did not differ statistically between students from suburban/
urban communities (16%) and those from rural communities
(14%).
In terms of computer hardware, nearly 80 percent of
students in the Digital Promise study reported using a
laptop for remote learning during the pandemic, whereas
other students relied on a desktop computer (15%), a tablet
(3%), or a smartphone (2%). About 8% of students reported
experiencing serious hardware or software problems that
interfered with their coursework often or very often, though
these rates were higher among Black and Hispanic students
(15% and 10%, respectively) than among White students (6%);
and they were higher among students from households
earning under $50,000 (11%) than among students from
households earning over $100,000 (4%) (Means & Neisler ,
2020).
5
The Digital Divide Among College Students
The Indiana-Ohio survey found similar levels of technology
inadequacy across students. Approximately 19% of
undergraduates reported having inadequate technology
of some type for full participation in online learning, with
students reporting inadequate Internet access (11%),
inadequate hardware (8%), or primary reliance on a cellphone
(8%). 4 Similar to the Digital Promise findings, the Indiana-Ohio
survey found that students from underrepresented racial
and ethnic groups were substantially more likely than White
students to deal with inadequate technology (see T able 1).
For example, the rate of technol ogy inadequacy was around
ten percentage points higher among Black students (28%)
than among White students (18%). 5 Levels of inadequate
technology were also higher among students from small-town
or rural areas (21%) in comparison to those from suburban
areas (16%).
In addition to technology gaps by race/ ethnicity and
residential setting, the Indiana-Ohio survey revealed digital
divides by academic class and institutional type. T able 1
shows that freshmen and sophomores were more likely to
experience inadequate technology than upperclassmen. 6
Regarding institutional type, the results indicated that
technology barriers were more common at regional or
comprehensive universities, which tend to serve more
students from disadvantaged backgrounds than do flagship
research universities.
I TABLE 1. Percentage of Indiana- Ohio Respondents with Inadequate Techno logy by Race/Ethnicity,
Residence, Cass Standing, and Institutional Type
Ohio State University Indiana University Combined
All Students 20% 18% 19%
Race / Ethnicity
African-American 29% 28% 28%
Asian-American 20% 17% 19%
Hispanic 28% 24% 25%
White 19% 17% 18%
Other 15% 15% 15%
Residential Setting
Urban 20% 16% 18%
Suburban 16% 16% 16%
Small Town/Rur al 25% 20% 21%
Class Standing
Freshman 23% 25% 24%
Sophomore 23% 21% 21%
Junior 20% 17% 18%
Senior 18% 15% 16%
Type of Campus
Flagship 19% 17% 18%
Regional 26% 21% 22%
Source: Authors’ analysis of Indiana-Ohio COVID- 19 survey data. Table excludes international students; the cat egory “Other”
combines domestic U.S. race/ ethnicity groups which had a low number of responses to the survey, including Native American
students and those who identified with Two or Mor e Races.
6 The Digital Divide Among College Students
Inadequate T echnology and Student
Success
Several surveys fielded during the pandemic rev ealed that
many students experienced multiple academic challenges
while engaging in online learning. For example, a survey by the
SERU university consortium, conducted from May to July 2020
with over 30,000 undergraduates across nine public resear ch
universities (Soria et al., 2020; Soria & Horgos, 2020), found
that 76% lacked motivation for online learning (see T able 2).
More than half of students also reported a lack of interaction
with other students, the inability to learn effectively , and a
lack of access to an appropriate study space as obstacles to
success. SERU did not report these data by race or residential
setting; however , they did divide respondents into five
categories of social class and found that low-income students
were significantly more likely than higher-income students to
lack necessary technology (30% versus 10%) (Soria & Horgos,
2020).
I TABLE 2. Obs tacles to Online Learning during the COV ID- 19 Pandemic Among
Undergraduate Students at Public Research Universities in the U.S.
Type of Obstacle Percentage of Students who
Experienced Obstacle
Lack of motivation for online learning 76%
Lack of interaction/ communication with other students 64%
Inability to learn effectively in an online format 61%
Distracting home environment or lack of access to an appropriat e study space 56%
Course content that is not appropriate for online learning 43%
Lack of clear expectations for online learning from instructor(s) 39%
Lack of access to your instructor(s) 28%
Lack of access to academic advising 19%
Inability to attend classes at their scheduled online meeting time 18%
Inability to access learning support services 16%
Lack of access to technology necessary for online learning 16%
Lack of familiarity with technical tools necessary for online learning 14%
Source: Soria et al. (2020) The obstacles to remote learning f or undergraduate, graduate, and professional students.
7
The Digital Divide Among College Students
T echnology Adequacy
Strongly Agree
or Agree
Neither Agree
nor Disagree
Strongly Disagree
or Disagree
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Adequate Inadequate
I found my coursew ork
more challenging
Adequate Inadequate
It took more effort
to complete my
coursework
Adequate Inadequate
It was harder to
meet deadlines
Adequate Inadequate
I felt successful as a
college student
Source: Authors’ analysis of Indiana-Ohio COVID- 19 survey data.
I FIGURE 3. Reationship between T echnology Adequacy and Student Perceptions of
Success
Among students without adequate technology, the
academic experience was likely even more problematic.
As noted earlier, r esearch prior to COVID- 19 suggested
that inadequate technology is negatively associated with
overall college perf ormance, even when controlling for
socioeconomic background (Reisdorf et al., 2020). Across the
multi-institutional and national surveys conducted during
the COVID- 19 emergency transition, only the Indiana-Ohio
survey examined how technology access influenced students’
academic experience and success during this period. 7 As
Figure 3 shows, Indiana-Ohio survey respondents with
inadequate technology were more likely than their peers t o
agree that after the switch to online learning, coursew ork
became more challenging, took more effort, and that they
had a harder time meeting deadlines. Moreover , only 28% of
students without adequate t echnology felt successful as a
college student, compared to 46% of students with adequate
technology. 8
8 The Digital Divide Among College Students
During the COVID- 19 crisis, students dealt with a wide variety
of financial and personal challenges; having inadequate
technology seemed to exacerbate the impact of those
challenges on students’ academic success. For example, a
student in the Indiana-Ohio survey commented:
I think everyone, instructors, university , students
had the rug pulled out from under them, but I
couldn’t devote the focus to schoolwork bec ause
half my brain was busy having fits wondering if I
can afford to keep living. I used the food banks and
got some resources without spending money , but it
didn’t feel like enough especially since my internet
plans and configurations depended on using/
being on campus…. There was so much insecurity
and instability during this time. My grades and
schoolwork reflect that.
While students’ subjective assessment of their success is
important, more objective measures are also critical to
inform policy and practice. In order to understand whether
technology inadequacy interfered with students’ academic
performance, an analysis was conducted to determine which
students at Ohio State chose to switch to a “Pass / No P ass”
(P/NP) gr ading option for their Spring 2020 courses. 9 Students
who opt for a P /NP grading option may do so for various
reasons, but poor course performance was the most common
reason in Spring 2020. 10 The analysis showed that Ohio State
students with inadequate technology were more likely to
switch to P /NP for at least one course: 43% of students with
inadequate technology did so, compared to 34% of students
with acceptable technology (a difference of 9 per centage
points). After controlling for the student’s prior GP A as well
as the background variables listed in T able 1, a difference of 7
percentage points persisted across all demographic gr oups. 11
Yet because A frican-American and Hispanic students were
disproportionately likely to face inadequate technology ,
they were also more likely to switch t o P /NP: overall, 46%
of African-American students and 39% of Hispanic students
switched to P /NP in Spring 2020, compared with 35% of White
students. (See the Appendix for more detailed results.)
THE IMP ACT OF INSTITUTIONAL
TECHNOLOGY PROGRAMS
College and university administrator s are well aware that
students have encountered technology barriers during the
pandemic. In April 2020, Educause – a non-profit association
of colleges and companies focused on higher education
information technology – conducted a poll of 267 two-y ear
and four-year colleges in order to understand whether
students had the technology necessary for remote learning.
Across colleges, 36% of administrator s reported that students
were having “moderate or extreme difficulty” with Int ernet
access, and 26% reported that students had the same level
of difficulty with equipment and devices. In response, 81% of
colleges were loaning laptops to students, 4 7% were loaning
hotpots, and 28% were negotiating with vendors to pro vide
free or discounted equipment to students (Grajek, 2020).
Such lending programs tend to operat e on a small scale, as
it is time- and cost-intensive to identify individual students
who are truly in need, and to procure and deliver equipment
to them. Furthermore, little research exists regarding whether
investments in a large-scale technology progr am would have
a significant impact on the various digital divides in college. .12
Data from the Ohio-Indiana study were thus analyzed to
help address this issue. In contrast to Indiana University ,
Ohio State already had a large-scale technology pro vision
program in place: since 2018, Ohio State has pro vided iPad
Pros to every new first-year student. 13 Thus, one might expect
Ohio State students to report substantially lower levels of
technology inadequacy, compar ed to similar students at
Indiana University. Indeed, in their open-ended comments
on the survey, many Ohio State students indicat ed that
the university-provided iPad was their primary devic e for
completing coursework. One student commented:
The university iPad was much needed as it is my
only computer-like device available right now
with libraries closed and I am living at home
with no computer access and no laptop. Its tools
were therefore vital for me to be abl e to perform
coursework, and very helpful in general.
While student comments provided important qualitative
evidence supporting Ohio State’s technology program, a
quantitative analysis of rates of technology inadequacy
between Ohio State and Indiana University revealed
mixed results. Specifically, a c omparison of Ohio State and
Indiana University students found no differences in rat es
of technology inadequacy, y et Ohio State students were
significantly more likely to “strongly agree” that their device
was adequate (67% vs. 57%, respectively). 14 The absence of a
larger difference in the rate of technol ogy inadequacy may
9
The Digital Divide Among College Students
be due to the fact that Ohio State’s iPads are WiFi only. F or
example, one student commented:
There is no internet provider where I live who
services the area, so my family couldn’t get internet
connection even if we could afford it. A hotspot
provided either in the software of the iPad or just a
hotspot device would have been extremely helpful to
allow me to work on my assignments in my home.
In general, for students who returned home to a residence
without broadband wireless, the WiFi-only iPad would not be
very useful for academic work. 15
STA TE POLICY APPRO ACHES IN THE
MIDWEST
When the COVID- 19 pandemic struck, several Midwestern
states had already taken steps to expand broadband Internet
access, and the pandemic has further heightened the need
to move forward with those legislative efforts. Over the past
two years, Midwestern states’ policies regar ding broadband
have clustered into four key ar eas: streamlining bureaucratic
and regulatory models, supporting community and private
sector engagement and training, lever aging state resources,
and making other financial investments in broadband access.
Below we provide an ov erview of each area, along with
illustrative examples.
Streamlining Bureaucratic and Reguator y
Models
Across the country, regulat ory frameworks for
telecommunications and electricity were devel oped prior to
the advent of broadband, and these frameworks may need
updates to reflect the critical role of broadband in daily life.
Several Midwestern states hav e recently passed legislation to
remove barriers for collabor ation with telecommunications
companies or broadband service providers to construct or
improve telecommunications facilities (Cash, 2019). These la ws
recognize the importance of leveraging electric c orporations
and incentivizing electric cooperatives to work with the Stat e
to improve broadband. For e xample, Missouri’s Electrical
Corporation Broadband Authorization Act authorizes an
electrical corporation to own, construct, install, maintain,
repair, and r eplace broadband infrastructure, and to enter int o
contracts with broadband affiliates with shortened approval
processes. The Act also reduces administrative barrier s to
expedite expansions of broadband access (Morton, 2020).
Several states in the Midwest have also pr oposed legislation
to limit contract awards or procur ements to service providers
which adhere to principles of net neutrality (Morton, 2019). 16 As
part of their regulatory reforms, states have put a particular
emphasis on wireless broadband. For example, Wisconsin
passed legislation to facilitate the deployment of wireless
equipment by wireless service companies, 17 and Nebraska
gave wireless providers public rights-of-wa y access to provide
services. 18
Supporting Community and Private Sector
Engagement and T raining
In many underserved areas, Community Anchor Institutions
(CAIs) play a key role in broadband adoption and education.
According to the Feder al Communications Commission (2011),
CAIs are entities such as government offices, schools, colleg es,
or libraries that “provide outreach, access, equipment, and
support services to facilitate greater use of broadband
service by vulnerable populations, including low-income, the
unemployed, and the aged” (p. 17700). T argeted legislation
can help bolster CAI efforts. For example, Michigan’s MERIT
Network is a non-profit organization governed by Michigan’s
public universities that operates almost 4,000 miles of
fiber-optic infrastructure in the state. The state’s Broadband
Technol ogy Opportunities Program provided funding for MERIT
to extend critical broadband service to community anchor
institutions in rural and underserved communities (Sallet,
2019).
In addition to partnerships with CAIs, states have supported
community efforts through the creation of broadband
certifications and trainings. For example, Indiana now offer s
Community Broadband Certifications, which send a signal to
stakeholders that the community is ready for infrastructur e
investment (Office of Lieutenant Governor Suzanne Crouch,
2020). However , the onus is on the community to seek out and
acquire the investment. CAIs can help communities assess
the costs and benefits of broadband investment and support
communities through the planning process. For example, the
University of Missouri has developed a toolkit for community
broadband assessment and planning and is currently piloting
its implementation with Bollinger County (Denkler et al., 2020).
10 The Digital Divide Among College Students
Leveraging Federal F unding and State
Administration
During the COVID- 19 crisis, states used CARES Act funds,
other COVID- 19 relief funds, and other federal funding to
provide devices and hot spots to students without access.
For example, North Dakota allocated 10% of its CARES Act
Elementary and Secondary School Emergency Relief Fund to
K-12 schools that needed support with technol ogical capacity,
remote learning, and other emergency needs (North Dakota
Department of Public Instruction, 2020). Ohio allocated $50
million of the state CARES Act funding to provide hotspots and
Internet-enabled devices to K -12 students (Ohio Department
of Education, 2020).
While states have been creative with the ways they
navigate restrictions on federal funding to narro w the
digital divide during COVID- 19, many cities, colleges, and
companies have implemented their own strat egies to
expand broadband access. However , such efforts were not
always coordinated with each other or with the state’s larger
strategy. C onsequently, some states creat ed a centralized
state office to streamline, coordinate, and support the
administration of state and local regulation, programs, and
funding to expand broadband (Morton, 2019, 2020; Stauffer
et al., 2020). For example, in 2019 Illinois created the Office
of Broadband within the state’s Department of Commerce
and Economic Opportunity, which implements the Connect
Illinois broadband infrastructure grant progr am and related
programing. Such offices provide a valuable opportunity to
create a statewide vision for broadband and to coordinat e the
implementation of that vision through multiple public and
private entities within the state.
Making Direct Investments
States are beginning to invest directly in broadband through
grant programs, tax incentives, and user subsidies. F or
example, Minnesota’s Border-to-Border Broadband Grant
Program provides resourc es to motivate new and existing
providers to invest in building br oadband infrastructure
in unserved and underserved parts of the state. The grant
provides up to 50% of a project’s infrastructure costs. Thus far
it has connected 3,400 households, 5,200 businesses, and 300
community institutions across the state to ensure equitable
access (Minnesota Office of Broadband Development, 2018,
2020).
Some states are also providing tax incentives f or broadband
service providers and subsidies for low-income househol ds. 19
For example, Wisconsin exempt ed from the telephone
company tax any property used to provide br oadband service
to a rural or underserved area. 20 Illinois is working to pass
the Low-Income Broadband Assistance Program, which woul d
directly pay a portion of the monthly broadband bill for low-
income households. 21
CONCLUSION
Whether classes are interrupted by a pandemic, a climate
event, or other public emergency, the ability of students
to continue their studies and maintain academic progress
depends on access to computer hardware and robust Int ernet
access. However , in colleges across the country, including in
the Midwest, approximately 16% - 19% of students lack the
technology necessary to fully participate in online learning.
Further, this report documented significant digital divides
by family income, race and ethnicity , and residential setting.
Higher rates of technology inadequacy during the CO VID-19
pandemic were observed among lower-income students
(20%-30%) than higher-income students (10%-12%); Black
(17%-29%) and Hispanic (23%-28%) students relative to White
students (12%-17%); and students living in a rural area (14%-
25%) compared to those living in a suburban (16%) or urban
area (16%-20%). Regardless of demographic or academic
background, technology inadequacy creates an academic
struggle for students and threatens their academic success. As
a result, current continuity planning may have the unintended
consequence of magnifying inequities among students who
are already marginalized.
In order to strengthen academic continuity planning, states
and institutions can work together to ensure that all students
have access to adequate hardware and br oadband Internet.
Institutions might consider putting an emphasis on the
provision of large-format, WiFi-enabled mobile devices (such
as iPads or Surface tablets) which can remain with each
student regardless of where they may find themselves in an
emergency. For e xample, colleges might consider including
this hardware as part of the standard financial aid package for
students who receive need-based institutional aid. Colleges
should also maintain a formal program for short- and long-
term loans of tablets, laptops, and wireless hotspots for
students who have a demonstrated need for these devices.
In turn, states would better serve all students by reviewing
11
The Digital Divide Among College Students
their current broadband policies and legislation with an eye
to equity to ensure that policies are expanding broadband
access for rural, African-American, Hispanic, and other
underserved populations. For example, states might consider
investing in ubiquitous wireless broadband that would all ow
students to use mobile devices effectively from any l ocation.
Many colleges have already work ed to make this vision a
reality on and around their own campuses and are well-
positioned to partner with community and state leaders to
craft larger-scale implementations, such as citywide wireless
broadband.
Based on an overview of legislation in the Midwest, several
state policy options are worth considering:
J Streamline bureaucratic and regulatory models for
telecommunications, including removing barriers for
collaboration with broadband service providers.
J Support community and private sector engagement and
training, by bolstering the efforts of Community Anchor
Institutions and creating broadband certifications and
trainings for communities.
J Leverage state administration t o strategically allocate
indirect federal funding to support technology access and
to streamline, coordinate, and support the administration
of broadband programs through a centralized stat e office.
J Invest directly in broadband through programs that
incentivize or match private and local investment.
J In broadband expansion efforts, place a particular
emphasis on wireless broadband to minimize infrastructure
costs.
J Incentivize or support colleges in efforts to provide tablets,
laptops, and wireless access to students who would
otherwise have inadequate technology .
12 The Digital Divide Among College Students
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15
The Digital Divide Among College Students
APPENDIX
In order to understand whether technology inadequacy
continued to predict P /NP after controlling for academic and
demographic background, researchers conducted a l ogistic
regression model with Ohio State undergraduate survey
respondents, predicting the outcome of “switched to P /NP for
at least one course in Spring 2020. ” To be consistent with T able
1, international students were excluded from the model.
Results are shown in T able A1. Reference categories represent
the modal student: a White, Columbus-campus senior from a
suburban area with a GPA of 3.40. Prior GP A is converted
to a standardized scale with a standard error of 1 (or 0.56
GPA points). Inter actions between T echnology Inadequacy
and other controls were not statistically significant and
were dropped from the model. Predicted probabilities wer e
calculated using modal values for each control. For exampl e,
for the modal student, the model suggests that 34% would
switch to P /NP if they had adequate technology, while 41%
would switch to P /NP if they were dealing with inadequate
technology; this difference of 7 percentage points is r eflected
in the column “Change in Probability of P /NP. ”
I TABLE A1. Logis tic Regression Predicting P/N P Grades
Predictor Logit (S E) Change in Probability of P/N P
Inadequate T echnology 0.28 (0.09)*** + 0.07
Ethnicity: Black 0. 13 (0. 17) + 0.03
Ethnicity: Hispanic - 0.01 (0. 17) 0.00
Ethnicity: Asian 0.07 (0. 14) + 0.02
Ethnicity: Other 0.06 (0. 14) + 0.01
Campus: Regional - 0.75 (0. 14)*** - 0.14
Home: Rural / Small T own - 0.02 (0. 10) - 0.01
Home: Urban 0. 19 (0.09) + 0.04
Prior GPA - 0.37 (0.04)*** - 0.08
Rank: Freshman 0.04 (0. 16) + 0.01
Rank: Sophomore 0.06 (0. 10) + 0.01
Rank: Junior 0.08 (0.09) + 0.02
*** p < 0.001
1 In addition to the limitations of a small-format screen, students complain that cell service is often unreliabl e or slow due
to data limits or saturation of the network (Fernandez, 2019). In Hampton et al. (2020), r esearchers asked students whether
they sometimes left homework unfinished due to lack of computer or Internet acc ess; 49% of cellphone-dependent students
reported doing so, compared to 39% of those with slow home Internet and 17% of those with high-speed home Int ernet.
Cellphone-dependent students reported an overall GP A of 2.75, compared to a GPA of 3. 18 among students with high-speed
Internet access – a difference which remained statistically significant after c ontrolling for socioeconomic status and other
demographic factors.
2 For example, in the Hampton et al. (2020) study of Michigan 8th to 11th gr aders, only 37% of students with no home Internet
were instead able to access the Internet at a friend’s house – c ompared to 53% of students with high-speed home Internet.
16 The Digital Divide Among College Students
3 The two universities collaborated on a set of “ core” items, and each also included items unique to that university’s planning
needs. This brief provides original analyses conducted by the authors. F or overall reports from each survey , see Motz et al.
(2020) and Jaggars et al. (2020). The Ohio State survey was conducted from mid-April to mid-Ma y, closing just after students’
final grades were posted; the IU survey was conducted fr om mid-May to mid-June, beginning just after the spring semester
ended. Analyses regarding the representativeness of Ohio State student responses suggest that surve y respondents were
similar to the undergraduate population in most respects, including race/ ethnicity, first-generation status, and the lik elihood
of having previously taken an online course; howe ver, r espondents were less likely to be international students and had
slightly higher GPAs than the o verall undergraduate population. IU’s analysis of representativ eness is in progress; however ,
IU’s international students are known to be underrepresented due to an e xclusion of students who were not currently residing
in the U.S. at the time of the survey. It is also possibl e that students with the most inadequate technology were least likely to
respond to the survey; accordingly , our estimates of technology inadequacy may be conservative.
4 Students rated their level of agreement on a 5-point scal e (from Strongly Disagree to Strongly Agree) f or the following items:
“I had adequate access to the Internet connectivity necessary to participate in remot e instruction” and “I had adequate access
to computer hardware necessary to participate fully in remote instruction. ” Inadequacy of Internet or devices were defined as
strongly or moderately disagreeing with the relevant it em. Responses to the two questions overlapped; for exampl e, among
those who disagreed they had adequate Internet, 42% also disagreed that they had adequate hardwar e. In addition to these
two questions, students also selected the “primary method of connecting to the Internet to complet e your online coursework, ”
with one option being “mobile phone network data. ” Students selecting this option were defined as using a cellphone as their
primary device. This question overlapped with the first two; for exampl e, among those using a cellphone as their primary
device, 40% disagreed that they had adequate access to the Int ernet. Students with inadequate Internet, an inadequate
device, or who used a cellphone as their primary device were defined as having “Inadequate T echnology. ” (Based on other
responses on the survey regarding hardware, we suspect that the typical student with “inadequate technology” brought
adequate hardware back to a family home with inadequate Internet, where they c obbled together a solution such as using
their cellphone for streaming video, and using their laptop or wireless-only tablet f or mostly-offline tasks.) All other students
were defined as having “Acceptable T echnology” (although not necessarily ideal technology; many of these students reported
in other sections of the survey that they still had some challenges with limited Internet access). This definition of inadequacy
is more strict than one used in an earlier Ohio State-specific report (which included students who “neither agree nor disagree”
that they had adequate Internet/ devices, see Jaggars et al., 2020) and thus yields slightly lower estimates of inadequacy. Data
in Figure 1 is pooled across Indiana University and Ohio State surveys. These proportions were not significantly different
between the two universities.
5 Excludes international students; the category “Other” combines domestic U.S. race/ ethnicity groups which had a low number
of responses to the survey, including Nativ e American students and those who identified with Two or Mor e Races.
6 It is not clear why underclassmen would be more likely t o suffer from inadequate technology . Perhaps students with
inadequate technology are more likely to drop out bef ore graduation; or perhaps some freshmen require a few semester s to
diagnose their true technology needs and to scrape together an appropriat e solution to those needs.
7 The Digital Promise analysis combined technology challenges into a larg er scale that also captured six other challenges (such
as not knowing where to get help with the course, or problems sta ying motivated to do well in the course). Results found that
students with multiple challenges were less likely to be satisfied with their online c ourses; for example, among students with
no challenges (including no technology challenges), 81% wer e satisfied or very satisfied with their online courses, while among
students with four or more challenges (which may or may not have included t echnology challenges), only 32% were satisfied or
very satisfied (Means & Neisler , 2020).
8 Based on ordered probit analyses, differences in the distribution of responses f or the Adequate versus Inadequate groups
were statistically significant for each item.
9 Many universities across the country offered students P /NP or similar grading options for Spring 2020. At Ohio State, the P /
NP option was offered for all elective and general education c ourses, with a grade of D or above marked as “P ass, ” and a grade
below D marked as “No Pass. ” Individual academic programs had the discretion to offer the P /NP option for major-specific
requirements. Students were required to select the P /NP option by mid-April: four weeks after classwork pivoted to remot e
learning, and approximately two weeks befor e final exams.
10 Open-ended survey comments and other qualitative feedback from students suggest that in Spring 2020, students switched
to P /NP for a given course if they were struggling in that class. Relie ving GPA-r elated stress about that course allowed students
to put more time and effort into their remaining courses – and in particular , to focus on courses required for admission to
selective majors or graduate progr ams which may not accept a P /NP grade. Examination of administrative data shows that C
and D grades were largely replaced by P ass grades in the Spring 2020 semester.
17
The Digital Divide Among College Students
11 Researchers conducted a logistic regression model pr edicting the outcome of “switched to P /NP for at least one course in
Spring 2020” with the primary predictor of technology inadequacy , covariates listed in T able 1, and an additional covariate of
prior GPA. F or more information, see Appendix T able A1.
12 Almost all studies examining student laptop or device provision progr ams have focused on the K- 12 sector; see Weston et al.
(2010) for the most recent systematic review . In higher education, the only research summary is nearly two decades old (Kontos,
2002). Recent research is confined to case studies, with the most useful being focused on technol ogy provision initiatives in the
College of Education at Southeast Missouri State (Fridley & R ogers-Adkinson, 2016) and in 17 campuses across the United Ar ab
Emirates (Hargis et al., 2014).
13 Ohio State’s iPad Pro package includes a pencil, ke yboard, and a suite of learning apps. T ransfer students who first enrolled
at any college in Autumn 2018 or after are also included in Ohio Stat e’s iPad program. Among survey respondents at Ohio Stat e,
98% of freshmen had a university-issued iPad, along with 94% of sophomores, 6 3% of juniors, and 11% of seniors.
14 Results are based on a comparison between the two universities when contr olling for the confounding factors listed in
Tabl e 1. To be c onsistent with T able 1, international students were excluded fr om the analysis. The difference between the two
universities was statistically significant at p < 0.001, with most of the difference concentr ated at the threshold between Agree
and Strongly Agree. The model included interaction effects for class r ank, given that we would expect to see an institutional
difference most strongly among freshmen and sophomores, and to see little or no diff erence among seniors; while the results
do pattern in this direction, the interaction pattern is not statistically significant.
15 Providing a cellular-enabled device (at an additional cost of $ 150 per device) along with university payment of the student’s
monthly data charge would solve this problem. Howe ver, this appr oach is cost-prohibitive at the scale of Ohio State’s progr am,
which currently provides approximately 3 7,000 iP ads to students.
16 For an analysis regarding the rights of states to implement net neutr ality standards, see Lundgren (2020). For proposed
legislation in the Midwest, see H.B. 5094 (I.L. 2017), H.F . 3033 & S.F . 2880 (M.N. 2018), and L.B. 856 (N.E. 2018).
17 See A.B. 235 (W.I. 2019)
18 See Small Wireless Facilities Deployment Act, Neb . Rev. Stat. §86- 1201. (2019).
19 A potential drawback of tax credits for househol ds is that many low-income individuals are not familiar enough with the tax
code to leverage this kind of cr edit, see Dickert-Conlin, Fitzpatrick, & Hanson (2005).
20 See Wisconsin Stat. §76.80 (2019)
21 See H.B. 3491 (I.L. 2019)
18 The Digital Divide Among College Students
Compac t Le adership, 202 0- 21
President
Ms. Susan Heegaard
Chair
Dr. Da vid Eisler , President,
Ferris State University
Vice Chair
Rep. Rick Carfagna, Ohio
Legislature
Treasur er
Dr. Devinder Malhotr a,
Chancellor , Minnesota State
Past Chair
Ms. Olivia M.A. Madison,
Professor Emerita and Dean
Emerita of Library Services,
Iowa State University
Vision
MHEC members collaborate to address the region’s most pr essing challenges
in higher education and transform educational opportunities so that people and
communities thrive.
Mission
MHEC brings together midwestern states to devel op and support best
practices, collaborative efforts, and cost -sharing opportunities. Through these efforts
it works to ensure strong, equitable postsecondary educational opportunities and
outcomes for all.
Who MHE C Serves
MHEC is comprised of member states from the midwestern
United States. MHEC works with and for a variety of stakeholders within and across
member states, including higher education system leaders, state policymakers, l egislators,
and institutional leaders, while always maintaining a focus on students and their success.
How MH EC W orks
MHEC’s strategic approach highlights member states’ strong
desire for collaboration, effectiveness, and efficiency . MHEC believes that collaborative
actions informed by research and best practices are the catalyst f or improving quality ,
accessibility, rel evance, and affordability of postsecondary educational opportunities.
MHEC does this primarily through the following approaches: convenings, pr ograms,
research, and cost-savings contracts. Incr easingly, MHEC looks to l everage these
approaches in conjunction with each other to serve its strategic priorities.
... They posited that technological solutions are not neutral and have the potential to reinforce and exacerbate existing problems if they are implemented without first scrutinizing, and perhaps rethinking, the objectives of higher education. In a report released by Georgetown University (2021), academics and administrators in the United States highlighted how the disruption brought about by the COVID-19 pandemic has cast a spotlight on existing inequities and has created openings for meaningful systemic changes, which is a topic highlighted in a number of other studies (Harper, 2020;
Jaggars et al., 2021
). ...
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(Jaggars et al., 2021)
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[87]
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Birhanu Kassaw
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The education system is one of the sectors that have been severely affected by COVID-19. As a result, a new way of teaching-learning was initiated by world's educational institutions to try to educate their students through online learning platforms. Hence, this study aims at exploring barriers and enablers of online education as well as the psychosocial well-being of university students during COVID-19 in eastern Ethiopia with a particular focus on Haramaya University. A concurrent mixed method design was employed. A total of 384 participants were selected using a stratified random sampling technique. Questionnaires, key informant interviews, and document analyses were used to collect data. Quantitative data were analyzed using descriptive statistics and qualitative data were analyzed thematically, then the analyzed data were integrated to get a holistic picture of the study result. The study revealed that university students experienced high levels of barriers, low levels of enablers, and severe levels of psychosocial problems while attending their education online during the COVID-19 pandemic. Hence, proactive measures taken for identifying and removing barriers, enhancing enablers, and creating a support system that shields the psycho-social well-being of university students are recommended as appropriate intervention strategies to adapt the online education modality in universities during the COVID-19 pandemic.
... Academically, students reported feeling overwhelmed with the shift to remote education, especially due to a lack of consistency in the technology used to deliver their courses (McDaniel et al., 2020). In one analysis that included reports from several surveys, between 16 and 19% of students reported challenges regarding access to the necessary technology to participate in remote education
(Jaggars et al., 2021)
. Students also reported obstacles accessing appropriate distraction free study spaces (McDaniel et al., 2020), as well as a decreased sense of belonging, opportunities for collaboration with peers, and interest in course materials after instruction moved online (Means and Neisler, 2020;Madaus et al., 2021;Tarconish et al., in press). ...
What Happened Next? The Experiences of Postsecondary Students With Disabilities as Colleges and Universities Reconvened During the Pandemic
Joseph W. Madaus
Michael Faggella-Luby
Dukes Lyman
COVID-19 caused nearly every college and university in the United States to rapidly shift to remote learning during the spring 2020 semester. While this impacted all students to different degrees, students with disabilities (SWD) faced new challenges related to their mental health, the accessibility of their instruction, the receipt of accommodations, and their interactions with faculty and student support personnel. Literature is emerging that describes the experiences of SWD during the spring 2020 semester and the swift change to remote learning. However, little is currently known about what followed for these students. The present study builds from a prior investigation of SWD during the spring 2020 semester and examines student experiences and perceptions during the 2020–2021 academic year. Eighty-eight SWD from colleges across the United States completed an instrument that contained a mix of demographic, yes/no, Likert scale and open-ended items. Responses revealed most items related to accessing services and instruction showed no improvement from the spring 2020 semester, and that items related to mental health, motivation to learn, and connections with peers were perceived as worse than in spring 2020. Open-ended responses revealed similar themes, with some students describing no improvements, and others noting that accessibility service offices and faculty provided enhanced methods of communication and support. Implications for practice and future research are presented.
Adult Learner Engagement, Empowerment, Faculty-Student Interaction, and Technology Strategies
Theresa A. Paterra
The purpose of this chapter is to provide strategies for adult learners to engage in online learning and to empower themselves to succeed in online learning. In addition, this cannot be fully accomplished without some degree of faculty-student interaction. There are some strategies that work regardless of if a course is offered synchronously or asynchronously, such as time management and presence. Technology and the use of digital tools are essential in online learning and provide high motivation and participation to adult learning in an online course. In addition, technology is extremely important in our ever-advancing global market. Some strategies previously thought to be for in-person use only can be adapted to online learning. Cross-curriculum learning provides more motivation and participation when aligned with the concepts of a course.
Children’s Access to Reading Materials Relative to the Coronavirus (COVID-19) Pandemic: Preferred Formats and Resources
Rita Soulen
Lara Tedrow
Liberal Arts Education and Online Learning: Prospects and Challenges
Mar 2023
Aaron Einfeld
The COVID-19 pandemic forced liberal arts educators into an unplanned dive into online learning. Though many schools had little experience with online learning, some liberal arts colleges had already begun experimenting with online learning before the pandemic. This chapter begins by examining the perceptions, practices, and lessons learned from online liberal arts education before and during the pandemic. Based on this insight, this chapter discusses the ways that liberal arts educators can leverage online environments for learning in future. As the chapter illustrates, crisis and constraints can prompt new thinking and unexpected innovation. The chapter closes with advice and suggestions for future research, theory, and practice of online liberal arts education.KeywordsOnline learningHybrid learningLiberal learning outcomesOnline learning community
Shrinking the digital divide in online learning beyond the COVID-19 pandemic: A Systematic Literature Review
Nov 2022
Kudakwashe Maguraushe
Fine Masimba
Meshack Muderedzwa
Learning Management System Analytics to Examine the Behavior of Students in High Enrollment STEM Courses During the Transition to Online Instruction
Oct 2022
Rob Elliott
Xiao Luo
Chapter
Abdulsalami Ibrahim
Najwa Ahmed
The outbreak of COVID-19 pandemic in the spring of 2020 presents unprecedented challenges around the world. Schools, hospitals, government offices, and even transportation (both domestic and international) were put to closure. While developed countries used their monetary and technology resources to support their education systems during this trying time, digital divide is widely evident in the developing countries, which has posed a threat to the fragile educational systems across these countries. This study aimed at exploring technology professional development available to faculty during COVID-19 in the developing countries. Findings revealed a critical issue of concern, as many developing countries in Africa were not able to keep up with the impact of pandemic, which rendered universities and colleges closed. In the few countries where they could keep open, several technology professional developments were provided to educators before and during the pandemic to prepare them to navigate through virtual/remote instruction.
| https://www.researchgate.net/publication/349701773_The_Digital_Divide_Among_College_Students_Lessons_Learned_From_the_COVID-19_Emergency_Transition |
Acetic acid chromoendoscopy and Seattle protocol in Intestinal Metaplasia and Dysplasia and Barretts Esophagus With Low Grade Dysplasia - Clinical Trials Registry - ICH GCP
Barrett& #039;s esophagus is a complication of chronic gastroesophageal reflux disease that occurs in up to 10% to 15% of patients with this pathology. Well-defined r...
Acetic Acid for the Detection of Esophageal Neoplasms
Barrett's esophagus is a complication of chronic gastroesophageal reflux disease that occurs in up to 10% to 15% of patients with this pathology.
Well-defined risk factors have been established and are important because they are considered a precancerous lesion (intestinal metaplasia).
The conventional diagnostic methods are ineffective in reliably detecting potentially treatable lesions.
Investigators propose the use of vital chromoendoscopy with acetic acid using the simplified classification of Portsmouth looking for areas with loss of acetowhitening and taking targeted biopsies to increase the detection of esophageal neoplastic lesions.
Study Overview
Status
Recruiting
Conditions
Intestinal Metaplasia
Dysplasia
Barretts Esophagus With Low Grade Dysplasia
Intervention / Treatment
Diagnostic test: Acetic acid chromoendoscopy
Diagnostic test: Seattle protocol
Detailed Description
Barrett's esophagus is a complication of chronic gastroesophageal reflux disease that occurs in up to 10 to 15% of patients with this disease, well-defined risk factors have been established and are important because they are considered a precancerous condition (metaplasia intestinal).
Chromoendoscopy is postulated as an effective way for the detection of esophageal precancerous lesions, early detection and timely treatment with chromoendoscopy with acetic acid being a seemingly reliable alternative, so the investigators will use with the simplified classification of Portsmouth looking for areas with loss of acetowhitening and targeted biopsy to increase the detection of esophageal neoplastic lesions, our main objective being to compare the diagnostic effectiveness of directed biopsies of dysplastic lesions with acetic acid in patients with Barrett's esophagus compared to taking non-directed protocolized biopsies.
A clinical trial will be carried out, including all those patients older than 18 years who go to perform a superior endoscopy with diagnosis of Barrett's esophagus where patients will be up and B Seattle protocol group(four quadrant biopsy every 2 centimeters starting 1 centimeter from above the esophagogastric junction), then proton pump inhibitor washout and crossover allocation with the opposite corresponding manoeuver.
Histopathological results of both groups will be compared.
Demographic data of the participants will be collected and the evaluated areas of Barrett's esophagus with each method will be recorded in a data collection sheet detailing in a specific way the number of biopsies taken, specifying if there was loss of acetowhitening and alterations in the mucous pattern and in the case of the opposite arm, the total number of biopsies taken based on the Seattle protocol, said data will be condensed into a database for subsequent statistical analysis and publication of results.
Study Type
Interventional
Enrollment (Anticipated)
76
Phase
Not Applicable
Contacts and Locations
Study Contact
Name : Raul Alberto Gutiérrez Aguilar, Fellow
Phone Number : 21317-8 +525556276900
Email : [email protected]
Study Locations
Mexico
Mexico City, Mexico, 06700
Recruiting
Centro Medico Nacional Siglo XXI Hospital de Especialidades
Contact:
Raul Alberto Gutiérrez Aguilar, Fellow
Phone Number : 21317-8 +525556276900
Email : [email protected]
Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
17 years and older (Adult, Older Adult)
Accepts Healthy Volunteers
No
Genders Eligible for Study
All
Description
Inclusion Criteria:
Confirmed histological diagnosis of intestinal metaplasia in follow-up protocol without dysplasia
Patients whose endoscopic image is suggestive of esophageal intestinal metaplasia and is confirmed by histology
Barrett's esophagus minimally 2cm
Patients over 18 years of age who wish to participate in the study
Signed informed consent
Exclusion Criteria:
Histological evidence of esophageal adenocarcinoma or known with dysplasia
History of esophageal ablative therapy
Known allergy or intolerance to proton pump inhibitors or acetic acid
Evidence of esophageal varices
Los Angeles esophagitis C or D
Uncontrolled coagulopathy (INR> 1.5 or platelets <50,000)
Pregnancy
No authorization of informed consent
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
Primary Purpose : Diagnostic
Allocation : Randomized
Interventional Model : Crossover Assignment
Masking : Single
2
Arms and Interventions
Participant Group / Arm Intervention / Treatment Active Comparator: Chromoendoscopy with acetic acid and targeted biopsies Acetic acid is prepared at a concentration of 2.5%, after initial cleaning is done, it will be applied with a 7 French spray catheter, starting the proximal application performing a uniform application on the area of intestinal metaplasia an then will be timed for mucous visualization in search of areas of loss of acetowhitening, in case of finding such area will be registered the time in which there was loss of acetowhitening, the distance at which it is located from the upper dental arch in addition to the esophageal face on which the area is located, subsequently evaluation of the glandular pattern is performed only by classifying as normal (glands evenly distributed with normal or abnormal crypt density (compact crypts with increased density; focal irregularity or disorganized crypts; absence of a cryptic pattern), once this evaluation has been carried out, biopsies are directed to these areas to be sent to the pathology service. Diagnostic test: Acetic acid chromoendoscopy Acetic acid is prepared at a concentration of 2.5% in a 20ml syringe, it will be applied with a 7 french spray catheter compatible with a working channel 2.8mm onwards, starting the proximal application When distally performing a uniform application on the area of intestinal metaplasia and the timed time for mucous visualization in search of areas of loss of acetowhitening begins, in case of finding such area will be registered the time in which there was loss of acetowhitening, the distance at which it is located from the upper dental arch in addition to the face on which the area is located, subsequently evaluation of the glandular pattern is performed only by classifying as normal or abnormal, once this evaluation has been carried out, biopsies are directed to these areas to be sent to the pathology service. Active Comparator: Seattle protocol Take random biopsies by quadrants every 2 centimeters biopsy of the intestinal metaplasia areas 1cm above the esophagogastric junction begins, taking tissue every 2cm from the 4 quadrants, separating the biopsies in different bottles based on the length in which they were taken, to later be sent to the pathology service. Diagnostic test: Seattle protocol Take random biopsies by quadrants every 2 centimeters.
Biopsy of the intestinal metaplasia areas 1cm above the esophagogastric junction will be initiated, taking tissue every 2cm from the four quadrants, separating the biopsies in different bottles based on the length in which they were taken, to later be sent to the pathology service.
What is the study measuring?
Primary Outcome Measures
Outcome Measure Measure Description Time Frame Comparing the incidence of dysplasia by directed biopsies with acetic acid chromoendoscopy against taking non-directed protocolized biopsies( Seattle protocol) in patients with Barrett's esophagus. Time Frame: Patient will be on proton pump inhibitor (PP) for 6-8 weeks First the investigators will detect the incidence of dysplasia in Barrett esophagus in patients with acetic acid chromoendoscopy, using the Vienna Classification system by the pathologist. Patient will be on proton pump inhibitor (PP) for 6-8 weeks Comparing the incidence of dysplasia by directed biopsies with acetic acid chromoendoscopy against taking non-directed protocolized biopsies( Seattle protocol) in patients with Barrett's esophagus. Time Frame: After the wash out time of 6-8 weeks on PPI, this maneuver will be added The second maneuver consist on taking non directed biopsies by the Seattle protocol in the same patient.
And the incidence of dysplasia on biopsies will be looked for using Vienna Classification system again. After the wash out time of 6-8 weeks on PPI, this maneuver will be added
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Coordinación de Investigación en Salud, Mexico
Publications and helpful links
The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.
General Publications
Shaheen NJ, Falk GW, Iyer PG, Gerson LB; American College of Gastroenterology. ACG Clinical Guideline: Diagnosis and Management of Barrett's Esophagus. Am J Gastroenterol. 2016 Jan;111(1):30-50; quiz 51. doi: 10.1038/ajg.2015.322. Epub 2015 Nov 3. Erratum In: Am J Gastroenterol. 2016 Jul;111(7):1077.
Singh S, Sharma AN, Murad MH, Buttar NS, El-Serag HB, Katzka DA, Iyer PG. Central adiposity is associated with increased risk of esophageal inflammation, metaplasia, and adenocarcinoma: a systematic review and meta-analysis. Clin Gastroenterol Hepatol. 2013 Nov;11(11):1399-1412.e7. doi: 10.1016/j.cgh.2013.05.009. Epub 2013 May 22.
Rubenstein JH, Morgenstern H, Appelman H, Scheiman J, Schoenfeld P, McMahon LF Jr, Metko V, Near E, Kellenberg J, Kalish T, Inadomi JM. Prediction of Barrett's esophagus among men. Am J Gastroenterol. 2013 Mar;108(3):353-62. doi: 10.1038/ajg.2012.446. Epub 2013 Jan 15.
Sharma P, Falk GW, Weston AP, Reker D, Johnston M, Sampliner RE. Dysplasia and cancer in a large multicenter cohort of patients with Barrett's esophagus. Clin Gastroenterol Hepatol. 2006 May;4(5):566-72. doi: 10.1016/j.cgh.2006.03.001. Epub 2006 Apr 17.
Chedgy F, Fogg C, Kandiah K, Barr H, Higgins B, McCord M, Dewey A, De Caestecker J, Gadeke L, Stokes C, Poller D, Longcroft-Wheaton G, Bhandari P. Acetic acid-guided biopsies in Barrett's surveillance for neoplasia detection versus non-targeted biopsies (Seattle protocol): A feasibility study for a randomized tandem endoscopy trial. The ABBA study. Endosc Int Open. 2018 Jan;6(1):E43-E50. doi: 10.1055/s-0043-120829. Epub 2018 Jan 12.
Kandiah K, Chedgy FJQ, Subramaniam S, Longcroft-Wheaton G, Bassett P, Repici A, Sharma P, Pech O, Bhandari P. International development and validation of a classification system for the identification of Barrett's neoplasia using acetic acid chromoendoscopy: the Portsmouth acetic acid classification (PREDICT). Gut. 2018 Dec;67(12):2085-2091. doi: 10.1136/gutjnl-2017-314512. Epub 2017 Sep 28.
Tholoor S, Bhattacharyya R, Tsagkournis O, Longcroft-Wheaton G, Bhandari P. Acetic acid chromoendoscopy in Barrett's esophagus surveillance is superior to the standardized random biopsy protocol: results from a large cohort study (with video). Gastrointest Endosc. 2014 Sep;80(3):417-24. doi: 10.1016/j.gie.2014.01.041. Epub 2014 Apr 6.
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start (Actual)
July 3, 2019
Primary Completion (Anticipated)
October 1, 2022
Study Completion (Anticipated)
December 1, 2022
Study Registration Dates
First Submitted
July 25, 2019
First Submitted That Met QC Criteria
August 9, 2019
First Posted (Actual)
August 13, 2019
Study Record Updates
Last Update Posted (Actual)
July 22, 2022
Last Update Submitted That Met QC Criteria
July 21, 2022
Last Verified
July 1, 2022
More Information
Terms related to this study
Keywords
Chromoendoscopy
acetic acid
Dysplasia
Barrett Esophagus
Seattle protocol
Additional Relevant MeSH Terms
Digestive System Diseases
Pathologic Processes
Neoplasms
Gastrointestinal Diseases
Esophageal Diseases
Precancerous Conditions
Hyperplasia
Barrett Esophagus
Metaplasia
Physiological Effects of Drugs
Anti-Infective Agents
Antineoplastic Agents
Immunologic Factors
Protective Agents
Anti-Bacterial Agents
Adjuvants, Immunologic
Anticarcinogenic Agents
Acetic Acid
Retinol acetate
Other Study ID Numbers
R-2019-3601-143
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
No
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
No
Studies a U.S. FDA-regulated device product
No
This information was retrieved directly from the websiteclinicaltrials.govwithout any changes. If you have any requests to change, remove or update your study details, please [email protected]. As soon as a change is implemented onclinicaltrials.gov, this will be updated automatically on our website as well.
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| https://ichgcp.net/clinical-trials-registry/NCT04054713 |
(PDF) Genetic Diversity of Heat-Labile Toxin Expressed by Enterotoxigenic Escherichia coli Strains Isolated from Humans
PDF | The natural diversity of the elt operons, encoding the heat-labile toxin LT-I (LT), carried by enterotoxigenic Escherichia coli (ETEC) strains... | Find, read and cite all the research you need on ResearchGate
Genetic Diversity of Heat-Labile Toxin Expressed by Enterotoxigenic Escherichia coli Strains Isolated from Humans
May 2008
Journal of Bacteriology 190(7):2400-10
DOI: 10.1128/JB.00988-07
Authors:
Abstract and Figures
The natural diversity of the elt operons, encoding the heat-labile toxin LT-I (LT), carried by enterotoxigenic Escherichia coli (ETEC) strains isolated from humans was investigated. For many years, LT was supposed to be represented by a rather conserved toxin, and one derivative, produced by the reference H10407 strain, was intensively studied either as a virulence factor or as a vaccine adjuvant. Amplicons encompassing the two LT-encoding genes (eltA and eltB) of 51 human-derived ETEC strains, either LT(+) (25 strains) only or LT(+)/ST(+) (26 strains), isolated from asymptomatic (24 strains) or diarrheic (27 strains) subjects, were subjected to restriction fragment length polymorphism (RFLP) analysis and DNA sequencing. Seven polymorphic RFLP types of the H10407 strain were detected with six (BsaI, DdeI, HhaI, HincII, HphI, and MspI) restriction enzymes. Additionally, the single-nucleotide polymorphic analysis revealed 50 base changes in the elt operon, including 21 polymorphic sites at eltA and 9 at eltB. Based on the deduced amino acid sequences, 16 LT types were identified, including LT1, expressed by the H10407 strain and 23 other strains belonging to seven different serotypes, and LT2, expressed by 11 strains of six different serotypes. In vitro experiments carried out with purified toxins indicated that no significant differences in GM1-binding affinity could be detected among LT1, LT2, and LT4. However, LT4, but not other toxin types, showed reduced toxic activities measured either in vitro with cultured cells (Y-1 cells) or in vivo in rabbit ligated ileal loops. Collectively, these results indicate that the natural diversity of LTs produced by wild-type ETEC strains isolated from human hosts is considerably larger than previously assumed and may impact the pathogeneses of the strains and the epidemiology of the disease.
. Serotypes and relevant phenotypic features of ETEC strains analyzed in the present study …
LT structural model with locations of the polymorphic sites detected in the present study. The LT structural coordinates were retrieved from the PDB (code 1LTS). (A) Structural model of the whole toxin (A and B subunits). (B) Structural model of the A1 subunit with positions (arrows) of nine polymorphic sites with amino acid residues present in the available PDB file. (C) Structural model of the A2 subunit with positions (arrows) of seven polymorphic sites with amino acid residues present in the available PDB file. (D) Structural model of the B subunit with positions (arrows) of the five polymorphic sites with amino acid residues present in the available PDB file. Polymorphic sites are shaded dark. Three polymorphic sites (Q185R, S190L, and T193A) were located on a loop encompassing the disulfide bridge linking A1 and A2 subunits, which has not been structurally solved in the PDB file. …
Unrooted phylogram constructed by the neighbor-joining method showing the sequence relationships of the concatenated amino acid sequences of the mature A and B subunits of the detected LT variants. …
. Deduced amino acid compositions of variant A and B subunits obtained from sequenced elt operons of all ETEC strains analyzed in this study …
Figures - uploaded by
Andrea Balan
Supplementary resources (14)
Escherichia coli strain 4702-1 elt operon, complete sequence
Nucleotide Sequence
M.A. Lasaro · Juliana Rodrigues · Célia Samarina Vilaça Santos · Beatriz Ernestina Cabilio Guth · L.C.S. Ferreira
Escherichia coli strain 1372-1 elt operon, complete sequence
Nucleotide Sequence
M.A. Lasaro · Juliana Rodrigues · Célia Samarina Vilaça Santos · Beatriz Ernestina Cabilio Guth · L.C.S. Ferreira
Escherichia coli strain 61A-4 elt operon, complete sequence
Nucleotide Sequence
M.A. Lasaro · Juliana Rodrigues · Célia Samarina Vilaça Santos · Beatriz Ernestina Cabilio Guth · L.C.S. Ferreira
Escherichia coli strain 214-III elt operon, complete sequence
Nucleotide Sequence
M.A. Lasaro · Juliana Rodrigues · Célia Samarina Vilaça Santos · Beatriz Ernestina Cabilio Guth · L.C.S. Ferreira
Escherichia coli strain 4692-1 elt operon, complete sequence
M.A. Lasaro · Juliana Rodrigues · Célia Samarina Vilaça Santos · Beatriz Ernestina Cabilio Guth · L.C.S. Ferreira
Escherichia coli strain 121-I elt operon, complete sequence
Nucleotide Sequence
M.A. Lasaro · Juliana Rodrigues · Célia Samarina Vilaça Santos · Beatriz Ernestina Cabilio Guth · L.C.S. Ferreira
Escherichia coli strain PE0415 elt operon, complete sequence
Nucleotide Sequence
M.A. Lasaro · Juliana Rodrigues · Célia Samarina Vilaça Santos · Beatriz Ernestina Cabilio Guth · L.C.S. Ferreira
Escherichia coli strain 136-I elt operon, complete sequence
Nucleotide Sequence
M.A. Lasaro · Juliana Rodrigues · Célia Samarina Vilaça Santos · Beatriz Ernestina Cabilio Guth · L.C.S. Ferreira
Escherichia coli strain 63-V elt operon, complete sequence
Nucleotide Sequence
M.A. Lasaro · Juliana Rodrigues · Célia Samarina Vilaça Santos · Beatriz Ernestina Cabilio Guth · L.C.S. Ferreira
Escherichia coli strain 225-IV elt operon, complete sequence
Nucleotide Sequence
M.A. Lasaro · Juliana Rodrigues · Célia Samarina Vilaça Santos · Beatriz Ernestina Cabilio Guth · L.C.S. Ferreira
Escherichia coli strain PE0534 elt operon, complete sequence
Nucleotide Sequence
M.A. Lasaro · Juliana Rodrigues · Célia Samarina Vilaça Santos · Beatriz Ernestina Cabilio Guth · L.C.S. Ferreira
Escherichia coli strain 4321-1 elt operon, complete sequence
Nucleotide Sequence
M.A. Lasaro · Juliana Rodrigues · Célia Samarina Vilaça Santos · Beatriz Ernestina Cabilio Guth · L.C.S. Ferreira
Escherichia coli strain 2781-5 elt operon, complete sequence
Nucleotide Sequence
M.A. Lasaro · Juliana Rodrigues · Célia Samarina Vilaça Santos · Beatriz Ernestina Cabilio Guth · L.C.S. Ferreira
Escherichia coli strain PE0615 elt operon, complete sequence
Nucleotide Sequence
M.A. Lasaro · Juliana Rodrigues · Célia Samarina Vilaça Santos · Beatriz Ernestina Cabilio Guth · L.C.S. Ferreira
... Although clonal and stable lineages of ETEC are spread worldwide, epidemiological studies have revealed high genetic and phenotypic diversity among ETEC strains regarding serotypes, virulence features, mainly CFs and LT types, and genotypes disclosed by molecular approaches [7,[9][10]
[11]
[12][13][14]. Our group previously showed the occurrence of 16 LT types among ETEC strains derived from asymptomatic and diarrheic Brazilian children [11]. ...
... Although clonal and stable lineages of ETEC are spread worldwide, epidemiological studies have revealed high genetic and phenotypic diversity among ETEC strains regarding serotypes, virulence features, mainly CFs and LT types, and genotypes disclosed by molecular approaches [7,[9][10][11][12][13][14]. Our group previously showed the occurrence of 16 LT types among ETEC strains derived from asymptomatic and diarrheic Brazilian children
[11]
. These LT types were grouped into four phylogenetic clusters, two of which (A and D) comprised the majority of the variants closely related to the types LT1 and LT2, respectively. ...
... More recently, these results were confirmed by further studies, and twelve additional LT variants were found among clinical strains isolated from diverse geographic areas [12]. Genetic polymorphisms in noncoding regulatory sequences and in LT-structural genes have also been ascribed to different LT types
[11,
12,14]. However, considering the data available in the literature, thus far it has not been possible to correlate the ability to express LT and the natural genetic polymorphisms detected among different LT types. ...
Strain-specific transcriptional and posttranscriptional regulation of heat-labile toxin expression by enterotoxigenic Escherichia coli
Article
Full-text available
Denicar Fabris
Luís C S Ferreira
Enterotoxigenic Escherichia coli (ETEC) represents one of the most important etiological agents of diarrhea in developing countries and characteristically produces at least one of two enterotoxins: heat-labile toxin (LT) and heat-stable toxin (ST). It has been previously shown that the production and release of LT by human-derived ETEC strains are variable. Although the natural genetic polymorphisms of regulatory sequences of LT-encoding (eltAB) genes may explain the variable production of LT, the knowledge of the transcriptional and posttranscriptional aspects affecting LT expression among ETEC strains is not clear. To further understand the factors affecting LT expression, we evaluated the impact of the natural polymorphism in noncoding regulatory sequences of eltAB among clinically derived ETEC strains. Sequence analyses of seven clinically derived strains and the reference strain H10407 revealed polymorphic sites at both the promoter and upstream regions of the eltAB operon. Operon fusion assays with GFP revealed that specific nucleotide changes in the Pribnow box reduce eltAB transcription. Nonetheless, the total amounts of LT produced by the tested ETEC strains did not strictly correspond to the detected LT-specific mRNA levels. Indeed, the stability of LT varied according to the tested strain, indicating the presence of posttranscriptional mechanisms affecting LT expression. Taken together, our results indicate that the production of LT is a strain-specific process and involves transcriptional and posttranscriptional mechanisms that regulate the final amount of toxin produced and released by specific strains.
... The LTs that ETEC strains produce are likewise a diverse category of toxins. There are two main LT families known as LT-I and LT-II
[13]
. LT genes eltA and eltB produce LT-I and LT-II, respectively. ...
... LT genes eltA and eltB produce LT-I and LT-II, respectively. The ST genes are possible to express independently or in tandem with the LT genes eltA and eltB
[13]
. ETEC strains can express seven different toxin combinations: STh, STp, STh/LT, STp/LT, LT, and less typically, STh/STp and STh/STp [14]. ...
Molecular detection of Enterotoxigenic Escherichia coli Toxins and Colonization Factors from Diarrheic Children in Pediatric Teaching Hospital, Sulaymaniyah, Iraq
Article
Full-text available
Hezhan Faeq Rasul
Sirwan Muhsin Muhammed
Hunar Hiwa Arif
Paywast Jalal
Enterotoxigenic Escherichia coli (ETEC) is one well-established causative agent of diarrhea in the developing countries among young children. This prospective study was performed at Laboratories of University of Sulaimani (in Sulaymaniyah City/Iraq) from September to October 2021which aimed to determine the prevalence of ETEC among children and the most prevalence colonization factor (CFA/I) among ETEC. One hundred and twenty-five fresh stool samples were collected from hospitalized – children with diarrhea at Dr. Jamal Ahmed Rashid’s Pediatric Teaching Hospital. The collected samples were cultured on MacConkey and eosin methylene blue agar as selective and differential media for Gram- negative bacteria. Colonies were identified through Gram staining and biochemical tests including: Indole, methyl red, and catalase reaction test. Vitek-2 machine was depended to test some obtained isolates. Most of isolates (60%) showed positive results for E. coli – out of this percentage, 14 (18.66%) were positive for ETEC using polymerase chain reaction assay identifying stable and labile toxins (LTs). It was noticed that all of the ETEC isolates were stable toxin producer isolates whereas LT producer isolates were not identified. Colonization factor 5 (CS5) has been detected among three ETEC isolates (21.42%), meanwhile, 11 isolates (78.57%) have not expressed colonization factors at all.
... The major virulence factors of diarrhea-causing ETEC strains are enterotoxins, specifically a heat-labile toxin (LT) and a heat-stable toxin. These toxins alter the cellular signaling pathways, ultimately triggering an increase in chloride secretion and watery diarrhea (6,
7)
. The LT is an AB5 toxin encoded by the eltAB operon with similarities to cholera toxin; it binds to ADP and ribosylates the guanyl-nucleotide alpha regulatory binding protein of the adenylate cyclase system, thereby increasing the levels of cyclic AMP (8,9). ...
Production of monoclonal antibody of heat-labile toxin A subunit to identify enterotoxigenic Escherichia coli by epitope mapping using synthetic peptides
Article
Full-text available
Jun Young Park
Seung-Hak Cho
Background
Enterotoxigenic Escherichia coli (ETEC) is a major cause of diarrhea through two enterotoxins, a heat-labile toxin and a heat-stable toxin. These toxins alter the cellular signaling pathways, ultimately triggering an increase in chloride secretion and watery diarrhea.
Objective
For the development of an ETEC vaccine, we attempted to construct a peptide-specific monoclonal antibody library against heat-labile enterotoxin A subunit (LT-A) by epitope mapping using synthetic peptides.
Methods
Sera produced by five mice immunized with recombinant LT-A protein were examined for specific recognition with synthetic 15-mer and 34-mer peptides of LT-A proteins using enzyme-linked immunosorbent assay. The analysis revealed that the synthetic peptides number 8, 16, 24, 33, 36, 38, and 39 reacted with an anti-LT-A polyclonal antibody. For the possible prediction of LT-A epitopes, each full-length protein sequence was subjected to BCPreds analysis and three-dimensional protein structure analysis. The data showed that three peptides (synthetic peptide numbers: 33, 36, and 38–39) have identical antigenic specificities with LT-A protein, suggesting the usefulness of these linear peptide epitopes.
Results
Based on these peptides, we produced monoclonal antibodies to improve the specificity of LT-A detection. Monoclonal antibodies produced from two peptides (numbers 33 and 36) showed affinity for an LT-A recombinant antigen. Moreover, peptide epitope prediction analysis showed that the sites of the three peptides were identical to those exhibiting actual antigenicity. Also, it was confirmed that the amino acid sequence that actually showed antigenicity was included in the peptide predicted only by ETEC-LT-A-33. Also, the specificity of the antibody for ETEC-LT-A-33 was validated using bacterial cells, and the neutralizing effect of the antibody was determined by assessing cytokine release in infected HCT-8 cells.
Conclusion
The monoclonal antibodies produced in this study are useful toolsfor vaccine production against ETEC and can be used to identify peptide antigencandidates.
... Coded by Amplicons encompassing the two genes(eltA and eltB)
(Lasaro et al., 2008 )
, these genes carried on plasmid (Nataro and Kaper , 1998). There are two LT serogroup LT-I and LT-II : LT-I secreted from E. coli which infected human, the other LT-II mainly isolated from E. coli animal and rarely in human but not related with disease, generally toxin with oligomeric 86 kDa and consist of 2 subunit are A (one subunit with 28-kDa) and B (five identical subunit with 11.5-kDa), B subunits arranged in ring shape (Nataro and Kaper ,1998). ...
Molecular study of some virulence genes in Diarrheagenic E. coli isolated from pediatric patients with diarrhea in Wasit province
Thesis
Full-text available
Mar 2021
Rana H. Raheema
Ahmed I. Insaf
Diarrheagenic Escherichia coli is still an important pathogen that cause
diarrhea which lead to hospitalsadmissions and death specially in children.
A total of 210 samples were collectedafrom children underafive
years with diarrhea in different hospitals and private clinics, in Wasit
province, south of Iraq, 40 samples as a control from healthy children during
a period from 15th of September 2017 to 15th of December 2017. According
to culture, biochemical testsaand API 20E the results of 100 isolates were
supposed to be E. coli. The DNA were extracted from these 100 isolates from
diarrheal cases and for 40 isolates of the control, concentration of
DNAasamples were between (50-360 mg/µl) and theapurity between (1.8-2).
All isolates studied for detection 16SrRNA gene, then detection the
virulence gene of five Diarrheagenic Escherichia coli strains based on using
Multiplex PolymeraseaChain Reaction technique, by amplified 13 primer
(eaeA, bfpB, aggR, astA, pic, hly, stx, ,stx2, invE, ipaH, elt, estIa, estIb), the
results showed the distribution of the strains and its susceptibility to
antibiotics.
The results appeared that only 42% (42/100) of the isolates were
Diarrheagenic Escherichia Coli. The most frequent pathotypes was
Enteropathogenic E. coli was 45.3% (19/42) )with 9 typical and 10 atypical(,
followed by Enteroaggregative E. coli 40.5% (17/42 ), Enterotoxigenic E.
coli 7.1% (3/42), Enteroinvasive E. coli 7.1% (3/42), and 0% (0/42) was
Shigatoxin E. coli and no DEC in all control patients. The prevalence of
Enteropathogenic E. coli and Enteroaggregative infections was high in first II
and second years, while Enteroinvasive E.coli was high in third year also
cause infection in first age group, all Enterotoxigenic E.coli infections were in
above 1 year .
The antibiotic susceptibility test for 42 of Diarrheagenic Escherichia
coli isolates, were performed by disc diffusion method, using 11 antibiotics
and their results showed different percentages of resistance to antibiotics as
follows : the highest resistance was (95.2%) to Amoxicillin and Ampicillin,
Sulfa-Trimethoprim (92.9%), followed by (85.7%) for Tetracycline and
Cephalothin, Ceftriaxone (81%) and Cefotaxim ∕clavulanic acid (71.4%).
While the lowest resistance was to Chloramphenicol (19 %), Ciprofloxacin
(16.7%), Amikacin (7.1%) and no resistance was detected to Imipenem.
We can concluded in this study, that Multiplex PCR is a rapid, and
accurate procedure which can be used for aidentification and isolation of
Diarrheagenic E. coli strains successfully, Enteropathogenic E. coli and
Enteroaggregative E. coli are the most dominant pathotype in the studied
samples, tended to occur more in children less than 2 years age, while
Enterotoxigenic E. coli and Enteroinvasive E. coli tend to occur more in
children more than 2 years of age. The susceptibility test showed ahigh
resistance to different antibiotics in isolates which were collected from
hospitalized children than isolates collected from private clinics (without
history of hospital admission). The results also revealed that the most active
antibiotic against Diarrheagenic E. coli was Imipenem followed by
Amikacin, Ciprofloxacin and Chloramphenicol.
... Exposure to the large and immunogenic LT usually elicits a strong immune response, while ST, on the other hand, is small and nonimmunogenic. Different ETECs can produce one or both of these two toxins [71]
[72]
[73][74]. LT-only ETECs (i.e., ETECs that produce LT but not ST) seem to be more important contributors to travelers' diarrhea than childhood diarrhea [75][76][77]. ...
Human Mucosal IgA Immune Responses against Enterotoxigenic Escherichia coli
Article
Full-text available
Aug 2020
Saman Riaz
Hans Steinsland
Kurt Hanevik
Infection with enterotoxigenic Escherichia coli (ETEC) is a major contributor to diarrheal illness in children in low- and middle-income countries and travelers to these areas. There is an ongoing effort to develop vaccines against ETEC, and the most reliable immune correlate of protection against ETEC is considered to be the small intestinal secretory IgA response that targets ETEC-specific virulence factors. Since isolating IgA from small intestinal mucosa is technically and ethically challenging, requiring the use of invasive medical procedures, several other indirect methods are used as a proxy for gauging the small intestinal IgA responses. In this review, we summarize the literature reporting on anti-ETEC human IgA responses observed in blood, activated lymphocyte assayss, intestinal lavage/duodenal aspirates, and saliva from human volunteers being experimentally infected with ETEC. We describe the IgA response kinetics and responder ratios against classical and noncanonical ETEC antigens in the different sample types and discuss the implications that the results may have on vaccine development and testing.
View
Show abstract
... Previous reports demonstrated that the TC route is a safe and efficient immunization method [15][16][17][18][27][28][29]34,35]. In particular, the TC administration route prevents the toxicity of certain adjuvants, such as LT1, which may induce local and systemic side effects when delivered via parenteral routes [23,
36]
. Indeed, our results demonstrate that administration of DENV2 particles admixed with LT1 and delivered through the TC route led to the generation of specific antibody and cellular responses without any significant deleterious effects or local inflammatory reactions. ...
Transcutaneous Administration of Dengue Vaccines
Article
Full-text available
May 2020
Carla Longo
Samuel Santos Pereira
Alexia Adrianne Venceslau-Carvalho
Sara Araujo Pereira
In the present study, we evaluated the immunological responses induced by dengue vaccines under experimental conditions after delivery via a transcutaneous (TC) route. Vaccines against type 2 Dengue virus particles (DENV2 New Guinea C (NGC) strain) combined with enterotoxigenic Escherichia coli (ETEC) heat-labile toxin (LT) were administered to BALB/c mice in a three-dose immunization regimen via the TC route. As a control for the parenteral administration route, other mouse groups were immunized with the same vaccine formulation via the intradermic (ID) route. Our results showed that mice vaccinated either via the TC or ID routes developed similar protective immunity, as measured after lethal challenges with the DENV2 NGC strain. Notably, the vaccine delivered through the TC route induced lower serum antibody (IgG) responses with regard to ID-immunized mice, particularly after the third dose. The protective immunity elicited in TC-immunized mice was attributed to different antigen-specific antibody properties, such as epitope specificity and IgG subclass responses, and cellular immune responses, as determined by cytokine secretion profiles. Altogether, the results of the present study demonstrate the immunogenicity and protective properties of a dengue vaccine delivered through the TC route and offer perspectives for future clinical applications.
The diverse landscape of AB5-type toxins
Article
Jun 2023
Paris I. Brown
Adaobi Ojiakor
Antonio J. Chemello
Casey C. Fowler
Toxin linked mobile genetic elements in major enteric bacterial pathogens
Article
Full-text available
Mar 2023
Shruti Panwar
Shashi Kumari
Jyoti Verma --
Bhabatosh Das
One of the fascinating outcomes of human microbiome studies adopting multi-omics technology is its ability to decipher millions of microbial encoded functions in the most complex and crowded microbial ecosystem, including the human gastrointestinal (GI) tract without cultivating the microbes. It is well established that several functions that modulate the human metabolism, nutrient assimilation, immunity, infections, disease severity and therapeutic efficacy of drugs are mostly of microbial origins. In addition, these microbial functions are dynamic and can disseminate between microbial taxa residing in the same ecosystem or other microbial ecosystems through horizontal gene transfer. For clinicians and researchers alike, understanding the toxins, virulence factors and drug resistance traits encoded by the microbes associated with the human body is of utmost importance. Nevertheless, when such traits are genetically linked with mobile genetic elements (MGEs) that make them transmissible, it creates an additional burden to public health. This review mainly focuses on the functions of gut commensals and the dynamics and crosstalk between commensal and pathogenic bacteria in the gut. Also, the review summarises the plethora of MGEs linked with virulence genes present in the genomes of various enteric bacterial pathogens, which are transmissible among other pathogens and commensals.
Holotoxin disassembly by protein disulfide isomerase is less efficient for Escherichia coli heat-labile enterotoxin than cholera toxin
Article
Full-text available
Jan 2022
Albert Serrano
Jessica L. Guyette
Joel B. Heim
Suren Tatulian
Cholera toxin (CT) and Escherichia coli heat-labile enterotoxin (LT) are structurally similar AB5-type protein toxins. They move from the cell surface to the endoplasmic reticulum where the A1 catalytic subunit is separated from its holotoxin by protein disulfide isomerase (PDI), thus allowing the dissociated A1 subunit to enter the cytosol for a toxic effect. Despite similar mechanisms of toxicity, CT is more potent than LT. The difference has been attributed to a more stable domain assembly for CT as compared to LT, but this explanation has not been directly tested and is arguable as toxin disassembly is an indispensable step in the cellular action of these toxins. We show here that PDI disassembles CT more efficiently than LT, which provides a possible explanation for the greater potency of the former toxin. Furthermore, direct examination of CT and LT domain assemblies found no difference in toxin stability. Using novel analytic geometry approaches, we provide a detailed characterization of the positioning of the A subunit with respect to the B pentamer and demonstrate significant differences in the interdomain architecture of CT and LT. Protein docking analysis further suggests that these global structural differences result in distinct modes of PDI-toxin interactions. Our results highlight previously overlooked structural differences between CT and LT that provide a new model for the PDI-assisted disassembly and differential potency of these toxins.
Holotoxin Disassembly by Protein Disulfide Isomerase Is Less Efficient for Escherichia Coli Heat-labile Enterotoxin Than Cholera Toxin
Preprint
Full-text available
Sep 2021
Albert Serrano
Jessica L. Guyette
Joel B. Heim
Suren Tatulian
Cholera toxin (CT) and Escherichia coli heat-labile enterotoxin (LT) are structurally similar AB 5 -type protein toxins. They move from the cell surface to the endoplasmic reticulum where the A1 catalytic subunit is separated from its holotoxin by protein disulfide isomerase (PDI), thus allowing the dissociated A1 subunit to enter the cytosol for a toxic effect. Despite similar mechanisms of toxicity, CT is more potent than LT. The difference has been attributed to a more stable domain assembly for CT as compared to LT, but this explanation has not been directly tested and is arguable as toxin disassembly is an indispensable step in the cellular action of these toxins. We show here that PDI disassembles CT more efficiently than LT, which provides a possible explanation for the greater potency of the former toxin. Furthermore, direct examination of CT and LT domain assemblies found no difference in toxin stability. Using novel analytic geometry approaches, we provide a detailed characterization of the positioning of the A subunit with respect to the B 5 pentamer and demonstrate significant differences in the interdomain architecture of CT and LT. Protein docking analysis further shows that these global structural differences result in distinct modes of PDI-toxin interactions. Our results highlight previously overlooked structural differences between CT and LT that provide a new molecular explanation for the PDI-assisted disassembly and differential potency of these toxins.
Occurrence, distribution, and associations of O and H serogroups, colonization factor antigens, and toxins of enterotoxigenic Escherichia coli.
Article
Oct 1997
M K Wolf
Enterotoxigenic Escherichia coli (ETEC) is a leading cause of infectious diarrhea worldwide. Four categories of antigens have been commonly studied: O serogroup, H serogroup, colonization factor antigens (CFA), and toxins. A database has been complied from published reports of nearly 1,000 ETEC isolates from 18 locations and analyzed to determine the occurrence, distribution, and associations of O serogroup, H serogroup, CFA, and toxin type. Tables listing the associations of antigens are presented. This analysis documents the widespread nature and variety of ETEC. Even the most common combination of antigens, O6:H16 CFA/II LTST, accounted for only 11% of the ETEC isolates in the database. It was isolated from 12 locations. Many phenotypes occurred only once. CFA detection based on enzyme-linked antibodies with polyclonal sera is suggested as the preferred assay. A combination of CFA and toxin-based antigens is suggested as the most practical vaccine.
Random amplification of polymorphic DNA reveals serotype-specific clonal clusters among enterotoxigenic Escherichia coli strains isolated from humans
Article
Jun 1997
Ana Beatriz Furlanetto Pacheco
Beatriz Ernestina Cabilio Guth
Kelen C C Soares
| https://www.researchgate.net/publication/5628903_Genetic_Diversity_of_Heat-Labile_Toxin_Expressed_by_Enterotoxigenic_Escherichia_coli_Strains_Isolated_from_Humans |
Sustainability | Free Full-Text | Investigation of Small-Scale Photovoltaic Systems for Optimum Performance under Partial Shading Conditions
Not only are small photovoltaic (PV) systems widely used in poor countries and rural areas where the electrical loads are low but they can also be integrated into the national electricity grid to save electricity costs and reduce CO2 emissions. Partial shading (PS) is one of the phenomena that leads to a sharp decrease in the performance of PV systems. This study provides a comprehensive performance investigation of small systems (consisting of ten modules or fewer) under all possible shading patterns that result from one shading level (300 W/m2 is chosen). The most common configurations are considered for which a performance comparison is presented. Five small systems of different sizes are studied under PS. A new simplifying method is proposed to identify the distinct PS patterns under study. Consequently, the number of cases to be studied is significantly reduced from 1862 to 100 cases only. The study is conducted using the MATLAB/Simulink& reg; environment. The simulation results demonstrate the most outperformed configuration in each case of PS pattern and the amount of improvement for each configuration. The configurations include static series-parallel (SP), static total-cross-tied (TCT), dynamic switching between SP and TCT, and TCT-reconfiguration. The study provides PV systems& rsquo; owners with a set of guidelines to opt for the best configuration of their PV systems. The optimum recommended configuration is TCT reconfiguration, rather than dynamic switching between SP and TCT. The less recommended option, which enjoys simplicity but is still viable, is the static TCT. It outperforms the static SP in most cases of PS patterns.
Investigation of Small-Scale Photovoltaic Systems for Optimum Performance under Partial Shading Conditions
by Mahmoud A. M. Youssef 1,* , Abdelrahman M. Mohamed 2 , Yaser A. Khalaf 3 and Yehia S. Mohamed 2
Mechanical Engineering Department, Jouf University, Sakaka 72388, Saudi Arabia
Electrical Engineering Department, Jouf University, Sakaka 72388, Saudi Arabia
*
Author to whom correspondence should be addressed.
Sustainability 2022 , 14 (6), 3681; https://doi.org/10.3390/su14063681
Received: 7 February 2022 / Revised: 13 March 2022 / Accepted: 17 March 2022 / Published: 21 March 2022
(This article belongs to the Special Issue Technology Innovation and Applications of Power Electronics of Renewable Energy Systems )
Abstract
:
Not only are small photovoltaic (PV) systems widely used in poor countries and rural areas where the electrical loads are low but they can also be integrated into the national electricity grid to save electricity costs and reduce CO
2
emissions. Partial shading (PS) is one of the phenomena that leads to a sharp decrease in the performance of PV systems. This study provides a comprehensive performance investigation of small systems (consisting of ten modules or fewer) under all possible shading patterns that result from one shading level (300 W/m
2
is chosen). The most common configurations are considered for which a performance comparison is presented. Five small systems of different sizes are studied under PS. A new simplifying method is proposed to identify the distinct PS patterns under study. Consequently, the number of cases to be studied is significantly reduced from 1862 to 100 cases only. The study is conducted using the MATLAB/Simulink
®
environment. The simulation results demonstrate the most outperformed configuration in each case of PS pattern and the amount of improvement for each configuration. The configurations include static series-parallel (SP), static total-cross-tied (TCT), dynamic switching between SP and TCT, and TCT-reconfiguration. The study provides PV systems’ owners with a set of guidelines to opt for the best configuration of their PV systems. The optimum recommended configuration is TCT reconfiguration, rather than dynamic switching between SP and TCT. The less recommended option, which enjoys simplicity but is still viable, is the static TCT. It outperforms the static SP in most cases of PS patterns.
Keywords:
solar photovoltaic
;
maximum power extraction
;
array interconnection schemes
1. Introduction
1.1. Motivation
Day by day, the demand for electric energy increases, and the need for energy sources to meet these needs increases [
1
]. Most of the demand for electric power is being met by fossil fuels, which are a finite viable resource, along with the catastrophic environmental problems they cause to the planet. These conditions shed light on renewable energy due to its lasting abundance, environmental friendliness, and low maintenance cost [
2
,
3
]. Among the various renewable energy sources, photovoltaic (PV) energy has attracted attention due to its small size and ease of installation in consumption areas, such as rooftops, over-lighting poles, and others. Consequently, it leads to saving energy loss through transmission wires from generation areas to consumption areas. By 2050, it is expected that renewable energy will contribute to 79% of the total energy demand in the world, and PV will be the largest contributor among these energies [
4
].
Residential small-scale PV systems are currently widely used, and many solutions have been presented to integrate the PV systems in homes. It may be a stand-alone system or with the integration with utility [ 5 , 6 ]. Many advantages have been achieved from the renewable distribution generation as saving the losses of the transmission lines and improving the network frequency [ 7 , 8 ].
However, the PV technology still faces many challenges at the present time, which needs more research, including the problem of low energy generated due to environmental conditions [ 9 ]. Usually, there are several connections in series and parallel of the PV modules to obtain the required values of voltage and current [ 10 ]. Under normal conditions, sunlight is uniformly distributed over the PV modules, and the characteristic power-voltage curve has a single maximum power point at which the highest power can be extracted [ 11 ]. However, due to the presence of many causes of shading such as trees and buildings nearby, the accumulation of dust and clouds passing, the PV modules may not receive an equal amount of solar irradiance. Such effect is known as partial shading (PS) [ 12 ]. The PS not only causes a decrease in the output power but also may cause the arising of hotspots as a result of the increased mismatch between PV modules. In order to protect the modules from this effect, bypassing diodes are added to bypass the shaded PV cells or modules. However, this addition causes the appearance of several peaks in the characteristic curve, which makes it difficult to use the traditional tracking techniques to extract the maximum power. Various techniques have been addressed in the literature to solve this problem using metaheuristic methods such as genetic algorithm, cuckoo search, particle swarm optimization, ant colony optimization, and teaching-learning-based optimization [ 13 , 14 ]. Nevertheless, almost all of these techniques require more complex calculations and processing to extract the maximum power.
In [ 15 , 16 ], a simple method is proposed to detect partial shading easily in PV systems. It presents a simple and easy-to-implement controller to track the global maximum power point (MPP). It depends on estimating the voltages at the local maximum power points using only two mathematical equations to control the DC/DC converter.
Recently, many researchers in this area focus on improving the performance of the PV systems under the influence of different environmental conditions, including the partial shading phenomenon. Some researchers focus on developing the internal configuration of the modules to increase their ability to face this phenomenon. For example, article [
17
] investigated the performance of PV modules with different bus bars configurations for cells. It analyzed seven types of poly-Si PV cells and concluded that the five Busbar cells are the most efficient under PS. Article [
18
] focused on the modeling and functioning of a half-cell PV module under the PS using the MATLAB software package. Unlike others, the authors of [
19
] inspected how to reduce the PS effect by using the half-cell modules. They concluded that half-cell modules increase the power by 1.48% in the Fill Factor because of the reduction in electrical losses of cell connectors. The module current also is enhanced by about 3%.
In contrast, another team of researchers focuses on the system as a whole and how to deal with the shading of several modules within the system [ 20 , 21 ]. They investigate various systems under the influence of different PS patterns and experience new methods for static and dynamic connection. Dynamic connection means changing the connection form at the moment of shading. The attempts of this team are explained in detail in Section 1.2 .
The contribution of this work concludes all the applications of small-scale PV systems (stand-alone and utility-connected systems). The study investigates the performance of small-scale PV systems for optimum performance under partial shading conditions and presents an effective solution for the PV systems’ owners with a set of guidelines to opt for the best configuration of their PV systems. The recommendations increase the output energy yield for the PV systems. Also, the study covers all the possible shading patterns, and to achieve that, a new reduction methodology to eliminate the equivalent patterns has been presented.
1.2. Literature Review
To enhance the performance of solar energy under PS conditions, many efforts have been exerted in this regard. The authors of [ 20 ] tested various static configurations of the modules inside the array under 20 different PS patterns. A comparison was made to get the configuration that gives the best performance between static (series, parallel, series-parallel, bridge-linked, and total cross-tied). The study included three systems of different sizes (3 × 10), (4 × 5), and (5 × 5).
In research [
21
], a (4 × 4) system was studied under PS conditions to extract the highest possible power using several different connections. The results were tested and verified through practical experiments. The modeling and evaluation of the performance of a system (7 × 7) under 14 shading patterns were discussed in [
22
]. The output power, voltage, and current at the maximum power point along with the number of local maximum points were compared. In research [
23
], a (2 × 4) system was studied under several shading patterns through MATLAB simulation and experimental verification. The results showed that the total-cross-tied (TCT) method provided the best performance, but the research did not include all possible shading patterns. In [
24
], six possible configurations for a (5 × 4) system were tested under PS. TCT was the best one when a column is entirely and unevenly shaded.
Due to the demerits of the static form of the PV configuration, researchers have proposed to make a dynamic change of electrical connections according to the PS situation to give the best performance. In [ 25 ], static and dynamic reconfiguration techniques were studied to enhance a PV system’s performance. In [ 26 ], a (6 × 4) system was studied under four different levels of solar irradiance and the results were experimentally verified. In [ 27 ], a study was carried out on a (6 × 6) system under three levels of irradiance and a comparison between the TCT technique and magic square technique was introduced.
In [ 28 ], the triple-tied configuration was studied and its performance was compared with the other techniques. Authors in [ 29 ] studied different reconfiguration techniques and a new scheme was presented to improve the performance of the system. Furthermore, authors in [ 30 ] presented a comprehensive study about static, reconfiguration, and metaheuristic interconnection schemes. TCT, Su-Do-Ku, Dominance square, competence square, and a proposed array configuration were studied in detail in [ 31 ]. A new Su-Do-Ku PV configuration is proposed like hyper Su-Do-Ku and compared with the already existing PV array configurations in [ 32 ]. Research [ 33 ] presented a new socio-inspired PV reconfiguration approach, called democratic political to effectively reduce the mismatching power losses. Three case studies were carried out to verify the proposed technique. On the other side, research [ 34 ] focused on large-sized systems such as (16 × 16) and (25 × 25). Also, research [ 35 ] assessed the shading losses in a large PV power plant with 2.85 MW nominal power and 10,010 modules. It introduced a methodology for the assessment of annual energy loss for the large PV stations.
An improved dynamic array reconfiguration strategy was proposed based on current injection in [
36
]. In this strategy, the output power output and the multiple peaks in the PV array characteristic curve were also avoided. However, it needed some modifications in the power converters. A dynamic L-shaped reconfiguration was presented in [
37
], relying on changing each array connection to be in the form of letter L to enhance the amount of power generated from the system. In addition, a new array configuration was presented. Re-allocation of a PV module-fixed electrical connection was introduced in [
38
] where a new proposed “Shape-do-ku” puzzle was presented and simulated for a (4 × 4) system.
1.3. Novelty of Work
Most of the past research focused on studying PV systems under the influence of a specific number of shading patterns, but the PS patterns cannot be fully evaluated. Moreover, most of the previous studies focused on large systems, and there are no comprehensive studies on small systems, despite their prevalence in the homes of low-consumption rural areas. In addition, small PV systems can be used in urban houses to partially supply the required electricity and to integrate into the public electricity grid. They can be sometimes used to energize streetlights on highways. On the other side, with the development of manufacturing technology and the use of multilayer boards, the resulting capacity of one module is increasing. That makes the PV systems need a smaller number of PV modules for the same power generated. However, the loss of electricity resulting from one module as a result of partial shading is more effective.
Our study comes here as a good contributor in this area of research.
It provides a comprehensive investigation of the performance of small PV systems (consisting of 10 modules or fewer) rather than for large systems as in most previous studies.
PV systems are tested under all possible shading patterns as a result of a single shading level (300 W/m 2 ) for common wiring configurations rather than for a set number of patterns as in previous studies.
To be able to cover all possible PS patterns, a new reduction methodology is proposed to eliminate the equivalent patterns. Consequently, the number of studied patterns is limited to a feasible value as low as 100 cases.
The study affords a few recommendations for the proper choice of the PV system configuration, seeking optimum performance under PS conditions.
2. Mathematical Modeling
There are several ways to model a PV cell as a single diode model (SDM), double diode model, and triple diode model. SDM does not provide highly accurate results in large systems due to inherent variations in cell characteristics [ 24 ].
However, since the study is concerned with small systems, SDM would be appropriate for both simplicity and a reasonable level of accuracy. SDM PV equivalent circuit is illustrated in Figure 1 .
SDM is also available in Simulink as in
Figure 2
, which makes it easier to re-study for similar systems with different variables. The current of PV cell is related to the module voltage, thermal voltage, series and parallel resistance, and diode ideality factor as:
I
p
v
=
I
p
h
0
(
e
V
p
v
+
I
p
v
R
s
a
V
t
−
1
)
−
V
p
I
p
v
R
s
R
s
h
(1)
where
I PV
: output current of the PV cell,
I ph
: light generated current,
I
0
: reverse saturation current,
R S
: series resistance, a: diode ideality factor,
R sh
: shunt resistance, and
V t
: thermal voltage of the module which is given as:
V
t
=
K
T
N
s
q
(2)
where
K
: Boltzmann’s constant,
T
: absolute temperature in Kelvins,
q
: electron charge,
N S
: number of series cells. The generated current is directly related to the amount of irradiance as:
I
p
h
T
C
(3)
where
G
: solar irradiance,
K i
: temperature coefficient of short circuit current, and
T STC
: reference temperature at the standard test conditions (
STC
). The standard test conditions are defined by:
G STC
= 1000 W/m
2
, air mass ratio = 1.5, and temperature of the module = 25 °C.
Finally, the reverse saturation current can be extracted from open circuit voltage
V OC
at STC and temperature voltage coefficient
K V
as:
=
I
S
C
,
S
T
C
+
K
i
(
T
−
T
S
T
C
)
e
V
p
v
+
I
p
v
R
s
a
V
t
−
1
(4)
Suntech Power STD275-24-Vd PV module is used where its parameters and data specification are taken from the database of National Renewable Energy Laboratory (NREL) as in Table 1 .
To validate the model, the simulated results are compared with the practical data (taken from the datasheet [ 39 ]) of the Suntech Power STD275-24-Vd PV module. Figure 3 a,b represents the I-V and P-V curves for the designed model and datasheet. It is observed that there is an agreement between the model results and the practical data.
3. System Description
In this study, the focus is on small PV systems, which are identified as systems with 10 modules or fewer. A comprehensive study of these small systems under PS conditions is introduced. Since there are not many possible ways to connect small systems (unlike large systems), it can be considered that they are mainly limited to a small number of common static configurations as (Series, Parallel, series-parallel (SP), and total-cross-tied TCT).
Since the series configuration is characterized by being the least in the number of connecting wires, it has several disadvantages such as: the low value of the current produced under normal conditions, the large value of the voltage on both ends of the system, and the significant decrease in the generated power when PS occurs [
14
]. In contrast, the parallel configuration is characterized by having one maximum power point under both normal conditions and PS conditions. It also gives the highest power under PS conditions. Nevertheless, it is disadvantaged by the large amount of current passing through the installation and into the inverter or batteries, as well as low output voltage levels [
16
]. This makes both methods unfavorable options in most cases. Therefore, it can be considered that the comparison is mainly between SP and TCT for static configurations. Also, dynamic switching between SP and TCT is proposed to be investigated in addition to TCT-reconfiguration (in which the shaded module positions are changed according to the PS pattern).
PV systems can be divided into two main types:
i.
Symmetrical dimension systems: symmetrical systems that consist of 10 modules or fewer with equal numbers of rows and columns are mainly configured in two systems (2 × 2) and (3 × 3).
ii.
Asymmetrical dimension systems: asymmetrical systems are those in which the number of rows is not equal to the number of columns. Asymmetrical systems that consist of 10 modules or fewer are mainly configured in three systems (2 × 3), (2 × 4), and (2 × 5).
4. Shading Patterns Description
Although the probability of some shading patterns is greater than other patterns, it is difficult to predict the typical shading pattern. Moreover, some shading patterns arise after the installation of the system. What distinguishes this research is the possibility of studying all shadow patterns that may occur in small PV systems resulting from one level of shading. A shading level of 300 W/m
2
is chosen, while the normal condition is a solar irradiance level of 1000 W/m
2
. It is also considered that the module temperature is constant at 25 °C.
Because of the limited size of the system, all possible shading patterns can be identified and counted as in Table 2 . There are 1862 possibilities for the five PV systems. A simplifying method is presented to reduce the number of shading possibilities. In order to avoid repetition, it is sufficient to keep one case in which the shading pattern is similar in both connections’ SP and TCT. So, all patterns in which the number of shaded modules in all rows and columns of the first pattern is equal to all rows and columns of the second type are characterized by giving an equal performance in both configurations of SP and TCT.
For example, when studying the system shown in Figure 4 , it is noticed that both patterns of PS give the same performance when connected to the two configurations under study. Consequently, it is sufficient to study only one pattern of the two. In other words, swapping a column for another column, or a row for another row does not affect the performance of the system for both SP and TCT.
This limits all possible shading patterns to a limited number for comparison. From Table 2 , it is clear that the proposed method reduces the probable cases from 1862 to only 100 cases, which can be conveniently studied.
5. Performance Parameters
To compare different configurations, performance assessment parameters must be determined to choose the best configuration that gives the highest performance. Selected factors are open-circuit voltage
V OC
, short-circuit current
I SC
, global maximum power point voltage
V GMPP
, global maximum power point current
I GMPP
, power losses, and the number of local maximum power points.
The mismatching power loss,
PL
% is given by:
P
o
w
e
r
l
o
s
s
,
P
l
%
=
P
M
P
P
−
P
P
S
C
P
M
P
P
×
100
(5)
where
P MPP
and
P PSC
are the maximum power point values without any shading and with PS condition, respectively. As the PL value is less, the performance of the PV system is higher.
The ratio of maximum power output to the input irradiance power is called the efficiency η% and calculated by (7):
E
f
f
i
c
i
c
y
,
η
%
=
V
M
P
P
×
I
M
P
P
G
×
A
×
100
(6)
where G is the solar irradiance and A is the net array area. As the η value is higher, the performance of the PV system is better.
To measure the difference between static SP and TCT a simple equation is used. It is considered that static TCT is better than static SP by (K
T
%) defined as:
K
T
%
=
P
T
C
T
−
P
S
P
P
T
C
T
×
100
(7)
Also, to measure the difference between static TCT and Reconfigurable TCT another simple equation is used. It is considered that reconfigurable TCT is better than static TCT by (K
RT
%) defined as:
K
R
T
%
=
P
T
C
T
m
a
x
−
P
T
C
T
P
T
C
(8)
where PTCT max is the maximum power for the same number of shaded modules using reconfigurable TCT technique
6. Simulation Results and Discussion
This section evaluates systems’ performance and shows the simulation results. The diagram in Figure 5 demonstrates the research methodology. For every PS case, the results are divided according to the number of shaded modules where the highest performance data is bolded if any. The measured parameters are V OC , I SC , V GMPP , I GMPP , P GMPP , PL , efficiency, and the number of local MPPs. The comparison for every case is between static SP, static TCT, the dynamic change between them, and reconfigurable TCT.
The most important performance parameter in this comparative study is the global maximum power of the PV system. For this reason, our discussion is fundamentally based on the output power of the PV system under various shading patterns to evaluate different connectivity configurations. The best connectivity configuration is the one that produces the highest power under specific shading conditions for the same system. Although other performance parameters are of less importance, they are fully reported in the tables of
Appendix A
for the sake of completeness. In addition, the I-V and P-V characteristic curves of the different systems under study are also included in
Appendix A
for full characterization of the system.
6.1. Symmetrical Dimension Systems
6.1.1. System 2 × 2
System 2 × 2 consists of five possible cases, which can be classified into four sections according to the number of shaded modules. Figure 6 explains the output power for all system 2 × 2 cases. For one shaded module (case 1), TCT presents a better performance (with 774.6 W output power) than that of SP (726.2 W). The same observation can be applied when all the modules are shaded except one (as in case 5). Reconfigurable TCT cannot add new information as there are no multiple cases to choose from for the same number of shaded modules.
However, when two modules are shaded, there are three cases (Case 2, 3, and 4). In case 2, TCT has the same performance as SP (with 539.1 W output). Case 3 also has the same performance for SP and TCT (with 719.1 W output). In case 4, TCT (with 719.1 W) is better than SP (with 539.1 W). So, it is observed that dynamic change between SP and TCT is useful only for case 4 and cannot improve the performance in either case 2 or case 3. On the other hand, with reconfigurable TCT, the shade pattern can be changed from case 2 to case 3 or 4 with an improvement in output power by 25.09%. That ensures the best performance for two shaded modules.
In the case of static configuration, it is clear that the TCT configuration achieves better results in terms of the amount of power generated in three out of five possible cases, while it is equal to the SP configuration in only two cases. As a result, the dynamic switching between the two configurations does not introduce any advantage.
In the case of TCT-reconfiguration, the amount of improvement in the resulting power is only in one case out of the five cases, with a noticeable increase in the amount of power and a single MPP in the I-V curve. Reconfigurable TCT reduces the number of maximum power points to the least possible value among all cases of TCT.
Figure A1
shows the I-V and P-V characteristic curves of the five cases, divided according to the number of shaded modules. The curves indicate the numbers and positions of local maximum power points as well as the position of the global maximum power point. V
MPP
of TCT in all cases (except case 2) is near to the V
OC
values. In contrast, with TCT reconfiguration, the V
MPP
of all cases is kept near to the V
OC
values.
Table A1
presents more details about the simulated results and of the performance parameters for various shading cases.
6.1.2. System 3 × 3
Practically, system 3 × 3 is more common than 2 × 2. System 3 × 3 has 32 possible shading cases, which can be divided into eight sections according to the number of shaded modules. The bar chart of the output power for different cases is shown in
Figure 7
. Again, for one shaded module (case 1), TCT presents a better performance (with 2067 W output power) than SP (1914 W). The same conclusion can be drawn for case 32 with different power levels. Thus, reconfigurable TCT cannot introduce any improvement for the first and last cases. With two shaded modules (case 2, 3, and 4), the results are similar to that of the 2 × 2 system. TCT reconfigurable ensures the best output power (with 1978 W) where the dynamic change to SP improves case 2 (to 1674 instead of 1634). However, this does not ensure the best performance for the two shaded module cases.
With three shaded modules, there are six possible cases (5 to 10). TCT reconfigurable here has more effective results as it can choose from six different cases. It can change from shade pattern in (case 5, 6, or 7) to give the highest possible power (of 1905 W). The improvement ratios are 14.2%, 22.3%, 22.3% for the three cases, respectively. The same result can be observed at the state of four shaded modules, but with smaller improvement ratios (8.76%, 3.56%, and 3.56% for cases 11, 13, and 14, respectively).
For the rest shading states, symmetry is observed. The states of five, six, seven, and eight shaded modules are similar to four, three, two, and one shaded modules, respectively. This is due to the symmetric dimension of the system.
It can be inferred from
Figure 7
, that the TCT method is superior in 24 out of 32 possible cases, while it is equal to the SP method in only four cases. Consequently, in the case of static configuration, SP configuration is not preferred, while the dynamic switching between the two configurations improves only four cases by a small percentage in most cases. The location of the same number of shaded modules significantly affects the system performance. For this reason, reconfigurable TCT has a significant effect on the performance. With the TCT reconfiguration technique, the performance is improved in 16 cases, which represents 50% of all the possible cases, and the percentage of power improvement is larger compared to the dynamic method. So, the TCT reconfiguration technique is highly recommended. Five cases (4, 7, 14, 15, and 28) have significantly smaller V
MPP
in SP than TCT, where only one case (27) has the opposite state. From
Figure A2
b, it is observed that with TCT reconfiguration, case 3 may be the best replacement for the different shading patterns with a good position of the global MPP. The same observation can be extracted from
Figure A2
a–e. The simulated results of different performance parameters are reported in
Table A2
.
6.2. Asymmetrical Dimension Systems
They comprise the systems in which the number of rows does not equal the number of columns, including systems 2 × 3, 2 × 4, and 2 × 5. Here, 11, 20, and 32 cases are presented for systems 2 × 3, 2 × 4, and 2 × 5, respectively.
6.2.1. System 2 × 3
The 2 × 3 system is considered one of the simplest cases of asymmetric systems and is characterized by 11 possible PS cases for one level of shading when comparing between TCT and SP.
Figure 8
shows the bar chart of the output power for all system shading cases. When one module is shaded, TCT presents better output power by 5.3% than SP. The same result is found in the case of shading five modules (TCT is 4.9% better than SP). At the state of two shaded modules, TCT is better than SP in case 2 (with output power 6.61% higher) and case 4 (with output power 28.78% higher). However, TCT gives the same performance as SP in case 3. Reconfigurable TCT can change the shading pattern in case 3 to achieve an output power of 1270 W with an improvement ratio of 23.74%. Three and four shaded modules states are similar to the two shaded in the output performance but with a smaller output power owing to the wider shaded area. There is also an exception in case 8 where SP is better than TCT by a smaller ratio (0.5%). However, the optimum performance for four shaded modules can be achieved with reconfigurable TCT as in cases 9 and 10. Thorough simulation results of the performance parameters under various shading conditions can be found in
Table A3
.
In summary, the TCT method is superior in 7 out of 11 possible cases, while it is equal to the SP method in three cases. SP is outperformed in only one case by a very small percentage. This shows that in the case of static configuration, TCT is highly preferred over the SP configuration. The dynamic switching between the two configurations does not introduce any significant effect. In the case of TCT-reconfiguration, it is noticed that the performance improves in three cases, with a high percentage of power improvement. It is interesting to note that TCT provides higher V
MPP
values almost in all cases than that of the SP method. The I-V and P-V characteristic curves of the eleven cases are shown in
Figure A3
, classified according to the number of shaded modules. From every figure (from
Figure A3
a–e), representing a specific state, the best TCT, which is a used case for the TCT reconfiguration, can be easily extracted along with the position of the MPP location.
6.2.2. System 2 × 4
System 2 × 4 is characterized by 20 possible shading patterns for one shading level when comparing TCT and SP. The simulated output power is demonstrated in
Figure 9
. One, two, and three shaded modules states are similar in the general performance to those of 2 × 3 systems with just different output power values. However, four shaded modules states have six possible cases. TCT performance is equal to SP in two cases (8 and 11 with 1078 W) and TCT is better in the rest four cases (with 1146 W for cases 9 and 10 and 1439 W for cases 12 and 13). This gives the reconfigurable TCT the ability to improve four cases to give 1439 W with an improvement ratio of 20.36% (for cases 8 and 11) and 25.1% (for cases 9 and 10). Five, six, and seven shaded modules states are similar in the general performance to three, two, and one shaded modules states, respectively. In addition, more improvement ratios are remarkable when using reconfigurable TCT with 20.73% in case 14 and 30.38% in case 17.
In conclusion, the TCT method is superior in 15 cases, while it is equal to the SP method in four cases only. SP is better in only one case by a slight percentage. It is noticeable here that TCT presents higher V
MPP
values in seven cases than SP, while the voltage values are almost equal in the rest cases.
Again, in the static configuration, the SP method is not highly preferred when compared to TCT, while the dynamic switching between the two configurations does not add any significant effect. In the case of TCT-reconfiguration, the performance improves in seven cases, with a significant percentage of power improvement. For complete characterization of the performance parameters, one may refer to Table A4 . The I-V and P-V characteristic curves of the 20 cases are shown in Figure A4 .
6.2.3. System 2 × 5
System 2 × 5 has 32 cases and can be classified into nine groups according to the number of shaded modules.
Figure 10
explains the output power for all 2 × 5 system cases. The TCT method is better than SP in 23 cases with a ratio of output power improvement between 4% and 31.36%. In contrast, SP is slightly better in only three cases 16, 20, and 26 with output-power improvement percent of 0.82%, 0.26%, and 0.65%, respectively. For the remaining six cases, SP gives the same performance as TCT. Again, in the static configuration, the SP method is not preferred when compared to TCT, while the dynamic switching between the two configurations does not give any significant performance change.
Reconfigurable TCT can give an output power better than TCT. The performance is improved in seven states when using TCT-reconfiguration, with a noticeable percentage of power improvement. It can improve one case, in each group of two, three, seven, and eight shaded modules, with 10.38% in case 2, 16.31% in case 5, 25% in case 26, and 25.4% in case 29, respectively. The improvement is more significant in the states of four, five, and six shaded modules. In each of the three states, there are six possible cases. Half of them have the highest possible power, where reconfigurable TCT can improve the other half to give output power as the first half. The improvement ratio can be as large as 32.26% as in case 8.
Additionally, it is worth mentioning that the TCT introduces a higher V
MPP
value, compared to that of SP, in a quarter of the possible cases, while it is almost equal in the rest of the cases. Consequently, the TCT-reconfiguration method ensures the highest possible V
MPP
value in all cases.
From the I-V and P-V characteristic curves of the 32 cases that are shown in Figure A5 , the best case for the TCT reconfiguration can be determined along with the location of the global MPP. Moreover, a comparison between the partial pattern and the unshaded case may be conducted. The full simulated performance parameters are reported in Table A5 .
7. Conclusions
The present study presents a performance investigation of small PV systems under all possible shading patterns. Small systems are defined as those consisting of 10 modules or fewer. There are five configurations that are most commonly used; two of which are symmetrical (2 × 2 and 3 × 3) and three are asymmetrical (2 × 3, 2 × 4, and 2 × 5). The main techniques of small static systems are SP and TCT.
All possible shading patterns, arising from a single shading level (300 W/m
2
) under the two wiring techniques (SP and TCT), are studied. A new simplifying method is utilized to reduce the number of cases to be studied. The proposed method reduces the probable cases from 1862 to only 100 cases for the five systems. TCT configuration shows superiority in most cases, which makes TCT configuration the best static configuration for small PV systems. Some systems may follow the technique of dynamic switching between the (SP and TCT) according to the PS pattern to choose the best one. However, by applying this to small systems, it is notable that the amount of resultant improvement is slight or even has no value such as a 2 × 2 system. Thus, the extra complexity associated with dynamic switching does not compensate for the expected improvement.
The technique of TCT-reconfiguration (in which the shaded modules positions are re-arranged in the array according to the PS pattern by changing the electrical connections) is also tested to obtain the highest possible performance. Significant improvement is observed in a large number of cases in all small PV systems. This improvement occurs with the increase in the number of shaded units in half the system. The only drawback of this method is the need for many connections. However, due to the limited size of these systems, the required cable lengths are not long.
Hence, it is highly recommended to those who intend to develop their custom systems not to adopt dynamic switching configuration, but to implement TCT-reconfiguration. Furthermore, those who prefer to stick to static-configuration systems for their simplicity should follow the configurations of static TCT.
Table 3
summarizes the number of cases in which TCT excelled in static configurations, in front of the number of cases that improved when transitioning to the dynamic switching between the SP and TCT configurations. The number of improved cases with TCT-reconfiguration techniques is also compared to the static TCT.
Author Contributions
Conceptualization, M.A.M.Y., A.M.M. and Y.S.M.; methodology, A.M.M.; software, A.M.M.; validation, M.A.M.Y., Y.A.K. and Y.S.M.; formal analysis, M.A.M.Y.; investigation, A.M.M.; writing—original draft preparation, A.M.M.; writing—review and editing, A.M.M., Y.A.K. and M.A.M.Y.; supervision, M.A.M.Y. and Y.S.M.; project administration, M.A.M.Y.; funding acquisition, M.A.M.Y. All authors have read and agreed to the published version of the manuscript.
Funding
This work was funded by the Deanship of Scientific Research at Jouf University under grant No. (DSR-2021-02-03102).
Institutional Review Board Statement
Not applicable.
Informed Consent Statement
Not applicable.
Data Availability Statement
Not applicable.
Conflicts of Interest
The authors declare no conflict of interest.
Appendix A
Table A1. System 2 × 2 case studies and the resulted data.
Table A1. System 2 × 2 case studies and the resulted data.
Case Number. Number of Shaded Modules Partial Shading Pattern Series-Parallel Total-Cross-Tied K T % K RT % V OC I SC V GMPP I GMPP P GMPP PL % Efficiency % Number of Local MPPs V OC I SC V GMPP I GMPP P GMPP PL % Efficiency % Number of Local MPPs 0 0 0 89.4 16.7 70.2 15.7 1100 0.00 14.17 1 89.4 16.7 70.2 15.7 1100 0.00 14.17 1 0.00 0.00 0 0 0 1 1 1 88.5 16.7 71.3 10.2 726.2 33.98 9.36 2 88.5 16.7 73.9 10.5 774.6 29.58 9.98 2 6.25 0.00 0 1 0 2 2 2 87.3 16.7 34.4 15.7 539.1 50.99 6.95 2 87.3 16.7 34.4 15.7 539.1 50.99 6.95 2 0.00 25.09 0 1 1 3 1 87.7 10.8 70.6 10.2 719.7 34.57 9.27 1 87.7 10.8 70.6 10.2 719.7 34.57 9.27 1 0.00 0.00 1 2 0 4 1 87.3 16.7 34.4 15.7 539.1 50.99 6.95 2 87.7 10.8 70.6 10.2 719.7 34.57 9.27 1 25.09 0.00 1 1 1 5 3 2 86.3 10.8 35 10.2 356.1 67.63 4.59 2 86.5 10.8 76 4.85 369 66.45 4.75 2 3.50 0.00 1 2 1
Figure A1. (I-V) and (P-V) characteristic curves of the PV 2 × 2 system under different numbers of shaded modules as follow: ( a ) One shaded module, ( b ) Two shaded modules, and ( c ) Three shaded modules.
Figure A1. (I-V) and (P-V) characteristic curves of the PV 2 × 2 system under different numbers of shaded modules as follow: ( a ) One shaded module, ( b ) Two shaded modules, and ( c ) Three shaded modules.
Table A2. System 3 × 3 case studies and the resulted data.
Table A2. System 3 × 3 case studies and the resulted data.
Case Number. Number of Shaded Modules Partial Shading Pattern Series-Parallel Total-Cross-Tied K T % K RT % V OC I SC V GMPP I GMPP P GMPP PL % Efficiency % Number of Local MPPs V OC I SC V GMPP I GMPP P GMPP PL % Efficiency % Number of Local MPPs 0 0 0 134.1 25 105.4 23.5 2476 0.00 14.18 1 134.1 25 105.4 23.5 2476 0.00 14.18 1 0.00 0.00 0 0 0 0 0 1 1 1 133.4 25 106.3 18 1914 22.70 10.96 2 133.5 25 110.7 18.7 2067 16.52 11.84 2 7.40 0.00 0 0 1 0 0 2 2 2 132.8 25 71.4 23.5 1674 32.39 9.59 2 132.9 25 69.6 23.5 1634 34.01 9.36 2 −2.45 17.39 0 0 1 1 0 3 1 132.9 25 106.1 18 1912 22.78 10.95 2 133 25 107.9 18.3 1978 20.11 11.33 2 3.34 0.00 1 0 2 0 0 4 1 132.8 25 71.4 23.5 1674 32.39 9.59 2 133 25 107.9 18.3 1978 20.11 11.33 2 15.37 0.00 1 0 1 1 0 5 3 3 132 25 96.6 23.5 1634 34.01 9.36 2 132 25 96.6 23.5 1634 34.01 9.36 2 0.00 14.23 0 0 1 1 1 6 2 132.1 25 108.2 12.5 1355 45.27 7.76 3 132.3 25 113.7 13 1481 40.19 8.48 3 8.51 22.26 1 0 2 1 0 7 2 132 25 96.6 23.5 1634 34.01 9.36 2 132.3 25 113.7 13 1481 40.19 8.48 3 −10.33 22.26 1 0 1 1 1 8 1 132.4 19.2 105.6 18 1905 23.06 10.91 1 132.4 19.2 105.6 18 1905 23.06 10.91 1 0.00 0.00 1 1 3 0 0 9 1 132.1 25 108.2 12.5 1355 45.27 7.76 3 132.4 19.2 105.6 18 1905 23.06 10.91 1 28.87 0.00 1 1 2 1 0 10 1 132 25 96.6 23.5 1634 34.01 9.36 2 132.4 19.2 105.6 18 1905 23.06 10.91 1 14.23 0.00 1 1 1 1 1 11 4 3 131.3 25 70.1 18 1263 48.99 7.23 3 131.5 25 72.1 18.5 1334 46.12 7.64 3 5.32 8.76 1 0 2 1 1 12 2 131.6 19.2 107.2 12.54 1345 45.68 7.70 2 131.8 19.2 112.3 13 1462 40.95 8.37 2 8.00 0.00 1 1 3 1 0 13 2 131.6 25 107.9 12.5 1353 45.36 7.75 2 131.7 25 110.2 12.8 1410 43.05 8.07 2 4.04 3.56 2 0 2 2 0 14 2 131.3 25 70.1 18 1263 48.99 7.23 3 131.7 25 110.2 12.8 1410 43.05 8.07 2 10.43 3.56 2 0 1 2 1 15 2 131.3 25 70.1 18 1263 48.99 7.23 3 131.8 19.2 112.3 13 1462 40.95 8.37 2 13.61 0.00 1 1 1 1 2 16 1 131.6 25 107.9 12.5 1353 45.36 7.75 2 131.8 19.2 112.3 13 1462 40.95 8.37 2 7.46 0.00 2 1 2 2 0 17 5 3 130.7 25 71.6 12.5 897 63.77 5.14 3 130.8 25 74.3 12.9 959.4 61.25 5.49 3 6.50 31.08 2 0 2 2 1 18 2 131 19.2 107 12.6 1343 45.76 7.69 2 131.1 19.2 108.9 12.8 1392 43.78 7.97 2 3.52 0.00 2 1 3 2 0 19 2 130.7 25 71.6 12.5 897 63.77 5.14 3 131.1 19.2 108.9 12.8 1392 43.78 7.97 2 35.56 0.00 2 1 2 1 2 20 3 130.7 25 71.6 12.5 897 63.77 5.14 3 130.9 19.2 69.8 18 1257 49.23 7.20 2 28.64 9.70 1 1 2 1 2 21 2 130.8 19.2 70.1 18 1263 48.99 7.23 2 131.1 19.2 108.9 12.8 1392 43.78 7.97 2 9.27 0.00 1 2 3 1 1 22 3 130.8 19.2 70.1 18 1263 48.99 7.23 2 130.9 19.2 69.8 18 1257 49.23 7.20 2 −0.48 9.70 1 1 3 1 1 23 6 3 129.9 25 113.2 7.2 817.3 66.99 4.68 2 129.9 25 113.2 7.2 817.3 66.99 4.68 2 0.00 38.73 3 0 2 2 2 24 2 130.5 13.3 106.3 12.6 1334 46.12 7.64 1 130.5 13.3 106.3 12.6 1334 46.12 7.64 1 0.00 0.00 2 2 3 3 0 25 3 130 19.1 71.7 12.5 896.7 63.78 5.13 3 130.3 19.2 73 12.9 941.2 61.99 5.39 3 4.73 29.45 2 1 3 2 1 26 2 129.9 25 113.2 7.2 817.3 66.99 4.68 2 130.5 13.3 106.3 12.6 1334 46.12 7.64 1 38.73 0.00 2 2 2 2 2 27 3 129.9 25 113.2 7.2 817.3 66.99 4.68 2 130.3 19.2 73 12.9 941.2 61.99 5.39 3 13.16 29.45 2 1 2 2 2 28 2 130 19.1 71.7 12.5 896.7 63.78 5.13 3 130.5 13.3 106.3 12.6 1334 46.12 7.64 1 32.78 0.00 2 2 3 2 1 29 7 3 129.3 19.2 111.1 7.2 759.2 69.34 4.35 2 129.3 19.2 112.3 7.2 811.2 67.24 4.65 2 6.41 7.92 3 1 3 2 2 30 3 129.4 13.3 71.7 12.5 896.4 63.80 5.13 2 129.6 13.3 70.2 12.6 880.8 64.43 5.04 2 −1.77 0.00 2 2 3 3 1 31 3 129.3 19.2 111.1 7.2 759.2 69.34 4.35 2 129.6 13.3 70.2 12.6 880.8 64.43 5.04 2 13.81 0.00 2 2 3 2 2 32 8 3 128.6 13.3 109.4 7.1 778.8 68.55 4.46 2 128.7 13.3 111.1 7.2 802.1 67.61 4.59 2 2.90 0.00 3 2 3 3 2
Figure A2. (I-V) and (P-V) characteristic curves of the PV 3 × 3 system under different numbers of shaded modules as follow: ( a ) One shaded module, ( b ) Two shaded modules, ( c ) Three shaded modules, ( d ) Four shaded modules, ( e ) Five shaded modules, ( f ) Six shaded modules, ( g ) Seven shaded modules, and ( h ) Eight shaded modules.
Figure A2. (I-V) and (P-V) characteristic curves of the PV 3 × 3 system under different numbers of shaded modules as follow: ( a ) One shaded module, ( b ) Two shaded modules, ( c ) Three shaded modules, ( d ) Four shaded modules, ( e ) Five shaded modules, ( f ) Six shaded modules, ( g ) Seven shaded modules, and ( h ) Eight shaded modules.
Table A3. System 2 × 3 case studies and the resulted data.
Table A3. System 2 × 3 case studies and the resulted data.
Case Number. Number of Shaded Modules Partial Shading Pattern Series-Parallel Total-Cross-Tied K T % K RT % V OC I SC V GMPP I GMPP P GMPP PL % Efficiency % Number of Local MPPs V OC I SC V GMPP I GMPP P GMPP PL % Efficiency % Number of Local MPPs 0 0 0 89.4 25 70.2 23.5 1651 0.00 14.18 1 89.4 25 70.2 23.5 1651 0.00 14.18 1 0.00 0.00 0 0 0 0 1 1 1 88.8 25 70.8 18 1276 22.71 10.96 2 88.8 25 72.8 18.5 1347 18.41 11.57 2 5.27 0.00 0 1 0 0 2 2 2 88.1 25 72.2 12.5 904.5 45.22 7.77 2 88.8 25 75 12.9 968.5 41.34 8.32 2 6.61 23.74 0 1 1 0 3 1 88.3 19.2 70.4 18 1270 23.08 10.91 1 88.3 19.2 70.4 18 1270 23.08 10.91 1 0.00 0.00 1 2 0 0 4 1 88.1 25 72.2 15.5 904.5 45.22 7.77 2 88.3 19.2 70.4 18 1270 23.08 10.91 1 28.78 0.00 1 1 1 0 5 3 3 87.3 25 34.4 23.5 808.7 51.02 6.95 2 87.7 25 34.4 23.5 808.7 51.02 6.95 2 0.00 14.89 0 1 1 1 6 2 87.6 19.2 71.5 12.5 896.3 45.71 7.70 2 87.6 19.2 73.7 12.9 950.2 42.45 8.16 2 5.67 0.00 1 2 1 0 7 2 87.3 25 34.4 23.5 807.7 51.08 6.94 2 87.6 19.2 73.7 12.9 950.2 42.45 8.16 2 15.00 0.00 1 1 1 1 8 4 3 86.7 19.2 34.8 18 625.3 62.13 5.37 2 86.8 19.2 34.6 18 622.2 62.31 5.34 2 −0.50 30.06 1 2 1 1 9 2 87 13.3 70.9 12.6 889.6 46.12 7.64 1 87 13.3 70.9 12.6 889.6 46.12 7.64 1 0.00 0.00 2 2 2 0 10 2 86.7 19.2 34.8 18 625.3 62.13 5.37 2 87 13.3 70.9 12.6 889.6 46.12 7.64 2 29.71 0.00 2 2 1 1 11 5 3 86 13.3 73.3 7.1 521 68.44 4.48 2 86.1 13.3 75.3 7.3 548.1 66.80 4.71 2 4.94 0.00 2 2 2 1
Figure A3. (I-V) and (P-V) Characteristic curves of the PV 2 × 3 system under different numbers of shaded modules as follow: ( a ) One shaded module, ( b ) Two shaded modules, ( c ) Three shaded modules, ( d ) Four shaded modules, and ( e ) Five shaded modules.
Figure A3. (I-V) and (P-V) Characteristic curves of the PV 2 × 3 system under different numbers of shaded modules as follow: ( a ) One shaded module, ( b ) Two shaded modules, ( c ) Three shaded modules, ( d ) Four shaded modules, and ( e ) Five shaded modules.
Table A4. System 2 × 4 case studies and the resulted data.
Table A4. System 2 × 4 case studies and the resulted data.
Case Number. Number of Shaded Modules Partial Shading Pattern Series-Parallel Total-Cross-Tied K T % K RT % V OC I SC V GMPP I GMPP P GMPP PL % Efficiency % Number of Local MPPs V OC I SC V GMPP I GMPP P GMPP PL % Efficiency % Number of Local MPPs 0 0 0 89.4 33.3 70.2 31.4 2201 0.00 14.18 1 89.4 33.3 70.2 31.4 2201 0.00 14.18 1 0.00 0.00 0 0 0 0 0 1 1 1 89 33.3 70.6 25.9 1826 17.04 11.76 2 89 33.3 72.9 26.5 1913 13.08 12.32 2 4.55 0.00 0 1 0 0 0 2 2 2 88.5 33.3 71.3 20.4 1452 34.03 9.35 2 88.5 33.3 73.9 21 1549 29.62 9.98 2 6.26 14.89 0 1 1 0 0 3 1 88.5 33.3 71.3 20.4 1452 34.03 9.35 2 88.6 27.5 70.4 25.9 1820 17.31 11.72 1 20.22 0.00 1 1 1 0 0 4 1 88.6 27.5 70.4 25.9 1820 17.31 11.72 1 88.6 27.5 70.4 25.9 1820 17.31 11.72 1 0.00 0.00 1 2 0 0 0 5 3 3 87.9 33.3 35.1 31.1 1097 50.16 7.07 2 88 33.3 75.5 15.3 1159 47.34 7.47 2 5.35 23.80 0 1 1 1 0 6 2 88 27.5 71 20.4 1446 34.30 9.32 2 88.2 27.5 72.7 20.9 1521 30.90 9.80 2 4.93 0.00 1 2 1 0 0 7 2 87.9 33.3 35.1 31.1 1097 50.16 7.07 2 88.2 27.5 72.7 20.9 1521 30.90 9.80 2 27.88 0.00 1 1 1 1 0 8 4 4 87.3 33.3 34.4 31.1 1078 51.02 6.94 2 87.3 33.3 34.4 31.1 1078 51.02 6.94 2 0.00 25.09 0 1 1 1 1 9 3 87.6 27.5 72.2 14.9 1075 51.16 6.93 2 87.6 27.5 74.7 15.3 1146 47.93 7.38 2 6.20 20.36 1 2 1 1 0 10 3 87.3 33.3 34.4 31.1 1078 51.02 6.94 2 87.6 27.5 74.7 15.3 1146 47.93 7.38 2 5.93 20.36 1 1 1 1 1 11 2 87.7 21.7 70.6 20.4 1439 34.62 9.27 1 87.7 21.7 70.6 20.4 1439 34.62 9.27 1 0.00 0.00 2 2 2 0 0 12 2 87.5 27.5 72.2 14.9 1075 51.16 6.93 2 87.7 21.7 70.6 20.4 1439 34.62 9.27 1 25.30 0.00 2 1 2 1 0 13 2 87.3 33.3 34.4 31.1 1078 51.02 6.94 2 87.7 21.7 70.6 20.4 1439 34.62 9.27 1 25.09 0.00 2 1 1 1 1 14 5 4 86.8 27.5 34.6 25.8 894.7 59.35 5.76 2 86.8 27.5 34.5 25.8 891.8 59.48 5.74 2 −0.33 20.73 1 2 1 1 1 15 3 87 21.7 71.6 14.9 1067 51.52 6.87 2 87.1 21.7 73.5 15.3 1125 48.89 7.25 2 5.16 0.00 2 2 2 1 0 16 3 86.8 27.5 34.6 25.8 894.7 59.35 5.76 2 87.1 21.7 73.5 15.3 1125 48.89 7.25 2 20.47 0.00 2 1 1 2 1 17 6 4 86.3 21.7 35 20.3 712.2 67.64 4.59 2 86.5 21.7 76 9.7 738 66.47 4.75 2 3.50 30.38 2 2 2 1 1 18 3 86.6 15.8 71 14.9 1060 51.84 6.83 1 86.6 15.8 71 14.9 1060 51.84 6.83 1 0.00 0.00 3 2 2 2 0 19 3 86.3 21.7 35 20.3 712.2 67.64 4.59 2 86.6 15.8 71 14.9 1060 51.84 6.83 1 32.81 0.00 3 1 2 2 1 20 7 4 85.5 15.8 72.9 9.5 690.8 68.61 4.45 2 85.9 15.8 74.9 9.7 726.1 67.01 4.68 2 4.86 0.00 3 2 2 2 1
Figure A4. (I-V) and (P-V) Characteristic curves of the PV 2 × 4 system under different numbers of shaded modules as follow: ( a ) One shaded module, ( b ) Two shaded modules, ( c ) Three shaded modules, ( d ) Four shaded modules, ( e ) Five shaded modules, ( f ) Six shaded modules, and ( g ) Seven shaded modules.
Figure A4. (I-V) and (P-V) Characteristic curves of the PV 2 × 4 system under different numbers of shaded modules as follow: ( a ) One shaded module, ( b ) Two shaded modules, ( c ) Three shaded modules, ( d ) Four shaded modules, ( e ) Five shaded modules, ( f ) Six shaded modules, and ( g ) Seven shaded modules.
Table A5. System 2 × 5 case studies and the resulted data.
Table A5. System 2 × 5 case studies and the resulted data.
Case Number. Number of Shaded Modules Partial Shading Pattern Series-Parallel Total-Cross-Tied K T % K RT % V OC I SC V GMPP I GMPP P GMPP PL % Efficiency % Number of Local MPPs V OC I SC V GMPP I GMPP P GMPP PL % Efficiency % Number of Local MPPs 0 0 0 89.4 41.6 70.2 39.2 2751 0.00 14.18 1 89.4 41.6 70.2 39.2 2751 0.00 14.18 1 0.00 0.00 0 0 0 0 0 0 1 1 1 89.4 41.6 70.5 33.7 2376 13.63 12.24 2 89 41.6 71.7 34.5 2475 10.03 12.76 2 4.00 0.00 0 1 0 0 0 0 2 2 2 88.6 41.6 71 28.2 2002 27.23 10.32 2 88.7 41.6 73.2 29 2124 22.79 10.95 2 5.74 10.38 0 1 1 0 0 0 3 1 88.6 41.6 71 28.2 2002 27.23 10.32 2 88.7 35.8 70.3 33.7 2370 13.85 12.21 1 15.53 0.00 1 1 1 0 0 0 4 1 88.7 35.8 70.3 33.7 2370 13.85 12.21 1 88.7 35.8 70.3 33.7 2370 13.85 12.21 1 0.00 0.00 1 2 0 0 0 0 5 3 3 88.3 41.6 71.8 22.7 1630 40.75 8.40 2 88.3 41.6 74.6 23.4 1745 36.57 8.99 2 6.59 16.31 0 1 1 1 0 0 6 2 88.4 35.8 70.7 28.2 1995 27.48 10.28 2 88.4 35.8 72.1 28.9 2085 24.21 10.75 2 4.32 0.00 1 2 1 0 0 0 7 2 88.3 41.6 71.8 22.7 1630 40.75 8.40 2 88.4 35.8 72.1 28.9 2085 24.21 10.75 2 21.82 0.00 1 1 1 1 0 0 8 4 4 87.8 41.6 34.9 39.1 1366 50.35 7.04 2 87.9 41.6 75.9 17.8 1348 51.00 6.95 2 −1.34 32.26 0 1 1 1 1 0 9 3 87.9 35.8 71.4 22.7 1622 41.04 8.36 2 88 35.8 73.8 23.4 1725 37.30 8.89 2 5.97 13.32 1 2 1 1 0 0 10 3 87.8 41.6 34.9 39.1 1366 50.35 7.04 2 87.8 41.6 34.9 39.1 1366 50.35 7.04 2 0.00 31.36 1 1 1 1 1 0 11 2 88 30 70.5 28.2 1990 27.66 10.26 1 88 30 70.5 28.2 1990 27.66 10.26 1 0.00 0.00 2 2 2 0 0 0 12 2 87.9 35.8 71.4 22.7 1622 41.04 8.36 2 88 30 70.5 28.2 1990 27.66 10.26 1 18.49 0.00 2 1 2 1 0 0 13 2 87.8 41.6 34.9 39.1 1366 50.35 7.04 2 88 30 70.5 28.2 1990 27.66 10.26 1 31.36 0.00 2 1 1 1 1 0 14 5 5 87.3 41.6 34.3 39.2 1348 51.00 6.95 1 87.3 41.6 34.3 39.2 1348 51.00 6.95 1 0.00 20.43 0 1 1 1 1 1 15 4 87.4 35.8 72.8 17.2 1255 54.38 6.47 2 87.6 35.8 75.3 17.8 1337 51.40 6.89 2 6.13 21.07 1 2 1 1 1 0 16 4 87.3 41.6 34.3 39.2 1348 51.00 6.95 1 87.6 35.8 75.3 17.8 1337 51.40 6.89 2 −0.82 21.07 1 1 1 1 1 1 17 3 87.6 30 71.1 22.7 1616 41.26 8.33 2 87.7 30 72.6 23.3 1694 38.42 8.73 2 4.60 0.00 2 2 2 1 0 0 18 3 87.4 35.8 72.8 17.2 1255 54.38 6.47 2 87.7 30 72.6 23.3 1694 38.42 8.73 2 25.91 0.00 2 1 1 2 1 0 19 3 87.3 41.6 34.3 39.2 1348 51.00 6.95 1 87.7 30 72.6 23.3 1694 38.42 8.73 2 20.43 0.00 2 1 1 1 1 1 20 6 5 86.9 35.8 34.6 33.7 1164 57.69 6.00 2 87 35.8 34.5 33.7 1161 57.80 5.98 2 −0.26 27.84 1 2 1 1 1 1 21 4 87.1 30 72.2 17.3 1245 54.74 6.42 2 87.2 30 74.5 17.8 1323 51.91 6.82 2 5.90 17.78 2 2 2 1 1 0 22 4 86.9 35.8 34.6 33.7 1164 57.69 6.00 2 87.2 30 74.5 17.8 1323 51.91 6.82 2 12.02 17.78 2 1 1 1 2 1 23 3 87.3 24.1 70.7 22.8 1609 41.51 8.29 1 87.3 24.1 70.7 22.8 1609 41.51 8.29 1 0.00 0.00 3 2 2 2 0 0 24 3 87.1 30 72.2 17.3 1245 54.74 6.42 2 87.3 24.1 70.7 22.8 1609 41.51 8.29 1 22.62 0.00 3 1 2 2 1 0 25 3 86.9 35.8 34.6 33.7 1164 57.69 6.00 2 87.3 24.1 70.7 22.8 1609 41.51 8.29 1 27.66 0.00 3 1 1 2 1 1 26 7 5 86.5 30 34.8 28.2 981.3 64.33 5.06 2 86.6 30 34.6 28.2 975 64.56 5.02 2 −0.65 25.00 2 2 2 1 1 1 27 4 86.7 24.1 71.6 17.3 1237 55.03 6.37 2 86.8 24.1 73.4 17.7 1300 52.74 6.70 2 4.85 0.00 3 2 2 2 1 0 28 4 86.5 30 34.8 28.2 981.3 64.33 5.06 2 86.8 24.1 73.4 17.7 1300 52.74 6.70 2 24.52 0.00 3 1 1 2 2 1 29 8 5 86.1 24.1 73.6 11.9 872.6 68.28 4.50 2 86.2 24.1 75.6 12.1 917.5 66.65 4.73 2 4.89 25.41 3 2 2 2 1 1 30 4 86.4 18.3 71.2 17.3 1230 55.29 6.34 1 86.4 18.3 71.2 17.3 1230 55.29 6.34 1 0.00 0.00 4 2 2 2 2 0 31 4 86.1 24.1 73.6 11.9 872.6 68.28 4.50 2 86.4 18.3 71.2 17.3 1230 55.29 6.34 1 29.06 0.00 4 2 2 2 1 1 32 9 5 85.7 18.3 72.7 11.8 860.9 68.71 4.44 2 85.8 18.3 74.5 12.1 903.2 67.17 4.65 2 4.68 0.00 4 2 2 2 2 1
Figure A5. (I-V) and (P-V) characteristic curves of the PV 2 × 5 system under different numbers of shaded modules as follow: ( a ) One shaded module, ( b ) Two shaded modules, ( c ) Three shaded modules, ( d ) Four shaded modules, ( e ) Five shaded modules, ( f ) Six shaded modules, ( g ) Seven shaded modules, ( h ) Eight shaded modules, and ( i ) Nine shaded modules.
Figure A5. (I-V) and (P-V) characteristic curves of the PV 2 × 5 system under different numbers of shaded modules as follow: ( a ) One shaded module, ( b ) Two shaded modules, ( c ) Three shaded modules, ( d ) Four shaded modules, ( e ) Five shaded modules, ( f ) Six shaded modules, ( g ) Seven shaded modules, ( h ) Eight shaded modules, and ( i ) Nine shaded modules.
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MANUALZZ the Universal Manuals Library, STP275_270_24Vd1. Available online: https://manualzz.com/doc/10607158/stp275_270_24vd1 (accessed on 3 January 2022).
Figure 1. Single diode model PV equivalent circuit.
Figure 1. Single diode model PV equivalent circuit.
Figure 2. Default MATLAB Simulink model.
Figure 3. I-V and P-V curves at different radiation levels ( a ) Simulation results ( b ) Datasheet curves.
Figure 3. I-V and P-V curves at different radiation levels ( a ) Simulation results ( b ) Datasheet curves.
Figure 4. Examples to explain the simplifying method.
Figure 4. Examples to explain the simplifying method.
Figure 5. Diagram explaining the research methodology.
Figure 5. Diagram explaining the research methodology.
Figure 6. Bar chart of the output power for all 2 × 2 system cases.
Figure 6. Bar chart of the output power for all 2 × 2 system cases.
Figure 7. Bar chart of the output power for all 3 × 3 system cases.
Figure 7. Bar chart of the output power for all 3 × 3 system cases.
Figure 8. Bar chart of the output power for all 2 × 3 system cases.
Figure 9. Bar chart of the output power for all 2 × 4 system cases.
Figure 9. Bar chart of the output power for all 2 × 4 system cases.
Figure 10. Bar chart of the output power for all 2 × 5 system cases.
Figure 10. Bar chart of the output power for all 2 × 5 system cases.
Table 1. Electrical characteristics of Suntech Power STD275-24-Vd PV module.
Table 1. Electrical characteristics of Suntech Power STD275-24-Vd PV module.
Parameter Value Maximum power (W) 275.184 Cells per module Ns 72 Open circuit voltage (V) 44.7 Short circuit current (A) 8.26 Voltage at maximum power point (V) 35.1 Current at maximum power point (A) 7.84 Voltage temperature coefficient (%/°C) −0.313 Current temperature coefficient (%/°C) 0.053995 Diode saturation current I 0 at STC (A) 4.8633 × 10 − 11 Diode ideality factor 0.93444 Shunt resistance (Ω) 830.73 Series resistance (Ω) 0.57826 Module efficiency at STC 14.2% Dimension 1.956 m × 0.992 m
Table 2. Number of possible shading patterns before and after applying the simplifying method.
Table 2. Number of possible shading patterns before and after applying the simplifying method.
System Number of PS Patterns Can Be Simplified to a Repeated Distinguish Patterns Number of 2 × 2 4C1 = 4 1 4C2 = 6 3 4C3 = 4 1 Total = (14) Total = (5) 2 × 3 6C1 = 6 1 6C2 = 15 3 6C3 = 20 3 6C4 = 15 3 6C5 = 6 1 Total = (62) Total = (11) 2 × 4 8C1 = 8 1 8C2 = 28 3 8C3 = 56 3 8C4 = 70 6 8C5 = 56 3 8C6 = 28 3 8C7 = 8 1 Total = (254) Total = (20) 3 × 3 9C1 = 9 1 9C2 = 36 3 9C3 = 84 6 9C4 = 126 6 9C5 = 126 6 9C6 = 84 6 9C7 = 36 3 9C8 = 9 1 Total = (510) Total = (32) 2 × 5 10C1 = 10 1 10C2 = 45 3 10C3 = 120 3 10C4 = 210 6 10C5 = 252 6 10C6 = 210 6 10C7 = 120 3 10C8 = 45 3 10C9 = 10 1 Total = (1022) Total = (32) Five systems Total = 1862 Total = 100
Table 3. All possible numbers of improved cases according to the configuration.
Table 3. All possible numbers of improved cases according to the configuration.
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Doing Business in the 21st Century with the New Generation of Chinese Managers: A Study of Generational Shifts in Work Values in China | Request PDF
Request PDF | Doing Business in the 21st Century with the New Generation of Chinese Managers: A Study of Generational Shifts in Work Values in China | Our goal is to develop a profile of Chinese managers, and in particular a profile of the New Generation of Chinese managers. The purpose for... | Find, read and cite all the research you need on ResearchGate
Doing Business in the 21st Century with the New Generation of Chinese Managers: A Study of Generational Shifts in Work Values in China
February 1999
Journal of International Business Studies 30(2):415-427
DOI: 10.1057/palgrave.jibs.8490077
Authors:
Sally Stewart
Abstract
Our goal is to develop a profile of Chinese managers, and in particular a profile of the New Generation of Chinese managers. The purpose for developing this profile is primarily to provide relevant information for non-Chinese business people, especially Westerners, who plan to engage in business in China. This profile is based on measures of individual values (Individualism, Collectivism and Confucianism) relevant to China and business. Our findings suggest that the New Generation manager is more individualistic and more likely to act independently, while taking risks in the pursuit of profits. However, these New managers are, likewise, not forsaking their Confucian values. Thus, they may be viewed as crossverging their Eastern and Western influences, while on the road of modernization.© 1999 JIBS. Journal of International Business Studies (1999) 30, 415–427
2.3+ billion citations
... In the openness to change dimension, this study found that work meaningfulness has a role in bridging the relationship between openness to change toward work engagement. This finding contradicts a study by
Ralston et al. (1999)
that stated how individuals who value openness to new things and enjoy challenges tend to be incapable of focusing on what must be done. This is because individuals who value openness to change will consistently attempt to change and enjoy new challenges, hence they will try to seek better work opportunities in other places and seek better opportunities at what they think they are good at, which makes them to sustain or focus less on their jobs. ...
... Pada dimensi openness to change, studi ini menemukan bahwa work meaningfulness memiliki peran sebagai jembatan dalam hubungan openness to change terhadap work engagement. Temuan ini berkontradiksi dengan hasil studi oleh
Ralston et al. (1999)
yang menyatakan bahwa individu dengan nilai hidup terbuka pada hal baru dan menyukai tantangan cenderung tidak dapat berfokus pada apa yang dilakukan. Hal ini dikarenakan individu dengan nilai hidup terbuka pada perubahan selalu berusaha untuk berubah dan menyukai tantangan baru, sehingga mereka selalu berusaha untuk mengejar kesempatan kerja yang lebih baik di tempat lain dan mencari kesempatan yang mereka nilai lebih baik, yang menyebabkan mereka tidak bertahan lama dan berfokus pada pekerjaannya. ...
Schwartz’s Values, Perceived Organizational Support (POS), and Work Engagement: The Mediating Role of Work Meaningfulness [Schwartz’s Values, Perceived Organizational Support (POS), dan Work Engagement: Peran Mediasi dari Work Meaningfulness]
Conditions of the situation after the COVID-19 pandemic have an impact on the phenomenon of employee work engagement. Employees who are accustomed to working from home are asked to adjust to the new work design such as hybrid working. By having values and perceived organizational support (POS), employees who can find work meaningfulness will have higher work engagement in any work design after the COVID-19 pandemic. This study aims to examine the role of work meaningfulness as a mediator in the relationship between perceived organizational support (POS) and values toward work engagement. The data collection was carried out online and involved 220 Indonesian employees who worked in various fields. Study participants were recruited by purposive sampling method. Instruments of this study consist of the Survey of Perceived Organizational Support (SPOS), Portrait Values Questionnaire (PVQ), The Work and Meaning Inventory (WAMI), and Utrecht Work Engagement Scale (UWES). The data analysis in this study utilized the PROCESS mediation analysis. The results showed that work meaningfulness significantly had a mediating effect on perceived organizational support (POS) toward work engagement (β = .743; p < .001). Woek meaningfulness also had a mediating effect on values toward work engagement (β = .581; p < .001). Especially for values, work meaningfulness had a significant mediating effect on self-transcendence (β = .129; p < .01), openness to change (β = .120; p < .05), and conservation (β = .220; p < .01), but has no mediation effect on self-enhancement towards work engagement (β = .108; p > .05). This result confirms that having meaningfulness experience during working would increase the role of situational factors (perceived organizational support [POS]) and individual factor (values) toward work engagement. Kondisi pasca pandemi COVID-19 berdampak pada fenomena work engagement karyawan di tempat kerja. Karyawan yang terbiasa bekerja dari rumah diminta untuk menyesuaikan diri dengan desain kerja baru yang berupa hybrid working. Dengan memiliki values dan perceived organizational support (POS), karyawan yang dapat menemukan work meaningfulness akan memiliki work engagement yang lebih tinggi pada kondisi desain kerja apapun pasca pandemi COVID-19. Studi ini bertujuan menguji peran work meaningfulness sebagai mediator dalam hubungan antara perceived organizational support (POS) dan values terhadap work engagement. Pengumpulan data studi dilakukan secara daring dengan melibatkan 220 karyawan dari berbagai bidang. Partisipan studi direkrut dengan metode purposive sampling. Pengumpulan data menggunakan Survey of Perceived Organizational Support (SPOS), Portrait Values Questionnaire (PVQ), The Work and Meaningful Inventory (WAMI), dan Utrecht Work Engagement Scale (UWES). Analisis data menggunakan uji mediasi PROCESS. Hasil studi menunjukkan bahwa work meaningfulness secara signifikan memiliki efek mediasi pada perceived organizational support (POS) terhadap work engagement (β = 0,743; p < 0,001). Work meaningfulness juga mampu memediasi hubungan antara values dan work engagement (β = 0,581; p < 0,001). Khusus untuk variable values, work meaningfulness memiliki efek mediasi pada dimensi self-trancendence (β = 0,129; p < 0,01), openness to change (β = 0,120; p < 0,05), dan conservation (β = 0,220; p < 0,01) terhadap work engagement, namun pada dimensi self-enhancement, work meaningfulness tidak memiliki efek mediasi dalam hubungan antara self-enhancement terhadap work engagement (β = 0,108; p > 0,05). Hasil tersebut mengkonfirmasi bahwa memiliki pengalaman meaningful selama bekerja dapat meningkatkan peran faktor situasional (perceived organizational support [POS]) dan faktor individual (values) terhadap work engagement.
... Specifically for the Chinese context, the Chinese Cultural Connection (1987) study led by Michael Bond highlighted the importance of cultural values, and sparked off a number of peripheral studies about the uniqueness of the Chinese context. These are reviewed next for their relevance to a modern China, as particularly argued by
Ralston et al. (1999)
, China's rapid economic development since the 1970s has (already) resulted in significant generational shifts in work values (notwithstanding the impact of Industry 4.0). Thus, commonly associated Confucius values (see also Chau, 2013) have different meanings between the latter and present generations, which make it even more necessary to revisit the topic today. ...
... In a similar vein,
Ralston et al. (1999)
concluded that the rapid economic development in China since her opening-up policy could have the greatest influence in work values among different generations: more individualistic and less Confucian value ideologies were exposed to the new generation of Chinese managers compared with older ones. The combination of power distance and Chinese traditionality has been found to impact on organizational support and work outcomes, although power distance presented a stronger moderating effect than Chinese traditionalism (Farh et al., 2007). ...
Insights on measuring China’s new national culture from leaders of the Fourth Industrial Revolution
Ruiqi Zhang
Liyan Tang
Understanding China’s national culture is increasingly important for enabling greater international collaborative activities as China takes her central stage in the global arena. However, the country’s rapid modernization, such as through leading innovations in Industry 4.0 (specifically the ‘Made in China 2025’ policy), may have provoked a cultural turn that is difficult to capture with existing cultural measurement tools. This study conducted interviews with leaders of Chinese establishments that have updated their operations to the Industry 4.0 specification to understand their impact on general perception and workplace culture. Based on these insights, this article argues that existing models for measuring national culture are not necessarily being old that makes them unsuitable for application to a ‘new’ China but that Chinese establishments operating Industry 4.0 are a unique case for which generalized models can no longer be universally applicable. Instead, augmented/alternative cultural dimensions are suggested as new theoretical constructs for this unique context.
... In addition, individuals differ in their willingness to take responsibility for their harmful acts (Berscheid & Walster, 1967), especially due to different moral values rooted in culture. In Chinese society, Confucianism greatly shapes people's moral values despite the founding of the new China creating social change
(Ralston, Egri, Stewart, Terpstra, & Kaicheng, 1999)
. Confucian values have three elements, with ren emphasizing benevolence to or compassion for others (Wright & Twitchett, 1962), yi representing the principle of moral rightness (Cheng, 1972), and li specifying many concrete norms for social relationships (Wright & Twitchett, 1962). ...
... Moreover, when those around firm leaders also hold Confucian values, these individuals are likely to sensitize or even pressure firm leaders to accept responsibility for the harm. The impact of Confucian values varies across China due to its geographical vastness and the existence of many ethnic groups with subcultures
(Ralston et al., 1999)
. Thus, in areas with a stronger Confucian influence, leaders of privatized SOEs are more likely to recognize and feel responsible for the distress experienced by laid-off SOE workers and their families as a result of privatization and thus make restitution later through corporate philanthropy. ...
Guilt and Corporate Philanthropy: The Case of the Privatization in China
Firms’ harm-inflicting decisions/actions can make firm leaders feel guilt toward those who are harmed, which then motivates them to make restitution through corporate philanthropy. Our primary setting for investigating this proposition is the privatization of Chinese firms. We argue that massive layoffs resulting from privatization triggered guilt among firm leaders to drive corporate philanthropy. The analysis of a national survey of Chinese private firms shows that on average privatized firms made approximately 26% more charitable contributions than firms founded as private. This was particularly the case when (a) privatization resulted in layoffs (vs. no layoffs), (b) the firms’ provinces experienced greater unemployment at the time of privatization, (c) the firms’ leaders were directly involved in privatization, (d) the influence of Confucianism was stronger in their provinces, and (e) firm leaders had stronger ties with laid-off workers. An interview-based field study of 25 firm leaders involved in privatization provides qualitative evidence of the influence of guilt on privatized firms’ philanthropy. Finally, a vignette experiment conducted on EMBA students shows the mediation of guilt between privatization and firms’ philanthropic intention. These findings establish guilt as a potent emotional driver of corporate philanthropy, helping redirect the attention of corporate philanthropy research toward nonfinancial drivers.
... To address the research questions, a qualitative content analysis approach was used on a dataset obtained from interviews with managers from various backgrounds. Qualitative content analysis aims to interpret textual data through systematic classification process, with special consideration to their context, in order to identify the core concepts within the data
(Mayring, 2010;
Zhang and Wildemuth, 2016). It was chosen as method of inquiry because it is consistent with our research goal: during the data analysis, our goal was to identify the main concepts from the interviewees' narratives which relate to our research questions and provide a comparison between the concepts of The Analects, the concepts of international management literature on Confucian management and our empirical results. ...
... With all these considered, Confucianism is not the only ancient ideology impacting Chinese leadership ethics: Daoism, Mohism and Legalism also have had an influence (Cheung and Chan, 2005) -and there are many other cultural backdrops behind Chinese management. Therefore, and even though their impact is less emphasized and claimed to be less independent
(Ralston et al., 1999)
, the focus on Confucianism can also be considered as a limitation of this paper. ...
Does Confucius have a say in management today Empirical evidence from Asia and Europe
With the growing number of Sino-European business transactions, the cooperation of Chinese and European managers is becoming an increasingly important topic. In the theoretical foundation, we review the main concepts of Confucianism and apply them for modern management. The result is a conceptual framework which is tested in the empirical part, based on the results of more than 30 interviews. The data gained from Chinese managers was compared with that of a control group consisting of managers of European and Asian origin. The methodology and the findings of this research enabled us to discover more subtle differences between the concepts of Confucianism, Chinese, and Western management practices.
View
Show abstract
... We specifically focus on job demands as the push factors that affect Chinese migrant workers' decision to leave their urban job (i.e. the health-impairment process) and entrepreneurial resources as the pull factors that increase Chinese migrant workers' intention to seek self-employment as a career choice in their hometown (i.e. the motivational process) (Xanthopoulou et al. 2007). Further, given the significant economic, political, and social changes in transitional China and the effect of these changes on the work-value orientation of different generations of workers (Dou, Wang, and Zhou 2006;Egri and Ralston 2004;
Ralston et al. 1999)
, we attempt to discover whether there is any discrepancy in the antecedents of entrepreneurial intention between the 'new' and 'old' generations of migrant workers in China. ...
... Significant economic, political, and social changes in transitional China in the past decades have had significant effects on the work values of different generations of Chinese people (Dou, Wang, and Zhou 2006;Egri and Ralston 2004;
Ralston et al. 1999)
. The older and younger generations of migrant workers have had very different experiences in their growth environments, work participation, value orientation, and entrepreneurial spirit. ...
Should I stay or should I go? Job demands' push and entrepreneurial resources' pull in Chinese migrant workers' return-home entrepreneurial intention
... Individualism is defined as a self-orientation that puts more emphasis on autonomy and control
(Ralston, Egri, Stewart, Terpstra, & Kaicheng, 1999)
, whereas collectivism is defined as group-orientation that attaches more importance to group interests and compliance (Ho & Chiu, 1994). Triandis (1995) stated that individualists are mainly driven by their own needs, preferences and rights, giving priority to themselves rather than to group. ...
... German people have a characteristic of individualism through autonomy and independence (Kühlmann & Rabl, 2009). While Chinese people are often portrayed as collectivist (Hsu, 1981;Hui & Triandis, 1986;Liu et al., 2007) and are depicted by the Confucian rules of face-saving (Boisot & Child, 1996;Liu et al., 2007;
Ralston et al., 1999;
Ralston, Kai-Cheng, Wang, Terpstra, & Wei, 1996;Redding, 1990) and forbearance (Hwang, 1997). Collectivist Chinese tend to accept one's fate, maintain harmony in a group, and give priority to group needs, interests and compliance rather than to themselves (Liu et al., 2007). ...
Stress Management at the Workplace: A Comparative Study between Chinese and German Companies
Thesis
Sep 2020
Although extensive scholarly and practical attention has been paid to workplace stress in cross-cultural settings over the past decades, the comparative studies on workplace stress management between Chinese and German companies remain elusive. To fill this research gap, a comparative study on stress management at the workplace between Chinese and German companies has been conducted in two culturally different countries: China and Germany. To obtain a relatively comprehensive and accurate comparison of stress management at the workplace between Chinese and German companies, four new scales, namely Sources of Work Stress Scale, Coping with Stress Scale, Health and Well-being Scale, and Job Satisfaction Scale, have been developed and validated by several empirical studies with German and Chinese samples. The softwares SPSS 22, Smart PLS 3 and Amos 22 were used to test the factor structure, reliability, validity and the cross-cultural equivalence for each scale. The aim of these important steps is to lay a solid foundation for the current comparative study and ensure the validity of the research results. After the reliability, validity and cross-cultural equivalence were all established by several pre-surveys with Chinese and German samples, the formal questionnaire surveys with four scales were conducted in Chinese and German companies. Participants could finish either the paper-and-pencil version or the online version of questionnaires. In China, participants were randomly chosen from a variety of industries in different cities. Correspondingly, German participants were randomly selected from various industries in different cities in Germany. The independent-samples t test and effect size statistics were conducted to identify whether there are some significant differences between Chinese and German employees’ sources of work stress, coping with stress at work, and the consequences of work stress, such as health and well-being, and job satisfaction. Results of hypotheses testing regarding Chinese and German employees’ sources of work stress indicate that all the hypotheses were supported except one hypothesis. Specifically speaking, compared with their German counterparts, Chinese employees reported significantly more stress caused by workload, competition and comparison, role uncertainty, lack of control, pay and career prospects, lack of competency, relationships at work, and boredom at work. However, Chinese employees did not report significantly more stress caused by work-life balance compared with German employees. Results of hypotheses testing regarding Chinese and German employees’ coping with stress indicate that Chinese employees use positive thinking and self-blame as ways to deal with stress more often compared with their German counterparts. German employees use physical exercises, leisure and relaxation, and problem-solving coping as ways to deal with stress more often than their Chinese counterparts. Results of hypotheses testing show that German employees use religious coping as a way to deal with stress not significantly more often than Chinese employees. However, German employees use acceptance as a way to deal with stress more often rather than less often compared with their Chinese counterparts. Results of hypotheses testing regarding Chinese and German employees’ job satisfaction indicate that German employees reported significantly higher level of job satisfaction than their Chinese counterparts. Results of hypotheses testing regarding Chinese and German employees’ physical health and psychological well-being find that there is no significant difference between Chinese employees and German employees in physical health and there is also no significant difference between Chinese employees and German employees in psychological well-being. The correlation analyses were also conducted in both samples to observe the relationship between health and well-being and job satisfaction as well as the relationship between job satisfaction and turnover intention. Results of hypotheses testing find that the problems of physical health and the problems of psychological well-being are both negatively related to the level of job satisfaction in German samples. In Chinese samples, the problems of physical health are not significantly related to job satisfaction, only the problems of psychological well-being are negatively related to the level of job satisfaction. Results of hypotheses testing indicate that the job satisfaction is negatively related to turnover intention in both samples. Employees who report higher levels of job satisfaction will report lower intention to quit.
... States (Centers and Bugantal, 1966) and Japan (Worthley et al., 2009) found that women in the workplace placed a higher value on relationships with others than men did. Similarly, Chinese women were reported to tend to value collectivism more highly than men did
(Ralston et al., 1999)
. Empirical studies found perceived coworker support (Sloan, 2017) or satisfaction with co-workers (Boles et al., 2007) were more strongly related to OC for women than for men. ...
... Broadly, intrinsic rewards affected male OC more, while social rewards affected female OC more. These results support our hypotheses derived from prior studies (Gilligan, 1982;Gneezy et al., 2003;Hitotsuyanagi-Hansel et al., 2016;Keller et al., 2015;Law et al., 2009;
Ralston et al., 1999;
Sebastian Reiche, 2007;Tannen, 1994). To our knowledge, this study is the first to explain the difference in the OC-rewards relationship between male and female employees in companies with different national cultures. ...
Gender differences in organizational commitment and rewards within Japanese manufacturing companies in China
Abstract
Purpose – The purpose of this paper is to investigate gender differences in organizational commitment (OC)
and the relationship between OC and rewards among employees who work for Japanese manufacturing
companies within China.
Design/methodology/approach – This study utilized hierarchical regression analysis to examine survey
data obtained from 27,854 employees who worked for 64 Japanese manufacturing companies within China.
Findings – The results reveal that autonomy and role clarity had a stronger influence, and co-worker support
had a weaker influence, on OC for male employees than for female employees. These differences may be
because more male employees than female employees prefer working with higher autonomy and well-defined
roles than with co-worker support. After all, male employees, who place a great emphasis on independence,
competition, decision-making and challenges, rely on intrinsic rewards more than social rewards.
Research limitations/implications – This study used data collected from Japanese manufacturing
companies to understand the differences between OC and rewards in local male and female Chinese employees.
We recommend that future research uses other national affiliates to clarify the characteristics of male and
female Chinese workers more objectively and to test the validity of this research.
Practical implications – The results of this study support revising human resource management practices
within multinational enterprises to enable female and male host-country workers to contribute to their companies
on a long-term basis by taking into account the differences between the cultures of the home and host countries.
Originality/value – Although previous research has elucidated the OC–rewards relationship in particular
countries, it has not met the requirements of foreign managers from different corporate cultures who face
differences in the OC–rewards relationship between their male and female employees. In this sense, this
research is the first attempt to tackle this theme and contribute to the literature.
Keywords Exploratory factor analysis, Gender, Japanese manufacturing companies, China, Organizational
commitment, Rewards
Paper type Research paper
... Chinese society, Confucian culture greatly shapes moral values despite social changes after the founding of the new China
(Ralston, Egri, Stewart, Terpstra, & Kaicheng, 1999)
. Confucian values have three elements, with ren emphasizing benevolence to or compassion for others (Wright & Twitchett, 1962), yi representing the principle of moral rightness (Cheng, 1972), and li specifying many concrete norms for social relationships (Wright & Twitchett, 1962 (Ralston et al., 1999). ...
... Chinese society, Confucian culture greatly shapes moral values despite social changes after the founding of the new China (Ralston, Egri, Stewart, Terpstra, & Kaicheng, 1999). Confucian values have three elements, with ren emphasizing benevolence to or compassion for others (Wright & Twitchett, 1962), yi representing the principle of moral rightness (Cheng, 1972), and li specifying many concrete norms for social relationships (Wright & Twitchett, 1962
(Ralston et al., 1999)
. Thus, in areas with stronger influence of Confucianism, leaders of privatized SOEs are more likely to recognize and feel responsible for the distress experienced by laid-off SOE workers and their families as a result of privatization and thus make restitution later through corporate philanthropy. ...
Guilt and Corporate Philanthropy: The Case of the Privatization in China
Firms' harm-inflicting decisions/actions can make firm leaders feel guilt toward those who are harmed, which then motivates them to make restitution through corporate philanthropy. Our primary setting for investigating this proposition is the privatization of Chinese firms. We argue that massive layoffs resulting from privatization triggered guilt among firm leaders to drive corporate philanthropy. The analysis of a national survey of Chinese private firms shows that on average privatized firms made approximately 26% more charitable contributions than firms founded as private. This is particularly the case when (1) privatization resulted in layoffs (vs. no layoffs), (2) their provinces experienced greater unemployment at the time of privatization, (3) their leaders were directly involved in privatization, (4) the influence of Confucianism was stronger in their provinces, and (5) firm leaders had stronger ties with laid-off workers. An interview-based field study of 25 firm leaders involved in privatization provides qualitative evidence for the influence of guilt on privatized firms' philanthropy. Finally, a vignette experiment conducted on EMBA students shows the mediation of guilt between privatization and firms' philanthropy intention. These findings establish guilt as a potent emotional driver of corporate philanthropy, helping redirect the attention of corporate philanthropy research to non-financial drivers. ABSTRACT Firms' harm-inflicting decisions/actions can make firm leaders feel guilt toward those who are harmed, which then motivates them to make restitution through corporate philanthropy. Our primary setting for investigating this proposition is the privatization of Chinese firms. We argue that massive layoffs resulting from privatization triggered guilt among firm leaders to drive corporate philanthropy. The analysis of a national survey of Chinese private firms shows that on average privatized firms made approximately 26% more charitable contributions than firms founded as private. This is particularly the case when (1) privatization resulted in layoffs (vs. no layoffs), (2) their provinces experienced greater unemployment at the time of privatization, (3) their leaders were directly involved in privatization, (4) the influence of Confucianism was stronger in their provinces, and (5) firm leaders had stronger ties with laid-off workers. An interview-based field study of 25 firm leaders involved in privatization provides qualitative evidence for the influence of guilt on privatized firms' philanthropy. Finally, a vignette experiment conducted on EMBA students shows the mediation of guilt between privatization and firms' philanthropy intention. These findings establish guilt as a potent emotional driver of corporate philanthropy, helping redirect the attention of corporate philanthropy research to non-financial drivers.
... Chinese society, Confucian culture greatly shapes moral values despite social changes after the founding of the new China
(Ralston, Egri, Stewart, Terpstra, & Kaicheng, 1999)
. Confucian values have three elements, with ren emphasizing benevolence to or compassion for others (Wright & Twitchett, 1962), yi representing the principle of moral rightness (Cheng, 1972), and li specifying many concrete norms for social relationships (Wright & Twitchett, 1962 (Ralston et al., 1999). ...
... Chinese society, Confucian culture greatly shapes moral values despite social changes after the founding of the new China (Ralston, Egri, Stewart, Terpstra, & Kaicheng, 1999). Confucian values have three elements, with ren emphasizing benevolence to or compassion for others (Wright & Twitchett, 1962), yi representing the principle of moral rightness (Cheng, 1972), and li specifying many concrete norms for social relationships (Wright & Twitchett, 1962
(Ralston et al., 1999)
. Thus, in areas with stronger influence of Confucianism, leaders of privatized SOEs are more likely to recognize and feel responsible for the distress experienced by laid-off SOE workers and their families as a result of privatization and thus make restitution later through corporate philanthropy. ...
Guilt and Corporate Philanthropy: The Case of the Privatization in China
Qi Li
Heli Wang
Junkang Ji
Zhi Huang
Firms' harm-inflicting decisions/actions can make firm leaders feel guilt toward those who are harmed, which then motivates them to make restitution through corporate philanthropy. Our primary setting for investigating this proposition is the privatization of Chinese firms. We argue that massive layoffs resulting from privatization triggered guilt among firm leaders to drive corporate philanthropy. The analysis of a national survey of Chinese private firms shows that on average privatized firms made approximately 26% more charitable contributions than firms founded as private. This is particularly the case when (1) privatization resulted in layoffs (vs. no layoffs), (2) their provinces experienced greater unemployment at the time of privatization, (3) their leaders were directly involved in privatization, (4) the influence of Confucianism was stronger in their provinces, and (5) firm leaders had stronger ties with laid-off workers. An interview-based field study of 25 firm leaders involved in privatization provides qualitative evidence for the influence of guilt on privatized firms' philanthropy. Finally, a vignette experiment conducted on EMBA students shows the mediation of guilt between privatization and firms' philanthropy intention. These findings establish guilt as a potent emotional driver of corporate philanthropy, helping redirect the attention of corporate philanthropy research to non-financial drivers. ABSTRACT Firms' harm-inflicting decisions/actions can make firm leaders feel guilt toward those who are harmed, which then motivates them to make restitution through corporate philanthropy. Our primary setting for investigating this proposition is the privatization of Chinese firms. We argue that massive layoffs resulting from privatization triggered guilt among firm leaders to drive corporate philanthropy. The analysis of a national survey of Chinese private firms shows that on average privatized firms made approximately 26% more charitable contributions than firms founded as private. This is particularly the case when (1) privatization resulted in layoffs (vs. no layoffs), (2) their provinces experienced greater unemployment at the time of privatization, (3) their leaders were directly involved in privatization, (4) the influence of Confucianism was stronger in their provinces, and (5) firm leaders had stronger ties with laid-off workers. An interview-based field study of 25 firm leaders involved in privatization provides qualitative evidence for the influence of guilt on privatized firms' philanthropy. Finally, a vignette experiment conducted on EMBA students shows the mediation of guilt between privatization and firms' philanthropy intention. These findings establish guilt as a potent emotional driver of corporate philanthropy, helping redirect the attention of corporate philanthropy research to non-financial drivers.
... Dissanaike et al., 2020;Frattaroli, 2020). In addition, individualistic, self-serving Chinese managers are willing to take more risks to pursue profits than managers from previous generations or other countries
(Ralston et al., 1999)
. Aktas et al. (2016) also note that a manager's personal characteristics may result in suboptimal M&A target selection and that acquirers' CARs are negatively correlated with their incumbent CEOs' self-centeredness. ...
Do antitrust laws erode shareholder returns? Evidence from the Chinese market
Sang Jun Cho
Chune Young Chung
Daniel Sungyeon Kim
Using data on 4784 completed mergers and acquisitions in China announced between 2002 and 2016, we find that the adoption of the Chinese Anti-Monopoly Law substantially reduces the shareholder returns for horizontal acquisitions. Based on our findings on reduced post-merger sales and returns, we argue that a loss of market power drives this negative relationship. We also find that the acquiring firms’ cost efficiency does not significantly change as a result of the combination, suggesting that the decline in shareholders’ wealth after horizontal mergers is not because of reduced cost efficiency. Furthermore, we conduct a series of robustness checks to examine how adopting antitrust law decreases the wealth of producing firms’ shareholders. Overall, our results indicate that the government must implement stricter guidelines for antitrust policies to protect consumer welfare.
... Prominent examples are early internet entrepreneurs like Jack Ma or Robin Li 1 , whose companies have since strongly influenced the whole country and have become entrepreneurial role models for people throughout China. That period saw a paradigmatic shift towards Western entrepreneurial values such as independence,individualism, and risk-taking on Chinese businesspeople
(Ralston et al., 1999)
. This shift of values favoured the development of China's entrepreneurial spirit.We suggest updatingDai et al.'s (2019) historical account and argue for adding a fourth type or generation, generation Z, to that classification system. ...
Entrepreneurship in China: Autoethnographic Insights into a Pulsating Entrepreneurial Society
Chapter
Full-text available
Jan 2022
Maximilian Scheu
Andreas Kuckertz
This paper provides a unique perspective on the Chinese entrepreneurial landscape via insights that result from a combination of evidence drawn from the academic literature and the lead author's experience from living for over two years in China. That experience underpins an autoethnographic account of entrepreneurship in China. That account is accompanied by reflections on China's entrepreneurship-backed rise, the idea of mass entrepreneurship, and characteristics of China's environment that affect entrepreneurship. The paper thus offers readers a first impression of the reality of entrepreneurship in China. It also provides real-world entrepreneurial insights into China from a foreign perspective. Those general impressions could equip readers to identify promising research paths and understand differences to the Western system.
... First, our sample only includes university students. It has been shown that values and mindsets differ across generational cohorts that have totally different childhood experience
(Ralston et al., 1999;
Hung et al., 2007;Wang et al., 2022). In the future, scholars should replicate this research in other populations, and, if possible, make a cross-generational comparison to enhance generalizability. ...
Exploring the Antecedents of Money Attitudes in China: Evidence From University Students
Article
Full-text available
Jun 2022
Yuqian Li
Fengfei Hu
With rapid economic growth and institutional reform, the pursuit of money and material possessions has become the most prevalent value in contemporary China. This study focuses on the cultural root of money attitudes among the young adults. Specifically, 332 Chinese university students participated in a survey to report on their need for power, need for achievement, belief in guanxi, and love of money. Confirmatory factor analysis and regression analysis were applied to test the proposed hypotheses. The results show positive influences of need for power and need for achievement on individuals’ love of money. Moreover, belief in guanxi mediates the relationship between need for power and love of money. The application of indigenous cultural concepts in analyzing social behavior in Eastern cultures is emphasized. Limitations and directions for future research are also discussed.
... The lack thereof is associated with less satisfaction and a worse work environment. Research on selfrealization, work values, workplace commitment, work satisfaction, and performance have attracted ample research in recent decades [88], especially due to the relation between these key variables and engagement and work motivation [89]
[90]
[91]. ...
Public Service Motivation and Determining Factors to Attract and Retain Health Professionals in the Public Sector: A Systematic Review
Article
Full-text available
Alexandre Fernandes
Gonçalo Santinha
Teresa Forte
(1) Background: The motivational determinants of health professionals to choose and remain in the public sector have been increasingly addressed, including the customized approach of Public Service Motivation (PSM). However, to date, no systematic research overview has been performed in this domain, leaving the body of literature unstructured. This article fills this gap by assessing the motivational factors of choice for the public sector in the health field, and the conceptual and methodological trends of this research stream. (2) Methods: This study follows the PRISMA protocol to ascertain patterns in past research and inform researchers, practitioners, and policymakers. Eighty-nine documents published between 1998 and 2021 were retained after selecting them according to their theme and outlined goals. (3) Results: Common motivational determinants are remuneration, available resources, work conditions, and frequency of contact and interaction with patients. The PSM construct and scale are often employed as main frameworks, but there is also a concern in assessing motivation drawing on psychological constructs that reflect the challenging line of work and environment that is health care, such as presenteeism, stress, and perception of hindrances. (4) Conclusions: By focusing on health professionals’ motivation, this study contributes to a timely systematization in challenging times for health institutions and their human resources
... They also argue that generational cohorts explain differences better than age and they have become popular in industry reporting (KPMG 2017;Lu 2020;O'Reilly 2014). There is a lack of a unified and recognised definition and of China's generational cohorts (Hung et al. 2007;
Ralston et al. 1999)
Categorising generations by decade is common in China for both academics and practitioners (Liao and Zhang 2007;Pan 2017;Yang 2018). With respect to this reality and in line with research habits, this research adopts this segmentation method and focuses on five generational groups: post-60s (born between 1960 and 1969), post-70s (born between 1970 and 1979), post-80s (born 1980 and 1989), post-90s (born between 1990 and 1999) and post-00s (born between 2000 and 2009). ...
Generational homogeneity and heterogeneity in city image perception: an explorative study of Guangzhou
Article
Full-text available
Dec 2021
Dian Wang
Bowen Zhang
Yingying Wu
Xinwen Zhang
This study examines perceptions of Guangzhou and looks for generational differences in projected image and information channel preferences. Based on a content analysis of 47 official city image advertisements, 16 themes are extracted and tested as traits of Guangzhou’s city image. Targeting all of China, an online questionnaire is undertaken, returning 1601 valid responses covering five generational groups: post-60s, post-70s, post-80s, post-90s, and post-00s. Free factor analysis and Kendall correlation analysis are used. The results suggest that there are no significant differences among the generational groups for information channels or perceptions of Guangzhou, since the dimensions of image perception are similar. However, an emphasis on different traits is identified, suggesting different preferences among generational groups which requires the attention of the city image communication authorities. The purpose of this study is to examine audience perceptions of Guangzhou and to look for generational differences in projected image and information channel preferences. Based on a content analysis of 47 official city promotional videos, 16 themes are extracted and tested as traits of Guangzhou’s city image. Targeting all of China, an online questionnaire is undertaken, returning 1601 valid responses covering five generational groups: post-60s, post-70s, post-80s, post-90s, and post-00s. Free factor analysis and Kendall correlation analysis are used. The results suggest that there are no significant differences among the generational groups for information channels or perceptions of Guangzhou, since the dimensions of image perception are similar. However, an emphasis on different traits is identified, suggesting different preferences among generational groups which require the attention of the city image communication authorities. The similarities in perceptions of the dimensions of city image of the generational groups and the emphases on different traits are similar to existing research. However, a clear and theoretically based generational segmentation is required for future research. Consistency between the projected and perceived images of Guangzhou in all information channels suggest the need of continuous use of integrated marketing communication strategy.
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... A divergence theory believes that national (traditional) culture shapes the value systems (Lincoln et al., 1978;Kelley and Worthley, 1981), whereas the convergence theory proposes that the business environment is the driving force that mainly affects the values (England and Lee, 1974;Yip, 1992). Over the controversy, Ralston et al. (1993) proposed the cross-vergence theory as an alternative and perfected the theory in the subsequent studies (Ralston et al., 1997
(Ralston et al., , 1999a
(Ralston et al., ,b, 2006a. A cross-vergence theory maintains that neither national culture nor economic ideology (the proxy of the business environment) can independently shape the contemporary values of a society. ...
Values Evolution in Transitional China: An Institutional Perspective
Nov 2021
Gong Sun
Jian Li
The values are greatly affected by the social and economic environment of a country. Thus, social transformation can lead to the values evolution. China has been experiencing a huge social, political, and economic transition in the past four decades. The previous studies that explore the value changes in China mainly compare the values across the regions or generation cohorts. This research investigates the issue from an institutional perspective. Specifically, we propose that the diversification of ownership types-the essence of the economic and institutional reform since 1978 may result in value change. By surveying 327 participants from the state-owned enterprises (SOEs) and 220 respondents from the privately owned enterprises (POEs), the comparisons between SOEs and POEs on four value dimensions-individualism, power distance, risk aversion, and money orientation-were performed. The results basically support cross-vergence theory in the values evolution. The implications and limitations are presented as well.
... Individual values are shaped by the institutions that structure a society; thus, by considering those institutions, we can ascertain the relative priorities that shape their managers' individual values. East Asia presents an interesting context for this analysis because of the socio-cultural similarities embedded in philosophical and spiritual traditions, as well as its diverging paths of economic development
(Ralston, Egri, Stewart, Terpstra, & Yu, 1999)
. Societies develop at different rates due to the interaction of exogenous influences-political, technological, and historical-and it would be naïve to assume that all managers in East Asia wholly subscribe to the same set of value priorities that drive their behaviors. ...
Toward understanding Convergence and Divergence: Inter-ocular testing of traditional philosophies, economic orientation, and religiosity/spirituality
J BUS RES
Doris Viengkham
Chris Baumann
Hume F. Winzar
This study brings together three institutional pillars that represent values in four East Asian societies-China, Japan, Korea, and Vietnam-traditional philosophies, economic orientation, and religiosity/spirituality-where previous literature examined these values domains separately and independently. In the process, we challenge the more traditional approaches to measuring values, and testing for differences and similarities among cultural groups. Personal values, by definition, are important influences on behaviour, but some values are more important than others. The appropriate measure for relative influence is an ipsative measure rather than a normative measure, such as a Likert scale. Contrary to conclusions drawn from null-hypothesis significance tests, we show that the four societies have similar perceptions of Capitalism and Modernization, and have small differences on most other dimensions. We show that measures of effect size and "inter-ocular testing" (looking at the data) produce more nuanced interpretations of divergence and convergence in the Confucian Orbit.
... A review by Schmitt et al. (1994) found a series of differences affecting management and business such as face saving, time perspective and differences in individualism/collectivism (Hofstede, 1980;Hofstede et al., 2010). Cultural differences have also been found to affect managerial decision making
(Ralston et al., 1999;
Casas Klett and Arnulf, 2020). ...
Limits of a Second Language: Native and Second Languages in Management Team Communication
Cultural differences in speech acts are common challenges in management involving Chinese and Western managers. Comparing four groups – Native-speaking Chinese, English-speaking Chinese, Chinese-speaking Westerners, and non-Chinese- speaking Westerners, we assessed the effects of language and ethnicity on the ability to predict communication obstacles in a management team scenario. Bilingual subjects were less likely to be influenced by ethnic biases. Still, bilinguals were not more likely to adjust their metacognitions about communication toward those of the native speakers. The study creates a link between management, cognition and linguistics, as well as having consequences for the study of metacognition in cross-cultural management.
... The basis of these assumptions is a binary between Western individualism, which emphasises 'I' consciousness, and East Asian collectivism, which emphasises 'we' consciousness (Brewer and Chen 2007). Recent studies in this academic tradition have found a trend towards individualisation in various Asian societies (Chiou 2001;Lu and Yang 2006;Omi 2012;
Ralston et al. 1999
). This encourages researchers to take a dynamic rather than a static perspective to analyse East Asian societies, including Taiwan. ...
‘Be true to yourself’: Transnational mobility, identity, and the construction of a mobile self by Taiwanese young adults
Article
Full-text available
Adopting Salazar's 'imaginaries of mobility,' this paper investigates how transnational mobility becomes imaginable, desirable or even experientially imperative for mobile Taiwanese young adults in the context of globalisation. It analyses the ways by which they interpret their mobilities as a pursuit of self-identity while negotiating the tensions between collectivism and individualism of Taiwanese society. Based on personal profiles and self-narratives of mobility appearing on a Taiwanese media website devoted to the topic of transnational mobility, I demonstrate how writers present a 'mobile self' characterised by being geographically mobile, socially transgressive and culturally cosmopolitan. This self is depicted in sharp contrast with the immobile at home and narrated as an integral part of achieving identity through three kinds of self-transformation: becoming true to oneself , becoming independent, and becoming a dreamer. While these narratives resonate Western discourses of mobility, they are interpreted from the lens of individualism-collectivism opposition in East Asia and of generational conflicts in Taiwan. Specifically, transnational mobility, regardless forms, is framed as a generational revolt against a collectivist society that represses individuality. The results show how imaginaries of mobility are recontextualised, producing meaning and practice based on local references. ARTICLE HISTORY
... Culture is considered to be dynamic and constantly evolving in societies (Fang, 2012;Hofstede, 1991;Rokeach, 1973;Yan, 2010). In this regard, crossvergence theory (e.g.,
Ralston, Egri, Stewart, Terpstra, & Yu, 1999;
Ralston, Gustafson, Cheung, & Terpstra, 1993;Ralston, Holt, Terpstra, & Yu, 1997) postulates that cultural values are subject to the influence of globalisation and to those of a unique national culture and social traditions. On one hand, cultures are becoming similar and displaying convergence among one another; on the other hand, national or local cultures continue to preserve features that render them distinct from other cultures. ...
Developing and validating a Chinese cultural value scale in tourism
TOURISM MANAGE
Songshan Huang
Chinese cultural values are important in understanding Chinese tourists’ behaviour. However, the literature is void of a relevant scale measuring Chinese cultural values in tourism. This research aims to develop and validate a Chinese cultural values scale in tourism (abbreviated as CCV-T). Following a rigorous scale development procedure and applying multi-stage studies, the research identified a 5-factor measurement scale of CCV-T, composed of 17 items with sufficient reliability and validity. The five Chinese cultural value factors are Leisure and Life Enjoyment (LLE), Filial Piety and Relationship (FPR), Self-fulfilment, Righteousness, and Humanity. The CCV-T scale provides a simplified and holistic structure measuring tourism-related Chinese cultural values. This research provides a solid base to further understand the relationships between Chinese cultural values and tourist behaviour.
... Evidence in the literature suggests that Chinese society remains deeply attached to the Confucian tradition in hierarchical and filial piety status, in spite of the introduction of Communism (Su and Littlefield, 2001). Empirical research
(Ralston et al., 1999)
also shows that business and organizational structures observe Confucian ethical values and adopt a Confucian-type hierarchical structure. ...
The impact of organizational position level and cultural flow direction on the relationship between cultural intelligence and expatriate cross-border adaptation
Article
Ying Zhang
Yuran Li
Mark Frost
Edwin T.C. Cheng
Purpose
This paper aims to examine the critical role played by cultural flow in fostering successful expatriate cross-border transitions.
Design/methodology/approach
The authors develop and test a model on the interplay among cultural intelligence, organizational position level, cultural flow direction and expatriate adaptation, using a data set of 387 expatriate on cross-border transitions along the Belt & Road area.
Findings
The authors find that both organizational position level and cultural flow moderate the relationship between cultural intelligence and expatriate adaptation, whereby the relationship is contingent on the interaction of organizational position status and assignment directions between high power distance and low power distance host environments.
Originality/value
Previous research has shown that higher levels of cultural intelligence are positively related to better expatriate adaptation. However, there is a lack of research on the effect of position difference and cultural flow on such relationship. Our study is among the first to examine how the interaction between cultural flow and organizational position level influences the cultural intelligence (CI) and cultural adjustment relationship in cross-cultural transitions.
... This sequence of low-level constructs seems like a more meaningful representation of the underlying dynamics than assessing Organizational Learning Capability as an overarching construct. This may happen because Chinese respondents are prone to think in particular, pragmatic terms and wary of abstract theoretical concepts
(Ralston et al., 1999;
Norenzayan et al., 2010) and frequently embrace paradoxes that would create contradiction and cognitive dissonance in Westerners (Li and Tang, 2013;Li, 2012). ...
Developing a measurement scale for organizational learning capabilities in China
Wanwen Dai
Phoenia Iao
Haojin Dai
Jan Ketil Arnulf
The purpose of this study was to develop a measurement instrument for organizational learning capability in a Chinese management context. Previous research has indicated a need for measurement instruments with proven ecological validity in China, because the learning capability of organizations is influenced by the organization’s external environment.
We followed a consequent inductive procedure from item sampling through exploratory factor analysis (EFA) to confirmatory factor analysis (CFA) and nomological validation. The initial part sampled relevant descriptors from a diverse sample of 159 employees from heterogeneous backgrounds in China. After sorting by an expert panel, EFA of data from a sample of 161 executive students yielded a three-dimensional construct comprising Knowledge Acquisition, Knowledge Sharing, and Knowledge Utilization. These three constructs were again tested in CFA using a sample of 357 employees from five companies.
Our findings across the three samples resulted in a three-dimensional measurement scale that we call the Organizational Learning Capability Questionnaire (OLCQ). The OLCQ displayed high internal consistency, reliability and nomological validity.
This focus of this study has only been to establish a measurement instrument that allows indigenous research on organizational learning in China. The approach was statistically driven grounded approach, not a theoretical assumption of learning mechanisms special to the Chinese culture. Further research is needed to estimate how this approach yields results that are different from other cultures, or the extent to which our findings can be explained by features of the Chinese culture or business environment.
This study offers a practical measurement instrument to assess practical and scientific problems of organizational learning i China.
We provide a measurement instrument for organizational learning capability with proven ecological validity and with promising consequences for research and practice in China. The instrument is empirically grounded in the practices and behaviors of Chinese managers, avoiding biases that stem from previously identified shortcomings in cross-cultural management research. To our knowledge, it is the first of its kind and a contribution to a call for indigenous management theories with contextual validity.
... Unlike Western traditions and narratives, Chinese philosophy is rarely taught through long texts (although these exist) or sacred books, but is expressed as aphorisms that often live on as proverbs that most people know (Mou, 2009;Feng, 2015). These powerful traditions form a most important background to understand the emerging theories of Chinese management Ma and Tsui, 2015), as Chinese have a tendency to leap from philosophy to pragmatic action, bypassing theory
(Ralston et al., 1999)
. Chinese classics have been shown to be important strategic guidelines for Chinese business leaders (Chen and Lee, 2008). ...
Are Chinese Teams Like Western Teams? Indigenous Management Theory to Leapfrog Essentialist Team Myths
Our study analyzes a gap in research on Chinese and Western management teams, based on a broad literature review. We claim that prevalent theoretical perspectives in the management team literature might be biased toward a Western-centric view of team dynamics. This obscures alternative ways of understanding top teams encompassing Chinese cultural traditions. We outline how an essentialist team conceptualization leads to a paradox consisting of three mutually contradicting myths. Myth 1 implies that Western groups of managers comply with theoretically “ideal” team processes and characteristics. Myth 2 derives from research literature on Chinese teams claiming that team features are assumed absent or weak in China due to cultural particularities. Paradoxically, the same research tradition constructs another third myth by reporting that Chinese teams successfully comply with the Western ideal team model. The three coexisting myths point to a theoretical confounding of contextual mediators in team processes. We discuss how indigenous Chinese leadership theory and Chinese systems of philosophy give Chinese teams access to distinct and effective team processes to reach high-performance outcomes. This paper aims to open the rich possibilities of Chinese management and team practices to the cross-cultural context, and on return to novel understanding of Western teams beyond traditional essentialist theory anchors.
... Cross-cultural research of China reflects adherence to tradition and nationalism amidst the continually growing influence of Western ideas about business and management. While there are vast and multiple cultural values at play within the expanse of this Republic, the execution of typical autocratic praxis is, in large part, mutually incompatible with an effective leadership model predicated on the reach and governance of the Chinese Communist Party and communal ideologies (Chen, 1995;Fu et al., 2013, p. 886;
Ralston et al., 1999)
. Jackson, Louw, and Zhao (2013) examined the growing international and cross-cultural relationship between China and Africa within the last five years. ...
A Review of Autocratic, Paternalistic, and Charismatic Leadership in Three Collectivist Cultures
The conception of culture serves as a primary issue within both organization and leadership research. Examination of organizational leadership and culture provides researchers with comprehensive tools to better understand effective leadership within an increasingly globalized organizational context. Amidst the broad spectrum of leadership theory are the subsequent conceptions of three leadership theories: (a) autocratic leadership, (b) paternalistic leadership, (c) charismatic leadership. A deeper understanding of organizational leadership and its varied application and effectiveness requires fastidious consideration of the social, cultural and in some cases religious contexts in which leadership exists. The three selected theories are placed against the cultural contextual framework of Confucian Asia (China), Sub-Saharan Africa, and Latin America (Mexico) as representatives of many cultural dimensions identified within the GLOBE study. Therefore, the primary objective of this investigation is to review the development of specific leadership theories and cross-cultural values informed by their application or prevalence within three selected collectivist regions. Ultimately, the
research findings support the contentions of some scholars, that while the nexus of organizational leadership theories should be cross-culturally static, the reality of shifting ideals relative to interface with a diverse global marketplace, presents differing behaviors across cultures and in some cases within regional cultural clusters.
... Work values reveal an individual's evaluative tendency toward work and reflect his/her attitudes toward all job-related rewards, level of participation and engagement, and career ambition [23,24]. Studies on work values and organizational issues such as workplace commitment, overall job satisfaction, and employee job performance have attracted extensive attention in the past decades [24][25][26][27][28][29]
[30]
, mainly because these work-related values can drive employees to involve themselves in their work [31] and further facilitate employee job performance [24]. ...
Nurse Practitioners’ Work Values and Their Conflict Management Approaches in a Stressful Workplace: A Taiwan Study
Globalization has created an urgent need to understand management practices in different cultures. This study examines Confucianism-based work values of nurse practitioners in Taiwan and explores their impact on conflict management approaches in order to help health practitioners maintain sustainable work relationships and improve organizational effectiveness in an increasingly stressful workplace. Based on the data from 259 nurse practitioners in Taiwan, this study shows that nurse practitioners in Taiwan consider holistic rewards, self-fulfillment and personal growth, challenge and responsibility, autonomy, and meaningfulness as important work values. Hierarchical regression results further indicate that nurse practitioners with strong group-centered needs, such as needs for holistic rewards, preferred collaborative methods to manage conflicts in the workplace, and individuals with strong self-centered needs, such as needs for personal growth and self-fulfillment and needs for autonomy, preferred competitive methods to manage conflicts. Interestingly, this study also finds that self-centered needs such as needs for self-fulfillment and personal growth, and needs for challenge and responsibility are also related to collaborative approaches. Managerial implications are then discussed for conflict management training for nurse practitioners under stressful work conditions.
... Hofstede's culture dimensions contend that values will differ by culture (Chow, Shields, & Wu, 1999). Work values have been assessed across different countries with examples including Canada (Kuron et al., 2015;Lyons, Higgins, & Duxbury, 2010), China
(Ralston, Egri, Stewart, Terpstra, & Kaicheng, 1999)
, New Zealand (Cennamo & Gardner, 2008), and the U.S. . In a rare multi-national study (U.S, Australian, Singapore, Germany, China), Cogin (2012) reveals both similarities and differences across cultures. ...
Understanding the work values of Gen Z business students
Nov 2019
Michael J. Maloni
Mark S. Hiatt
Stacy Campbell
The next generation (i.e., post-Millennials/Gen Z) now represents a majority of our business students. Yet, there is limited empirical evidence of the career expectations of this emerging generation, thereby impeding our ability to effectively engage students both in the classroom and in the career development process. To overcome this gap, we surveyed business students at seven different U.S. universities to assess their career work expectations. The results show broad similarities between Gen Z and the prior Gen Y generation yet also highlight some meaningful, significant variations. Supporting and extending existing literature, the results depict a typical business student who focuses on a stable career by developing strong skillsets that allow them to advance quickly in the workplace. A follow up survey of business faculty and career service personnel reveals that both groups are relatively out of touch with such student expectations. Specific recommendations are subsequently provided to enable business faculty to enrich student interest in their courses as well as help academic programs and career services enhance the fit of these students with majors and careers.
View
... Chinese managers are leaving their collectivistic values behind in favour of more individualistic ideals
(Ralston, Egri, Stewart, Terpstra, & Kaicheng, 1999)
. A more recent analysis confirms such modernisation theory that values change as countries prosper, noting "average increases in individualism and indulgence" (Beugelsdijk, Maseland, & van Hoorn, 2015, p. 237). ...
Authentic leadership: An empirical assessment of the ephemeral
Thesis
Full-text available
This thesis quantitatively examines how individual cultural differences impact on authentic leadership efficacy and isolates its key mediating mechanisms. Four major advances are presented. The first is a formula for calculating respondents’ Western Values Scores from existing indices – a logical advance along traditional lines of cultural research. The second is the development of a new Holistic Cognition Scale (HCS) that captures cultural differences in cognitive schemata. The third and fourth advances are the moderation and mediation assessments of authentic leadership efficacy. The results indicate that the final 14-item HCS is a valid and reliable measure of respondents’ analytic and holistic thought. Contrary to expectations, I find no significant moderation effects from individual cultural differences and authentic leadership proves remarkably robust to cultural forces. Lastly, I identify followers’ personal identification, affect-based trust, and work engagement as the three main mediating mechanisms through which authentic leadership positively influences desirable organisational outcomes.
A Critical Discourse Analysis of News Reports on UN Climate Change Conferences from Chinese and US Mainstream Newspapers
Thesis
Full-text available
Yuqing Zhao
Since the time of the Industrial Revolution, human activities have been the main cause for various environmental issues. Under the circumstances, climate change, which puts the mere survival of human beings at risk, has become one of the biggest global concerns. With such a great urgency, UN climate change conferences, which provide forums for countries around the world to negotiate on the issue of climate change, have increasingly come into the spotlight of news media. In an attempt to figure out reporting focuses of both Chinese and US newspaper reports on those conferences, the research, under the guidance of critical discourse analysis (CDA), analyzed 792 newspaper reports on UN climate change conferences from 2015 to 2019, namely, on COP21, COP22, COP23, COP24 and COP25 with the combination of quantitative and qualitative methods. The quantitative method involves the corpus analysis, and the qualitative method entails Fairclough’s three stages of discourse analysis. The research also aims at uncovering hidden ideologies reflected in those reporting focuses, and factors affecting the formation of those ideologies.
In the stage of description, the results show that both Chinese and US newspapers have a particular focus on their own countries and highest leaders, with emphases on different specific aspects. In Chinese newspaper articles, China’s national image, action and contribution in fighting against climate change, and cooperative interactions with other countries are specific areas of focus. In US newspapers, individualism in terms of government officials, the division between the central and local governments, and less cooperative international relationships are the main focuses. As for interactions between the highest leaders of the two countries, cooperation is the main focus for President Xi and President Obama. In terms of President Trump, however, his dropping out of the Paris Agreement is the reporting emphasis, which indicates his deviation from the cooperative path set by the Obama administration. In the stage of interpretation, in terms of news sources, it is found that journalists from both countries value the objectivity and reliability of reporting, applying reliable sources from people with influence. With regard to reporting modes, the application of direct discourse increases the authenticity and reliability of news reporting, and indirect discourse allows more room for journalists’ interpretation, affecting the truthfulness of reporting to some extent. Based on the two stages above, in the stage of explanation, the differences in reports indicate the two countries’ different political, economic, and cultural conditions. China is an emerging large country under the influence of Confucianism, which values collectivism and rules. Therefore, China tends to have consistence in climate change policies, and always shows cooperative attitudes to the global fight against climate change. In contrast, the US is an established great power that appreciates individualism and freedom because of the influence from Christianity. Hence, the US is inclined to emphasize the importance of individual roles, and tends to be inconsistent with its climate change policies because of the two-party system.
The research provides an example of applying CDA to the field of climate change conferences, and gives an insight into the different ideologies that are reflected in Chinese and US newspapers. By knowing the reporting focuses and ideologies in US newspaper reports, Chinese media can better adjust and improve their reports so that Chinese stories can be more easily accepted among international readers.
Beyond Positive and Negative eWOM: The Role of Trust Propensity and Individuation in Shaping Consumers’ Perception of Brand Image
Article
Oct 2021
Int J Hospit Tourism Admin
Pengji Wang
This study aims to identify the impact of psychological mechanisms, such as trust propensity and individuation, on response to eWOM by differentiating between volume of positive/negative eWOM and net eWOM valence (e.g., when positive eWOM volume exceeds negative eWOM volume and vice versa). Analysis based on 428 survey responses from Australia and China shows that positive eWOM positively influences brand image, particularly for individuals with a high trust propensity. Surprisingly, negative eWOM does not affect brand image, but negative net valence is influential, particularly for consumers with a high trust propensity and those scoring high on individuation.
An empirical investigation of regional differences in consumption behaviors in an emerging economy
Stephanie Geiger-Oneto
Hieu Nguyen
Widely regarded as one of the most dynamic economies in Southeast Asia, Vietnam has increasingly attracted scholarly interest from diverse business disciplines. However, previous marketing research on Vietnam largely treats the country as a homogenous society. We draw on the literature in sociology, geography, history and predict that significant regional differences exist in consumers' consumption behaviors between the North and South of Vietnam, bearing important implications for international marketers. Using secondary survey data collected by an international market research firm, we show that consumers in Hanoi (HN) and Ho Chi Minh City (HCMC) differ greatly in how they perceive the impact of an economic crisis, how they change their consumption behaviors as a result, and whether they will cut back on spending on themselves, their families, and children. Our results also demonstrate that HN and HCMC consumers differ in their attitude toward luxury product consumption, attitude toward advertising, and marketing versus non‐marketing controlled sources of information. Our research provides important implications for both managers and researchers interested in this fast‐growing economy.
A cross-institutional exploratory investigation of COVID-19 spread: formal vs. informal institutions
Oct 2022
Imane El Ouadghiri
Jonathan Peillex
We investigate the effect of culture on COVID-19 spread using a sample of 67 countries over the first 10 months of the pandemic. We find that individualistic countries have higher number of COVID-19 cases, an effect that is independent from formal institutions. A two-ways interaction effects, however, between formal institutions and individualism, shows that effective political institutions, sound governance, and better economic conditions reduce the effect on individualism on CVODI-19 spread. Our findings provide evidence that are useful not only for explaining differences in COVID-19 spread between countries but can also enable policymakers and organizations to understand what generally determines individuals’ compliance with formal rules and regulations.
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Identity-Consistent Self-Image Maintenance Following Leader Abuse: Integrating Self-Presentation and Self-Concept Orientation Perspectives
J MANAGE
Lei Huang
Ted A. Paterson
Siting Wang
Although coping with an abusive boss can be psychologically demanding, those who suffer from leader abuse often stay in these unpleasant relationships, actively managing the way they are viewed in the eyes of their abusive leader (source of the abuse) and coworkers (observers of the abuse). Accordingly, the abusive supervision literature has relied almost exclusively on an emotional appraisal perspective to study the self-image implications following leader abuse. The present study seeks to add to this emerging line of scholarly conversations by presenting a novel theoretical alternative. Specifically, we integrate self-presentation and self-concept orientation perspectives to portray individuals’ identity-driven self-image maintenance following leader abuse. We argue that only those with a stronger relational self-concept are likely to be motivated to preserve their identity-consistent self-image and present themselves in positive and socially desirable ways towards both their coworkers and leader following leader abuse. Using survey data collected from working professionals in China across two field studies, we found support for our hypotheses that when employees with a stronger relational self-concept experienced abusive supervision, they were motivated to help their coworkers as a result of their relational reputation maintenance concerns and use ingratiation tactics towards their leader due to their image preservation motives. We also offered insights about both theoretical and practical implications of our research and discussed study limitations and directions for future research.
Chapitre 15. La contextualisation de la recherche : une démarche processuelle
Chapter
Sep 2020
Doha Sahraoui Bentaleb
Chafik Bentaleb
When and why narcissism leads to taking charge? The roles of coworker narcissism and employee comparative identity
Xin Liu
Jih-Yu Mao
Xiaoming Zheng
Peter D. Harms
When and why do narcissists take charge in the workplace? Integrating the narcissism literature and self‐identity theory, we argue that coworker narcissism is a key contingency that triggers narcissistic employees' comparative identity, which subsequently facilitates their taking charge behaviours. The results of two studies (Study 1: a two‐wave survey study of 351 frontline employees and 67 team leaders; Study 2: a scenario‐based experimental study of 190 workers) provide evidence that coworker narcissism moderates the relationship between employee narcissism and employee comparative identity, such that the relationship is strengthened when coworker narcissism is high rather than low. Employee comparative identity is positively related to employee taking charge behaviour. Furthermore, coworker narcissism moderates the indirect effect of employee narcissism on employee taking charge behaviour through employee comparative identity, such that the indirect effect is strengthened when coworker narcissism is high rather than low. These results contribute to the growing literature on the interpersonal dynamics of narcissists in the workplace and the impacts of narcissism on proactive behaviours.
Generations in Family Business: A Multi-field Review and Future Research Agenda
Article
Jan 2022
FAM BUS REV
Vittoria Magrelli
Paola Rovelli
Carlotta Benedetti
Alfredo De Massis
The concept of generations has become increasingly important in the social science fields to explain diverse phenomena affecting organizations. This is especially true in the family business field where generations are considered a constitutive element. Nevertheless, there is still a limited understanding of generations and the implications of their involvement in family business. We review prior studies on generations by considering different social science fields, which we analyze according to a novel theoretical framework. Building on this framework, and placing particular emphasis on family firms, we identify important knowledge gaps that serve as a springboard for future research.
CEO experience and corporate financing decisions: Evidence from a natural experiment in China
Article
Oct 2021
CHINA ECON REV
Ying Hao
Yuxiu Huang
Xuegang Cui
Qiang Liu
Using the unique setting in China's economic transition and market reform, we investigate whether CEOs' experience regarding an economic boom affect corporate financing decisions. Economic booming, as a result of China's reform and open policy since 1978, affects individual risk preferences and decision behavior for those who grew up during the reform process. We find that Reform-and-Opening CEOs, who experience the reform and open-up era early in life, implement more aggressive capital structure policies and maintain higher leverage compared to Planned Economy CEOs. Furthermore, we determine that Reform-and-Opening CEOs tend to conduct debt issuance more frequently to cover financing needs as they can better deal with the liquidity risk of debt financing and confront the pressures arising from frequent monitoring by the debt markets. Using the stagewise regression, we find a cumulative effect of early growth experience. We also use the common trend test and placebo tests to deal with the concern that Reform-and-Opening CEOs pursue significantly more aggressive financial policies relevant to the systematic differences. Additional tests rule out the possibility that our results are driven by industry competition, state ownership, and educational ideology.
Chinese Traditional Cultural and Cross-Cultural Management
Article
Full-text available
Confucian culture is an ancient culture that has been circulating in China for thousands of years. It represents the value of most Chinese people and plays an important role in Chinese history. From state governance to family management, Confucian culture has influenced all aspects of Chinese people, and, of course, has a great influence on the management of Chinese enterprise managers. However, cultural differences and conflicts when managing multinational teams are inevitable. Therefore, in this article, we will discuss Confucian culture and how to integrate it into modern enterprise management to solve the adverse consequences of cultural differences and conflicts, and discuss the drawbacks of Confucianism to modern enterprise management.
Human Resource Management in Asia
Chapter
Jan 2021
Fang Cooke
Vivien Supangco
This chapter reviews key characteristics and developments of human resource management (HRM) in Asian countries against the backdrop of their rich historical features and the rapidly changing landscape on many fronts. It takes stock of what has been researched in the HRM field and the theoretical perspectives underpinning it. There is a growing trend for positivist HRM studies of hypothesized organizational conditions and individual behaviors, at the expense of in-depth qualitative studies of the motivations, actions, and interactions of social groups, and outcomes in specific organizational settings. It is clear that Asian countries are advancing at a rapid pace in their economic development, powered by growing technological competences. However, each nation-state is confronted with a different set of HRM challenges, ranging from skills shortage to workforce aging, informalization of employment, changing expectations, behavior of the workforce, and so forth. We argue that the understanding of people management in workplaces must take into account a range of institutional, cultural, organizational, and individual factors. We also argue that HRM research needs to be engaged with real and live issues that are confronting employing organizations and individuals, with the aim of adding social value and extending our intellectual horizon.
Two-way in-/congruence in three components of paternalistic leadership and subordinate justice: the mediating role of perceptions of renqing
Article
Feb 2021
Han Ren
Zhengqiang Zhong
Charles Weizheng Chen
Chris Brewster
This paper examines the effects of two-way congruences and incongruences between three components of paternalistic leadership, namely, benevolence, morality, and authoritarianism, on overall subordinate justice perceptions. We hypothesize that these dyad in-/congruences would differentially predict subordinate overall justice perceptions, with perceptions of renqing as a mediator. With data collected from two-wave surveys in the People’s Republic of China, the results indicate that dyad congruences and incongruences between benevolence, morality, and authoritarianism have significant impacts on subordinate perceptions of renqing and, ultimately, their overall justice perception. Our findings underscore that to fully understand the influencing processes of paternalistic leadership on subordinate outcomes, it is important to take into account the context and the different combinations of its three dimensions.
How Ethics and Benevolence in Leadership Inspires Creativity: The Mediating Role of LMX and Motivation, Complemented by Culture with Greater Power Distance.
Article
Jan 2020
Mohsin Adnan Ansari
Danish Ahmed Siddiqui
Tournament incentives, age diversity and firm performance
Article
Jan 2021
J Empir Finance
Oleksandr Talavera
Shuxing Yin
Mao Zhang
This study introduces a new dimension, age diversity of non-CEO executives, which moderates the relationship between promotion-based tournament incentives, measured as the pay gap between the CEO and non-CEO executives, and firm performance. For a sample of Chinese listed firms from 2005 to 2015, we find that the tournament incentives for non-CEO executives relate positively to firm performance. This relationship is weaker when non-CEO executives are from different age cohorts, whereas the tournament effect is enhanced when non-CEO executives are from the same age cohort. The negative moderation effect of age diversity is more pronounced in state firms and in the Northern China Plain cultural region. The negative moderation effect disappears in firms with CEOs who have overseas experience. We reason that the peer pressure among the similar-aged non-CEO executives enhances the tournament competition and that age hierarchy reduces incentives for younger executives to compete. Our findings have important implications for firms not only in China, but also in countries and regions where seniority is highly valued when setting executive compensation and optimizing organizational structure.
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Conclusions, Implications, and Future Research
Chapter
Jan 2017
Chunyan Zhu
A Cross-Cultural Study of Relationship Proneness and Its Implications for Relationship Marketing
Chapter
Jan 2013
Riyad Eid
Jack Wei
Faye Mcintyre
Salil Taplade
This paper examines relationship proneness of consumers in a cross-cultural setting; specifically, the relationship proneness between Chinese and U.S. consumers of Generation Y (born from 1976 to 1995) and its effects on relational satisfaction and relationship commitment. Based on previous research (e.g., De Wulf, Odekerken- Schröder, & Iacobucci, 2001) and cultural theories (e.g., Hofstede, 1980, 2001), nine hypotheses were developed involving the effects of relationship building tactics (i.e., direct mail, preferential treatment, communication, and tangible rewards) on relationship proneness, relational satisfaction and store loyalty. This quantitative study used a survey among two samples of consumers in China and the U.S. The final sample size was comprised of 349 student consumers. The findings of the research provide managerial implications for international retailers. Relationship proneness is a meaningful personal characteristic that can be used to describe or predict consumer behavior across cultures. A relationship marketing strategy that works for one culture may also work well in another culture. It is possible and appropriate, at least with generation Y consumers, to employ standardized approaches in relationship marketing across cultures.
Literature Review and Research Hypotheses
Chapter
Jan 2017
Chunyan Zhu
Zooming in on the Effect of National Culture on Knowledge Sharing Behavior
Chapter
Jan 2011
This research project investigates what are the national cultural factors that influence employees’ cross-cultural knowledge sharing in online environments and in what way. The chapter draws on findings from 41 in-depth interviewees conducted with 20 Chinese and 21 American employees who worked for a large multinational corporation. The rich interview data identified three national cultural differences that impacted Chinese and American participants s’ knowledge sharing through an online system, namely, language, differences grounded in collectivism/individualism, and different levels of uncertainty avoidance. English created a barrier for Chinese users to post their ideas but it didn’t seem to stop them from consuming knowledge. Differences grounded in collectivist/individualist values were mainly reflected in these two cultural groups’ different logic regarding the relationship between different working contexts and the need to share. Chinese participants also showed a higher level of uncertainty avoidance than American participants. Together these cultural differences could explain why Chinese shared knowledge less frequently than their American peers. Despite these reported cultural differences, findings from this research suggest that the actual cultural differences were smaller than what literature implies. Possible explanations for fewer cultural differences are explored. Practical implications for knowledge management practitioners are also offered.
Guilty and Corporate Philanthropy: The Case of the Epic Privatization in China
Long Term Orientation in China: Generational Differences and Cultural Measurement Standards
Douglas Chun
Zhen Zhang
China has undergone significant societal changes in recent decades, however, questions remain as to how these changes have influenced the values of different generations in the country. Using concepts used to measure LTO from both Hofstede’s revised VSM08 questionnaire and Bearden et al.’s (2006) modified scale, we conducted a survey with 1154 people in China. We found participants born in or before 1981 have higher long-term orientation compared to individuals born after 1981. Perhaps more importantly, we found that when measured by these concepts, our overall sample scored lower on the STO/LTO scale than Hofstede’s LTO scale indicate. Our findings have large implications on the instruction educators and consultants are providing their students in regards to ethnic cultures. We suggest that business practitioners should be aware of these cultural value changes when formulating strategic plans, as these attitudinal and behavioral changes have the potential to greatly impact their business interactions, and that instructors should be aware of the plasticity of living cultures."
Perspective taking and voice solicitation: a moderated mediation model
Fangzhou Liu
Employee voice can be beneficial and critical for organizational success. However, evidence shows that power and position create a ‘leaders’ bubble’ that is hard to penetrate unless leaders proactively solicit voice from employees. Drawing on the situated focus theory of power and supervisor‐subordinate goal‐congruence literature, we hypothesize that followers’ perspective taking affects leaders’ voice solicitation through supervisor‐subordinate goal congruence. Furthermore, we propose that the perception of organizational politics weakens this indirect relationship, whereas information sharing strengthens it. Survey data collected from 213 Chinese employees provide support for a positive indirect relationship that existed between perspective taking and voice solicitation through supervisor‐subordinate goal congruence, and this indirect relationship was stronger when the employees’ perception of organizational politics was low.
Historical and Conceptual Context of Chinese International Students’ Citizenship
This chapter explores the literature that relates to students studying abroad and the current research on Chinese students in New Zealand, more specifically providing a background for understanding the experiences of participants in this study. Second, the chapter provides a conceptual understanding of citizen and citizenship. The term ‘citizen’ is not independent of history. To understand the concept of citizenship, traditional notions are reviewed in a historical context. The historical development of the concept of ‘citizen’ is traced by considering differing philosophical perspectives on citizenship.
A deep acting perspective generation Y hotel employees’ workplace deviance
Yanping Yu
Purpose
This study aims to develop a measurement scale to assess generation Y China hotel employees’ workplace deviance and then investigate the effect of generation Y employees’ deep acting on workplace deviance by focusing on the mediating effect of emotional exhaustion and the moderating effect of organizational identification.
Design/methodology/approach
The study first adopts a mixed-methods approach to develop the scale of generation Y hotel employees’ workplace deviance, then multiple data is collected targeting 580 hotel employees by a three-stage survey. Structural equation modeling (SEM) and a hierarchical regression analysis were used to test the hypotheses.
Findings
Workplace deviance of generation Y hotel employees in China was divided into two dimensions, aggression and neglect. Deep acting was found to be negatively related to workplace deviance, and emotional exhaustion had a mediating effect on the relationship between deep acting and workplace deviance. Organizational identification strengthened the effect of deep acting on neglect and the effect of deep acting on emotional exhaustion, whereas it did not moderate the relationship between deep acting and aggression.
Originality/value
First, this study provides a more powerful explanatory perspective on the conservation of resources theory to explore future research by especially targeting generation Y employees. Second, this study develops the elements of workplace deviance structure of generation Y hotel employees, especially in the Chinese cultural context. Third, it explores the inherent mechanism of how and why deep acting impacts workplace deviance.
Reverse Angle
Chapter
Paul Ross
The most consequential relationship that a foreign employee working in a Chinese company is likely to have is with a direct supervisor. With an eye towards ensuring that the relationship between employee and supervisor is a positive one, this chapter endeavors to present the supervisor’s view of the world and give the foreign employee an appreciation for the supervisor’s motivations, concerns, and expectations. It also addresses the basic and very practical issue of how the foreign employee should approach the Chinese boss and take first critical steps on the road to building a relationship that is satisfactory and mutually beneficial.
Does Latin America Exist? (And Is There a Confucian Culture?): A Global Analysis of Cross-Cultural Differences
Does Latin America exist?
Latin American studies centers (like African, or Middle Eastern or West European studies centers) are based on the assumption that Latin America (and Africa, the Middle East, etc.) are more than arbitary geographic expressions: they define coherent cultural regions, having people with distinctive values and worldviews that make them think differently and behave differently from people of other cultures.
The most powerful challenge to this view currently comes from the rational choice school, whose practitioners occasionally mention the importance of cultural differences but whose models almost always ignore them, implicitly assuming that in a given situation all people will make the same “rational” choices regardless of cultural perspectives. But if major differences exist between the worldviews and motivations of people in different cultural zones, a rational choice model that applies to the United States may not accurately describe the behavior of people in other cultures.
The existence of meaningful cultural areas has been challenged on other grounds as well. Modernization theory focuses on the differences between “traditional” and “modern” societies, each of which are characterized by distinctive economic, political, social, and cultural institutions. This perspective tends to attribute any differences between Latin American and highly industrialized societies to differences in their levels of economic development: with economic development, these differences will tend to disappear. Differences between various “traditional” cultures tend to be ignored.
The usefulness of “Latin America” as a meaningful cultural boundary could also be disputed on various other grounds.
The dimension of individualism-collectivism, as identified by Hofstede (1980), was studied using items developed both theoretically and emically in nine diverse cultures. The dimension was found to be analysable into four stable etic factors: Individualism had two aspects (Separation from Ingroups and Self-Reliance with Hedonism) and collectivism had two aspects (Family Integrity and Interdependence with Sociability). These four factors are orthogonal to each other. The location of nine cultures on these four factors was used to compute a “collectivism” score which correlated r = + · 73 with Hofstede's (1980) collectivism scores for the nine cultures. This approach enables the measurement of individualism-collectivism in each culture as well as across cultures, and shows that different methods for measuring individualism-collectivism converge.
Universals in the Content and Structure of Values: Theoretical Advances and Empirical Tests in 20 Countries
Publisher Summary This chapter addresses the universals in the content and structure of values, concentrating on the theoretical advances and empirical tests in 20 countries, and its four basic issues: substantive contents of human values; identification of comprehensive set of values; extent to which the meaning of particular values was equivalent for different groups of people; and how the relations among different values was structured. Substantial progress has been made toward resolving each of these issues. Ten motivationally distinct value types that were likely to be recognized within and across cultures and used to form value priorities were identified. Set of value types that was relatively comprehensive, encompassing virtually all the types of values to which individuals attribute at least moderate importance as criteria of evaluation was demonstrated. The evidence from 20 countries was assembled, showing that the meaning of the value types and most of the single values that constitute them was reasonably equivalent across most groups. Two basic dimensions that organize value systems into an integrated motivational structure with consistent value conflicts and compatibilities were discovered. By identifying universal aspects of value content and structure, the chapter has laid the foundations for investigating culture-specific aspects in the future.
Fostering Corporate Entrepreneurship: Cross-Cultural Comparisons of the Importance of Individualism Versus Collectivism
| https://www.researchgate.net/publication/5222864_Doing_Business_in_the_21st_Century_with_the_New_Generation_of_Chinese_Managers_A_Study_of_Generational_Shifts_in_Work_Values_in_China |
Addiction doc says: It’s not the drugs. It’s the ACEs…adverse childhood experiences. – ACEs Too High
He says: Addiction shouldn’t be called “addiction”. It should be called “ritualized compulsive comfort-seeking”. He says: Ritualized compulsive comfort-seeking (what traditionalists call addiction) is a normal response to the adversity experienced in childhood, just like bleeding is a normal response to being stabbed. He says: The solution to changing the illegal or unhealthy ritualized compulsive comfort-seeking behavior…
He says: Addiction shouldn’t be called “addiction”. It should be called “ritualized compulsive comfort-seeking”.
He says: Ritualized compulsive comfort-seeking (what traditionalists call addiction) is a normal
response to the adversity experienced in childhood, just like bleeding is a normal response to being stabbed.
He says: The solution to changing the illegal or unhealthy ritualized compulsive comfort-seeking behavior of opioid addiction is to address a person’s adverse childhood experiences (ACEs) individually and in group therapy; treat people with respect; provide medication assistance in the form of buprenorphine, an opioid used to treat opioid addiction; and help them find a ritualized compulsive comfort-seeking behavior that won’t kill them or put them in jail.
This “he” isn’t some hippy-dippy new age dreamer. He is Dr. Daniel Sumrok, director of the Center for Addiction Sciences at the University of Tennessee Health Science Center’s College of Medicine. The center is the first to receive the Center of Excellence designation from the
Addiction Medicine Foundation
, a national organization that accredits physician training in addiction medicine. Sumrok is also one of the first 106 physicians in the U.S. to become board-certified in addiction medicine by the
American Board of Medical Specialties
.
Sumrok, a family physician and former U.S. Army Green Beret who’s served the rural area around McKenzie, TN, for the last 28 years, combines the latest science of addiction and applies it to his patients, most of whom are addicted to opioids — but also to alcohol, food, sex, gambling, etc. He sees them in the center’s two outpatient clinics: his clinic, which the Center for Addiction Science has taken over as its rural clinic, and another that opened recently in downtown Memphis.
Since he first sat down in the early 1980s to write a research paper (“
Public Health Legacy of the Vietnam War: Post-Traumatic Stress Disorder and Implications for Appalachians
”) to describe the symptoms of the
newly named post-traumatic stress disorder
in Vietnam veterans – “problems with the law, having trouble sleeping, anxiety, divorce, sleep troubles, substance use disorders, depression, anxiety, cognitive and chronic pain issues” — Sumrok has pieced together the ingredients for a revolutionary approach to addiction. It’s an approach that’s advocated by many of the leading thinkers in addiction and trauma, including Drs. Gabor Maté
, Lance Dodes
and Bessel van der Kolk
. Surprisingly, it’s a fairly simple formula: Treat people with respect instead of blaming or shaming them. Listen intently to what they have to say. Integrate the healing traditions of the culture in which they live. Use prescription drugs, if necessary. And integrate adverse childhood experiences science: ACEs.
“My patients seem to respond really well to this,” he says.
ACEs understanding changes practice
Learning about ACEs more than two years ago was a big turning point for his understanding of addictions, explains Sumrok. “I was working in an eating disorders clinic and someone told me ‘90 percent of these folks have sexual trauma’. I remember thinking: That can’t be right. But that was exactly right. Since I’ve learned about ACEs, I talk about it every day.”
He also practices it every day, by integrating ACEs assessments for all patients in his clinics. He currently has about 200 patients who are addicted, most to opioids (heroin and prescription pain relievers, including oxycodone, hydrocodone, codeine, morphine, and fentanyl). “I’ve seen about 1,200 patients who are addicted,” he says. “Of those, more than 1,100 have an ACE score of 3 or more.”
Sumrok knows that score says a lot about their health and ability to cope: ACEs comes from the
CDC-Kaiser Permanente Adverse Childhood Experiences Study
(ACE Study), groundbreaking research that looked at how 10 types of childhood trauma affect long-term health. They include: physical, emotional and sexual abuse; physical and emotional neglect; living with a family member who’s addicted to alcohol or other substances, or who’s depressed or has other mental illnesses; experiencing parental divorce or separation; having a family member who’s incarcerated, and witnessing a mother being abused.
Subsequent ACE surveys
include racism, witnessing violence outside the home, bullying, losing a parent to deportation, living in an unsafe neighborhood, and involvement with the foster care system. Other types of childhood adversity can also include being homeless, living in a war zone, being an immigrant, moving many times, witnessing a sibling being abused, witnessing a father or other caregiver or extended family member being abused, involvement with the criminal justice system, attending a school that enforces a zero-tolerance discipline policy, etc.
The ACE Study is one of five parts of ACEs science, which also includes how toxic stress from ACEs damage children’s developing brains; how toxic stress from ACEs affects health; and how it can affect our genes and be passed from one generation to another (epigenetics); and resilience research, which shows the brain is plastic and the body wants to heal. Resilience research focuses on what happens when individuals, organizations and systems integrate trauma-informed and resilience-building practices, for example in education
and in the family court system
.
The ACE Study found that the higher someone’s ACE score – the more types of childhood adversity a person experienced – the higher their risk of chronic disease, mental illness, violence, being a victim of violence and a bunch of other consequences. The study found that most people (64%) have at least one ACE; 12% of the population has an ACE score of 4. Having an ACE score of 4 nearly doubles the risk of heart disease and cancer. It increases the likelihood of becoming an alcoholic by 700 percent and the risk of attempted suicide by 1200 percent. (For more information, go to ACEs Science 101
. To calculate your ACE and resilience scores, go to: Got Your ACE Score?
)
High ACE scores also relate to addiction: Compared with people who have zero ACEs, people with ACE scores are two to four times more likely to use alcohol or other drugs and to start using drugs at an earlier age. People with an ACE score of 5 or higher are seven to 10 times more likely to use illegal drugs, to report addiction and to inject illegal drugs.
The ACE Study also found that it didn’t matter what the types of ACEs were
. An ACE score of 4 that includes divorce, physical abuse, an incarcerated family member and a depressed family member has the same statistical health consequences as an ACE score of 4 that includes living with an alcoholic, verbal abuse, emotional neglect and physical neglect.
Subsequent research on the link between childhood adversity and addiction corroborates the findings from the ACE Study, including studies that have found that people who’ve experienced childhood trauma have more chronic pain and use more prescription drugs; people who experienced five or more traumatic events are three times more likely to misuse prescription pain medications.
Dr. Dan Sumrok with group therapy members at McKenzie, TN, clinic (Photo: Yalonda James, The Commercial Appeal)
“ACEs just doesn’t predict substance abuse disorders,” says Sumrok. “All of our major chronic diseases link to substance abuse, so this is too big to ignore.”
Whether you’re talking about obesity, addiction to cigarettes, alcohol or opioids, the cause is the same, he says: “It’s the trauma of childhood that causes neurobiological changes.” And the symptoms he saw 40 years ago in soldiers returning from Vietnam are the same in the people he sees today who are addicted to opioids or other substances or behaviors that help them cope with the anxiety, depression, hopelessness, fear, anger, and/or frustration that continues to be generated from the trauma they experienced as children.
Learning about ACEs helped him understand that the original definition of PTSD, which many people still cling to, is not accurate. In the 1980s, PTSD was defined as a result of trauma that was outside the realm of normal experience.
“That was just wrong,” says Sumrok. “Divorce, living with depressed or addicted family members are very common events for kids. My efforts are around helping people to see the connections, and that their experiences are predictable and normal. And the longer the experiences last, the bigger the effect.”
He also says, “Drop the ‘D’, because PTSD is not a disorder.” It’s what he learned from van der Kolk, who wrote The Body Keeps the Score
. “Bessel says we’ve named this thing wrong. Post-traumatic stress is a brain adaptation. It’s not an imagined fear. If one of your feet was bitten off by a lion, you’re going to be on guard for lions,” explains Sumrok. “Hypervigilance is not an imagined fear, if you’ve had one foot bitten off by a lion. It’s a real fear, and you’re going to be on the lookout for that lion. I tell my patients that they’ve had real trauma that’s not imagined. They’re not crazy.”
Patients who learn about their ACEs understand that they can heal
This is what happens when a person sees Sumrok for the first time: They fill out the 10-question ACE survey ( Got Your ACE Score?
) in the waiting room. “Then when I see them, I go through each question and ask them again,” says Sumrok, who also does a normal physical exam. “Frequently, there’s a difference between the two. For example, this morning, I saw a woman and she reported an ACE score of 1 on the survey. Then, when I asked her the questions, she reported nine out of 10.”
That’s just how I grew up, she told Sumrok. She didn’t think being beaten, humiliated or seeing her mother smoking crack every day was harmful or unusual, especially since most kids she knew were experiencing the same thing.
Sumrok normalizes their addiction, which he explains is the coping behavior they adopted because they weren’t provided with a healthy alternative when they were young. He explains the science of adverse childhood experiences to them, and how their addictions are a normal – and a predictable – result of their childhood trauma. He explains what happens in the brain when they experience toxic stress, how their amygdala is their emotional fuse box. How the thinking part of their brain didn’t develop the way it should have. How it goes offline at the first sign of danger, even if they’re not connecting the trigger with the experience. Drugs like Zoloft don’t really help much, he tells them. Zoloft and other anti-depressants don’t remove the memory triggered by the odor of after shave that was worn by your uncle who sexually abused you when you were eight, or the memory triggered by a voice that sounds just like your mother who used to beat you with a belt, or by a face of a man who looks like your father who used to scream at you about how worthless you were…the examples are infinite. That’s why van der Kolk says, “’The body keeps the score’,” Sumrok says.
“After I explain all this to them, many of them stare at me and say: ‘You mean I’m not crazy?’” says Sumrok. “I tell them, ‘No, you’re not crazy’.” Sometimes he yells out the door to his nurse: ‘Patsy! Where’s my not-crazy stamp? I need to stamp this person’s chart.”
For people who are addicted to opioids, he prescribes buprenorphine (one of the brand names: Suboxone), which helps them to withdraw from opioids and to keep their job, or return to work. For most people, the drug is less addictive than other opioids. Sometimes if people are young, healthy and haven’t been addicted long, they can withdraw from opioids without buprenorphine.
“There’s no buzz associated with buprenorphine,” says Sumrok. “They can concentrate and think. Once they’re free of the continuous distraction of the acquisition and use of substances, they become pretty valuable employees.”
For people who are addicted to alcohol, he prescribes naltrexone (one of the brand names: Revia), because alcoholics have a high risk of death if they aren’t provided medication. And in this current national attention on opioids, Sumrok is careful to point out that although
33,000 people died from opioid overdose in 2015
, 88,000 people die annually from alcohol-related causes
, and 480,000 from cigarette smoking
. The complicating factor — and why policies don’t work when they chase the eradication of one drug, only to focus on eradicating the next popular drug of choice for “ritualized compulsive comfort-seeking” — is that many people use opioids and
alcohol and
cigarettes. And if they receive no help to get at why
they’re using legal or illegal substances, they will move on to another, more easily accessible drug when the current drug they’re using becomes more difficult to find.
All patients sign a contract agreeing that they won’t drink alcohol or take other drugs. “We don’t mess around with that,” says Sumrok. “We can’t deal with them being deceptive, because if they drink or do other drugs, it can kill them. If their drug screens aren’t consistent, we ask them to find another doctor.” Just about everybody stays, he says.
They also participate in group therapy. For physicians who prescribe buprenorphine, it’s now required, but Sumrok had seen the research about the effectiveness of group therapy, and had started 12-step groups for his patients about 10 years ago. Talking with others who have the same experiences helps each person normalize their own experiences. Sumrok and the others in the group help each other find “ritualized compulsive comfort-seeking behaviors” that won’t kill them or put them in jail, such as coaching their kid’s soccer team or volunteering at a food bank. (Sumrok often quotes Forest Gump: “Helping helps the helper.”). He also encourages them to integrate other rituals into their lives, such as walking 30 minutes a day or other exercise, joining a 12-step group or finding a path to encourage a spiritual awakening.
“Six months into this,” says Sumrok, “they start saying things like, ‘My wife and I are back together’, they’re hanging out with their kids. It’s pretty cool to see how people get their lives back. My favorite word is ‘normal’. When they tell me they feel normal, I know they’re doing okay.”
So, how long does it take before they’re cured? “How long should you take insulin if you have diabetes?” responds Sumrok, making the point that this is a chronic disease, that people should be in treatment for as long as it is necessary, and that some may relapse. His goal is for them to not have to use buprenorphine, but he knows that because of the number and duration of their ACEs, and the paucity of resilience factors provided to them when they were children, many will need continual support. He helps them learn how to integrate that support into their lives.
“When a diabetes patient comes in with a blood sugar level of 300, we don’t say: ‘Give me back that insulin.’ We intensify the treatment to get them back in balance,” explains Sumrok. “Only in addictions do we shame people. We tell them they can’t be part of this recovery anymore. We create a teeny hoop that’s called abstinence, and not too many people can jump through that hoop. If every time we saw a diabetic, we told them that their kidneys were going to fail, they would be blind and we would amputate their extremities, there wouldn’t be many diabetics who got help. I have patients who drop out, and then return a couple of months later, and say, ‘Doc, Christmas came, I saw some of my buddies, and I started using again.’ I tell them, ‘Come on in. Let’s work with you.’ And I remind myself that I’m not saving souls, I’m saving their asses. It’s about getting them so they can function at work, at home, at play. It’s not about making them perfect human beings.
“It has been abundantly clear to me and reinforced over a 40-year career,” continues Sumrok, “that patients desire, and respond better to, sensitive and informed care. From the Navajo Nation to Appalachia to Memphis and from the mountains of Honduras to the jungles of Amazonia, people regard respect as the sine qua non
of quality care.”
Stories AND data drive solutions
Although Sumrok thinks his approach benefits his patients, he knows he needs data to prove it. When he saw a recent
study that said 43% of people on buprenorphine
were using other opioids, he did his own analysis of a sample of his patients, and found that only 8% were using other opioids. After tracking down those who were, most had good reasons, such as a man whose arm and shoulder were in a new cast after surgery repairing an injury, and he was taking a narcotic. Only one did not, and when shown his drug test, he said, “You know what? I slipped.” He talked about it in group, says Sumrok, and everyone in his group hovered around him to make sure he’d continue the program.
Dr. Karen Derefinko
Because Sumrok has kept fastidious records of the patients who have done their ACE scores, Dr. Karen Derefinko, a clinical psychologist and assistant professor in the Department of Preventive Medicine at the University of Tennessee Health Science Center, is starting a research project to examine all 1,200 records in Sumrok’s clinic in McKenzie to look at the relationship between people’s ACE scores and their adherence to treatment and their relapses.
“We think that people with high ACE scores are likely to have more relapses,” she says. “And that may be because people with higher scores have fewer resources and more difficulty associated with adhering to their treatment plans.”
She and her research assistant will de-identify the records, so that all information is anonymous, and then collect the data. Once that data is analyzed — probably within two months — Derefinko and her assistant will conduct focus groups of some of Sumrok’s patients. She’s already been sitting in some of the groups.
“Dan encourages this participatory nature of his groups,” she says. “People are very willing to talk. After the group sessions, they’re often not done talking about why they came to Sumrok and why other programs didn’t work for them.”
Through the records and the focus groups, Derefinko hopes to identify barriers to care, which include basics such as how people can find good care easily (most of Sumrok’s patients find out about him through word of mouth), being wary of the treatment because it isn’t explained to them, or — what Sumrok hears a lot — being judged or talked down to instead of given understanding and respect.
“In Shelby County, people complain about barriers to care, which many people think is because of economics,” she says. “But it may not be just economics that is keeping people from accessing treatment; it may be more about being judged, and not knowing what the treatment looks like.”
Being treated with respect builds trust, trust builds health
One of Sumrok’s patients – I’ll call him John, which is not his real name – has been driving 140 miles from Southeast Missouri to see Sumrok for the last five years. He began using drugs off and on during his 20s. When he was in his 30s, he injured his back, was sent to a worker’s comp physician, who prescribed stronger doses of pain killers until his back stopped hurting.
“I was taking pain pills like candy,” says the 46-year-old, who is married and has a son. “All of a sudden, the pills are gone, and you’re very sick, and I start looking for them everywhere – on the street, taking them from family members without asking – just to keep me from getting sick. I thought I had to have them to function. If I didn’t have six or seven pain pills, I wasn’t going to be able to get out of bed. If I didn’t get them, I’d be sick, puking….I’d do about anything to have those pills.”
After he spent his and his wife’s life savings, and the money they’d put away to buy a home, and his retirement fund from a previous job; after he saw friends die from overdosing; and after he realized that he was risking losing his wife and son, he told his wife he needed help, and they found Sumrok.
“It’s been a miracle, for sure,” says John. As the Suboxone took effect, “after two or three weeks, I began to feel normal again.”
About two years ago, Sumrok asked him to fill out the ACE survey. “It really did make a difference,” says John. He had never connected experiences in his childhood with using drugs as an adult.
“When I was just a baby,” recalls John, “my grandpa took me from my mother, and told my parents: ‘When you guys are stable, I’ll let you have him back.’ Up until I was 10 or 11, I called them ‘Mom’ and ‘Dad’.’” His older sisters were sent to live with his other set of grandparents. He didn’t live with his parents again until he was 15 years old. His sisters were adults and out on their own by then.
Until he did the ACE survey and talked with Sumrok about his childhood, it didn’t dawn on him that losing his mother, father and his sisters at a young age could have affected him in ways he didn’t realize. “I knew I was loved by my grandfather and grandmother, but being a young kid and seeing other kids going out with their parents was frustrating,” he says. “I lived with old people who never left the house, while my parents were out running around. I maybe thought my mom and dad didn’t care about me enough to change. I might have always felt like I wasn’t important enough to my mom and dad for them to change the way they were living and acting.”
But now he has a better understanding of what it was like to be a 19-year-old in the late 1960s and involved in the drug and party scene then, as his parents were. He understands them better, and why they weren’t able to care for him. He and his family members have “had our discussions,” says John. “My family life is a whole lot better. I didn’t have relationships with my parents or sisters. We only live seven miles apart, and I barely saw them twice a year, if that. But now I have my wife back. I’ve got my son back. And I see my parents and sisters all the time. We’re a tight-knit family.” He’s also able to hold a job, and is a reliable employee.
John sees Sumrok once a month now. He participates in group therapy, where they can safely talk about their ACE scores without having to get into specifics. He checks in with Sumrok, who renews his prescription.
“I like group therapy with Dr. Sumrok,” says John. “He talks to us with respect. We feel very comfortable with him. Dr. Sumrok never lies. I trust him fully. And he trusts me. It took five or six months to build that trust. The more I met with him, the more I realized that he was really concerned about me. He wants to help people. Let him train more doctors in the procedures he uses. You can’t treat people like they’re nobodies.”
A 29-year-old patient, who chose to be called “Mr. Big” since I’m not using his real name, has been seeing Sumrok for the last six months. He had been in a methadone treatment program, and found Sumrok after he couldn’t pay for treatment any longer. Sumrok was the only physician who would take his insurance. Mr. Big filled out the ACE survey in the waiting room, but reported his score as a two. Then Sumrok went through the survey with him, and Mr. Big’s score climbed to an 8.
“It does help me understand my addiction better,” says Mr. Big, who is a single father of two children, five and six years old. “For one, my trauma in my childhood was very dramatic. I thought everyone’s parents did what they were doing. I could see why I related to narcotics and stuff. It was the only place I had to turn. I started taking opiates when I was 11 or 12 years old. I was playing football, and broke my ankle. They gave me painkillers that made me feel like Superman. I couldn’t get enough, because I wasn’t feeling like Superman without it.”
The Suboxone helps him feel “normal — probably the way everybody else feels,” says Mr. Big. “Nothing I took ever gave me that feeling before. I’m a better person, father, and a better brother” to his sister, whom he convinced to also get help from Sumrok.
The first time he went for help, to a methadone clinic, he didn’t like it for two reasons: Methadone made him nod off or feel high, and the people at the clinic treated him as if he was a number, or just there for the drugs. “That’s just unprofessional, in my opinion,” he says. “Sumrok actually sits down and talks to you like a human being.”
Mr. Big wants to work with Sumrok to develop a “game plan so that I can live without my medicine,” he says. He just wants to live a normal life. What does a normal life mean?
“It means that I’m home overnight with my children,” he says. “I don’t have to rob, lie, steal, or cheat to find drugs. I can fit in with society and not be high off my mind. I can wake up every day and do stuff. My children — they know Daddy’s not in bed sick any more. It’s wonderful. I’m wore out. I never knew that first grade and kindergarten had homework that was so complicated.”
With addictions and deaths on upswing, how to increase addiction docs?
Prescription and illicit opioids are the “main driver of drug overdose deaths,” according to the
CDC, with 33,091 deaths in 2015
. That’s four times more than 1999. And between 2014 and 2015, Tennessee saw a 13.8 percent increase in opioid deaths. More than 1,000 people died from opioid overdoses in 2014, and tens of thousands of people lead desperate lives, most of them unknowingly fueled by their childhood experiences. Only 10% of these are getting the help they need, says Sumrok.
Dan Sumrok is just one doctor, in one part of the country. How can what he does be scaled up to thousands of physicians who can treat addiction — all types of addiction — successfully in all parts of the U.S.? By doing what Dr. David Stern, Robert Kaplan executive dean and vice-chancellor for clinical affairs for the
University of Tennessee’s College of Medicine
and the University of Tennessee
Health Sciences Center, did: launch the
Center for Addiction Science
.
“This really starts with Dr. Altha Stewart, who’s the director of the
Center for Health in Justice-Involved Youth
,” says Stern. “She’s the one who showed me that kids with high ACE scores end up in trouble. When I developed the Center for Addiction Science, it had to be like a cancer center, it had to be multi-disciplinary. In the old days, we thought people who had addictions were weak in the moral department. You really needed someone to straighten you out, because your mother didn’t do a good enough job.”
Dr. David Stern
But that approach doesn’t work. Neither does criminalizing addictions. Stigma drives problems underground, says Stern, instead of driving them to a solution. The center is taking an integrated approach to using research and education to help people in all possible ways, from physiology to genetics to counseling.
Stern believes that every physician should know about ACEs science, which is one of the reasons he chose Sumrok to lead the center, along with his willingness to be creative and seek solutions across disciplines. “Two of the most prevalent things in acute care are depression and addiction,” says Stern. “I think it’s important to be able to understand what ACEs mean to patients, what addiction is all about, how to recognize it, how to treat it.” He’s in the process of finding an associate dean for medical education, and is looking for someone who will integrate ACEs and other social determinants of health into the school’s curriculum.
“I think a medical school should provide for the community it serves,” says Stern. “This medical school should be the medical school for Memphis. We should develop solutions that are scalable.”
Dr. Altha Stewart, associate professor of psychiatry in the University of Tennessee College of Medicine, learned about ACEs in 2009 when a group in Shelby County began educating people about ACEs science. They brought Dr. Vincent Felitti, co-founder of the ACE Study, and Robin Karr Morse, who wrote
Ghosts from the Nursery: Tracing the Roots of Violence
, which was published in 2007, to give a presentation. (Karr-Morse later wrote
Scared Sick: The Role of Childhood Trauma in Adult Disease
with Meredith S. Wiley; it was published in 2012.)
Dr. Altha Stewart
“It’s become a core part of what I do now in my professional work,” says Stewart, who was recently named president-elect of the
American Psychiatric Association
. She’s working with the Shelby County community and the local criminal justice system to integrate trauma-informed and resilience-building practices to find ways to help youth who enter the justice system — all of whom have likely experienced ACEs — instead of shaming, blaming or punishing them.
The things that have happened to kids — as well as to many people who come into the health care system — are out of their control, says Stewart. “When you’re a child, you don’t control the people who abuse and assault you, who create hostile environments, who don’t provide you with clean clothes,” she
says. “If a child can’t control their environment, because of these things they grow up thinking they’re bad, different, horrible people. This new approach (integrating trauma-informed and resilient-building practices based on ACEs science) helps them feel like they’re not drowning anymore. When they can pop their head out of the water and get a breath, and see outstretched hands, a life preserver, a life boat, that changes their entire perspective.”
When Sumrok began integrating ACEs into addiction treatment, that was innovative, says Stewart. “If you don’t ask these questions, people tend not to tell you,” she says. Sumrok’s approach is part of a shift in patient engagement and involvement. “The trend in health care is that patients are partners in their treatment.”
This new knowledge about why and how humans behave the way they do also speaks to how “we have trained the medical profession,” says Stewart. The traditional approach is that physicians “know everything. The people whom we treat know nothing. We tell them what to do, and if they don’t get better or do what we say, it’s their own fault.
“That’s simply not true,” she emphasizes. “Some of us have come to understand that there’s more expertise in the community and our patients than we’ve understood. That takes a bit of humility on the part of a physician, and an understanding that we are partners in helping a person heal.”
Sumrok’s experience with the young fellows at the Center for Addiction Science is giving him some real hope that the medical profession can change. When he’s explained to them how important it is to ask patients about ACEs and other aspects of their lives — such as food availability, safe housing, transportation, jobs (in the medical profession vernacular: social determinants of health) — “they say ‘isn’t that just taking a patient history?’”
He and others at the University of Tennessee Health Sciences Center have an opportunity to educate young physicians outside the state, too. Derefinko is also director of the newly created National Center for Research of the Addiction Medicine Foundation. The foundation oversees the 130 addiction medicine fellowships at 46 medical schools across the country.
“We want metrics to understand the impact they’re having” when they go out in the world, says Derefinko: where they go, whom they’re treating, how they’re practicing, whether they’re integrating ACEs science. In addition, the foundation will be developing some accreditation guidelines so that all fellows receive the latest and best education in addiction medicine.
One of those elements, says Sumrok, has to be empathy, which physicians can practice by listening, acknowledging and understanding how the experiences in a person’s childhood and adulthood have shaped their lives and health.
“Can you teach empathy?” he asks. “Can people learn to be empathetic providers? I think you can. I think so.”
_______________________
If you’re interested in becoming more involved in the PACEs science community, join our companion social network, PACEs Connection. Just go to PACEsConnection.com
and click “Join”. PACEsConnection.com is the leading advocate for information about the science of positive and adverse childhood experiences (PACEs) and the rapidly expanding, global PACEs science movement.
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Rates of lymphocytic thyroiditis and ultrasound features of citologically-interrogated thyroid nodules based on the area of residence in a Sicily province | Request PDF
Request PDF | Rates of lymphocytic thyroiditis and ultrasound features of citologically-interrogated thyroid nodules based on the area of residence in a Sicily province | PurposeTo verify the prevalence of autoimmune thyroiditis (AIT) and the ultrasound characteristics (composition and volume) of thyroid nodules... | Find, read and cite all the research you need on ResearchGate
Rates of lymphocytic thyroiditis and ultrasound features of citologically-interrogated thyroid nodules based on the area of residence in a Sicily province
Endocrine 72(Suppl 5)
DOI: 10.1007/s12020-020-02521-z
Authors:
Università degli Studi di Messina
Giovanni Capodicasa
Show all 10 authors Hide
Abstract and Figures
PurposeTo verify the prevalence of autoimmune thyroiditis (AIT) and the ultrasound characteristics (composition and volume) of thyroid nodules with respect to the area of residence in the province of Messina, some areas having environmental issues.Methods
Fine-needle aspiration-interrogated nodules (n = 902) of 809 patients were evaluated upon stratification into 8 areas of residence.ResultsOverall, women were younger than men (55.3 ± 14.0 vs. 58.6 ± 12.6 years, P = 0.0083). Patients residing in three areas (one hosting two garbage dumps, one hosting a petrochemical complex and a thermoelectrical power plant, and one hosting several ceramic factories [CFA]) were younger than those residing in the city of Messina (MEA) (52.9 ± 13.4 vs. 57.7 ± 13.6 years, P < 0.0001). Also, patients residing in those three areas had a greater rate of AIT, diagnosed either ultrasonographically/serologically (22.2% of patients) or cytologically (26.3% of nodules), compared with MEA (11.7% of patients, P = 0.0007 or 20.2% of nodules, P = 0.0815). Rates of AIT ranged 12.5–28.6% in the remaining four areas. Overall, nodules in women were smaller than in men (3.6 ± 5.7 vs. 6.1 ± 9.4 ml, P = 0.0006). Compared with the other seven areas, patients living in CFA had the largest nodules (6.8 ± 6.8 ml, P = 0.0040–0.0291), with the nodule volume being inversely correlated to patient’s age (r = −0.4955, P = 0.0431).Conclusion
Rates of AIT and associated ultrasound features of thyroid nodules vary in different areas of our province. Further studies correlating these rates and features with exposure to specific toxicants are warranted.
Province of Messina (Sicily, Italy) and its subdivision into eight areas (see text). The province is 68 km long on the Ionian seaside and 150 km long on the Tyrrhenian seaside. Abbreviations in alphabetical orde: CFA the area that hosts the major ceramic factory center of the northern Sicily, which includes five towns, EIA the seven Eolian Islands, including their four municipalities; GDA the garbage dump area, including the six towns that host two garbage dumps, ICA the Ionian coast area, which includes the 18 eastern costal towns overlooking the Ionian Sea, MEA the city of Messina and the four easternmost towns overlooking the Tyrrhenian Sea, MOA the 47 towns located on two mountain ranges (the Nebrodi and the Peloritani mountains), mun municipality, nod nodules, PCTPA the area that hosts a petrochemical complex and a thermoelectrical power plant, which includes 13 towns, pts patients, TCA the Tyrrhenian coast area, which includes the ten costal towns overlooking the Tyrrhenian Sea other than those of MEA, GDA, PCTPA, and CFA. For a list of all municipalities of the province of Messina see Supplementary Table 1 …
Age at observation and F:M ratio (white bars = men; black bars = women; striped bars = men and women) based on area of residence. The polluted areas (GDA, PCTPA and CFA) were considered either alone or taken as a whole. Statistically significant differences are indicated by asterisks (*0.001 < P < 0.01; **0.001 < P < 0.0001; ***P < 0.0001), and borderline significant differences (0.05 < P < 0.10) are indicated by the caret (^). For abbreviations see Fig. 1 legend …
Volume of thyroid nodules according to gender (white bars = men; black bars = women; striped bars = men and women) and area of residence. The polluted areas (GDA, PCTPA, and CFA) were considered either alone or taken as a whole. Statistically significant differences are indicated by asterisks (*0.001 < P < 0.01; **0.001 < P < 0.0001; ***P < 0.0001), and borderline significant differences (0.05 < P < 0.10) are indicated by the caret (^). For abbreviations see Fig. 1 legend …
Frequency of serologically and/or ultrasonographically diagnosed autoimmune thyroiditis according to gender (white bars = men; black bars = women; striped bars = men and women) and area of residence. Autoimmune thyroiditis was diagnosed based on serum thyroid autoantibodies positivity (i.e., thyroid peroxidase antibodies and/or thyroglobulin antibodies) and/or the ultrasonographic appearance of the thyroid parenchyma (hypoechoic and inhomogeneous). The polluted areas (GDA, PCTPA, and CFA) were considered either alone or taken as a whole. Statistically significant differences are indicated by asterisks (*0.001 < P < 0.01; **0.001 < P < 0.0001; ***P < 0.0001), and borderline significant differences (0.05 < P < 0.10) are indicated by the caret (^). For abbreviations see Fig. 1 legend. Overall, AIT was significantly more frequent in females compared with males (110/637 [17.3%] vs. 16/172 [9.3%], OR = 2.035, 95% CI = 1.169–3.542, P = 0.0106) …
Frequency of cytologically diagnosed autoimmune thyroiditis according to gender (white bars = men; black bars = women; striped bars = men and women) and area of residence. Note that cystic nodules were disregarded. Autoimmune thyroiditis was diagnosed based on the presence of lymphocytes either infiltrating thyroid follicles or in the background along with signs of inflammation and moderate amount of colloid. The polluted areas (GDA, PCTPA, and CFA) were considered either alone or taken as a whole. Statistically significant differences are indicated by asterisks (*0.001 < P < 0.01; **0.001 < P < 0.0001; ***P < 0.0001), and borderline significant differences (0.05 < P < 0.10) are indicated by the caret (^). For abbreviations see Fig. 1 legend …
Figures - available from: Endocrine
Endocrine (2021) 72:744 – 757
https://doi.org/10.1007/s12020-020-02521-z
ORIGINAL ARTICLE
Rates of lymphocytic thyroiditis and ultrasound features
of citologically-interrogated thyroid nodules based on the
area of residence in a Sicily province
Roberto Vita 1 ● Flavia Di Bari 1 ● Giovanni Capodicasa 1 ● Sarah Perelli 1 ● Anna Maria Bonanno 2 ● Antonio Ieni 2 ●
Mariacarla Moleti 1 ● Francesco Vermiglio 1,3 ● Giovanni Tuccari 2 ● Salvatore Benvenga 1,4,5
Received: 2 July 2020 / Accepted: 3 October 2020 / Published online: 15 October 2020
© Springer Science + Business Media, LLC, part of Springer Nature 2020
Abstract
Purpose To verify the prevalence of autoimmune thyroiditis (AIT) and the ultrasound characte ristics (composition and
volume) of thyroid nodules with respect to the area of residence in the province of Messina, some areas having environ-
mental issues.
Methods Fine-needle aspiration-interrogated nodules ( n = 902) of 809 pati ents were evaluated upon strati fi cation into 8
areas of residence.
Results Overall, women were younger than men (55.3 ± 14.0 vs. 58.6 ± 12.6 years, P = 0 .0083). Patients residing in three
areas (one hosting two garbage dumps, one hosting a petrochemical complex and a thermoel ectrical power plant, and one
hosting several ceramic factories [CFA]) were younger than those residing in the city of Messina (MEA) (52.9 ± 13.4 vs.
57.7 ± 13.6 years, P < 0.0001). Also, patients residing in those three areas had a greater rate of AIT, diagnosed either
ultrasonographically/serologically (22.2% of patients) or cytologically (26.3% of nodules), compared with MEA (11.7% of
patients, P = 0.0007 or 20.2% of nodules, P = 0.0815). Rates of AIT ranged 12.5 – 28.6% in the remaining four areas.
Overall, nodules in wom en were smaller than in men (3.6 ± 5.7 vs. 6.1 ± 9.4 ml, P = 0.0006). Compared with the other seven
areas, patients living in CFA had the largest nodules (6.8 ± 6.8 ml, P = 0.0040 – 0.0291), with the nodule volume being
inversely correlated to patient ’ s age ( r = − 0.4955, P = 0.0431).
Conclusion Rates of AIT and associated ultrasound features of thyroid nodule s vary in different areas of our province.
Further studies correlating these rates and features wi th exposure to speci fi c toxicants are warranted.
Keywords Thyroid nodules ● Chronic lymphocytic thyroiditis ● Autoimmune thyroiditis ● Fine-n eedle aspiration ●
Environment ● Pollution
Abbreviations
AIT autoimmune thyroiditis
CAIT cytology-based autoimmune thyroiditis
CFA ceramic factory area
CO carbon monoxide
EIA Eolian Islands
FNA fi ne-needle aspiration
FT3 free triiodothyronine
FT4 free thyroxine
GDA garbage dump area
* Roberto Vita
[email protected]
1 Department of Clinical and Experimental Medicine,
University of Messina, Viale Gazzi, 98125 Messina, Italy
2 Department of Human Pathology of Adult and Evolutive Age
Gaetano Barresi - Section of Pathological Anatomy,
University of Messina, Viale Gazzi, 98125 Messina, Italy
3 Interdepartmental Program on New Models of Multidisciplinary
Management in Endocrinology, University Hospital, A.O.U.
Policlinico G. Martino, Viale Gazzi, 98125 Messina, Italy
4 Master Program on Childhood, Adolescent and Women ’ s
Endocrine Health, University of Messina, Viale Gazzi,
98125 Messina, Italy
5 Interdepartmental Program of Molecular & Clinical Endocrinology
and Women ’ s Endocrine Health, University Hospital, A.O.U.
Policlinico G. Martino, Viale Gazzi, 98125 Messina, Italy
Supplementary information The online version of this article ( https://
doi.org/10.1007/s12020-020-02521-z ) contains supplementary
Trace Element Status and Hypothyroidism: A Systematic Review and Meta-analysis
Sep 2020
BIOL TRACE ELEM RES
Sepide Talebi
Ehsan Ghaedi
Erfan Sadeghi
Gholamreza Askari
The relationship between thyroid hormones metabolism and trace element levels has biological plausibility; however, previous reports that compared trace element levels in patients with hypothyroidism and healthy individuals yielded conflicting results. Therefore, the aim of this meta-analysis was to investigate the association between selected trace elements (i.e., selenium (Se), zinc (Zn), iron (Fe), manganese (Mn), copper (Cu), lead (Pb)), and magnesium (Mg) concentrations in patients with hypothyroidism and healthy controls. Electronic databases, including PubMed, Scopus, Embase, and Science Direct, were searched systematically until September 2019. Thirty-two observational studies were included in the final analyses. Hedges’ g tests were used to estimate effect sizes, as trace element concentrations were reported using different measurement units across the studies. Selenium (Hedges’ g = − 0.52; 95% CI = [− 1.05, − 0.002]; P = 0.049) and Zn (Hedges’ g = − 0.86; 95% CI = [− 1.66, − 0.06]; P = 0.035) concentrations were significantly lower, whereas Pb concentrations were significantly higher (Hedges’ g = 0.34; 95% CI = [0.10, 0.59]; P = 0.006) in patients with hypothyroidism compared with healthy controls. There were no differences in the concentrations of Fe, Cu, Mn, and Mg between the groups. Patients with hypothyroidism exhibited lower Se and Zn and increased Pb concentrations compared with healthy controls. High-quality studies with larger sample sizes are required to explicate the link between trace element status and hypothyroidism.
View
Show abstract
Increased risk for hypothyroidism associated with carbon monoxide poisoning: a nationwide population-based cohort study
Nov 2019
Chien-Cheng Huang
Chung-Han Ho
Yi-Chen Chen
How-Ran Guo
Carbon monoxide poisoning (COP) may cause injuries to the central nervous and endocrine systems, which might increase the risk of developing hypothyroidism. We wanted to evaluate the association between COP and the risk of developing hypothyroidism because epidemiological data on this potential association are limited. We conducted a nationwide population-based cohort study using the Nationwide Poisoning Database and identified 24,328 COP subjects diagnosed between 1999 and 2012. By matching the index date and age, we selected 72,984 non-COP subjects for comparison. Subjects with thyroid diseases and malignancy before 1999 were excluded. We followed up the two groups of subjects until 2013 and compared the risk of developing hypothyroidism. COP subjects had a significantly higher risk for hypothyroidism than non-COP subjects (adjusted hazard ratio [AHR]: 3.8; 95% confidence interval [CI]: 3.2–4.7) after adjusting for age, sex, underlying comorbidities, and monthly income, and the AHR was particular higher in subjects with diabetes mellitus, hyperlipidemia, and mental disorder. The increased risk was highest in the first month after COP (AHR: 41.0; 95% CI: 5.4–310.6), and the impact remained significant even after 4 years. In conclusion, COP was associated with an increased risk for hypothyroidism. Further studies regarding the underlying mechanisms are warranted.
Association of Exposure to Ambient Air Pollution With Thyroid Function During Pregnancy
Oct 2019
Akhgar Ghassabian
Livia Pierotti
Mikel Basterrechea
Mònica Guxens
Importance
Air pollutants interact with estrogen nuclear receptors, but their effect on thyroid signaling is less clear. Thyroid function is of particular importance for pregnant women because of the thyroid’s role in fetal brain development.
Objective
To determine the short-term association of exposure to air pollution in the first trimester with thyroid function throughout pregnancy.
Design, Setting, and Participants
In this cohort study, 9931 pregnant women from 4 European cohorts (the Amsterdam Born Children and Their Development Study, the Generation R Study, Infancia y Medio Ambiente, and Rhea) and 1 US cohort (Project Viva) with data on air pollution exposure and thyroid function during pregnancy were included. The recruitment period for the Amsterdam Born Children and Their Development Study was January 2003 to March 2004; for Generation R, April 2002 to January 2006; for Infancia y Medio Ambiente, November 2003 to January 2008; for Rhea, February 2007 to February 2008; and for Project Viva, April 1999 to November 2002. Statistical analyses were conducted from January 2018 to April 2019.
Main Outcomes and Measures
Residential air pollution concentrations (ie, nitrogen oxide and particulate matter [PM]) during the first trimester of pregnancy were estimated using land-use regression and satellite-derived aerosol optical depth models. Free thyroxine, thyrotropin, and thyroid peroxidase antibody levels were measured across gestation. Hypothyroxinemia was defined as free thyroxine below the fifth percentile of the cohort distribution with normal thyrotropin levels, following the American Thyroid Association guidelines.
Results
Among 9931 participants, the mean (SD) age was 31.2 (4.8) years, 4853 (48.9%) had more than secondary educational levels, 5616 (56.6%) were nulliparous, 404 (4.2%) had hypothyroxinemia, and 506 (6.7%) tested positive for thyroid peroxidase antibodies. Concentrations of nitrogen dioxide and PM with an aerodynamic diameter of 2.5 μm or less (PM2.5) were lower and had less variation in women in the US cohort than those in European cohorts. No associations of nitrogen oxide with thyroid function were found. Higher exposures to PM2.5 were associated with higher odds of hypothyroxinemia in pregnant women (odds ratio per 5-μg/m3 change, 1.21; 95% CI, 1.00-1.47). Although exposure to PM with an aerodynamic diameter of 10 μm or less was not significantly associated with hypothyroxinemia, the coefficient was similar to that for the association of PM2.5 with hypothyroxinemia (odds ratio per 10-μg/m3 change, 1.18; 95% CI, 0.93-1.48). Absorbances of PM2.5 and PM with aerodynamic diameter from 2.5 to 10 μg and were not associated with hypothyroxinemia. There was substantial heterogeneity among cohorts with respect to thyroid peroxidase antibodies (P for heterogeneity, <.001), showing associations of nitrogen oxide and PM with thyroid autoimmunity only in the women in the Generation R Study.
Conclusions and Relevance
The findings of this study suggest that first-trimester exposures to PM2.5 were associated with mild thyroid dysfunction throughout pregnancy. The association of PM2.5 exposure with thyroid function during pregnancy is of global health importance because air pollution exposure is widespread and hypothyroxinemia may adversely influence the brain development of offspring.
Stable consumption of swordfish favors, whereas stable consumption of oily fish protects from, development of postpartum thyroiditis
Jul 2019
ENDOCRINE
Salvatore Benvenga
Roberto Vita
Flavia Di Bari
Maria Le Donne
Purpose
In 236 pregnant women, we showed that selective or predominant consumption of swordfish (group A) was associated with high rates of positivity for serum thyroid autoantibodies (TPOAb and TgAb) throughout day 4 postpartum. In contrast, selective or predominant consumption of oily fish (group B) was associated with TPOAb and TgAb negativity. Rates were intermediate in group C (scanty consumption of swordfish) and group D (consumption of fish other than swordfish and oily fish). Gestational TPOAb positivity is a risk factor for postpartum thyroiditis (PPT), which evolves into permanent hypothyroidism (PH) in about 50% of cases. Purpose of this study was to verify that the different rates of thyroid autoantibodies in the four groups translated into different PPT rates.
Methods
We expanded our previous cohort (n = 412) and duration of follow-up (month 12 postpartum), and measured frequency of PPT and PH.
Results
At first timester of gestation, we confirmed the different Ab positivity rates in group A vs. group B (TPOAb = 21.7% vs. 4.7%, P < 0.0001; TgAb = 14.1% vs. 2.4%, P < 0.05). Overall, PPT prevalence was 63/412 (15.3%), but 22/92 in group A (23.9%), 4/85 in group B (4.7%; P < 0.0001 vs. group A), 17/108 (15.7%) in group C, and 16/117 (13.7%) in group D. Approximately half of the PPT women had PH, regardless of fish group.
Conclusions
In conclusion, stable consumption of oily fish (which is enriched in polyunsaturated omega-3 fatty acids) protects from PPT, while stable consumption of swordfish (which is enriched in pollutants) favors PPT. Thus, a dietary prophylaxis of PPT is possible.
The increasing prevalence of chronic lymphocytic thyroiditis in papillary microcarcinoma
Dec 2018
REV ENDOCR METAB DIS
Roberto Vita
Antonio Ieni
Prof. Dr. Giovanni Tuccari
Salvatore Benvenga
Although the incidence of some malignancy has decreased over the recent years, this is not the case of papillary thyroid microcarcinoma (PTMC), whose incidence has increased worldwide. Most PTMC are found incidentally after histological examination of specimens from surgery for benign thyroid disease. Hashimoto’s thyroiditis, whose incidence has also increased, coexists in about one in three PTMC patients. Three different mechanisms have been proposed to clarify the association between chronic lymphocytic thyroiditis and PTMC, namely tumor development/growth by: (i) TSH stimulation, (ii) expression of certain proto-oncogenes, (iii) chemokines and other molecules produced by the lymphocytic infiltrate. Whether Hashimoto’s thyroiditis protects against lymph node metastasis is debated. Overall, autommune thyroiditis seems to contribute to the favorable prognosis of PTMC. Major limitations of the studies so far performed include: (i) retrospective design, (ii) limited statistical power, (iii) high risk of selection bias, (iv) and predominant Asian ethnicity of patients. Full genetic profiling of both diseases and identification of environmental factors capable to trigger them, as well as well-powered prospective studies on different ethnical groups, may help understand their causal association and why their frequencies are continuing raising.
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| https://www.researchgate.net/publication/346242140_Rates_of_lymphocytic_thyroiditis_and_ultrasound_features_of_citologically-interrogated_thyroid_nodules_based_on_the_area_of_residence_in_a_Sicily_province |
Network Working Group Henk Smit
INTERNET DRAFT Tony Li
Procket Networks
August 2003
IS-IS extensions for Traffic Engineering
<draft-ietf-isis-traffic-05.txt>
Status
This document is an Internet-Draft and is subject to all provisions
of Section 10 of RFC2026.
Internet-Drafts are working documents of the Internet Engineering
Task Force (IETF), its areas, and its working groups. Note that
other groups may also distribute working documents as Internet-
Drafts.
Internet-Drafts are draft documents valid for a maximum of six months
and may be updated, replaced, or obsoleted by other documents at any
time. It is inappropriate to use Internet-Drafts as reference
material or to cite them other than as "work in progress."
The list of current Internet-Drafts can be accessed at
http://www.ietf.org/ietf/1id-abstracts.txt
The list of Internet-Draft Shadow Directories can be accessed at
http://www.ietf.org/shadow.html.
Abstract
This document describes extensions to the IS-IS protocol to support
Traffic Engineering.
This document extends the IS-IS protocol by specifying new
information that an Intermediate System [router] can place in Link
State Protocol Data Units. This information describes additional
details of the state of the network that are useful for traffic
engineering computations.
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1.0 Introduction
The IS-IS protocol is specified in ISO 10589 [1], with extensions for
supporting IPv4 specified in RFC 1195 [3]. Each Intermediate System
(IS) [router] advertises one or more IS-IS Link State Protocol Data
Units (LSPs) with routing information. Each LSP is composed of a
fixed header and a number of tuples, each consisting of a Type, a
Length, and a Value. Such tuples are commonly known as TLVs, and are
a good way of encoding information in a flexible and extensible
format.
The changes in this document include the design of new TLVs to
replace the existing IS Neighbor TLV, IP Reachability TLV and add
additional information. Mechanisms and procedures to migrate to the
new TLVs are not discussed in this document.
The primary goal of these extensions is to add more information about
the characteristics of a particular link to an IS-IS's LSP. The
characteristics described in this document are needed for Traffic
Engineering [4] (TE). Secondary goals include increasing the dynamic
range of the IS-IS metric and improving the encoding of IP prefixes.
The router id is useful for traffic engineering purposes because it
describes a single address that can always be used to reference a
particular router.
2.0 Introducing Sub-TLVs
This document introduces a new way to encode routing information in
IS-IS. The new object is called a sub-TLV. Sub-TLVs are similar to
regular TLVs. They use the same concepts as regular TLVs. The
difference is that TLVs exist inside IS-IS packets, while sub-TLVs
exist inside TLVs. TLVs are used to add extra information to IS-IS
packets. Sub-TLVs are used to add extra information to particular
TLVs. Each sub-TLV consists of three fields. A one-octet Type field,
a one-octet Length field, and zero or more octets of Value. The Type
field indicates the type of items in the Value field. The Length
field indicates the length of the Value field in octets. Each sub-
TLV can potentially hold multiple items. The number of items in a
sub-TLV can be computed from the length of the whole sub-TLV, when
the length of each item is known. Unknown sub-TLVs are to be ignored
and skipped on receipt.
The Sub-TLV type space is managed by the IETF IS-IS WG
(http://www.ietf.org/html.charters/isis-charter.html). New type
values are allocated following review on the IETF IS-IS mailing list.
This will normally require publication of additional documentation
describing how the new type is used. In the event that the IS-IS
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working group has disbanded the review shall be performed by a
Designated Expert assigned by the responsible Area Director.
3.0 The extended IS reachability TLV
The extended IS reachability TLV is TLV type 22.
The existing IS reachability (TLV type 2, defined in ISO 10589 [1])
contains information about a series of IS neighbors. For each
neighbor, there is a structure that contains the default metric, the
delay, the monetary cost, the reliability, and the 7-octet ID of the
adjacent neighbor. Of this information, the default metric is
commonly used. The default metric is currently one octet, with one
bit used to indicate that the metric is present and one bit used to
indicate whether the metric is internal or external. The remaining 6
bits are used to store the actual metric, resulting a possible metric
range of 0-63. This limitation is one of the restrictions that we
would like to lift.
The remaining three metrics (delay, monetary cost, and reliability)
are not commonly implemented and reflect unused overhead in the TLV.
The neighbor is identified by its system Id (typically 6-octets),
plus one octet to indicate the pseudonode number if the neighbor is
on a LAN interface. Thus, the existing TLV consumes 11 octets per
neighbor, with 4 octets for metric and 7 octets for neighbor
identification. To indicate multiple adjacencies, this structure is
repeated within the IS reachability TLV. Because the TLV is limited
to 255 octets of content, a single TLV can describe up to 23
neighbors. The IS reachability TLV can be repeated within the LSP
fragments to describe further neighbors.
The proposed extended IS reachability TLV contains a new data
structure, consisting of:
7 octets of system Id and pseudonode number
3 octets of default metric
1 octet of length of sub-TLVs
0-244 octets of sub-TLVs,
where each sub-TLV consists of a sequence of
1 octet of sub-type
1 octet of length of the value field of the sub-TLV
0-242 octets of value
Thus, if no sub-TLVs are used, the new encoding requires 11 octets
and can contain up to 23 neighbors. Please note that while the
encoding allows for 255 octets of sub-TLVs, the maximum value cannot
fit in the overall IS reachability TLV. The practical maximum is 255
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octets minus the 11 octets described above, or 244 octets. Further,
there is no defined mechanism for extending the sub-TLV space for a
particular neighbor. Thus, wasting sub-TLV space is discouraged.
The metric octets are encoded as a 24-bit unsigned integer. Note that
the metric field in the new extended IP reachability TLV is encoded
as a 32-bit unsigned integer. These different sizes were chosen so
that it is very unlikely that the cost of an intra-area route has to
be chopped off to fit in the metric field of an inter-area route.
To preclude overflow within a SPF implementation, all metrics greater
than or equal to MAX_PATH_METRIC SHALL be considered to have a metric
of MAX_PATH_METRIC. It is easiest to select MAX_PATH_METRIC such
that MAX_PATH_METRIC plus a single link metric does not overflow the
number of bits for internal metric calculation. We assume that this
is 32 bits. Thus, MAX_PATH_METRIC is 4,261,412,864 (0xFE000000, 2^32
- 2^25).
If a link is advertised with the maximum link metric (2^24 - 1), this
link MUST NOT be considered during the normal SPF computation. This
will allow advertisement of a link for other purposes than building
the normal Shortest Path Tree. An example is a link that is available
for traffic engineering, but not for hop-by-hop routing.
Certain sub-TLVs are proposed here:
Sub-TLV type Length (octets) Name
3 4 Administrative group (color)
6 4 IPv4 interface address
8 4 IPv4 neighbor address
9 4 Maximum link bandwidth
10 4 Reservable link bandwidth
11 32 Unreserved bandwidth
18 3 TE Default metric
250-254 Reserved for cisco specific extensions
255 Reserved for future expansion
Each of these sub-TLVs is described below. Unless stated otherwise,
multiple occurrences of the information are supported by multiple
inclusions of the sub-TLV.
3.1 Sub-TLV 3: Administrative group (color, resource class)
The administrative group sub-TLV contains a 4-octet bit mask assigned
by the network administrator. Each set bit corresponds to one
administrative group assigned to the interface.
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By convention the least significant bit is referred to as 'group 0',
and the most significant bit is referred to as 'group 31'.
This sub-TLV is OPTIONAL. This sub-TLV SHOULD appear at most once in
each extended IS reachability TLV.
3.2 Sub-TLV 6: IPv4 interface address
This sub-TLV contains a 4-octet IPv4 address for the interface
described by the (main) TLV. This sub-TLV can occur multiple times.
Implementations MUST NOT inject a /32 prefix for the interface
address into their routing or forwarding table, because this can lead
to forwarding loops when interacting with systems that do not support
this sub-TLV.
If a router implements the basic TLV extensions in this document, it
MAY add or omit this sub-TLV to the description of an adjacency. If
a router implements traffic engineering, it MUST include this sub-
TLV.
3.3 Sub-TLV 8: IPv4 neighbor address
This sub-TLV contains a single IPv4 address for a neighboring router
on this link. This sub-TLV can occur multiple times.
Implementations MUST NOT inject a /32 prefix for the neighbor address
into their routing or forwarding table, because this can lead to
forwarding loops when interacting with systems that do not support
this sub-TLV.
If a router implements the basic TLV extensions in this document, it
MAY add or omit this sub-TLV to the description of an adjacency. If
a router implements traffic engineering, it MUST include this sub-TLV
on point-to-point adjacencies.
3.4 Sub-TLV 9: Maximum link bandwidth
This sub-TLV contains the maximum bandwidth that can be used on this
link in this direction (from the system originating the LSP to its
neighbors). This is useful for traffic engineering.
The maximum link bandwidth is encoded in 32 bits in IEEE floating
point format. The units are bytes (not bits!) per second.
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This sub-TLV is optional. This sub-TLV SHOULD appear at most once in
each extended IS reachability TLV.
3.5 Sub-TLV 10: Maximum reservable link bandwidth
This sub-TLV contains the maximum amount of bandwidth that can be
reserved in this direction on this link. Note that for
oversubscription purposes, this can be greater than the bandwidth of
the link.
The maximum reservable link bandwidth is encoded in 32 bits in IEEE
floating point format. The units are bytes (not bits!) per second.
This sub-TLV is optional. This sub-TLV SHOULD appear at most once in
each extended IS reachability TLV.
3.6 Sub-TLV 11: Unreserved bandwidth
This sub-TLV contains the amount of bandwidth reservable in this
direction on this link. Note that for oversubscription purposes,
this can be greater than the bandwidth of the link.
Because of the need for priority and preemption, each head end needs
to know the amount of reserved bandwidth at each priority level.
Thus, this sub-TLV contains eight 32 bit IEEE floating point numbers.
The units are bytes (not bits!) per second. The values correspond to
the bandwidth that can be reserved with a setup priority 0 through 7,
arranged in increasing order with priority 0 occurring at the start
of the sub-TLV, and priority 7 at the end of the sub-TLV.
For stability reasons, rapid changes in the values in this sub-TLV
SHOULD NOT cause rapid generation of LSPs.
This sub-TLV is optional. This sub-TLV SHOULD appear at most once in
each extended IS reachability TLV.
3.7 Sub-TLV 18: Traffic Engineering Default metric
This sub-TLV contains a 24-bit unsigned integer. This metric is
administratively assigned and can be used to present a differently
weighted topology to traffic engineering SPF calculations.
To preclude overflow within a SPF implementation, all metrics greater
than or equal to MAX_PATH_METRIC SHALL be considered to have a metric
of MAX_PATH_METRIC. It is easiest to select MAX_PATH_METRIC such
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that MAX_PATH_METRIC plus a single link metric does not overflow the
number of bits for internal metric calculation. We assume that this
is 32 bits. Thus, MAX_PATH_METRIC is 4,261,412,864 (0xFE000000, 2^32
- 2^25).
This sub-TLV is optional. This sub-TLV SHOULD appear at most once in
each extended IS reachability TLV. If a link is advertised without
this sub-TLV, traffic engineering SPF calculations MUST use the
normal default metric of this link, which is advertised in the fixed
part of the extended IS reachability TLV.
4.0 The extended IP reachability TLV
The extended IP reachability TLV is TLV type 135.
The existing IP reachability TLVs (TLV type 128 and TLV type 130,
defined in RFC 1195 [3]) carry IP prefixes in a format that is
analogous to the IS neighbor TLV from ISO 10589 [1]. They carry four
metrics, of which only the default metric is commonly used. Of this,
the default metric has a possible range of 0-63. This limitation is
one of the restrictions that we would like to lift.
In addition, route redistribution (a.k.a. route leaking) has a key
problem that was not fully addressed by the existing IP reachability
TLVs. RFC 1195 [3] allows a router to advertise prefixes upwards in
the level hierarchy. Unfortunately there were no mechanisms defined
to advertise prefixes downwards in the level hierarchy.
To address these two issues, the proposed extended IP reachability
TLV provides for a 32 bit metric and adds one bit to indicate that a
prefix has been redistributed 'down' in the hierarchy.
The proposed extended IP reachability TLV contains a new data
structure, consisting of:
4 octets of metric information
1 octet of control information, consisting of
1 bit of up/down information
1 bit indicating the presence of sub-TLVs
6 bits of prefix length
0-4 octet of IPv4 prefix
0-250 optional octets of sub-TVLs, if present consisting of
1 octet of length of sub-TLVs
0-249 octets of sub-TLVs,
where each sub-TLV consists of a sequence of
1 octet of sub-type
1 octet of length of the value field of the sub-TLV
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0-247 octets of value
This data structure can be replicated within the TLV, not to exceed
the maximum length of the TLV.
The 6 bits of prefix length can have the values 0-32 and indicate the
number of significant bits in the prefix. The prefix is encoded in
the minimal number of octets for the given number of significant
bits. This implies:
Significant bits Octets
0 0
1-8 1
9-16 2
17-24 3
25-32 4
The remaining bits of prefix are transmitted as zero and ignored upon
receipt.
If a prefix is advertised with a metric larger then MAX_PATH_METRIC
(0xFE000000, see paragraph 3.0), this prefix MUST NOT be considered
during the normal SPF computation. This allows advertisement of a
prefix for other purposes than building the normal IP routing table.
4.1 The up/down bit
Without any additional mechanisms, if routers were allowed to
redistribute IP prefixes freely in both directions between level 1
and level 2, those routers can not determine looping of routing
information. A problem occurs when a router learns a prefix via
level 2 routing and advertises that prefix down into a level 1 area,
where another router might pick up the route and advertise the prefix
back up into the level 2 backbone. If the original source withdraws
the prefix, those two routers might end up having a routing loop
between them, where part of the looped path is via level 1 routing
and the other part of the looped path is via level 2 routing. The
solution that RFC 1195 [3] poses is to allow only advertising
prefixes upward in the level hierarchy, and to disallow the
advertising of prefixes downward in the hierarchy.
To prevent this looping of prefixes between levels, a new bit of
information is defined in the new extended IP reachability TLV. This
bit is called the up/down bit. The up/down bit SHALL be set to 0
when a prefix is first injected into IS-IS. If a prefix is
advertised from a higher level to a lower level (e.g. level two to
level one), the bit SHALL be set to 1, to indicate that the prefix
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has traveled down the hierarchy. Prefixes that have the up/down bit
set to 1 may only be advertised down the hierarchy, i.e. to lower
levels.
These semantics apply even if IS-IS is extended in the future to have
additional levels. By insuring that prefixes follow only the IS-IS
hierarchy, we have insured that the information does not loop,
thereby insuring that there are no persistent forwarding loops.
If a prefix is advertised from an area to another area at the same
level, then the up/down bit SHALL be set to 1. This situation can
arise when a router implements multiple virtual routers at the same
level, but in different areas.
The semantics of the up/down bit in the new extended IP reachability
TLV are identical to the semantics of the up/down bit defined in RFC
2966 [2].
4.2 Expandability of the extended IP reachability TLV with sub-TLVs
The extended IP reachability TLV can hold sub-TLVs that apply to a
particular prefix. This allows for easy future extensions. If there
are no sub-TLVs associated with a prefix, the bit indicating the
presence of sub-TLVs SHALL be set to 0. If this bit is set to 1, the
first octet after the prefix will be interpreted as the length of all
sub-TLVs associated with this IPv4 prefix. Please note that while
the encoding allows for 255 octets of sub-TLVs, the maximum value
cannot fit in the overall extended IP reachability TLV. The practical
maximum is 255 octets minus the 5-9 octets described above, or 250
octets.
This document does not define any sub-TLVs yet for the extended IP
reachability TLV.
5.0 The Traffic Engineering router ID TLV
The Traffic Engineering router ID TLV is TLV type 134.
The router ID TLV contains the 4-octet router ID of the router
originating the LSP. This is useful in several regards:
For traffic engineering, it guarantees that we have a single stable
address that can always be referenced in a path that will be
reachable from multiple hops away, regardless of the state of the
node's interfaces.
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If OSPF is also active in the domain, traffic engineering can compute
the mapping between the OSPF and IS-IS topologies.
If a router does not implement traffic engineering it MAY add or omit
the Traffic Engineering router ID TLV. If a router implements
traffic engineering, it MUST include this TLV in its LSP. This TLV
SHOULD not be included more than once in a LSP.
If a router advertises the Traffic Engineering router ID TLV in its
LSP, and if it advertises prefixes via the Border Gateway Protocol
(BGP) with the BGP next hop attribute set to the BGP router ID, in
that case the Traffic Engineering router ID SHOULD be the same as the
BGP router ID.
Implementations MUST NOT inject a /32 prefix for the router ID into
their forwarding table, because this can lead to forwarding loops
when interacting with systems that do not support this TLV.
6. IANA Considerations
6.1 TLV codepoint allocations
This document defines the following new ISIS TLV types that need to
be reflected in the ISIS TLV code-point registry:
Type Description IIH LSP SNP
---- ----------------------------------- --- --- ---
22 The extended IS reachability TLV n y n
134 The Traffic Engineering router ID TLV n y n
135 The extended IP reachability TLV n y n
6.2 New registries
IANA is requested to create the following new registries.
6.2.1 Sub-TLVs for TLV 22
This registry contains codepoints for Sub-TLVs of TLV 22. The range
of values is 0-255. Allocations within the registry require
documentation of the use of the allocated value and approval by the
Designated Expert assigned by the IESG (see [5]).
Taking into consideration allocations specified in this document, the
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registry should be initialized as follows:
Type Description
---- -----------------------------------
0-2 unassigned
3 Administrative group (color)
4-5 unassiged
6 IPv4 interface address
7 unassigned
8 IPv4 neighbor address
9 Maximum link bandwidth
10 Reservable link bandwidth
11 Unreserved bandwidth
12-17 unassigned
18 TE Default metric
19-254 unassigned
255 Reserved for future expansion
<IANA-note> To be removed by the RFC editor at the time of publication
At the time of registry creation, please perform the following
allocations in this registry:
Type Description
---- -----------------------------------
250 Reserved for Cisco-proprietary extensions
251 Reserved for Cisco-proprietary extensions
</IANA-note>
6.2.2 Sub-TLVs for TLV 135
This registry contains codepoints for Sub-TLVs of TLV 135. The range
of values is 0-255. Allocations within the registry require
documentation of the use of the allocated value and approval by the
Designated Expert assigned by the IESG (see [5]).
No codepoints are defined in this document.
Normative References
[1] ISO, "Intermediate System to Intermediate System Intra-Domain
Routeing Exchange Protocol for use in Conjunction with the Protocol
for Providing the Connectionless-mode Network Service (ISO 8473)",
International Standard 10589:2002, Second Edition
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[2] RFC 2966, "Domain-wide Prefix Distribution with Two-Level IS-IS",
T. Li, T. Przygienda, H. Smit, October 2000.
Informative References
[3] RFC 1195, "Use of OSI IS-IS for routing in TCP/IP and dual
environments", R.W. Callon, December 1990
[4] RFC 2702, "Requirements for Traffic Engineering Over MPLS," D.
Awduche, J. Malcolm, J. Agogbua, M. O'Dell, and J. McManus, September
1999
[5] RFC 2434, "Guidelines for Writing an IANA Considerations Section
in RFCs", Narten, T., and H. Alvestrand, BCP 26, October 1998
Security Considerations
This document raises no new security issues for IS-IS.
Acknowledgments
The authors would like to thank Yakov Rekhter and Dave Katz for their
comments on this work.
Authors' Addresses
Tony Li
Procket Networks, Inc.
1100 Cadillac Court
Milpitas, CA 95035
Email: [email protected]
Voice: +1 408 6357900
Fax: +1 408 6356166
Henk Smit
Email: [email protected]
Expiration Date February 2004 [Page 12] | https://www.ietf.org/proceedings/58/I-D/draft-ietf-isis-traffic-05.txt |
PART II
PART II.
OFFENSES RELATED TO OBSCENITY
§712-1210 Definitions of terms in this
part.In this part, unless a different meaning is required:
"Age verification records of sexually
exploited individuals" means individually identifiable records pertaining to
every sexually exploited individual provided to patrons or customers of a
public establishment or in a private club or event. Such records shall include:
(1) Each sexually exploited individual's name and
date of birth, as ascertained by an examination of the individual's valid
driver's license, official state identification card, or passport;
(2) A certified copy of each sexually exploited
individual's driver's license, official state identification card, or passport;
and
(3) Any name ever used by each sexually exploited
individual including but not limited to maiden name, aliases, nicknames, stage
names, or professional names.
"Age verification records of sexual
performers" means individually identifiable records pertaining to every
sexual performer portrayed in a visual depiction of sexual conduct, which
include:
(1) Each performer's name and date of birth, as
ascertained by the producer's personal examination of a performer's valid
driver's license, official state identification card, or passport;
(2) A certified copy of each performer's valid
driver's license, official state identification card, or passport; and
(3) Any name ever used by each performer including,
but not limited to, maiden name, alias, nickname, stage name, or professional
name.
"Community standards" means the
standards of the State.
"Disseminate" means to manufacture,
issue, publish, sell, lend, distribute, transmit, exhibit, or present material
or to offer or agree to do the same.
"Erotic or nude massager" means a
nude person providing massage services with or without a license.
"Exotic or nude dancer" means a
person performing, dancing, or entertaining in the nude, and includes patrons
participating in a contest or receiving instruction in nude dancing.
"Intent to profit" means the intent
to obtain monetary gain.
"Material" means any printed matter,
visual representation, or sound recording, and includes but is not limited to
books, magazines, motion picture films, pamphlets, newspapers, pictures,
photographs, drawings, sculptures, and tape or wire recordings.
"Minor" means any person less than
sixteen years old.
"Nude" means unclothed or in attire,
including but not limited to sheer or see-through attire, so as to expose to
view any portion of the pubic hair, anus, cleft of the buttocks, genitals or
any portion of the female breast below the top of the areola.
"Performance" means any play, motion
picture film, dance, or other exhibition performed before an audience.
"Pornographic." Any material or
performance is "pornographic" if all of the following coalesce:
(a) The average person, applying contemporary
community standards would find that, taken as a whole, it appeals to the
prurient interest.
(b) It depicts or describes sexual conduct in a
patently offensive way.
(c) Taken as a whole, it lacks serious literary,
artistic, political, or scientific merit.
"Pornographic for minors." Any
material or performance is "pornographic for minors" if:
(1) It is primarily devoted to explicit and detailed
narrative accounts of sexual excitement, sexual conduct, or sadomasochistic
abuse; and:
(2) It contains any photograph, drawing, or similar
visual representation of any person of the age of puberty or older revealing
such person with less than a fully opaque covering of his or her genitals and
pubic area, or depicting such person in a state of sexual excitement or engaged
in acts of sexual conduct or sadomasochistic abuse; and:
"Produces" means to manufacture or
publish any pornographic performance, book, magazine, periodical, film,
videotape, computer image, or other similar matter and includes the
duplication, reproduction, or reissuing of any such matter, but does not
include mere distribution or any other activity that does not involve hiring,
contracting for, managing, or otherwise arranging for the participation of the
performers depicted.
"Sadomasochistic abuse" means
flagellation or torture by or upon a person as an act of sexual stimulation or
gratification.
"Sexual conduct" means acts of
masturbation, homosexuality, lesbianism, bestiality, sexual intercourse or
physical contact with a person's clothed or unclothed genitals, pubic area,
buttocks, or the breast or breasts of a female for the purpose of sexual stimulation,
gratification, or perversion.
"Sexual excitement" means the
condition of the human male or female genitals when in a state of sexual
stimulation or arousal.
"Sexually exploited individuals"
means erotic or nude massagers and exotic or nude dancers.
"Sexual performer" includes any
person portrayed in a pornographic visual depiction engaging in, or assisting
another person to engage in, sexual conduct. [L 1972, c 9, pt of §1; am L 1981,
c 106, §1; am L 2002, c 240, §4; am L 2005 c 10, §1]
COMMENTARY ON §712-1210
Act 106, Session Laws 1981, added the definition of
"community standards," to mean a statewide standard. It also amended
the definitions of "pornographic" and "pornographic to
minors." The conference committee stated in its report (Senate Conference
Committee Report No. 14 and House Conference Committee Report No. 12) that the
amendments were merely to conform the definitions to the holdings of the United
States Supreme Court in Miller v. California, 413 U.S. 15 (1973) and the Hawaii
Supreme Court in State v. Manzo, 58 Haw. 440 (1978).
Act 240, Session Laws 2002, amended this section by adding
definitions to comport with sexual exploitation of a minor offenses created by
the Act.
Act 10, Session Laws 2005, amended this section by repealing
the superfluous definition of "sexual conduct" added by Act 240,
Session Laws 2002. This section already provided a sufficient definition of
"sexual conduct". House Standing Committee Report No. 1281.
Law Journals and Reviews
State v. Kam: The Constitutional Status of Obscenity in Hawaii. 11 UH L. Rev. 253.
Case Notes
Grand jury was presented with sufficient information to
determine the existence of probable cause that material distributed to minor by
defendant was pornographic for minors under paragraph (7)(a). 82 H. 474, 923
P.2d 891.
Based on the plain language and legislative history of
§707-700 and construing the definition of "sexual contact" with
reference to other definitions relating to sexual relations in §707-700 and
this section, contact with the interior of the mouth constitutes "touching
of intimate parts" under the definition of "sexual contact" in
§707-700. 108 H. 279, 118 P.3d 1222.
Pornographic.
Construed; provision not unconstitutional for overbreadth or
void for vagueness. 58 H. 440, 573 P.2d 945.
Material held to be "utterly without redeeming social
value." 63 H. 418, 629 P.2d 1130.
Cited: 413 U.S. 15, 93 S.Ct. 2607.
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ABSTRACTS - technology.matthey.com
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PROPERTIES
Theoretical Investigation of Isomer Stability in Platinum–Palladium Nanoalloy Clusters
L. D. Lloyd, R. L. Johnston, S. Salhi
and N. T. wilson
, J. Mater. Chem.
, 2004, 14
, (11), 1691–1704 doi:10.1039/b313811a
http://dx.doi.org/10.1039/b313811a
The interatomic interactions of Pt–Pd nanoalloy clusters (1) were modelled by the Gupta many-body potential. For 18–20 atom clusters, a general algorithm was used to establish the lowest energy structures for each size and for all possible compositions. In the lowest energy isotopes (homotops), the Pd atoms are mainly at the surface, with the Pt atoms preferentially occupying interior sites.
Dendrimer-Templated Ag–Pd Bimetallic Nanoparticles
Y.-M. Chung
and H.-K. Rhee
, J. Colloid Interface Sci.
, 2004, 271
, (1), 131–135
doi:10.1016/j.jcis.2003.12.006
http://dx.doi.org/10.1016/j.jcis.2003.12.006
Ultrafine amine-terminated fourth-generation starburst poly(amidoamine) dendrimer-templated Ag–Pd bimetallic nanoparticles (1) were prepared from silver(I)-bis(oxalato)palladate(II) (2). The use of (2), in which two metal ions exist in one complex, prevented Ag halide formation. The particle size distributions of (1) were all in the narrow range of 2–5 nm, but were dependent upon the Ag/Pd ratio.
CHEMICAL COMPOUNDS
The Construction of P–O/P–N Ligands on Platinum and Palladium
P. Bergamini, V. Bertolasi
and F. Milani
,
Eur. J. Inorg. Chem.
, 2004, (6), 1277–1284 doi:10.1002/ejic.200300642
http://dx.doi.org/10.1002/ejic.200300642
Pt II
and Pd II
diphenyldiphosphinites were prepared by adding diols to a solution containing cis
-[MCl 2
(PPh 2
Cl 2
] (M = Pt or Pd) preformed in situ
from
cis
-[MCl 2
(1,5-COD)] and PPh 2
Cl. As for the P–O bond, the P–N bond can be formed via nucleophilic attack of an amine group on coordinated PPh 2
Cl in the presence of base to give aminophosphine-phosphinite and N
, N
′-bis(antipyryl-4-methyl)piperazine complexes of Pt II
and Pd II
.
C–H and N–H Activation by Pt(0) in N- and O-Heteroaromatic Compounds
J. T. Chantson
and S. Lotz
, J. Organomet. Chem.
, 2004, 689
, (7), 1315–1324
doi:10.1016/j.jorganchem.2004.01.030
http://dx.doi.org/10.1016/j.jorganchem.2004.01.030
[Pt(PEt 3
) 4
] reacts with azoles to give Pt(II) hydride complexes, trans
-[PtH(1-azolyl)(PEt 3
) 2
] (azolyl = indolyl, imidazolyl, benzimidazolyl, pyrazolyl, indazolyl), by oxidative insertion of the Pt centre into the N–H bonds of the respective azoles. Pyrrole was much less reactive. The trans
-[PtH(R)(PEt 3
) 2
] complexes (R = 2-furyl, 2-benzoxazolyl, 2-benzothiazolyl) were prepared via C–H bond activation.
ELECTROCHEMISTRY
The Electrochemical Formation and Properties of Bilayers Composed of Polypyrrole and C 60 Pd Films
M. Wysocka, K. Winkler
and A. L. Balch
, J. Mater. Chem.
, 2004, 14
, (6), 1036–1042 doi:10.1039/b312538f
http://dx.doi.org/10.1039/b312538f
Bilayers of polypyrrole and C 60
Pd were prepared by sequential electropolymerisation of the parent monomers and investigated by cyclic voltammetry. For the electrode/polypyrrole/C 60
Pd bilayer, the high permeability of the C 60
Pd film for the supporting electrolyte ions allowed the oxidation of the polypyrrole inner layer. For the electrode/C 60
Pd/polypyrrole bilayer, the outer polypyrrole layer inhibited the reduction of the inner C 60
Pd layer.
PHOTOCONVERSION
Effects of Chlorine Gas Exposure on the Optical Properties of Rhodium Phthalocyanine Films
L. Gaffo, O. D. D. Couto, R. Giro, M. J. S. P. Brasil, D. S. GalvãO, F. Cerdeira, O. N. de Oliveira
and K. Wohnrath
, Solid State Commun.
, 2004, 131
, (1), 53–56
doi:10.1016/j.ssc.2004.04.011
http://dx.doi.org/10.1016/j.ssc.2004.04.011
Rh phthalocyanine films (1) were deposited on glass by the Langmuir-Blodgett technique. On exposure to Cl 2
(1) changed from blue to transparent. Incorporation of Cl 2
caused quenching of the characteristic triplet centred around the Q-absorption band at 662 nm. Leaving prior Cl 2
exposed (1) in air for several hours resulted in a slow partial recovery of the optical spectra.
A Synthesis and Luminescence Study of Ir(ppz) 3 for Organic Light-Emitting Devices
E. J. Nam, J. H. Kim, B.-O. Kim, S. M. Kim, N. G. Park, Y. S. Kim, Y. K. Kim
and Y. Ha
,
Bull. Chem. Soc. Jpn.
, 2004, 77
, (4), 751–755 doi:10.1246/bcsj.77.751
http://dx.doi.org/10.1246/bcsj.77.751
OLEDs were fabricated with doped films of tris(1-phenyl-κ C 1
-pyrazolato-κ N 2
)iridium (1) in several hosts. The electroluminescence peak occurred at 450 nm. The luminance of the OLEDs was pure blue, but luminous efficiencies were low since the LUMO of (1) was higher than those of the hosts.
Photobleaching and Single Molecule Detection of a Phosphorescent Organometallic Iridium(III) Complex
M. Vacha, Y. Koide, M. Kotani
and H. Sato
,
J. Luminesc.
, 2004, 107
, (1–4), 51–56
doi:10.1016/j.jlumin.2003.12.015
http://dx.doi.org/10.1016/j.jlumin.2003.12.015
The photostability of bulk samples of Ir(ppy) 3
(1) (ppy = 2-phenylpyridine) in polymer films was examined by measuring the photobleaching kinetics under intense laser irradiation. On a single molecule level, (1) was characterised by phosphorescence time traces, distribution of phosphorescence intensity levels and by polarisation modulated excitation.
Synthesis and Characterization of Naphthyridine and Acridinedione Ligands Coordinated Ruthenium(II) Complexes and Their Applications in Dye-Sensitized Solar Cells
S. Anandan, J. Madhavan, P. Maruthamuthu, V. Raghukumar
and V. T. Ramakrishnan
, Sol. Energy Mater. Sol. Cells
, 2004, 81
, (4), 419–428
doi:10.1016/j.solmat.2003.11.026
http://dx.doi.org/10.1016/j.solmat.2003.11.026
The title complexes were synthesised and characterised, and then used in dye-sensitised solar cells. From the I
– V
curves, the short-circuit photocurrent ( I SC
) and the open-circuit photovolatage ( V OC
) were measured. A maximum current conversion efficiency of ∼ 7.7% was achieved by the 5-amino-4-phenyl-2-(4-methylphenyl)-7-(pyrrolidin-1-yl)-1,6-naphthyridine-8-carbonitrile coordinated Ru(II) complex.
ELECTRODEPOSITION AND SURFACE COATINGS
Mesoporous Microspheres Composed of PtRu Alloy
J. Jiang
and A. Kucernak
, Chem. Mater.
, 2004, 16
, (7), 1362–1367
doi:10.1021/cm035237j
http://dx.doi.org/10.1021/cm035237j
Electrochemical co-reduction of H 2
PtCl 6
and RuCl 3
dissolved in the aqueous domains of the liquid crystalline phase of an oligoethylene oxide surfactant (C 16
EO 8
) gave the title microspheres (1) (0.5–1 µm). The ordered mesoporous internal structure of (1) involves periodic pores of ∼ 2.4 nm in diameter separated by walls of ∼ 2.4 nm thick. (1) have high specific surface area.
Synthesis of PtN x Films by Reactive Laser Ablation
G. Soto
, Mater. Lett.
, 2004, 58
, (16), 2178–2180
doi:10.1016/j.matlet.2004.01.019
http://dx.doi.org/10.1016/j.matlet.2004.01.019
Thin films of Pt (1) with ∼ 14 at.% N were prepared by reactive laser ablation in molecular N 2
ambient. AES, XPS and electron energy loss spectroscopy were used to characterise (1). The existence of chemisorbed N was supported by the N 1s
binding energy of 398.4 eV. The +0.2 eV shift of the Pt 4f
peak position indicated charge transfer from Pt to N. The Pt formed an incipient nitride phase with composition near to Pt 6
N.
APPARATUS AND TECHNIQUE
Calorimetric Hydrocarbon Sensor for Automotive Exhaust Applications
M.-C. Wu
and A. L. Micheli
, Sens. Actuators B: Chem.
, 2004, 100
, (3), 291–297 doi:10.1016/j.snb.2003.11.010
http://dx.doi.org/10.1016/j.snb.2003.11.010
The title sensor (1) is a thermoelectric device supported on a planar Al 2
O 3
substrate. A non-selective Pt catalyst was used in (1) to detect hydrocarbons with high selectivity. For CO detection (1) uses a CO oxidation catalyst of Pb-modified Pt, which exhibits excellent CO selectivity at 200–400°C. (1) gave a linear output of 0–2.75 mV over 0–1000 ppm of propylene (at 350°C). Engine dynamometer evaluation showed that the response of (1) paralleled the change in concentration of the CO and hydrocarbons when the engine air:fuel ratio was varied.
Chemiresistor Coatings from Pt- and Au-Nanoparticle/Nonanedithiol Films: Sensitivity to Gases and Solvent Vapors
Y. Joseph, B. Guse, A. Yasuda
and T. Vossmeyer
, Sens. Actuators B: Chem.
, 2004, 98
, (2–3), 188–195
doi:10.1016/j.snb.2003.10.006
http://dx.doi.org/10.1016/j.snb.2003.10.006
Layer-by-layer self-assembly using 1,9-nonanedi-thiol and dodecylamine-stabilised nanoparticles of Pt or Au gave films (1) of thickness, 66 ± 2 and 31 ± 1 nm, respectively. The sensitivity of (1) was investigated by dosing them with NH 3
, CO and vapours of H 2
O and toluene (300 ppb–5000 ppm). (1) have a high signal:noise ratio. A detection limit for NH 3
< 100 ppb was achieved. NH 3
and CO bind to vacant sites on the metal nanoparticle cores.
HETEROGENEOUS CATALYSIS
Palladium(II) Chloride Catalyzed Selective Acetylation of Alcohols with Vinyl Acetate
J. W. J. Bosco
and A. K. Saikia
, Chem. Commun.
, 2004, (9), 1116–1117
doi:10.1039/b401218f
http://dx.doi.org/10.1039/b401218f
PdCl 2
with CuCl 2
can be used for the catalytic acetylation of primary and secondary alcohols with vinyl acetate. The reaction is carried out in dry toluene at room temperature. The catalyst system can be recovered by filtration. The acetaldehyde byproduct can be removed by evaporation along with the toluene solvent. This mild reaction proceeds more rapidly with primary alcohols.
Assembled Catalyst of Palladium and Non-Cross-Linked Amphiphilic Polymer Ligand for the Efficient Heterogeneous Heck Reaction
Y. M. A. Yamada, K. Takeda, H. Takahashi
and S. Ikegami
, Tetrahedron
, 2004, 60
, (18), 4097–4105
doi:10.1016/j.tet.2004.02.068
http://dx.doi.org/10.1016/j.tet.2004.02.068
An insoluble catalyst (1) was prepared from self-assembly of (NH 4
) 2
PdCl 4
and a non-cross-linked amphiphilic phosphine polymer. (1) in only 5.0 × 10 −5
mol equiv. concentration was effective for the heterogeneous Heck reaction of aryl iodides with acrylates, styrenes and acrylic acid. (1) could be recycled five times. (1) showed good stability in toluene and H 2
O and so efficiently catalysed the Heck reaction in these media. (1) can be used for the synthesis of resveratrol, a cyclooxygenase-II inhibitor.
Effect of Activated Carbon and Its Surface Property on the Activity of Ru/AC Catalyst
W. Han, B. Zhao, C. Huo
and H. Liu
, Chin. J. Catal.
, 2004, 25
, (3), 194–198
Activated C was pretreated by washing with HNO 3
and then calcined before the preparation of Ru/activated C catalysts (1) for NH 3
synthesis. The HNO 3
treatment increased the catalytic activity from 17.4 to 18.4%, due to the reduction of S and ash. Gas phase oxidation of the C caused the Ru to be more dispersed in (1) by changing the texture and surface groups of the support. Overall, the Ru dispersion and catalytic activity were improved from 43 to 62% and 17.4 to 19%, respectively.
HOMOGENEOUS CATALYSIS
The First Platinum-Catalyzed Hydroamination of Ethylene
J.-J. brunet, M. Cadena, N. C. Chu, O. Diallo, K. Jacob
and E. Mothes
,
Organometallics
, 2004, 23
, (6), 1264–1268 doi:10.1021/om030605e
http://dx.doi.org/10.1021/om030605e
The hydroamination of ethylene with aniline, using PtBr 2
as a catalyst precursor in n
-Bu 4
PBr under 25 bar of ethylene pressure, gave N
-ethylaniline with 80 turnovers after 10 h at 150°C. 2-Methylquinoline was simultaneously produced in ∼ 10 cycles. Additions of P(OMe) 3
(2 equiv./PtBr 2
) or of a proton source (3 equiv./PtBr 2
) were beneficial. A TON of 145 after 10 h at 150°C was achieved with a biphasic system ( n
-Bu 4
PBr/decane) in the presence of C 6
H 5
NH 3
+
(3 equiv./PtBr 2
). The lower the basicity of the arylamine, the higher the TON.
Important Consequences for Gas Chromatographic Analysis of the Sonogashira Cross-Coupling Reaction
E. H. Niemelä, A. F. Lee
and I. J. S. Fairlamb
, Tetrahedron Lett.
, 2004, 45
, (18), 3593–3595
doi:10.1016/j.tetlet.2004.03.060
http://dx.doi.org/10.1016/j.tetlet.2004.03.060
Typical quenching procedures for GC analysis of the Sonogashira reaction for 4-bromo-6-methyl-2-pyrone with phenylacetylene (catalysed by (Ph 3
P) 2
PdCl 2
) cannot be used. Turnover continues to occur in sample vials even after quenching by commonly used SiO 2
adsorption and product elution with CH 2
Cl 2
. Trace amounts of Pd are carried through the SiO 2
plug. Addition of 1,2-bis(diphenylphosphino)ethane to the sample inhibited any further reaction.
Role of Base in Palladium-Catalyzed Arylation of Carbanions
A. V. Mitin, A. N. Kashin
and I. P. Beletskaya
, J. Organomet. Chem.
, 2004,
689
, (6), 1085–1090
doi:10.1016/j.jorganchem.2003.12.039
http://dx.doi.org/10.1016/j.jorganchem.2003.12.039
The arylation of carbanions, derived from various sulfones, cyanoacetic ester and malononitrile, with aryl bromides using Pd 2
dba 3
/3L, L = PPh 3
, P t
Bu 3
, as well as the reaction of the carbanions with 1 equiv. of 4-CF 3
C 6
H 4
Pd(PPh 3
) 2
Br were carried out. A base stronger than the initial carbanion was required. The reaction mechanism includes the acceleration of the reductive elimination due to the deprotonation of the intermediate ArPdL 2
CHXY.
New Chiral Bis(oxazoline) Rh(I)-, Ir(I)- and Ru(II)-Complexes for Asymmetric Transfer Hydrogenations of Ketones
n. debono, m. besson, c. pinel
and l. djakovitch
, Tetrahedron Lett.
, 2004, 45
, (10), 2235–2238
doi:10.1016/j.tetlet.2003.12.163
http://dx.doi.org/10.1016/j.tetlet.2003.12.163
The transfer hydrogenation of acetophenone in 2-propanol was used to examine the title complexes. The Ru(II)-based catalyst exhibited good activity with 50% conversion and high enantioselectivity (89%), whereas the Rh(I)- and Ir(I)-complexes gave low conversions (∼ 20%) and poor enantioselectivities (16–20%). A free hydroxyl group on the ligand was a prerequisite for high enantioselectivity. The stronger the base present, the higher the conversion.
FUEL CELLS
Effect of Preparation Conditions of Pt/C Catalysts on Oxygen Electrode Performance in Proton Exchange Membrane Fuel Cells
J. H. Tian, F. B. Wang, Z. H. Q. Shan, R. J. Wang
and J. W. Zhang
, J. Appl. Electrochem.
, 2004, 34
, (5), 461–467
doi:10.1023/B:JACH.0000021860.94340.02
http://dx.doi.org/10.1023/B:JACH.0000021860.94340.02
Pt/C catalysts with 3.2 nm Pt crystallites were prepared by the impregnation-reduction method, varying conditions such as the reaction temperature, the concentration of H 2
PtCl 6
and different reducing agents. Heat treatment in N 2
of the C black support improved Pt dispersion and increased the relative content of Pt (111) orientation. This benefited the acceleration of the oxygen reduction reaction in the PEMFC.
Preparation and Performance of Pt–Co/C Catalyst for PEMFC
Y. Zhang, X. Li, X. Wu, M. Xu
and L. Deng
,
Precious Met. (Chin.)
, 2004, 25
, (1), 19–23
Pt–Co/C electrocatalysts (1) were prepared by the liquid deposition and high temperature alloying method. The Pt and Pt–Co have f.c.c. structure, with small particle size and high dispersity. The Co addition shortened the length of the Pt–Pt bond. (1) showed better performance than Pt/C in PEMFCs. The Co addition exhibited high catalytic activity.
ELECTRICAL AND ELECTRONIC ENGINEERING
Microstructure and Magnetic Properties of Bamboo-Like CoPt/Pt Multilayered Nanowire Arrays
y.-k. su, d.-h. qin, h.-l. zhang, h. li
and h.-l. li
, Chem. Phys. Lett.
, 2004, 388
, (4–6), 406–410
doi:10.1016/j.cplett.2004.03.041
http://dx.doi.org/10.1016/j.cplett.2004.03.041
Double-pulse electrodeposition into the pores of a porous anodic Al oxide template gave highly ordered CoPt/Pt multilayered nanowire arrays (1). The nanowires had a bamboo-like structure. The section lengths could be adjusted by varying the pulse width and pulse intensity. (1) exhibited in-plane anisotropy. High coercivity (H c
= 1.8 kOe) and squareness (Mr/Ms) ∼ 0.35 were obtained in (1) when the field was applied perpendicular to the wire axis of (1). This is attributed to the disordered f.c.c. CoPt formation.
Effects of Post-Annealing on the Dielectric Properties of Au/BaTiO 3 /Pt Thin Film Capacitors
E. J. H. Lee, F. M. Pontes, E. R. Leite, E. Longo, R. Magnani, P. S. Pizani
and J. A. Varela
, Mater: Lett.
, 2004, 58
, (11), 1715–1721
doi:10.1016/j.matlet.2003.10.047
http://dx.doi.org/10.1016/j.matlet.2003.10.047
BaTiO 3
thin films (1) were prepared by the polymeric precursor method and deposited onto Pt/Ti/SiO 2
/Si. The BaTiO 3
perovskite phase formation was investigated. (1) were post-annealed in O 2
and N 2
at 300°C for 2 h. Post-annealing in O 2
increased the dielectric relaxation phenomenon, whereas in N 2
a slight dielectric relaxation was produced.
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We depend on saliva to give us a sense of sweetness | The Splendid Table
Anthropologist and evolutionary biologist Nathaniel Dominy has studied saliva from around the globe.
We depend on saliva to give us a sense of sweetness
Listen: We depend on saliva to give us a sense of sweetness
Photo: Dorling Kindersley RF
Photo: Dorling Kindersley RF
Saliva helps us swallow food, protects our teeth and even gives us a sense of sweetness as it converts starch to glucose. Anthropologist and evolutionary biologistNathaniel Dominy, associate professor in the Department of Anthropology at Dartmouth College, has studied saliva from around the globe. He researches how humans acquire, process and assimilate food -- and how those behaviors affect the evolution of anatomical form and function.
Lynne Rossetto Kasper: Why do our mouths water?
Nathaniel Dominy: We produce saliva -- we produce quite a lot of it for four major reasons.
It's also protective because it neutralizes very acidic foods. Acid has the effect of etching away your teeth. Saliva reduces the acidity of very acidic things like fruit. For example, lemon has a pH of about 2, so it's very acidic.
Saliva also can act like an early alarm system. Your saliva is full of these proline-rich proteins, which appear to have no function other than to bind to tannins. Tannins give us that sense of astringency. If you've ever eaten an unripe banana for example, you feel that gritty sensation on your teeth, your teeth feel a little bit roughened. That's because all those tannins are binding to the proteins. You’re sacrificing all these proteins in your saliva to give you that roughened feeling in your mouth. This is thought to be an alarm system to let you know that what you’re eating isn't exactly the most nutritious thing because those tannins are something you generally want to avoid.
The fourth thing the saliva does is it actually allows you to digest foods initially in the mouth. You tend to think of your stomach and your small intestine as being the digestive powerhouses of the body. But actually you do a significant amount of digestion in the mouth before food ever reaches your stomach.
The major digestive enzyme in saliva is called amylase. Amylase is special because it hydrolyzes -- it dissolves starch grains in your foods. Most of the food that we eat is really starchy: potatoes, rice, bread, etc. Starch has become a central aspect of all modern human diets today, and we really depend on our saliva to help initiate digestion in the mouth and also give us a sense of sweetness. The reason why these things actually taste somewhat good is because in the mouth, the saliva is converting the starch grains directly into glucose, which is something that we perceive as relatively sweet.
LRK: The human brain needs a very large amount of glucose.
ND: Our brain is very costly to maintain, energetically. We spend about 20-25 percent of our energy feeding our brain. Our brain demands more energy than almost any other tissue in the body. We need sugary foods to feed the brain. But of course today we probably indulge too much.
LRK: Different peoples across the planet eat different diets. Does their saliva test differently?
ND: In fact, yes. We've done research looking at populations around the planet that have different traditional levels of starch intake. Americans and other North Americans tend to eat a lot of starch, so our diet is relatively starch-rich because of all the agricultural products that we eat. There are other populations around the planet, for example, certain Arctic populations that are living closer to the North Pole, who tend to have very little starch in their diet. There are hunter-gatherers who live in tropical Africa -- they tend to have very little starch in their diet as well.
What we've shown is that the number of genes that allow you to produce this amylase enzyme in the saliva, they tend to vary globally and they vary as a function of the amount of starch in the diet. For example, people in North America tend to have a lot of copies of this particular gene. They produce a lot more amylase in saliva than populations that don't really need copies because they're eating much less starch.
| https://www.splendidtable.org/story/2013/09/26/we-depend-on-saliva-to-give-us-a-sense-of-sweetness |
(PDF) Advanced Access
PDF | Evidence review work group (2011). Advanced Access. Rapid review. | Find, read and cite all the research you need on ResearchGate
Research
PDF Available
Advanced Access
January 2011
DOI: 10.13140/RG.2.2.23397.45283
Abstract
Evidence review work group (2011). Advanced Access. Rapid review.
Discover the world's research
25+ million members
160+ million publication pages
V AIL-P ACT Mini-Review [May 2011]
Evidence Review W ork Group
Advanced Access
For this mini-review , we searched the PubMed database from 1999-2011 for “advanced
access” or “open access,” “primary health care” or “primary care” or “ambulatory care.”
W e also did a Google search for similar terms to identify relevant res ources.
What is advanced access?
Advanced or open access is the reorganization of clinic practices to improve patients’
access to care. The objective is to allow patients to see a physician or other primary care
practitioner at a time and date that is convenient for them. The advanced access model is
often considered to be another scheduling system; however, it is better to be considered a
comprehensive approach to reengineering patient care delivery.
Since its introduction more than 12 years ago, advanced access has been the subject of
much research. Advanced access conver ges to the following principles in determining
successful implementation:
1. Understand supply/capacity and demand . Supply is the number of hours and
appointments available in a clinical practice. Demand is the patients’ requests for
appointments. Calculating demand allows appropriate matching of supply of
services.
2. Reduce backlog . Backlog is the number of patients waiting to see a physician.
Reducing backlog initially requires an upfront commitment of time from
providers to work extra hours to clear the backlog before advanced access
scheduling can begin. In addition, long term strategies can help sustain low
backlog. Examples of these strategies include extending visit intervals, fully
utilizing other care team members to shift clinical care and most clerical work
away from providers, optimizing continuity , maximizing activities for one visit so
as to reduce future work and reviewing schedules for duplicate visits.
3. Simplify appointment types and times . This implies equal access for any
problem, whether it is urgent, routine or preventative.
4. Develop contingency plans to sustain the system . The clinical practice needs to
plan for vacations, seasonal increases in demand (e.g. influenza season, back-to-
school physicals), and unexpected staff illness.
5. Reduce demand for unnecessary visits . This is done by emphasizing continuity
of care, managing of primary care panel size, extending visit intervals, and
providing other sources of access to care such as group visits, phone visits and e-
visits.
6. Optimize effective supply. Multiple steps are required to achieve this principle.
Delegate physicians’ functions that can be performed by someone else and
training allows. In addition, standardize best practices.
Advanced access makes intuitive sense, which is why it is frequently considered in the
context of patient-centered medical homes. Successful implementation of advanced
access has the following theoretical benefits:
Better patient access to services – all levels (primary, secondary and tertiary).
Maximum utilization of staff – practitioners work at their full scope of practice
thereby reducing practice overlaps and inefficiencies.
Better clinical outcomes – illnesses/diseases are diagnosed earlier, thus improving
the chances of cure and/or treatment.
More patients able to access health care services – a more efficient clinical
practice will be able to accommodate new patients.
Provider satisfaction improves.. Appropriate clinical practice size is determined so
that demand and supply are balanced. As a result, providers do not redirect
patients to the emergency departments or put them on long waiting lists.
Better utilization of financial resources – unnecessary and duplicate visits are
eliminated and providers are engaged in appropriate service provision.
What is the evidence that advanced access works?
The evidence of the impact of advanced access has not been entirely positive. Early
studies documenting the implementation of advanced access showed promising results
such as reduced wait times and better patient satisfaction. But a recent review of 124
studies from 1998 to 2008 by Mehrotra et al. 1 showed the majority of studies had major
methodological limitations. Among the studies that assessed outcomes beyond access to
show rate. Mehrota et al. did an evaluation of six practices in the Boston area and showed
that after implementation of advanced access, scheduling improved in some practices but
none could achieve same-day access. Patient and staff satisfaction and patient no-show
rate were unchanged. The author commented that there were multiple barriers
contributing to the lack of demonstrative success after implementation. These barriers
included extended provider leaves causing unexpected fluctuations of appointment
supply; the inability to assess appointment demand accurately, which was caused by not
knowing each physician’s panel size, which in turn not allow accurate calculation of
demand. T antau 2 highlighted other pitfalls that prevented sus tainable implementation.
These included the failure of not rigorously monitoring and matching daily and weekly
demand and supply for each provider; practices revert to carving out strategies to reserve
future supply rather than address backlog that will reemerge when demand and supply are
not balanced; poor continuity of care, which drive up demand for visits; backlog
reduction that relies solely on working harder and does not use other “smart strategies” to
fundamentally change the way demand is managed; and after achieving improved delays,
not continuing to aim for zero days’ delay .
Recent qualitative research with patients has indicated that same-day appointments and
the flexibility of accessing the appointment system at any time aren’t necessarily as
important as anticipated. 3 Among patients with chronic conditions, predictable and
regular appointment times that could be planned in advance may be more preferable,
especially when patients may not remember to call for their next routine appointment
when the time approaches. In contrast, patients with non-chronic or urgent medical needs
value sooner appointments (such as for a cold or viral infection) and are not as worried
about seeing their own provider. In fact, in one study , after the implementation of
advanced access scheduling, the number of chronic disease follow-up appointments
decreased but non-chronic disease care visits increased. 3 It was hypothesized that patients
previously combined their routine visits with consultations for non-chronic/urgent
problems. With advanced access in place, there could be a “decoupling” of the two types
of visits. What these recent studies show is that patient’ s preference may influence how
advanced access scheduling might be modified to accommodate their different needs. A
survey of 13,000 patients in the United Kingdom after the implementation of advanced
access showed that the top priority for patients was to be seen on their day of choice
rather than to be seen quickly . However, different patient groups had dif ferent priorities---
younger patients preferred to be seen on a specific day, while patients with ongoing
medical problems preferred the ability to book appointments well in advance. 4
It is important to note that better and quicker access to appointments is not equivalent to
improved access to care. Improved access is also about care that is coordinated, a strong
care relationship between provider and patient, and care that is longitudinally continuous
with a given care team/provider. Practices solely focused on advanced access to improve
the availability of same-day appointments, could miss the broader picture of improving
access to care. 5 For example, Phan et al. 6 and Salisbury et al. 7 found that after the
implementation of advanced access, continuity of care (as measured patients seeing the
same doctor in a given period of time) either remained the same or declined.
Thus, for successful implementation of advanced access practices should consider how
the primary care practice functions and the way care is delivered, patients’ preferences,
and barriers to sustainability .
Resources for advanced access implementation
Many resources are available that could inform advance access planning and
implementation. Below are a few to consider:
1. Alberta Access Improvement Measure website has a comprehensive list of brief
articles covering all aspects of advance access implementation. The website
includes a series of over 50 short articles covering a range of topics such as :
a. Examining Demand, Supply and Activity
b. Tips for balancing demand and supply
c. Strategies for reducing no-s hows
d. Provider capacity limits
e. Advanced access and contingency plans
f. Plans for patients of the absent provider
g. Five levels of mapping flow
h. Key measures of advanced access
i. Panel and caseload equity
j. Scripting at the front desk
http://www .alber taaim.ca/resourcespage.html
2. Mark Murray produced a short but helpful document on how to determine the
panel size for doctors.
http://www .aafp.o rg/fpm/2007/0400/p44.html
3. TransforMED, which is s a subsidiary of the American Academy of Family
Physicians, is a firm that helps practices implement patient centered medical
homes. Its resource website provides information on advanced access and other
general access to care resource materials.
http://www .transformed. com/resources/Access.cfm
References
1. Mehrotra A, Keehl-Markowitz L, A yanian JZ. Implementing open-access
scheduling of visits in primary care practices: a cautionary tale. Ann Intern Med.
Jun 17 2008;148(12):915-922.
2. T antau C. Accessing patie nt-centered care using the advanced access model. J
Ambul Care Manage. Jan-Mar 2009;32(1):32-43.
3. Gladstone J, Howard M. Effect of advanced access scheduling on chronic health
care in a Canadian practice. Can Fam Physician. Jan 2011;57(1):e21-25.'
4. Salisbury C, Goodall S, Montgomery AA, et al. Does Advanced Access improve
access to primary health care? Questionnaire survey of patients. Br J Gen Pract.
Aug 2007;57(541):615-621.
5. Pope C, Banks J, Salisbury C, Lattimer V . Improving access to primary care: eight
case studies of introducing Advanced Access in England. J Health Serv Res
Policy. Jan 2008;13(1):33-39.
6. Phan K, Brown SR. Decreased continuity in a residency clinic: a consequence of
open access scheduling. Fam Med. Jan 2009;41(1):46-50.
7. Salisbury C, Montgomery AA, Simons L, et al. Impact of Advanced Access on
access, workload, and continuity: controlled before-and-after and simulated-
patient study. Br J Gen Pract. Aug 2007;57(541):608-614.
Summary of articles cited in this write-up
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Applied Sciences | Free Full-Text | A Linked Data Application for Harmonizing Heterogeneous Biomedical Information
In the biomedical field, there is an ever-increasing number of large, fragmented, and isolated data sources stored in databases and ontologies that use heterogeneous formats and poorly integrated schemes. Researchers and healthcare professionals find it extremely difficult to master this huge amount of data and extract relevant information. In this work, we propose a linked data approach, based on multilayer networks and semantic Web standards, capable of integrating and harmonizing several biomedical datasets with different schemas and semi-structured data through a multi-model database providing polyglot persistence. The domain chosen concerns the analysis and aggregation of available data on neuroendocrine neoplasms (NENs), a relatively rare type of neoplasm. Integrated information includes twelve public datasets available in heterogeneous schemas and formats including RDF, CSV, TSV, SQL, OWL, and OBO. The proposed integrated model consists of six interconnected layers representing, respectively, information on the disease, the related phenotypic alterations, the affected genes, the related biological processes, molecular functions, the involved human tissues, and drugs and compounds that show documented interactions with them. The defined scheme extends an existing three-layer model covering a subset of the mentioned aspects. A client& ndash;server application was also developed to browse and search for information on the integrated model. The main challenges of this work concern the complexity of the biomedical domain, the syntactic and semantic heterogeneity of the datasets, and the organization of the integrated model. Unlike related works, multilayer networks have been adopted to organize the model in a manageable and stratified structure, without the need to change the original datasets but by transforming their data & ldquo;on the fly& rdquo; to respond to user requests.
A Linked Data Application for Harmonizing Heterogeneous Biomedical Information
by Nicola Capuano 1,* , Pasquale Foggia 2 , Luca Greco 2 and Pierluigi Ritrovato 2
School of Engineering, University of Basilicata, 85100 Potenza, Italy
Department of Information and Electrical Engineering and Applied Mathematics, University of Salerno, 84084 Fisciano, Italy
Appl. Sci. 2022 , 12 (18), 9317; https://doi.org/10.3390/app12189317
Received: 8 August 2022 / Revised: 9 September 2022 / Accepted: 14 September 2022 / Published: 16 September 2022
Abstract
:
In the biomedical field, there is an ever-increasing number of large, fragmented, and isolated data sources stored in databases and ontologies that use heterogeneous formats and poorly integrated schemes. Researchers and healthcare professionals find it extremely difficult to master this huge amount of data and extract relevant information. In this work, we propose a linked data approach, based on multilayer networks and semantic Web standards, capable of integrating and harmonizing several biomedical datasets with different schemas and semi-structured data through a multi-model database providing polyglot persistence. The domain chosen concerns the analysis and aggregation of available data on neuroendocrine neoplasms (NENs), a relatively rare type of neoplasm. Integrated information includes twelve public datasets available in heterogeneous schemas and formats including RDF, CSV, TSV, SQL, OWL, and OBO. The proposed integrated model consists of six interconnected layers representing, respectively, information on the disease, the related phenotypic alterations, the affected genes, the related biological processes, molecular functions, the involved human tissues, and drugs and compounds that show documented interactions with them. The defined scheme extends an existing three-layer model covering a subset of the mentioned aspects. A client–server application was also developed to browse and search for information on the integrated model. The main challenges of this work concern the complexity of the biomedical domain, the syntactic and semantic heterogeneity of the datasets, and the organization of the integrated model. Unlike related works, multilayer networks have been adopted to organize the model in a manageable and stratified structure, without the need to change the original datasets but by transforming their data “on the fly” to respond to user requests.
Keywords:
linked data
;
biomedical ontologies
;
multilayer network analysis
;
neuroendocrine neoplasms
;
semantic information integration
;
multi-model database
1. Introduction
The massive and continuous growth of biomedical data of a heterogeneous nature requires ever greater efforts aimed at their integration. Indeed, the proliferation of non-integrated and non-interoperable data greatly hinders their interpretation and prevents computer-assisted reasoning. Data integration and reproducibility are essential to biomedical studies; it becomes extremely important to observe the FAIR guiding principles where research works are recommended to be findable, accessible, interoperable, and reusable [ 1 ].
Generally, a key requirement for allowing data to be FAIR is the use of open approaches and standardized representation formalisms such as ontologies. Indeed, ontologies have proved crucial in supporting omics data integration [
2
]. However, since hundreds of biomedical ontologies have been designed and are currently available, a new problem has arisen, i.e., how to integrate different ontological schemes and make them interoperable [
3
]. To this end, in addition to syntactic issues related to the variety of models and formats, semantic problems arising from context-related different interpretations need to be encountered [
4
].
To get the most out of these data, different approaches are required for querying multiple ontologies and databases to provide researchers with biomedical information organized as interconnected entities in a semantic fashion [ 5 ]. The research described in this paper attempts to contribute toward this end within a specific domain, through an ontology-based linked data application. An approach to data aggregation and analysis in the field of rare neuroendocrine neoplasms (NENs) is proposed.
In previous research by the same authors [ 6 ] a novel linked data application was described for the same domain, integrating several existing biomedical ontologies including the National Cancer Institute Thesaurus , the Mondo Disease Ontology , the MedGen database, the Disease Ontology , the Orphanet Rare Disease Ontology , the DisGeNet database, and the Gene Ontology . Such data sources provided the relevant information to build a single knowledge model about NENs that is accessible via a client–server application.
In this work, an extension of the previous model through the integration of additional data sources is proposed. The knowledge model relies on the multilayer network formalism to semantically link heterogeneous data sources while grouping them into several “layers”, each corresponding to a specific “aspect” of the domain [ 7 ]. The original model consisted of three interconnected layers representing: information about diseases, affected genes, biological processes, and molecular functions of such genes and related gene products.
In addition to the information included in the original model, the extended version integrates information from new sources including the
Human Phenotype Ontology
, the
HPO-ORDO Ontological Module
, the
Human Protein Atlas
, the
Drug–Gene Interaction Database
as well as the
ChEMBL database
. Starting from the previous model, three additional layers have been designed and integrated to consider further aspects.
The first additional layer provides details about disease-related phenotypes such as morphology, development, biochemical, physiological, and other features. It has been shown that a deep understanding of rare diseases together with the identification of prognostic and therapeutic implications can be accelerated by analyzing and correlating phenotypic and genomic data.
The second additional layer provides an association between genes responsible for diseases and human tissue. This allows us to find commonalities between organs and illustrate the role of genes related to NENs.
The third additional layer provides details about drugs with documented interactions with genes affected by NENs. The complexity in the extraction of relevant information about these tumors is motivated by the great heterogeneity in their biological features that can also determine heterogeneous responses to therapeutic agents. They often present subpopulations of cells with different angiogenic, invasive, and metastatic properties.
According to [ 8 ], biomedical ontologies pose several integration challenges due to both the complexity of the domain and the characteristics of the ontologies themselves which include thousands of classes. Furthermore, biomedical ontologies present profound organizational differences to the point of often being difficult to reconcile due to syntactic and semantic heterogeneity. Although properly integrated, such ontologies are often difficult for researchers to use due to the lack of user-friendly interfaces.
The developed model is aimed to meet these challenges by improving the way information is stored, enhancing interoperability while simplifying the work of scientists studying these rare diseases. Moreover, a user-friendly interface can guide healthcare professionals and researchers through the process of searching for relationships between pathologies (and their related genes) also highlighting the effectiveness of adopted drugs. The adopted multilayer network formalism is useful for organizing the model into a manageable and layered structure. In accordance with [
4
], a
workflow-based approach
has been adopted to integrate data from external sources “on the fly” on a frequently updated local copy, based on user requests, therefore without the need to modify the original datasets and without the risk of using obsolete data.
The paper is organized as follows: in Section 2 some background information on NENs is provided and the related work on biomedical data integration is summarized; in Section 3 the starting point of this research is described, including the previous integration model as well the additional biomedical data sources; in Section 4 the structure of the new model and the related integration issues are presented; in Section 5 the extension of the developed application for browsing and querying the updated model is described. The last section summarizes the conclusions and outlines the ongoing work.
2. Background and Related Work
The research work described in this paper aims at supporting biologists, researchers, and specialists in the collection, organization, and analysis of existing biomedical data on neuroendocrine neoplasms (NENs) through the definition and development of a linked data application. During the last four decades, these neoplasms have shown a 6.4-times increasing age-adjusted annual incidence [ 9 ]. NENs have been observed in almost every tissue, either in the pure endocrine organs, the nerve structures, or in the diffuse neuroendocrine system.
The
World Health Organization
has defined two groups of NENs to enable consistent management of diseases regardless of their anatomical location [
10
]:
neuroendocrine carcinomas
(NECs) and
neuroendocrine tumors
(NETs). Although NETs appear as well-differentiated neoplasms and can be categorized into three levels—G1, G2, and G3 (low, intermediate, and high grade)—NECs are poorly differentiated neoplasms with only high grade (i.e., G3). Cell grade and differentiation often depend on different factors such as mitotic count and Ki-67 cell labeling index [
11
]. Moreover, NECs can be also classified into small- or large-cell-type NECs.
The integration of information about NENs is still quite difficult since variations depending on anatomical sites often lead to definitions different from the accepted and established ones. Heterogeneous data sources with different schemes and formats make the information retrieval and analysis process quite difficult to perform and often require the clinician to have advanced programming skills.
Some projects have been proposed to integrate and harmonize biological data sources. For example, in the
Gene Expression Data Warehouse
(GEDAW) project a data warehouse has been proposed to manage relevant information on liver gene expression data and related biomedical resources [
12
]. It provides the integration of gene information from several data sources, including
GenBank
and
BioMeKe
.
Bio2RDF
also has the purpose of transforming heterogeneous biomedical information into linked data using semantic Web technologies [
13
]. It currently consists of 11 billion triples and 35 connected datasets.
Bio2RDF
is part of the
Life Sciences Linked Open Data
(LSLOD), in the context of the
Linked Open Data
initiative [
14
].
The
Knowledge Base of Biomedicine
(KaBOB) integrates 18 biomedical data sources using 14 ontologies from the Open Biomedical Ontologies (OBO) initiative [
15
]. Such a model integrates data sources by producing a single biomedical entity for each set of data source-specific equivalent identifiers. Similarly, the
Genomic and Proteomic Knowledge Base
(GPKB) links several biomedical data sources such as
Entrez Gene
,
UniProt
,
IntAct
,
Expasy Enzyme
,
GO
,
GOA
,
BioCyc
,
Kegg
,
Reactome,
and
OMIM
[
16
]. It provides a set of maintenance procedures to update the knowledge base depending on the evolutions of its sources and their consistency.
The Software for Flexible Integration of Annotation (SoFIA) aims at integrating omics information from several sources [ 17 ]. It relies on a minimal workflow that, given a starting goal indicated by the researchers, allows one to complete the task and return a relevant subset of information. More recently, the R package Onassis has been introduced to easily associate samples from large-scale biomedical repositories to ontology-based annotations [ 18 ]. Onassis leverages NLP techniques, biomedical ontologies, and the R statistical framework to identify, relate, and analyze datasets from public repositories.
In the domain of cancer research, SysCancer has the aim to provide an integrated system that combines different stages of cancer studies [ 19 ]. The data warehouse can allow a multidimensional analysis of collected and integrated data meant for public access. In [ 20 ] the authors developed a cancer staging ontology based on the guidelines of the American Joint Commission on Cancer . The initial knowledge graph has been augmented by integrating additional open-source information about treatment and monitoring options depending on the inferred stage.
A network-based data integration framework for the semantic integration of clinical and omic data on breast cancer and neuroblastoma is presented in [ 21 ]. Here, a NoSQL database is used to combine heterogeneous raw data records and external knowledge sources. A cervical cancer ontology has been developed by [ 22 ] where the authors define 880 standardized concepts, 1182 common terms, 16 relations, and 6 attributes which are organized into 6 levels and 11 classes.
The first example of a linked data application, aimed at integrating and harmonizing existing information on NENs was reported in [ 6 ]. It connects data from several sources, providing a single access point to a detailed network of information, organized on three interconnected layers. The ontology developed in this latest paper and the related software prototype constitutes the starting point of the present study.
As anticipated in the introductory section, this work extends the existing ontological model by designing and integrating three additional layers, which refer to further aspects of the domain. On the other hand, the new model exhibits the innovations already proposed in the previous version compared to the existing literature, i.e., the use of multilayer networks to organize the model in a manageable structure, the use of a workflow-based approach to integrating external data “on the fly”, and the use of a user-friendly interface based on a multi-modal database with polyglot persistence.
3. Initial Model and New Information Sources
As anticipated in the previous section, the starting point of this work is the linked data application for NENs described in [ 6 ]. The next sub-section summarizes the content and the structure of the previous knowledge model whereas Section 3.2 provides a brief overview of the new biomedical information sources that, in the present study, have been integrated on top of the former model.
3.1. The Initial Integration Model
The former model already integrates several existing biomedical ontologies and databases that describe diseases, genes, gene products, biological processes, molecular functions, and the gene–disease and disease–disease associations. The entire list of the integrated data sources is reported in Table 1 . A single knowledge model has been built by extracting and linking relevant information for research on NENs.
Our model relies on the formalism of multilayer networks to address the heterogeneity of interconnected information; this allows us to represent complexity by generalizing a graph structure where the nodes and edges are distributed on different layers, each representing an “aspect” of the domain [ 23 ].
We define a multilayer network as a triple
M
=
(
V
,
E
,
L
)
where the sets
V
and
E
represent, respectively, the nodes and edges of the network, whereas
L
=
{
L
1
,
…
,
L
d
}
is the set of network layers [
24
]. In turn, each
L
i
∈
L
is a subgraph
L
i
=
(
V
i
,
E
i
)
composed by the nodes
V
i
and the edges
E
i
such that
V
=
∪
i
=
1
d
V
i
and
E
=
∪
i
=
1
d
E
i
.
In Figure 1 a sketch of the former model is depicted. The three interconnected layers represent information on diseases, affected genes, and their functions. We define specific concepts as shared nodes that realize bridges between layers. Layer 1 collects information about NENs as available in NCIT, ORDO, and DO ontologies. The disease class (and its subclasses) acts as a bridge from layer 1 to layer 2 to highlight the variations in the human genome (available in the DisGeNet database) that lead to the NENs described at the first level as well as disease–disease associations based on their molecular causes.
Then, the
gene
class (and its subclasses) acts as a bridge from layer 2 to layer 3 to highlight additional information on genes and gene products responsible for the onset of NENs (available in the
Gene Ontology
). This also includes genes’ molecular functions (i.e., the elementary activities of a gene product at the molecular level, such as binding or catalysis) and biological processes (i.e., the operations or sets of events relevant to the operation of living units: cells, tissues, organs, and organisms).
We implement interlayer relations with the
equivalent-class
OWL statement. In the same way, newly defined ontologies are linked with the original ontological sources. We developed a client–server application to access, browse, and query the defined model.
3.2. The Additional Biomedical Information Sources
The list of additional data sources integrated with the updated knowledge model is reported in Table 2 which also includes a reference to the official website.
The
Human Phenotype Ontology
(HPO) provides a standardized vocabulary of phenotypic abnormalities found in human diseases. It currently includes over 13,000 terms and more than 156,000 annotations describing phenotypic anomalies divided into five sub-ontologies that classify anomalies, link them to diseases, describe the mode of inheritance, the modifiers of clinical symptoms, the clinical course, and the frequency of specific clinical features. The ontological scheme is developed by the
Monarch Initiative
, using medical literature to improve biomedical research on rare diseases [
25
].
The
HPO-ORDO Ontological Module
(HOOM) is an ontology that integrates ORDO information on rare diseases with HPO information on phenotypic anomalies. HOOM qualifies the annotations between clinical entities and phenotypic anomalies according to the frequency and integrates the notion of diagnostic criterion. HOOM is intended for researchers and pharmaceutical companies wishing to co-analyze associations of rare and common disease phenotypes. Being designed to integrate the information of two different models, it does not contain instances but only classes and relationships.
The Human Protein Atlas (HPA) maps human proteins in cells, tissues, and organs using the integration of several omic technologies, including antibody-based imaging, mass spectrometry-based proteomics, transcriptomics, and systems biology [ 26 ]. It has contributed to thousands of publications in the field of human biology and disease and is recognized by the intergovernmental organization ELIXIR as a central European resource for the life science community. HPA consists of ten parts, each focusing on a particular aspect of the genome-wide analysis of human proteins.
In particular, the
HPA Tissue Section
has been used in this work. This section describes the expression profiles in human tissues of genes at both the
mRNA
and protein levels. The protein expression data of 44 normal human tissue types is derived from antibody-based protein profiling using immunohistochemistry. Protein data covers 15,323 genes (i.e., 76% of protein-coding genes) for which antibodies are available. The mRNA expression data is derived from deep RNA sequencing (RNA-seq) from 256 different types of normal tissue.
The
Drug–Gene Interaction Database
(DGIdb) is a Web resource that provides information on drug–gene interactions and druggable genes from publications, databases, and other Web sources [
27
]. Data on drugs, genes, and interactions are normalized and merged into conceptual groups. In the current version (4.0), DGIdb includes 100,273 interaction statements and 33,577 druggable gene category claims. In total, it includes 10,606 druggable genes and 54,591 drug–gene interactions, covering 41,102 genes and 14,449 drugs. DGIdb is accessible via a Web-based search interface, an application programming interface (API), and is downloadable as a collection of TSV archives.
The
ChEMBL
database is a large open-access drug discovery database managed by the
European Molecular Biology Laboratory
(EMBL). It is handled manually and has the purpose of capturing data and knowledge across the pharmaceutical research and development process. Information on molecules and their biological activity is extracted from full-text articles in several journals and supplemented with data on approved drugs and clinical development candidates, such as the mechanism of action and therapeutic indications [
28
]. It includes information on more than 2 million compounds and 14,000 drugs from more than 84,000 publications and about 200 datasets. It is accessible via a Web-based interface and can be downloaded as an SQL database or a collection of RDF files.
4. The Integration and Harmonization Process
To integrate the biomedical data sources described in
Section 3.2
, three additional layers were designed and harmonized with the initial model.
Figure 2
shows the updated model which now consists of six interconnected layers. The additional layers (opaque in the figure) contain information on the phenotypic anomalies connected to the NENs (layer 1b), the involved human tissues (layer 4), and the pharmacological interactions with the connected genes (layer 5). As in the original model, we don’t include explicit interlayer connections since they can be inferred from the projections of the same node in different layers. Furthermore, each pair of adjacent layers shares at least one node.
The new layer describing phenotypic anomalies, being closely related to diseases, is placed directly between layers 1 (diseases) and 2 (genes). In this way, the disease class (and its subclasses) allows a transition from layer 1 to layer 1b (to discover phenotypic anomalies related to diseases) and to layer 2 (to discover disease–gene connections). In turn, the gene class (and its subclasses) allows a transition from layer 2 to layer 3 (to discover gene functions), to layer 4 (to discover human tissues where gene products are expressed), and to layer 5 (to find drugs that have documented interactions with genes). In the next subsections, we describe in more detail the composition of each additional layer.
4.1. Layer 1b: Phenotypic Anomalies
As introduced in Section 2 , NENs are rare diseases that include heterogeneous neoplasms such as high-grade NETs in the lung, mixed medullary and follicular cell carcinomas, intrathyroidal NENs with paraganglioma features, NENs of the breast, NETs in the kidney, NETs of the bladder, etc. [ 10 ]. Although a rare disease occurs in less than 1 in 2000 individuals, due to the high number of such diseases (about 8000 according to Orphanet), it is estimated that around 4% of the European population has a rare disease diagnosis [ 29 ].
According to [ 30 ], about 80% of rare diseases are of genetic origin. However, due to a lack of clinical and scientific knowledge, the molecular cause is unknown for about 40% of them. The second level of the proposed model already includes information on known genetic variants linked to NENs. However, despite the increasing number of identified genetic variants, their functional impact and, consequently, the connection with rare diseases is still largely unknown. Furthermore, even for diseases for which one or more causative genes have been identified, these often do not explain the totality of cases.
This lack of knowledge often prevents patients from receiving adequate and timely care. It is estimated that specific therapies are available for less than 10% of rare diseases, including NENs. For this reason, having available detailed phenotypic data combined with ever-increasing amounts of genomic data is of enormous importance to accelerate the identification of clinically actionable prognostic or therapeutic implications and to improve the understanding of rare diseases [ 31 ]. Moreover, phenotype-based genomic analysis has also been shown to improve the diagnostic rate in patients with rare diseases [ 32 ].
Phenotypes are the observable traits of an organism. In medical contexts, however, the word phenotype is more often used to refer to some deviation from normal morphology, physiology, or behavior. A disease is commonly characterized by one or more phenotypic features which can affect all or only a subset of individuals with the disease as well as a time course over which the phenotypic features may have onset and evolve. The HPO ontology (see
Section 3.2
) describes a deep hierarchy of phenotypic abnormalities whereas the HOOM ontology (see
Section 3.2
) associates the phenotypic anomalies described in HPO with the clinical entities included in the ORDO ontology of rare diseases.
By harmonizing the information included in HPO and HOOM with the classes and properties of the first three layers of the initial knowledge model, we were able to construct layer 1b, aimed at describing known associations between NENs and phenotypic anomalies. Figure 3 represents the main classes and relations of our model. Gray classes and bold relationships are introduced by the integration scheme of layer 1b except for the dotted classes which are projected from the previous and subsequent layers.
The main classes of this layer are
phenotypic anomaly
, equivalent to the
phenotypic abnormality
class from HPO (i.e., the ancestor class of all described phenotypic anomalies), and the
disease–phenotype association
class, a subclass of the
association
class from HOOM (describing known associations between phenotypes and clinical entities). Only associations related to diseases classified as NENs in the first layer have been considered. Furthermore, a set of properties, inherited from HOOM and described in
Table 3
, are linked to each association, to qualify it with information about the frequency and the diagnostic criteria, and the provenance (e.g., scientific articles or expert opinions).
It should be noted that indirect connections between genes, gene variants, and phenotypic anomalies can be inferred from the model based on information from layer 2 that associates genes and gene variants with diseases.
4.2. Layer 4: Human Tissues
This layer enhances the model with information, inherent to NENs, on the human tissues associated with the genes that cause these diseases. This information is retrieved from the
Human Tissues
section of the HPA (see
Section 3.2
) which defines the distribution of gene products in the main tissues and organs of the human body. The collection and analysis of information relating to normal tissues are important and allow us to compare a pathological state with normality. On the other hand, inter-individual variations in the norm (e.g., age-related) can present a challenge in distinguishing a physiological condition from a pathological one.
The Human Tissues section of the HPA describes the level of expression of gene products in 44 different non-diseased tissues. These gene products and related genes play an important role in organ physiology and provide the basis for organ-specific research. By correlating genes and tissues it is possible to highlight genes that are simultaneously present in groups of tissues, compared to all other human tissues. Such information helps to find similar characteristics between different organs and allows us to elucidate the function of the genes associated with NENs.
Table 4
shows the main fields of the
HPA Normal Tissue Data Archive
. It is a tabular TSV file where each row represents the association between a gene and a human tissue. We filtered this extensive dataset to consider only the associations with a
medium
or
high
level of protein expression (
level
field), only for the subset of genes already included in layer 2 of the integrated model (therefore related to NENs). Then the value of the
reliability
field was considered. This value indicates the level of reliability of the analyzed protein expression pattern based on knowledge-based evaluation of available RNA-seq data, protein/gene characterization data, and immunohistochemical data from one or several antibodies designed toward non-overlapping sequences of the same gene. In our case, only the associations that are considered as
enhanced
,
supported
, or
approved
were retained whereas
uncertain
associations were discarded.
To harmonize the filtered information with the multi-layered knowledge model, an ontological representation of gene–tissue association is created as represented in Figure 4 where gray classes and bold relationships are introduced by the scheme of this layer except for the dotted classes which are projected from the previous layers. In particular, the classes Tissues and Cell-Types were introduced whose instances are taken from the HPA-controlled vocabularies.
A
Gene–Tissue Association
class was also introduced whose instances are dynamically generated from the filtered version of the HPA Normal Tissue Data Archive. Each instance maps a gene with a tissue and a cell type by also specifying the related level (
medium
or
high
, which are instances of the
Level
class) and reliability (
enhanced
,
supported
, or
approved
which are instances of the
Reliability
class). Even in this case, indirect connections between diseases and tissues can be inferred from the model based on information from the previous layers that associate genes and diseases.
4.3. Layer 5: Drug Interactions
NENs are biologically heterogeneous and contain subpopulations of cells with different angiogenic, invasive, and metastatic properties. As their response to therapeutic agents is equally heterogeneous, their treatment still represents an important clinical problem [ 33 ]. Understanding drugs’ effects on NENs has been importantly investigated in the last years also using in vitro studies that have been essential to clarifying drug mechanism of action. Some innovative therapeutic options are also based on the study of the molecular pathways involved in the development and growth of NENs.
In this context, the research has recently focused on the so-called druggable genome that is, genes and gene products known or expected to interact with bioavailable compounds. In addition to the presence of a protein structure that can be powerfully bound by small molecules, good potential targets are proteins for which modulation of biological function could provide therapeutic benefits for the patient. Targeted therapy has proven to be a successful strategy in oncology, with the introduction of new therapeutic agents, including monoclonal antibodies and small molecule kinase inhibitors [ 34 ].
Following this trend, whereas the previous levels of the model offer researchers the ability to find mutated or altered genes implicated in NENs, the last level is designed to provide them with information on compounds and drugs that show documented interactions with these genes. The main external information sources integrated into this level are ChEMBL and DGIdb (see Section 3.2 ) describing, respectively, drugs and drug–gene interactions.
Table 5 shows the main fields of the DGIdb Interactions Archive . It is a tabular TSV file where each row represents a documented interaction between a drug and a gene. We filtered this information (made of more than 85,000 associations) to consider only interactions with genes already included in the model. The standardized HGNC (Human Genome Organization Gene Nomenclature Committee) gene name was used to associate the correct Gene class from layer 2. Instead, the drug-concept-id field was used to link the right instance of the Substance class from the ChEMBL ontology.
To harmonize the filtered information with the multi-layered knowledge model, an ontological representation of drug–gene interaction is created as represented in
Figure 5
where gray classes and bold relationships are introduced by the scheme of this layer except for the dotted classes which are projected from the previous layers. In particular, the new class
Drug
maps, through the
equivalent-class
relation, the external general
Substance
class from
ChEMBL
. The class
Gene–Drug Interaction
maps a row of the
DGIdb Interactions Archive
and connects the
Gene
class with the
Drug
class with the
interaction-has-gene
and the
interaction-has-drug
object properties, respectively.
Additional information, connected to the Gene–Drug Interaction class through the interaction-has-type property, is the Interaction Type that explains the way a dug or compound interacts with a gene according to a controlled vocabulary defined by DGIdb as reported in Table 6 . Each term is represented within the model as an individual of the Interaction Type class. The meaning of each term is explained in the same table. Additional information like the interaction score (see Table 5 ) and a link to the ChEMBL Web page describing in detail each substance is included in the model through data properties.
5. Developed Prototype and Validation Results
A client–server application was developed as an extension of the one already presented in [ 6 ] to retrieve the relevant information from our integrated model. We selected Virtuoso Universal Server as the middleware to store the original biomedical ontologies and databases; such an open-source solution allows us to manage different data formats with several access protocols. We store the original datasets to the server, scheduling periodical updates starting from the original endpoints (not straightly used for performance issues). Our multilayer integration model is also hosted on the same server.
We developed a lightweight Java desktop application to allow quick and easy user interaction. A visual interface is provided to specify input queries, which are in turn translated as SPARQL sequences and forwarded via HTTP to the server. Obtained results are shown graphically to the user. For RDF and SPARQL management, our client application relies on the Jena Framework. We also use
OWL API
for the client-side manipulation of OWL ontologies.
Figure 6
summarizes our system architecture highlighting the main modules. Notice that the dashed dataset comes from the previous version.
Figure 7
shows the “phenotypes” section of the client application. Once the user has selected a subset of NETs and/or NECs from the “diseases” area—see (Capuano, Foggia, Greco, and Ritrovato, 2022)—this section allows him to obtain the phenotypic anomalies associated with the selected diseases. The user can decide whether to carry out the analysis only on the previously selected diseases or not. The information obtained in this phase is extracted from layer 1b (see
Section 4.1
) starting from the rare diseases present in the ORDO ontology, and then extrapolating the associations with the anomalies in ORDO-HOOM and finally the information relating to the anomalies in HPO. The user can click on the
name
of the anomaly and on the
frequency
value to get more information.
Figure 8
shows the “tissue” section of the client application. Information about the human tissues in which a neoplasm can occur is extracted from layer 4 (see
Section 4.2
) starting from the
Normal Tissue Data Archive
of HPA. Once the user has selected a subset of genes involved in NETs and/or NECs under investigation (including gene–disease, variation–disease, and disease–disease associations, cytogenetics anomalies, molecular anomalies, etc.)—through the “genetic information” tab described in (Capuano, Foggia, Greco, and Ritrovato, 2022)—he can obtain here the list of human tissues in which each gene has a medium or high level of expression. Displayed data on each tissue is associated with a link to the online version of HPA where the user can find additional information (see
Figure 9
).
Figure 10
shows the “drugs” section of the client application where the user can obtain information on compounds and drugs that show documented interactions with the genes selected in one of the preceding steps and, as consequence, can potentially impact the associated diseases. The information obtained in this phase is extracted from layer 5 (see
Section 4.3
) starting the integration of gene information included in GO with information on drugs included in ChEMBL and drug–gene interactions included in DGIdb. Displayed data on each drug is associated with a link to the online version of ChEMBL where the user can find additional information (see
Figure 11
).
A test installation of the server was conducted on a Linux machine with a 2.3 GHz quad-core Intel Core i7 processor and 16 Gb of RAM. With this hardware configuration, most of the queries are answered in a fraction of a second, and only the most complex ones (that combine information from semantic and non-semantic sources) require longer: in rare cases more than 2 s. These results are in line with recent RDF store benchmarks [ 35 ] which rank Virtuoso Universal Server as one of the fastest triple stores for both instant and analytical queries.
Our system validation was performed with the contribution of a domain expert that helped verify the consistency and correctness of the ontological knowledge as well as the quality of the alignment between the information sources. We adopted an iterative approach where the expert was asked to use the system and provide feedback; this allowed us to improve the level of alignment [ 36 ]. In the specific case, two validation iterations led to satisfactory results.
6. Conclusions and Further Work
In this paper, we have described the extension of previous research work aimed at designing and implementing a domain-specific linked data application for integrating relevant biomedical information on NENs. Additional biomedical aspects covered by the updated model include the phenotypic anomalies linked to these diseases, the involved human tissues, and the documented pharmacological interactions of existing drugs and compounds. Through the alignment and the integration of existing semantic and non-semantic biomedical sources, we were able to compose a knowledge base as a
multilayer network
managed through a multi-model database providing polyglot persistence. The model can be easily navigated and queried using a client application that provides a user-friendly graphical interface.
Several directions of extension of the proposed system can be envisaged. On the one hand, there is the possibility of integrating additional information sources within existing layers (integrating aspects already considered) as well as on additional layers (considering further aspects). On the other hand, it would be possible to apply the model to a connected biomedical domain, for example considering a different subset of rare diseases. The experimentation of the proposed system with researchers and professionals involved in the treatment of this type of neoplasms is also foreseen to collect feedback for system improvement as well as to assess the risks and critical success factors associated with the introduction of this kind of technology in real medical contexts [
37
].
Beyond the specific domain, the paper introduces and analyzes a way to integrate heterogeneous data sources, capable of being adapted to other contexts. Linked data makes the possible aggregation of information quite unlimited. Each information level can be enriched with further details so that the system becomes increasingly useful for user support. On the other hand, the multi-layer organization would help to deal with the variety of information in a more organized and governable way.
Another promising research direction is the application of existing metrics, such as those defined in [
38
], to measure the quality of the integrated knowledge model in terms of
relationship richness
,
attribute richness
,
inheritance richness
, etc. Indeed, evaluating such metrics on the integrated model, which includes ontological and non-ontological information, could be an interesting but challenging task that would require revising the definition of such metrics to support hybrid models. Moreover, approaches to automatic ontology alignment could be investigated and incorporated into the proposed system as integrated schemas.
Author Contributions
Conceptualization, P.R. and P.F.; methodology, N.C. and L.G.; software, N.C. and L.G.; validation, P.R. and P.F.; formal analysis, N.C. and L.G.; writing-original draft preparation, N.C. and L.G.; writing-review and editing, N.C. and P.R.; supervision, P.F.; funding acquisition, P.R. All authors have read and agreed to the published version of the manuscript.
Funding
This work is partially supported by the RarePlatNet project on diagnostic and therapeutic innovations for neuroendocrine and endocrine tumors and glioblastoma through an integrated technological platform of clinical, genomic, ICT, pharmacological, and pharmaceutical skills , funded by the Campania region, Italy under the grant on POR CAMPANIA FESR 2014/2020, axis 1, objective 1.2.
Institutional Review Board Statement
Not applicable.
Informed Consent Statement
Not applicable.
Conflicts of Interest
The authors declare no conflict of interest.
References
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Figure 1. Visual representation of the initial integration model.
Figure 1. Visual representation of the initial integration model.
Figure 2. Visual representation of the updated integration model.
Figure 2. Visual representation of the updated integration model.
Figure 3. Relevant classes and relations of the additional layer 1b.
Figure 3. Relevant classes and relations of the additional layer 1b.
Figure 4. Relevant classes and relations of the additional layer 4.
Figure 4. Relevant classes and relations of the additional layer 4.
Figure 5. Relevant classes and relations of the additional layer 5.
Figure 5. Relevant classes and relations of the additional layer 5.
Figure 6. Client–server architecture of the developed prototype.
Figure 6. Client–server architecture of the developed prototype.
Figure 7. The “Phenotypes” section of the client application.
Figure 7. The “Phenotypes” section of the client application.
Figure 8. The “Tissues” section of the client application.
Figure 8. The “Tissues” section of the client application.
Figure 9. Additional online information from HPA linked to the “tissues” section.
Figure 9. Additional online information from HPA linked to the “tissues” section.
Figure 10. The “Drugs” section of the client application.
Figure 10. The “Drugs” section of the client application.
Figure 11. Additional online information from ChEMBL linked to the “drugs” section.
Figure 11. Additional online information from ChEMBL linked to the “drugs” section.
Table 1. List of the biomedical information sources integrated with the former model.
Table 1. List of the biomedical information sources integrated with the former model.
Information Source Format Website National Cancer Institute Thesaurus (NCIT) OWL, OBO ncithesaurus.nci.nih.gov Orphanet Rare Disease Ontology (ORDO) OWL www.ebi.ac.uk/ols/ontologies/ordo Disease Ontology (DO) OWL, OBO disease-ontology.org Mondo Disease Ontology (MONDO) OWL, OBO mondo.monarchinitiative.org Gene Ontology (GO) OWL, OBO, CSV geneontology.org MedGen database CSV www.ncbi.nlm.nih.gov/medgen DisGeNet database RDF, CSV www.disgenet.org
Table 2. List of additional biomedical information sources.
Table 2. List of additional biomedical information sources.
Information Source Format Website Human Phenotype Ontology (HPO) OWL, OBO hpo.jax.org HPO-ORDO Ontological Module (HOOM) OWL bioportal.bioontology.org/ontologies/HOOM Human Protein Atlas (HPA) TSV www.proteinatlas.org Drug–Gene Interaction Database (DGIdb) TSV www.dgidb.org ChEMBL Database RDF, SQL www.ebi.ac.uk/chembl
Table 3. The HOOM sub-classes qualifying a disease–phenotype association.
Table 3. The HOOM sub-classes qualifying a disease–phenotype association.
Class Sub classes Description Frequency Association Obligate The phenotypic abnormality is always present, and the diagnosis cannot be confirmed if it is absent Very Frequent The phenotypic abnormality is present in 80% to 99% of cases Frequent The phenotypic abnormality is present in 30% to 79% of cases Rare The phenotypic abnormality is present in 5% to 29% of cases Very Rare The phenotypic abnormality is present in 1% to 4% of cases Diagnostic Criteria Criterion The phenotypic anomaly is used consensually to establish the clinical diagnosis Exclusion The phenotypic anomaly allows to exclude the diagnosis Pathognomonic The phenotypic anomaly is sufficient to undoubtedly establish the diagnosis Provenance … Each subclass represents a set of scientific articles or expert advice qualifying the association
Table 4. The main fields of the HPA Normal Tissue Data Archive .
Table 4. The main fields of the HPA Normal Tissue Data Archive .
Table 5. The main fields of the DGIdb Interactions Archive .
Table 5. The main fields of the DGIdb Interactions Archive .
Field Description Example gene-name Gene identifier ( HGNC taxonomy) ITGB5 entrez-id Gene identifier ( NCBI Entrez taxonomy) 3693 drug-name Name of the interacting drug CILENGITIDE drug-concept-id Drug identifier ( ChEMBL taxonomy) CHEMBL429876 interaction-types Types of gene–drug interaction (controlled vocabulary, see Table 6 ) inhibitor interaction-score The strength of the interaction calculated by multiplying the number of sources that report the interaction with its specificity (if the gene or the drug interacts with many other drugs or genes, the interaction specificity is low, otherwise it is high) 9.55
Table 6. Types of drug–gene interactions supported by layer 5.
Table 6. Types of drug–gene interactions supported by layer 5.
Interaction Type Description activator A drug activates a biological response from a target, although the mechanism by which it does so may not be understood agonist A drug binds to a target receptor and activates the receptor to produce a biological response allosteric modulator Drugs exert their effects on their protein targets via a different binding site than the natural (orthosteric) ligand site antagonist A drug blocks or dampens agonist-mediated responses rather than provoking a biological response itself upon binding to a target receptor antibody An antibody drug specifically binds the target molecule antisense oligonucleotide A complementary RNA drug binds to an mRNA target to inhibit translation by physically obstructing the mRNA translation machinery inducer The drug increases the activity of its target enzyme inhibitor The drug binds to a target and decreases its expression or activity inhibitory allosteric modulator The drug will inhibit activity of its target enzyme inverse agonist A drug binds to the same target as an agonist but induces a pharmacological response opposite to that of the agonist modulator The drug regulates or changes the activity of its target, but it may not involve any direct binding to the target negative modulator The drug negatively regulates the amount or activity of its target, but it may not involve any direct binding to the target partial agonist A drug will elicit a reduced amplitude functional response at its target receptor, as compared to the response elicited by a full agonist positive modulator The drug increases activity of the target enzyme suppressor The drug directly or indirectly affects its target, suppressing a physiological process vaccine The drugs stimulate or restore an immune response to their target
Chicago/Turabian Style
Capuano, Nicola, Pasquale Foggia, Luca Greco, and Pierluigi Ritrovato. 2022. "A Linked Data Application for Harmonizing Heterogeneous Biomedical Information" Applied Sciences12, no. 18: 9317.
https://doi.org/10.3390/app12189317
Note that from the first issue of 2016, this journal uses article numbers instead of page numbers. See further details here .
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MDPI and ACS Style
Capuano, N.; Foggia, P.; Greco, L.; Ritrovato, P. A Linked Data Application for Harmonizing Heterogeneous Biomedical Information. Appl. Sci. 2022, 12, 9317.
https://doi.org/10.3390/app12189317
AMA Style
Capuano N, Foggia P, Greco L, Ritrovato P. A Linked Data Application for Harmonizing Heterogeneous Biomedical Information. Applied Sciences. 2022; 12(18):9317.
https://doi.org/10.3390/app12189317
Chicago/Turabian Style
Capuano, Nicola, Pasquale Foggia, Luca Greco, and Pierluigi Ritrovato. 2022. "A Linked Data Application for Harmonizing Heterogeneous Biomedical Information" Applied Sciences12, no. 18: 9317.
https://doi.org/10.3390/app12189317
| https://www.mdpi.com/2076-3417/12/18/9317 |
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The Sacred Heart
Love is a funny thing. Materialists will tell us that it is purely the result of a series of electro-chemical responses in the brain, and yet others will tell us that it is the result of fate, the conspiracy of the alignment of the planets or the times we find ourselves in. The heart has long been understood as the centre of a person, a place of knowledge as much as will. It makes us do unreasonable things like acts of unwarranted kindness and altruism and by the edge of its blade we can be hurt in ways that we just can’t speak about. And yet none of these express what love is in itself — only God does that.
On Friday we venerate the Heart of our Lord as the symbol of his human love in which God’s divine love is revealed to us. In most of the prayers to or the meditations on the Sacred Heart, even those very ancient prayers, the woundedness of our Lord’s heart comes to the fore. That heart pierced with a lance and bruised with outrages and blasphemies is a stark and realistic image of the extent to which Christ loves us. Christ, who is the image of the unseen God, the Icon of the Father, shows us precisely what God’s love for us looks like. And it looks like a heart pierced and bruised on account of our sins, yet burning with ardent love for you and for me. This divine love is not for softies.
The time when we celebrate this feast is very fitting. We have come to the end of the Church’s celebration of the mysteries of our redemption: the Passion, the Cross, the Resurrection, the Ascension, Pentecost, the Feast of the Blessed Trinity and Corpus Christi. But today we commemorate the divine-human love which motivated them all. In adoring the Sacred Heart, we adore the totality of Christ’s saving work — it represents the way in which God holds nothing back from us. And in order to share his divine life with us, he reaches down into the very depths of our life, even — and especially — where it is painful, difficult to speak of, hidden. By taking it all and joining it to himself, he scoops us up, he enables us to become like him. By sharing our life, and by sharing our pains, he heals us, he sanctifies us, and he strengthens us.
It is also true that his heart welcomes us precisely so that we might become like it. The whole thrust of our Christian life is that we might be conformed to our Saviour, that we might resemble him, and in this sense, in the life of faith, we should ask ourselves continually whether our heart resembles his. His Sacred Heart is both the example and the cause of our becoming like him. His love is attractive. The more we consider the love with which Jesus acted, and spoke and gave of himself for us, the more we can begin, by his grace, to imitate him — it is truly the school of Christian perfection.
And we begin in that school by prayer. When St John Henry Newman, our Cardinal, chose his motto, he looked to St Francis de Sales’ Treatise on the Love of God. The phrase he chose and paraphrased, Cor ad Cor loquiturrepresents for us the central mystery of the prayer that can begin to transform us. St Francis de Sales wrote:
Truly the chief exercise in mystical theology is to speak to God and to hear God speak in the bottom of the heart; and because this discourse passes in most secret aspirations and inspirations, we term it a silent conversing. Eyes speak to eyes, and heart to heart, and none understand what passes save those who speak.
We may be no great shakes at the spiritual life, or prayer, or we may feel that excelling in virtue is beyond us, but if we can in the simplest of ways open our poor heart to his Sacred Heart, and speak to him as to a friend, if we can entrust our lives to him and ask him devoutly and sincerely to shape us after the model of his Heart, then our Christian life will be all the more graced.
The Corpus Christi procession concluded with Benediction at the University Chaplaincy. #oxfordoratory
The procession finished at the University’s Catholic Chaplaincy. #oxfordoratory
The numbers caught the attention of the local media:
https://www.oxfordmail.co.uk/news/23582016.oxfords-catholic-congregations-take-part-corpus-christi-procession/
#oxfordoratory
Children scattered flower petals before the Blessed Sacrament all the way. #oxfordoratory
Our route now passes through the city in a straight line, taking us directly through the busiest shopping areas. #oxfordoratory
The canopy was carried by members of the University of Oxford wearing their academic dress. #oxfordoratory
Fr Robert Ombres OP preached a sermon. #oxfordoratory
We paused at Blackfriars. #oxfordoratory
We were joined by local clergy and religious orders as we processed through the streets to the Dominican Priory at Blackfriars. #oxfordoratory
The processions sets off… #oxfordoratory
We had record numbers for the procession this year. There wasn’t space in church for everyone at the beginning! There were more people outside too. #oxfordoratory
The beginning of our Corpus Christi procession last Sunday.#oxfordoratory
The Oratory Prayer Book is now shipping internationally!
We’ve made it even easier to buy the Oratory Prayer Book from anywhere in the world.
And we’ve made it easier to order multiple copies too — in the UK and worldwide.
Order your copy here:https://tinyurl.com/opb-buy
If you have one, we’d love to hear what you think about it. Let us know in the comments, or tag a photo of your prayer book in the wild with #oratoryprayerbook
Thanks to @acatholicinoxford for the photo.
#oxfordoratory
Worship
What does it actually mean to worship God? In the New Testament, the word we most often translate as ‘worship’ doesn’t mean to reverence another in some abstract sense. It always involves some kind of bodily action. When we think about the magi visiting the Holy Family, we sometimes convey this motion by describing them — after they fall to their knees — as ‘doing homage’. But it’s actually that same word here we might translate elsewhere as ‘worship’. It’s just that we recognise the need to describe the bodily sign of their submission and adoration of the new born King with something that sounds a bit more physical.
The word we usually translate as ‘worship’ ( proskuneo) comes literally from a root meaning ‘to make yourself like a dog before the other person’. It originally meant prostrating yourself on the floor to show your humble submission before another. By the time of the New Testament, people wouldn’t necessarily have had the root of this word in mind whenever they used it,* but the word still carries with it the idea of doing something with your body to express your worship.
The feast of Corpus Christi is all about this kind of bodily worship. It’s tied to the fact that we are not pure spirits, but that we are human beings, body and soul. To worship God is not just a spiritual act. The right worship of God does not consist in simply having the right kinds of thoughts towards him. But the worship of God involves the humble submission of our entire human being, body and soul, before the God who is greater than all of us.
And ever since the Incarnation, we do this not just before an abstract spirit. Because, from the moment of the Incarnation, God really does have a human body, that we can worship, that we fall down on our knees before, like the magi and the Canaanite woman, and so many others in the Gospel who kneel down and worship Christ. When we worship God, we kneel before God who is present in the flesh, under the appearances of bread and wine, in our churches all over the world.
Corpus Christi is a joyful celebration of Christ’s presence among us, and it gives us an opportunity to think about how we respond to that gift. All this talk of kneeling and worship might not sound so joyful, but one of the great paradoxes of Christianity is that we find our greatest freedom in the humble service of God. Our greatest joy really should be found in finding ways to express this loving worship. So at least once a year, it is no bad thing to think about how we express with our own bodies that worship of God’s body, and what ways we can find to worship him even more perfectly.
This Sunday, we will carry Christ’s Body through the streets of our city. We have a chance to demonstrate to the world our love, our joyful service, our worship of him, through our presence. The procession leaves our church at 2:30pm. Make sure you are there.
But we should also think about the more ordinary things, like making sure we show that worship whenever we are in his presence. We should show through our behaviour in church that we believe him to be there: by genuflecting before him in the tabernacle of the church, and by keeping the church quiet and prayerful.
We show our worship above all by kneeling down before him — like all those people in the Gospel — for the moment of Holy Communion. And we allow the priest to place the Host on our tongues, so that we don’t handle unnecessarily what is holy and precious, and no particles of Our Lord’s Body are ever dropped or lost through carelessness.
We continue that worship in our prayers of thanksgiving after Communion and once the Mass has ended. We certainly never leave church during Communion. And we might think of ways of extending the time we spend with Christ present in the Blessed Sacrament: by attending Mass during the week sometimes, or visiting him during the times each week when his Body is exposed solemnly on the altar for Adoration, or even just by visiting an empty church, where he is waiting for us to show him our worship.
Our Lord is hidden there, waiting for us to come and visit him, and make our request to him. See how good he is! He is there in the Sacrament of his love, sighing and interceding incessantly with his Father for sinners. To what outrages does he not expose himself, that he may remain in the midst of us! He is there to console us; and therefore we ought often to visit him. How pleasing to him is the short quarter of an hour that we steal from our occupations, from something of no use, to come and pray to him, to visit him, to console him for all the outrages he receives! When he sees pure souls coming eagerly to him, he smiles upon them. They come with that simplicity which pleases him so much, to ask his pardon for all sinners, for the outrages of so many ungrateful men. What happiness do we not feel in the presence of God, when we find ourselves alone at his feet before the holy tabernacles! ‘Come, my soul, redouble thy fervour; thou art alone adoring thy God. His eyes rest upon thee alone.’
— St John Mary Vianney
* One exception is that I do think Christ had this root meaning in mind when he spoke to the Canaanite woman in Matthew 15:21–28. He wasn’t randomly insulting her by comparing her to a dog, but drawing attention to the fact that she was making herself like a dog before him — i.e. worshipping him — because she recognised him to be God. In other words, he was acknowledging her worship as proof of her faith and humility.
On Saturday, Fr Rupert led Men’s Oratory on a walking pilgrimage to Islip, birthplace of St Edward the Confessor. #oxfordoratory
Congratulations to Elizabeth who was received into the Church yesterday evening on the Feast of the Visitation. #oxfordoratory
| https://www.oxfordoratory.org.uk/tour/blog/post/9981-9981/blog/post/10006-10006/getting-here.php |
JCM | Free Full-Text | Combining HAIC and Sorafenib as a Salvage Treatment for Patients with Treatment-Failed or Advanced Hepatocellular Carcinoma: A Single-Center Experience
Background: Hepatic arterial infusion chemotherapy (HAIC) has been proven to be an effective treatment for advanced HCC. In this study, we present our single-center experience of implementing combined sorafenib and HAIC treatment for these patients and compare the treatment benefit with that of sorafenib alone. Methods: This was a retrospective single-center study. Our study included 71 patients who started taking sorafenib between 2019 and 2020 at Changhua Christian Hospital in order to treat advanced HCC or as a salvage treatment after the failure of a previous treatment for HCC. Of these patients, 40 received combined HAIC and sorafenib treatment. The efficacy of sorafenib alone or in combination with HAIC was measured in regard to overall survival and progression-free survival. Multivariate regression analysis was performed to identify factors associated with overall survival and progression-free survival. Results: HAIC combined with sorafenib treatment and sorafenib alone resulted in different outcomes. The combination treatment resulted in a better image response and objective response rate. Moreover, among the patients aged under 65 years old and male patients, the combination therapy resulted in a better progression-free survival than sorafenib alone. A tumor size ≥ 3 cm, AFP > 400, and ascites were associated with a poor progression-free survival among young patients. However, the overall survival of these two groups showed no significant difference. Conclusions: Combined HAIC and sorafenib treatment showed a treatment effect equivalent to that of sorafenib alone as a salvage treatment modality used to treat patients with advanced HCC or with experience of a previously failed treatment.
Combining HAIC and Sorafenib as a Salvage Treatment for Patients with Treatment-Failed or Advanced Hepatocellular Carcinoma: A Single-Center Experience
by Chia-Bang Chen 1,* , Chun-Min Chen 2 , Ruo-Han Tzeng 3 , Chen-Te Chou 1 , Pei-Yuan Su 4 , You-Chuen Hsu 4 and Cheng-Da Yang 4
1
Department of Medical Imaging, Changhua Christian Hospital, Changhua 500, Taiwan
2
Big Data Center, Changhua Christian Hospital, Changhua 500, Taiwan
3
Department of Hematology, Changhua Christian Hospital, Changhua 500, Taiwan
4
Division of Gastroenterology & Hepatology, Changhua Christian Hospital, Changhua 500, Taiwan
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2023 , 12 (5), 1887; https://doi.org/10.3390/jcm12051887
Received: 11 January 2023 / Revised: 15 February 2023 / Accepted: 24 February 2023 / Published: 27 February 2023
(This article belongs to the Special Issue Gastrointestinal Malignancies: Screening, Diagnosis, and Treatment: Part II )
Background: Hepatic arterial infusion chemotherapy (HAIC) has been proven to be an effective treatment for advanced HCC. In this study, we present our single-center experience of implementing combined sorafenib and HAIC treatment for these patients and compare the treatment benefit with that of sorafenib alone. Methods: This was a retrospective single-center study. Our study included 71 patients who started taking sorafenib between 2019 and 2020 at Changhua Christian Hospital in order to treat advanced HCC or as a salvage treatment after the failure of a previous treatment for HCC. Of these patients, 40 received combined HAIC and sorafenib treatment. The efficacy of sorafenib alone or in combination with HAIC was measured in regard to overall survival and progression-free survival. Multivariate regression analysis was performed to identify factors associated with overall survival and progression-free survival. Results: HAIC combined with sorafenib treatment and sorafenib alone resulted in different outcomes. The combination treatment resulted in a better image response and objective response rate. Moreover, among the patients aged under 65 years old and male patients, the combination therapy resulted in a better progression-free survival than sorafenib alone. A tumor size ≥ 3 cm, AFP > 400, and ascites were associated with a poor progression-free survival among young patients. However, the overall survival of these two groups showed no significant difference. Conclusions: Combined HAIC and sorafenib treatment showed a treatment effect equivalent to that of sorafenib alone as a salvage treatment modality used to treat patients with advanced HCC or with experience of a previously failed treatment.
Keywords:
hepatocellular carcinoma
;
hepatic arterial infusion chemotherapy
;
sorafenib
1. Introduction
The poor prognosis of hepatocellular carcinoma (HCC) is a global health concern [ 1 ]. A total of 840,000 new cases of liver cancer and 780,000 related deaths were reported in 2018 [ 2 ], and it was estimated that more than 1 million people are affected by HCC annually by 2025 [ 3 ]. As screening for HCC has become more prevalent in recent years, HCC can be diagnosed in its early stage more frequently, and patients with early HCC can be treated with curative methods such as surgical resection, liver transplantation, or radiofrequency ablation (RFA). Trans-arterial chemoembolization (TACE) or Yttrium-90 radioembolization is the proper treatment for patients who cannot undergo these curative procedures due to their advanced tumor stage, poor liver function, or inadequate liver reserve [ 4 , 5 ]. Alternatively, if the tumor has invaded the major vascular system or if previous treatment has failed, only limited treatment modalities are available, including systemic chemotherapy, targeted therapy, or hepatic arterial infusion chemotherapy (HAIC) [ 4 , 5 , 6 , 7 , 8 , 9 , 10 ].
According to several guidelines from Japan, Europe, and the United States, the first-line treatment for patients with advanced or treatment-failed HCC is sorafenib [ 11 ]. In addition to sorafenib, HAIC can also be applied. Through the direct delivery of chemotherapy agents into the hepatic tumor-feeding vessels, an increased local chemotherapy drug concentration and reduced systemic toxicity can be achieved [ 12 ], and several studies have shown HAIC to be effective in improving the treatment response and survival.
Traditionally, HAIC has been carried out through the implantation of a chemoport. A modification of HAIC was presented by Tsai [
13
], who used an angiographic catheter inserted into the left subclavian artery to deliver the chemotherapy drug without a chemoport. The HAIC procedure implemented at our hospital was further modified based on catheter insertion through the left brachial arterial approach, together with the use of sorafenib during the outpatient department follow-up. Previous clinical trials have shown that the addition of HAIC to sorafenib is equally effective as compared to sorafenib therapy alone in terms of overall survival (OS) [
14
].
In this study, we compared the OS and progression-free survival (PFS) of patients with advanced or treatment-failed HCC receiving either a combination of HAIC and sorafenib or sorafenib alone and attempted to identify the possible prognostic factors.
2. Methods
2.1. Study Design and Patient Selection
All patients included in the study were affected by advanced or treatment-failed HCC and received sorafenib and/or HAIC treatment between January 2019 and May 2020 at the Changhua Christian Hospital. The inclusion criteria for HAIC were as follows: (1) patients with advanced HCC who were ineligible for surgical resection, RFA, or TACE; (2) patients who had experienced previous treatment for HCC with progressive disease; (3) patients with an adequate liver reserve and serum bilirubin levels < 2 mg/dL; (4) patients without extra-hepatic metastases; (5) patients with ECOG 0 or 1; and (6) patients aged > 20 years old. The exclusion criteria included (1) patients with decompensated hepatic failure and serum total bilirubin levels > 2 mg/dL; (2) patients with extra-hepatic metastases; and (3) patients with an active inflammatory or infections process and a serum white blood cell count > 10,000/μL.
In total, 75 patients with advanced HCC were enrolled, including 44 patients in the combination group and 31 patients taking sorafenib alone. However, four patients in the combination group were lost to follow-up after the first course of HAIC, and these four patients were excluded. Finally, 71 patients were enrolled in this study, including 40 patients in the combination group and 31 patients receiving sorafenib alone. Data were retrospective collected and analyzed, including age, sex, previous treatments, and laboratory test results including albumin, bilirubin, the Child–Pugh score (CPS), the albumin-bilirubin (ALBI) grade, and alpha-fetoprotein (AFP) before and after procedures. The characteristics of the tumors, including the size, T-stage, vascularity, Barcelona clinic liver cancer (BCLC) stage (0: very early stage; A: early stage; B: intermediate stage; C: Advanced stage; D: any kind of tumor burden), and portal vein tumor thrombus classification according to the liver cancer study group of Japan (PVTT), were recorded after reviewing the CT or MRI and angiography images. The clinical course and 1-year survival rates of all the patients were retrospectively analyzed.
2.2. Treatment Protocol
Regarding the HAIC procedure, after the patient was hospitalized and transferred to the angiosuite, sonography of the left subclavian or brachial artery was performed to assess the patency of these vessels. For the 40 patients included in the combination group, the left subclavian arterial was accessed for the 9 starting patients, and the left brachial artery was accessed for the following 31 patients. After puncturing the target artery under sonographic guidance using a micro-puncture set (Cook Medical LLC, Birmingham, UK), a 0.035 inch guidewire and a 4 Fr. Mariner Cobra 1 catheter (Angiodynamics, Latham, NY, USA) were inserted. Angiography of the celiac trunk and the superior mesenteric artery was performed. Embolization of the gastroduodenal artery was routinely performed using metallic coils. In cases of any vascular branch arising from the proper hepatic artery so as to supply the stomach or duodenum, embolization was also performed on these vessels, and if necessary, a microcatheter (1,98Fr. Parkway Soft, Asahi, Japan) was used. However, if these vessels could not be accessed, the catheter tip was located at least 2 cm distal to these vascular branches so as to avoid gastroduodenal injury caused by chemotherapy.
Intra-arterial chemotherapy lasted for 5 days, and the regimen included the following:
Cisplatin (10 mg/m 2 ) and mitomycin-C (2 mg/m 2 ) dissolved in 50 mL of isotonic sodium chloride solution, infused for 20–30 min each and continued for 5 days;
100 mg/m 2 of 5-fluorouracil (5-FU) dissolved in 250 mL of isotonic sodium chloride solution, administered for 24 h using an infusion pump for 5 days;
Leucovorin (15 mg/m 2 ) every day.
After completion of the 5 days of chemotherapy, 10 mL of lipiodol (Guerbet, Paris, France) was delivered through the catheter for tumoral embolization, followed by the removal of the catheter and manual compressions of the puncture site for hemostasis for 20 min. The patient was discharged after 6 h of observation in the ward. The next course of HAIC was initiated after 4 to 6 weeks, according to the patient’s condition and will. Sorafenib was administered 7 days after discharge and discontinued 7 days before the next HAIC course. A dose reduction or discontinuation of sorafenib was performed according to the clinician’s decision. Computed tomography (CT) or magnetic resonance imaging (MRI) evaluation was performed after one or two cycles of HAIC or every 3–6 months.
2.3. Response and Definitions
The response was defined according to the mRECIST criteria as follows: (1) complete response (CR), indicating the disappearance of any intratumoral arterial enhancement in all the target lesions; (2) partial response (PR), marked by a decrease of at least 30% in the sum of the diameters of the target lesions; (3) progressive disease (PD), marked by an increase of at least 20% in the sum of the diameters of the viable target lesions; and (4) stable disease (SD) or any case that did not qualify for either PR or PD [ 15 ]. If CR was achieved, if PD was observed in the following image evaluation, or if the HAIC treatment was not favored by the patients, no further HAIC was arranged, and only sorafenib was prescribed at follow-up in the outpatient department. If SD or PR was achieved, another course of HAIC was arranged and performed for further treatment.
2.4. Follow-Up and Data Collection
Based on a standardized outcome protocol, we conducted a retrospective chart review. The demographics, treatment procedures, and outcomes of patients were collected. All causes of mortality were considered in this study. The primary outcome includes overall survival (OS), which was the primary endpoint and was defined as therapy time from the assignment of therapy to death. From the assignment of treatment to the development of disease progression or death from any cause, progression-free survival (PFS) was calculated. A regular outpatient evaluation was conducted after patients were discharged. A chart review and three-monthly evaluations were conducted in the first year after treatment.
2.5. Statistical Analysis
Statistical analysis was performed using the Statistical Package for the Social Sciences software version 22 (IBM Corporation, Armonk, NY, USA). A chi-square test was performed to demonstrate differences in the baseline characteristics. For continuous variables, the Mann–Whitney U test was used to compare the groups. The 12-month survival rate was estimated using the Kaplan–Meier method with right censoring at the 12-month mark, and the survival outcomes of the groups were compared by the log-rank test. Cox proportional hazards models were used to calculate the OS and PFS. Multivariate Cox regression analysis was performed to determine the prognostic factors for the survival outcomes and to calculate the hazards ratios (HR). The tumor response to treatment was evaluated using the chi-square test. Multivariate analyses of factors that influenced survival were conducted using the Cox proportional hazards model. Statistical significance was defined as a two-sided
p
-value < 0.05.
3. Results
3.1. Patient Characteristics
The basic characteristics of the enrolled patients are summarized in Table 1 . A total of 71 patients were enrolled in our study. These 71 patients had a median age of 66 years (ranging from 42 to 85). Male predominance was observed in both groups. More than 65% of the patients in the combination group had tumors of T-stages 3–4; however, 65% of the sorafenib group had T-stages 1–2. There were also significant differences in the BCLC stages and VP scores of these two groups. The patients in the HAIC group had more advanced HCC than the other group. There were no significant differences in age, prior HCC treatment (TACE/surgery), ascites, the Child–Pugh score, preoperative AFP, albumin, bilirubin, the ALBI score, or the tumor size.
3.2. Responses of the Combination and Sorafenib Groups
The responses of the combination and sorafenib groups are detailed in
Table 2
. The median PFS tended to be longer in the combination group than the sorafenib group (6 vs. 4 months), but the difference was not statistically significant (
p
= 0.106). The median OS (12 months) was similar in both groups. In the combination group, 14 (35%), 15 (38%), 6 (15%), and 5 (13%) patients exhibited CR, PR, SD, and PD. However, in the sorafenib group, a relatively poor response was noted, with 4 (13%), 6 (19%), 5 (16%), and 16 (52%) patients exhibiting CR, PR, SD, and PD. The objective response rate was significantly higher in the combination group than in the sorafenib group (73% vs. 32%,
p
= 0.001). Considering a reduction in AFP as an indicator of response to treatment, 40% of patients in the combination group showed reductions in AFP, but a reduction in AFP only occurred in 13% of patients in the sorafenib group. Among the patients who had AFP > 20 ng/mL before treatment, more than half in the combination group showed AFP reduction, but this only occurred in a quarter of those in the sorafenib group, indicating a better treatment response in the combination group.
3.3. Hazard Rate over One Year
Approximately 93% of progressions and 84–93% of deaths occurred within 9 months after treatment in both groups. The maximum risk of death and progression increased at 6 months, while the risk decreased at 9 months. Compared to the sorafenib group, the combination group had a lower mortality rate (6%) and disease progression rate at 3 months (24%) as well as a lower disease progression rate at 9 months (17%) ( Figure 1 ).
3.4. Survival Outcomes
During the first year after treatment, 18 patients in the combination group and 14 patients in the sorafenib group died, while 29 patients in the combination group and 28 patients in the sorafenib group had progressive disease. Kaplan–Meier curves showed that the entire population who received combination treatment had better OS and PFS than the sorafenib group, but no significant statistical difference could be found ( p = 0.779 in OS and p = 0.075 in PFS) ( Figure 2 ). Stratified analysis was performed according to age ( Figure 3 ) and gender ( Figure 4 ). Compared to the sorafenib group, the combination treatment was associated with better PFS among those patients less than 65 years in age ( p = 0.023 in Figure 3 C) and also among the male patients ( p = 0.045 in Figure 4 D). In patients aged < 65, the median PFS was 7.0 months in the combination group, which was better than the 4.0 months observed in the sorafenib group. Moreover, among the male patients, a longer median PFS was observed in the combination group (6 vs. 3 months) compared to the sorafenib group.
3.5. Multivariate Analysis of Tumoral Progression
A subgroup prognostic analysis of all the clinical variables was performed using the Cox proportional hazards model. The results of the multivariate analysis are listed in Table 3 (Model A–B). In Model A, for all patients aged under 65 years, combination treatment (HR = 0.08, 95% CI: 0.02–0.35; p = 0.001), preoperative AFP > 400 ng/mL (HR = 5.21, 95% CI: 1.13–23.99; p = 0.034), and a tumor size ≥ 3 cm (HR = 6.81, 95% CI: 1.35–34.25; p = 0.020) were prognostic predictors of PFS. In Model B, the survival analysis showed that combination treatment (HR = 0.29, 95% CI: 0.11–0.71; p = 0.007), an age ≥ 65 (HR = 2.71, 95% CI: 1.33–5.51; p = 0.006), and ascites (HR = 4.31, 95% CI: 1.43–13.01; p = 0.009) were significant predictors of PFS among male patients. In conclusion, the adjuvant treatment group showed a significant negative relationship with tumor progression in the subgroups analysis.
4. Discussion
In this study, we retrospectively evaluated the treatment benefits of combined HAIC-sorafenib and sorafenib alone for patients with advanced HCC or for whom previous treatments failed. Several studies have investigated the effects of sorafenib in combination with other treatments including HAIC [ 6 , 7 , 10 , 14 ], TACE [ 8 ], chemotherapy [ 9 ], and other molecular targeting agents [ 16 ]. In Taiwan, sorafenib therapy is the most common treatment modality for these patients due to the fact that its payment is fully covered by national health insurance. Our study revealed the combination treatment results in a better response in the image follow-up and a better objective response rate. The OS and PFS appeared to be better in patients receiving the combination treatment, but there was no significant statistical difference between the two groups. In the multivariate analysis, we observed that male patients who were under 65 years old with tumor sizes < 3 cm and a lower preoperative AFP level (<400 ng/mL) who were treated with combination therapy but were without ascites had a significantly better PFS.
There have been several studies discussing the treatment effects of HIAC or HAIC combined with sorafenib for HCC patients [ 5 , 6 , 7 , 9 , 10 , 11 , 12 , 13 , 14 , 16 , 17 ]. Most showed promising treatment effects of HIAC, with a median OS ranging from 10.1 to 17.1 months compared to sorafenib alone and with a median OS ranging from 6.5 to 10.7 months. Moreover, in patients affected by macroscopic vascular invasion of HCC, HAIC could provide a much better OS than sorafenib alone [ 10 , 17 ]. In our study, patients in the combination group had a more advanced tumor status and more tumors with macrovascular invasion, and combining HAIC with sorafenib as a salvage treatment could provide an OS of approximately 12 months, which is compatible with the results in the literature.
Recent studies have identified AFP as an important independent risk predictor associated with the pathological grade, progression, and survival risk [
18
]. Our results showed that patients with AFP > 400 ng/mL had a poorer prognosis than those with AFP < 20 or between 20 and 400 ng/mL. In addition to the serum AFP level, the tumor size is also an indicator of prognosis. A previous study showed that a tumor size ≥ 5 cm was associated with early recurrence and poor overall survival in patients with solitary HCC [
19
]. Our study showed that hazard ratios for a poor PFS sharply increased in patients with tumor sizes larger than 3 cm. For patients with larger tumors, aggressive treatment and close follow-up for the identification of early recurrence and possible metastases should be considered.
A gender disparity affecting the prognosis after treatment was noted in our study. It was previously demonstrated that male patients are affected HCC more frequently than females [
20
,
21
], which was also noted in our study. Moreover, after curative hepatectomy, a higher early recurrence rate was observed in males compared to females [
21
], and a longer survival was observed in females with HCC than in males [
22
]. However, our results showed that male patients had a better PFS after receiving combined HAIC and sorafenib treatment, which is not consistent with results in the literature. More studies and larger study populations are required to identify the potential influence of gender on HCC.
Patients with ascites are at risk of developing complications and have high mortality. Of the 71 patients in our study, ascites developed in 7 during follow-up. In the multivariant analysis, ascites was considered as a prognostic factor with a hazard ratio of approximately 4.31, indicating a poor prognosis.
Our study had some limitations. Firstly, the sample size was small since our investigation was a single-center study. Secondly, this study was carried out retrospectively, and selection bias could not be avoided. Additional research is therefore needed, including a validation study with a larger sample size or even a multi-center prospective study.
5. Conclusions
In conclusion, our study revealed that as a salvage treatment modality for patients with advanced HCC or those who underwent a previously failed treatment, combined HAIC and sorafenib treatment, showed equivalent treatment effects to sorafenib alone. Our findings support the prognostic impacts of the baseline tumor size, AFP, and ascites as important factors to consider in trial design. The current analyses also suggest that young male patients aged < 65 years old may benefit more from this combination treatment.
Author Contributions
Conceptualization, C.-B.C.; Methodology, C.-B.C.; Software, C.-M.C.; Formal analysis, C.-M.C.; Resources, R.-H.T., C.-T.C., P.-Y.S., Y.-C.H. and C.-D.Y.; Data curation, C.-B.C., R.-H.T., C.-T.C., P.-Y.S., Y.-C.H. and C.-D.Y.; Writing—original draft, C.-B.C.; Writing—review & editing, C.-M.C. All authors have read and agreed to the published version of the manuscript.
Funding
This research received no external funding.
Institutional Review Board Statement
The study protocol was approved by the Institutional Review Board of Changhua Christian Hospital (IRB number: 210620) and conformed with the principles of the Declaration of Helsinki.
Informed Consent Statement
The requirement to obtain informed consent from patients was waived due to the retrospective nature of the study.
Data Availability Statement
Data supporting the findings of this study are available from Changhua Christian Hospital. Restrictions apply to the availability of these data, which were used under license in this study. The data are, however, available from the authors upon request and with permission from Changhua Christian Hospital.
Conflicts of Interest
The authors declare that they have no conflict of interest.
References
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Figure 1. Percentages of death ( A ) and progression ( B ) by treatment strategy at 3 M, 6 M, 9 M, and 12 M (M, months).
Figure 1. Percentages of death ( A ) and progression ( B ) by treatment strategy at 3 M, 6 M, 9 M, and 12 M (M, months).
Figure 2. Kaplan–Meier survival analysis according to different treatments (HAIC-sorafenib versus sorafenib alone) for patients with HCC: ( A ) OS and ( B ) PFS. Blue, sorafenib with HAIC; red, sorafenib alone. HAIC, hepatic arterial infusion chemotherapy. Although the survival curves show a better OS and PFS in the combination group than in the sorafenib group, the log-rank test indicates no significant statistical difference between the survival curves.
Figure 3. Kaplan–Meier survival analysis according to different treatments (HAIC-sorafenib versus sorafenib alone) for patients of different age groups: ( A , B ) OS and ( C , D ) PFS. Among those younger than 65 years, the survival curves show a better OS and PFS in the combination group ( A , C ), and the log-rank test indicates a significant difference in PFS ( p = 0.023 in ( C )). Among those aged 65 and older, the log-rank test shows no significant differences between the survival curves ( B , D ).
Figure 3. Kaplan–Meier survival analysis according to different treatments (HAIC-sorafenib versus sorafenib alone) for patients of different age groups: ( A , B ) OS and ( C , D ) PFS. Among those younger than 65 years, the survival curves show a better OS and PFS in the combination group ( A , C ), and the log-rank test indicates a significant difference in PFS ( p = 0.023 in ( C )). Among those aged 65 and older, the log-rank test shows no significant differences between the survival curves ( B , D ).
Figure 4. Kaplan–Meier survival analysis according to different treatments (HAIC-sorafenib versus sorafenib alone) for patients of different genders: ( A , B ) OS and ( C , D ) PFS. The log-rank test indicates no significant differences between the survival curves for females ( A , C ). For male patients, the survival curve shows a better OS and PFS ( B , D ), and a significant difference was noted in PFS ( p = 0.045 in ( D )) according to the log-rank test.
Figure 4. Kaplan–Meier survival analysis according to different treatments (HAIC-sorafenib versus sorafenib alone) for patients of different genders: ( A , B ) OS and ( C , D ) PFS. The log-rank test indicates no significant differences between the survival curves for females ( A , C ). For male patients, the survival curve shows a better OS and PFS ( B , D ), and a significant difference was noted in PFS ( p = 0.045 in ( D )) according to the log-rank test.
Table 1. Patient characteristics.
Table 1. Patient characteristics.
HAIC-Sorafenib ( n = 40) Sorafenib ( n = 31) n % n % p -Value Age Aged < 65 21 53% 11 35% 0.153 Aged ≥ 65 19 48% 20 65% Gender Female 6 15% 11 35% 0.045 Male 34 85% 20 65% Prior treatment Without 6 15% 4 13% 0.801 With 34 85% 27 87% T-stage 1 0 0% 7 23% 0.002 2 14 35% 13 42% 3–4 26 65% 11 35% Ascites Absence 34 85% 30 97% 0.099 Presence 6 15% 1 3% Child Pugh Score A5 26 65% 20 65% 0.631 A6 9 23% 8 26% B7 3 8% 3 10% B8 2 5% 0 0% BCLC Stage A (early stage) 0 0% 7 23% <0.001 B (intermediate stage) 23 58% 13 42% C (advanced stage) 17 42% 11 35% PVTT stage 0 23 58% 26 84% 0.044 1–2 6 15% 1 3 3 5 12% 1 3 4 6 15% 3 10 Preoperative AFP <20 (ng/mL) 12 30% 15 48% 0.136 20–400 (ng/mL) 12 30% 10 32% >400 (ng/mL) 16 40% 6 19% Albumin ≤3.5 g/dL 11 28% 13 42% 0.202 >3.5 g/dL 29 73% 18 58% Bilirubin ≥1 mg/dL 13 33% 8 26% 0.540 <1 mg/dL 27 68% 23 74% ALBI score Mean ± SD −2.41 ± 0.4 −2.36 ± 0.46 0.643 Grade 1 (<−2.6) 13 32% 9 29% Grade 2 (−1.39 to −2.6) 27 68% 22 71% Grade 3 (>−1.39) 0 0% 0 0% Tumor size <3 cm 12 30% 14 45% 0.188 ≥3 cm 28 70% 17 55% HAIC courses Mean ± SD 2.03 ± 1.1 1 14 35% 2 18 45% 3 3 7% 4 3 7% 5 2 6%
Abbreviation: HAIC, hepatic arterial infusion chemotherapy. BCLC stage, Barcelona clinic liver cancer stage. PVTT, portal vein tumor thrombus. AFP, alpha-fetoprotein. ALBI score, albumin-bilirubin grade score. SD, standard deviation. Footnotes: BCLC stages A, B, and C (Stage A: Early stage. Tumors of any size or up to three tumors less than 3 cm, with well-preserved liver function. Stage B: Intermediate Stage. Tumors in the liver with well-preserved liver function. Stage C: Advanced stage, including invasion of the hepatic blood vessels or extrahepatic spread).
Table 2. Efficacy of and Response Rates for Sorafenib and HAIC-Sorafenib Therapy.
Table 2. Efficacy of and Response Rates for Sorafenib and HAIC-Sorafenib Therapy.
HAIC-Sorafenib ( n = 40) Sorafenib ( n = 31) n % n % p -Value Overall survival, months Median (range) 12.0 (2–12) 12.0 (2–12) 0.594 Time to progression, months Median (range) 6.0 (1–12) 4.0 (1–12) 0.106 Level of response, No. (%) Complete response 14 35% 4 13% 0.002 Partial response 15 38% 6 19% Stable response 6 15% 5 16% Progressive 5 13% 16 52% Response rate 29 73% 10 32% 0.001 AFP response AFP < 20 11 28% 15 48% 0.033 Non-AFP reduction group 13 33% 12 39% AFP reduction group 16 40% 4 13%
Abbreviation: AFP, alpha-fetoprotein.
Table 3. Cox regression analyses of DFS in patients aged under 65 (A) and in males (B).
Table 3. Cox regression analyses of DFS in patients aged under 65 (A) and in males (B).
Factors Associated with Tumor Progression Model A Model B HR 95% CI p -Value HR 95% CI p -Value Sex Female 1.42 (0.26–7.77) 0.684 Age age ≥ 65 2.71 (1.33–5.51) 0.006 Treatment strategy HAIC-sorafenib 0.08 (0.02–0.35) 0.001 0.29 (0.11–0.71) 0.007 Albumin alb ≤ 3.5 g/dL 1.23 (0.32–4.74) 0.760 0.99 (0.45–2.17) 0.977 Bilirubin >1 mg/dL 0.70 (0.19–2.53) 0.586 0.98 (0.45–2.12) 0.962 Preoperative T-stage Stage 1/2 1.67 (0.38–7.29) 0.497 1.70 (0.72–4.05) 0.227 Preoperative AFP AFP 20–400 (ng/mL) 1.53 (0.29–8.19) 0.617 0.150 Preoperative AFP AFP >400 (ng/mL) 5.21 (1.13–23.99) 0.034 1.47 (0.49–4.39) 0.490 Tumor size ≥3 cm 6.81 (1.35–34.25) 0.020 2.75 (0.94–8.05) 0.065 Ascites With 3.87 (0.31–48.00) 0.292 4.31 (1.43–13.01) 0.009 Prior treatment With 0.67 (0.09–4.87) 0.692 8.05 (0.75–86.17) 0.085 Child–Pugh Score Score B7/8 0.26 (0.02–4.20) 0.345 0.78 (0.09–6.68) 0.820
Abbreviations: HR, hazard ratio; CI, confidence interval; AFP, alpha-fetoprotein; HAIC, hepatic arterial infusion chemotherapy.
| https://www.mdpi.com/2077-0383/12/5/1887/xml |
Implementation of Technology-based Patient Engagement Strategies within Practice-based Research Networks | American Board of Family Medicine
Implementation of Technology-based Patient Engagement Strategies within Practice-based Research Networks
Beth Careyva , Kyle Shaak , Geoffrey Mills , Melanie Johnson , Samantha Goodrich , Brian Stello and Lorraine S. Wallace
The Journal of the American Board of Family
Medicine September 2016, 29 (5) 581-591; DOI: https://doi.org/10.3122/jabfm.2016.05.160044
Beth Careyva
the Department of Family Medicine, Lehigh Valley Health Network, Allentown, PA (BC, KS, MJ, BS); the Department of Family and Community Medicine, Thomas Jefferson University, Philadelphia (GM); the Department of Community Health, Lehigh Valley Health Network, Allentown (SG); and the Department of Family Medicine, Ohio State University, Columbus, OH (LSW).
Kyle Shaak
the Department of Family Medicine, Lehigh Valley Health Network, Allentown, PA (BC, KS, MJ, BS); the Department of Family and Community Medicine, Thomas Jefferson University, Philadelphia (GM); the Department of Community Health, Lehigh Valley Health Network, Allentown (SG); and the Department of Family Medicine, Ohio State University, Columbus, OH (LSW).
Geoffrey Mills
the Department of Family Medicine, Lehigh Valley Health Network, Allentown, PA (BC, KS, MJ, BS); the Department of Family and Community Medicine, Thomas Jefferson University, Philadelphia (GM); the Department of Community Health, Lehigh Valley Health Network, Allentown (SG); and the Department of Family Medicine, Ohio State University, Columbus, OH (LSW).
Melanie Johnson
the Department of Family Medicine, Lehigh Valley Health Network, Allentown, PA (BC, KS, MJ, BS); the Department of Family and Community Medicine, Thomas Jefferson University, Philadelphia (GM); the Department of Community Health, Lehigh Valley Health Network, Allentown (SG); and the Department of Family Medicine, Ohio State University, Columbus, OH (LSW).
Samantha Goodrich
the Department of Family Medicine, Lehigh Valley Health Network, Allentown, PA (BC, KS, MJ, BS); the Department of Family and Community Medicine, Thomas Jefferson University, Philadelphia (GM); the Department of Community Health, Lehigh Valley Health Network, Allentown (SG); and the Department of Family Medicine, Ohio State University, Columbus, OH (LSW).
Brian Stello
the Department of Family Medicine, Lehigh Valley Health Network, Allentown, PA (BC, KS, MJ, BS); the Department of Family and Community Medicine, Thomas Jefferson University, Philadelphia (GM); the Department of Community Health, Lehigh Valley Health Network, Allentown (SG); and the Department of Family Medicine, Ohio State University, Columbus, OH (LSW).
Lorraine S. Wallace
the Department of Family Medicine, Lehigh Valley Health Network, Allentown, PA (BC, KS, MJ, BS); the Department of Family and Community Medicine, Thomas Jefferson University, Philadelphia (GM); the Department of Community Health, Lehigh Valley Health Network, Allentown (SG); and the Department of Family Medicine, Ohio State University, Columbus, OH (LSW).
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Abstract
Background:Technology-based patient engagement strategies (such as patient portals) are increasingly available, yet little is known about current use and barriers within practice-based research networks (PBRNs). PBRN directors have unique opportunities to inform the implementation of patient-facing technology and to translate these findings into practice.
Methods:PBRN directors were queried regarding technology-based patient engagement strategies as part of the 2015 CAFM Educational Research Alliance (CERA) survey of PBRN directors. A total of 102 PBRN directors were identified via the Agency for Healthcare Research and Quality's registry; 54 of 96 eligible PBRN directors completed the survey, for a response rate of 56%.
Results:Use of technology-based patient engagement strategies within PBRNs was limited, with less than half of respondents reporting experience with the most frequently named tools (risk assessments/decision aids). Information technology (IT) support was the top barrier, followed by low rates of portal enrollment. For engaging participant practices, workload and practice leadership were cited as most important, with fewer respondents noting concerns about patient privacy.
Discussion:Given limited use of patient-facing technologies, PBRNs have an opportunity to clarify the optimal use of these strategies. Providing IT support and addressing clinician concerns regarding workload may facilitate the inclusion of innovative technologies in PBRNs.
Decision Support Techniques
Electronic Health Records
Health Services Research
Patient Participation
Practice-based Research
Privacy
Registries
Risk Assessment
Surveys & Questionnaires
United States Agency for Healthcare Research and Quality
Workload
Practice-based research network (PBRN) directors are uniquely poised to answer questions regarding the pragmatic implementation of evolving patient engagement technologies within PBRNs. Given the increasing availability of technology to communicate with patients, it was anticipated that PBRN directors may have valuable experience to share in using patient engagement technologies within practice-based research. PBRNs offer a rich research laboratory across multiple settings, ownership models, and organizational models, and even more diverse populations within ambulatory primary care practices. 1Primary care researchers within PBRNs have unique opportunities to inform the implementation of patient-facing technology, thereby translating research findings into practice. 2 , 3
Patient engagement strategies encompass information exchange and shared decision making to promote patient activation and self-management. 4Using technology—including videoconferencing, web-based tools, texting, and patient portals—for patient engagement may be instrumental in facilitating patient-centered care and improving both health-related outcomes and workflow. 5 ⇓ ⇓ – 8Technology-based patient engagement strategies include activities such as the transmission of clinical questions, biometric data, patient surveys (eg, decision aids and patient-reported outcomes), and risk calculators. Real-world examples include the use of videoconferencing to facilitate patient visits in rural areas, the use of portals to collect patient-reported outcomes, and Internet-connected scales to communicate daily body weight.
With the combination of an aging population and a primary care workforce shortage, there is a greater-than-ever need to explore innovative technology strategies that empower patients to be active participants in their health and health care. 9 , 10Primary care research is needed to inform the optimal use of these technologies to meet the tenets of the triple aim of better care, better quality, and lower cost. 11 , 12However, little is known about current research efforts related to the use of technology to engage patients and, more important, which barriers need to be overcome to optimize the use of such innovations. Technology has the potential to improve systems of care and health outcomes; therefore, further research is needed to inform the optimal implementation and evaluation of outcomes moving forward. 8 , 13 , 14
Clinician acceptance has been shown to be a major factor in the uptake of new technologies in practice. 15In a prior survey of clinicians, while most felt positive about technology use for patient engagement, concerns about workload and patient safety also surfaced. 16While the issue of clinician attitudes toward technology use has been examined previously, to our knowledge, no studies have queried technology use and acceptance among those leading PBRNs. To address this gap in the literature, the purpose of this study was to assess the current use of and perceived barriers to patient engagement technologies within practice-based research among a sample of PRBN directors throughout the United States and Canada.
Methods
Data for this study were collected via the Council of Academic Family Medicine Educational Research Alliance's (CERA) 2015 survey of PBRN directors. CERA is a joint initiative of all 4 major US academic family medicine organizations (Society of Teachers of Family Medicine, North American Primary Care Research Group, Association of Departments of Family Medicine, and Association of Family Medicine Residency Directors). Detailed information about CERA has been published elsewhere. 17All procedures used in this study were approved by the American Academy of Family Physicians Institutional Review Board.
Data Collection Procedures
Between September and October 2015, PRBN directors (n = 102) identified within the Agency for Healthcare Research and Quality's PBRN registry received an electronic invitation to complete a 10-minute survey. The survey was introduced as part of an electronic message that included a personalized greeting, a letter signed by each CERA organization president, and a link to the survey. Nonrespondents were sent 3 follow-up E-mails encouraging participation. Five E-mail invitations were returned (“bounced back”) and 1 individual indicated that the PBRN was no longer active; therefore, the useable sample included a total of 96 PBRN directors. Overall, 54 PBRN directors completed the survey, yielding a 56% overall response rate.
A collaborative team of researchers developed original content to design the 10-question survey. The survey included a collection of close-ended items addressing (1) demographic characteristics related to the scope and functioning of each director's PBRN, (2) current use of technology-based patient engagement strategies, (3) perceived barriers to the use of patient engagement technologies, and 4) factors affecting participant practice recruitment. Sample items included: “What proportion of practices within your PBRN have access to patient portals that could be used for research purposes,?” “In your opinion, which of the following are the 3 most important factors in determining which technology-based strategy to incorporate into your practice-based research?” and “How likely are each of the following characteristics to affect physician participation in studies using technology-based patient engagement strategies?” The questions pertaining to technology-based patient engagement strategies are included in the Appendix. Survey items aimed to evaluate the impact of PBRN scope (local, state, regional, national) on the use of technology-based patient engagement strategies within PBRNs, the role of patient portals in the overall use of technology-based patient engagement strategies, and the influence of familiarity with Health Insurance Portability and Accountability Act (HIPAA) regulations for technology use. Hypotheses being tested included the following: (1) regional/national PBRNs are more likely to be using technology-based patient engagement strategies than local/state PBRNs, and (2) PBRNs with increased access to patient portals in member practices are more likely to be engaged in studies involved patient engagement technologies.
Data Analysis
Descriptive statistics (frequencies, percentages) were used to depict characteristics of PBRNs in terms of current practices, barriers and facilitators, and attitudes toward the use of technology-based patient engagement strategies. For survey items that included count data, χ 2tests were used to compare PBRNs in terms of current practices, barriers and facilitators, and attitudes toward the use of technology-based patient engagement strategies. All data analyses were conducted using the SPSS version 22.0 (SPSS, Inc./IBM, Chicago, IL). Response rates varied per survey question, as represented in the tables.
Results
Overall PBRN characteristics are presented inTable 1. Survey respondents included representation from local (n = 11), state (n = 18), regional (n = 16), and national (n = 9) PBRNs. Almost half (46%) of PBRN directors were leading PBRNs that had been in existence a decade or longer.
Table 1.
Practice-Based Research Network Characteristics
The proportion of studies within each PBRN using technology-based patient engagement strategies is listed inTable 2. Of the 49 PBRN directors who responded to this question, 39 (80%) indicated using technology-based patient engagement strategies in fewer than 25% of their studies in the past 5 years. When comparing the percentage of studies using technology-based patient engagement strategies in the past 5 years, no significant differences were observed based on the scope of the PBRN (local/state vs regional/national; χ 2= 3.91; P> .05).
Table 2.
Percentage of Studies Including Technology-Based Patient Engagement Strategies among Practice-Based Research Networks
Technology-based patient engagement strategies used in the past 5 years by PBRNs are outlined inTable 3. Risk assessments or decision aids administered by web-based tools (n = 20), waiting room kiosks/computers (n = 13), or smartphone/personal tablet applications (n = 13) were most commonly used, whereas videoconferencing for patient visits (n = 4) and texting to transmit clinical information (n = 4) were used least frequently.
Table 3.
Practice-Based Research Network Use of Technology-Based Patient Engagement Strategies in the Past 5 Years
In terms of importance in determining which type of technology-based patient engagement strategy to incorporate into research studies, PBRN directors most frequently identified ease of use for practices (n = 33), ease of use for patients (n = 30), and ease of use for clinicians (n = 23). Factors least likely to affect the type of technology selected included cost (n = 16) and patient population (n = 5).
Directors' rankings of the top barriers to incorporating technology into research studies are reported inTable 4. Low rates of portal enrollment was selected as a top barrier, though only 47% PBRNs (n = 22) had access to patient portals in >50% of their practices. PBRN directors reported access to patient portals (Table 5). Among PBRN directors reporting technology-based patient engagement strategies in 0%, 1% to 50%, and >50% of studies, those who reported access to portals in ≥50% of the practices were not significantly more likely to have engaged in studies involving technology-based patient engagement strategies than PBRNs with access to portals in <50% of practices (χ 2= 1.92; P> .05).
Table 4.
Barriers to Incorporating Technology-Based Patient Engagement Strategies into Practice
Table 5.
Practices with Patient Portals in Each Practice-Based Research Network
In terms of familiarity with HIPAA regulations pertaining to the transfer of electronic information, PBRN directors described practices being most familiar with E-mail, followed by patient portals, texting, and videoconferencing (Figure 1). There were no significant differences between familiarity with HIPAA regulations (not at all familiar/slightly familiar/somewhat familiar vs moderately familiar/extremely familiar) and use of E-mail (χ 2= 0.12; P> .05), portal use (χ 2= 0.037; P> .05), texting (χ 2= 1.14; P> .05), or videoconferencing (χ 2= 1.42; P> .05).
Figure 1.
Familiarity with Health Insurance Portability and Accountability Act regulations for the transmission of electronic data.
Of the 39 PBRN directors who reported the use of technology-based patient engagement strategies, 35 responded to the survey question regarding the ease of recruitment for studies using these strategies. Of these, 54% reported ease of recruitment as good (n = 15) or very good (n = 4). A total of 34% of responding directors (n = 12) reported ease of recruitment as fair and 11% (n = 4) reported it as poor.
PBRN directors' perceptions of factors that may affect physician participation in studies are shown inFigure 2. Overall, workload was the most concerning factor identified, followed closely by practice leadership. Practice models identified as most likely to participate in PBRN studies were individual practitioner or group practice (n = 14), hospital-owned and university-affiliated (n = 11), federally qualified health center (n = 7), hospital-owned community-based practice (n = 2), and federal/national government health care agency (n = 2).
Figure 2.
Factors that may affect physician participation in studies including technology-based patient engagement strategies.
Discussion
This study aimed to evaluate the current use of, barriers to, and clinician acceptance of patient engagement technologies within studies conducted in PBRNs. Based on the increasing availability of new technologies, it was anticipated that PBRN directors would have experience with studies encompassing many different technology-based modalities for patient engagement. Instead, some of the most common technology-based tools (risk assessments or decision aids transmitted by web-based tools, kiosks, smartphones/tablets, or portals) were used by less than half of the PBRNs in the past 5 years. Decision aids have been found to improve knowledge and decrease decisional conflict when administered through different modalities and settings, which may explain their routine use within practice-based research. 18Further study is needed to clarify the optimal use of technology-based tools (such as videoconferencing, texting, and portals) to transmit other types of clinical data, including the contexts in which they may be most beneficial. 19 ⇓ – 21
It was expected that regional and national PBRNs would be more likely to have experience with technology-based patient engagement strategies because of increased access to technology within diverse practice sites, but no significant differences were noted based on scope of PBRN (local/state vs regional/national). This may be related to variability in the number of practices and resources within each PBRN, irrespective of geographic coverage, as well as increased probability of a greater number of technology platforms for regional and national PBRNs. The overall limited use of patient engagement technologies in practice-based research identified in this survey is consistent with a recent evaluation of patient engagement technologies in the inpatient setting, in which a systematic review highlighted limited use and gaps in the literature surrounding optimal implementation. 22
In terms of factors influencing the inclusion of technology in practice-based research studies, PBRN directors reported ease of use (for patients, practices, and clinicians, in descending order) as the most frequently cited factor in determining which technology-based patient engagement strategy to use in research. User-friendly technology has been found to be critical to successful implementation in the practice setting. 23Cost and the availability of tools in multiple languages were cited less frequently as factors in choosing which type of technology to implement. While a prior study noted cost as a barrier, 24this may be less relevant to practice-based researchers who are seeking to optimize the use of existing technologies in practices rather than purchasing new systems.
Linked to electronic medical records, patient portals are an example of existing technology available in an ever increasing number of practices for research purposes. However, most directors in this sample reported access to portals in less than half of practices within their PBRN. Given the potential for portals to be used to transmit decision aids, risk assessments, and clinical information, and to maximize the study sample and standardize data collection methods, it was expected that PBRNs with portal access in a greater number of practices may use technology-based patient engagement strategies more frequently than PBRNs with a patient portal in fewer practices. The lack of significant differences noted between PBRNs with varying degrees of access to patient portals and studies involving technology may be the result of both low rates of enrollment and a limited understanding of optimal implementation of patient portals for both clinical and research purposes. Further efforts to facilitate patient enrollment and to evaluate who might benefit most from patient engagement via patient portals may facilitate their use within practice-based research.
In addition to establishing current use of technology-based patient engagement strategies within PBRNs, directors were queried about barriers to technology implementation. Information technology (IT) support was the most frequently cited barrier to incorporating technology in practice settings. It is unclear whether the IT barrier is limited availability, lack of IT personnel trained in implementation science, institutional regulations, or something else. Further study is needed to clarify the type of IT support needed to optimize the implementation of technology for patient engagement. Similar to other studies, practice champions were also found to be particularly critical to successful implementation. 25Technology-based tools in multiple languages were cited as a barrier less frequently than anticipated based on a prior study, though this is undoubtedly dependent on the patient populations of each PBRN. 26Access to smartphones was 1 of the least commonly cited barriers, which corresponds to a recent study indicating that 55% of primary care patients use smartphones, and 70% of those patients with smartphones use them for health-related purposes. 27
An additional potential barrier to studies involving technology-based patient engagement strategies is clinician acceptance. Clinician acceptance is critical to the successful recruitment of practices and has been found to facilitate study implementation. 28We aimed to determine factors that were most critical for physician participation in studies involving technology for patient engagement. All but 1 PBRN director cited workload as a major factor in physician participation, whereas patient safety and patient privacy were cited less frequently than in prior studies. 16 , 29This may be in part the result of evolving experience and institutional policies regarding the management of patient privacy and patient safety within patient-facing technology-based interventions. Further study is needed to clarify whether workload is a greater concern for studies involving patient engagement technologies than for other types of practice-based research.
In light of expected concerns with patient privacy, PBRN directors reported practice familiarity with HIPAA regulations for transmission of clinical data. The directors reported variable practice familiarity with HIPAA regulations; practices were most familiar with regulations regarding E-mail and least familiar with those regarding videoconferencing. To be HIPAA compliant, E-mail, texting, portals, and other forms of patient-facing technology need to include safeguards for the transmission of protected health information, potentially including encryption and patient logins. 30 , 31There is more debate about adequate safeguards for videoconferencing, which is reflected in the PBRN directors' perceptions of decreased familiarity with HIPAA regulations for videoconferencing within practices. While it was thought that PBRNs reporting increased familiarity with HIPAA regulations may be more likely to use various technology-based tools to transmit clinical information, no significant differences were noted with respect to HIPAA familiarity and the reported percentage of studies using technology for patient engagement. This may be linked to other findings within this study indicating that patient privacy was not a major factor affecting physician participation. In addition, a more recent study confirmed the feasibility of protecting patient privacy while harnessing mobile technology to enhance patient and family engagement 32; however, questions still remain regarding adequate protection of patient privacy within other modalities such as videoconferencing. 33
Limitations
The findings generated from this study should be considered within the context of several limitations. First, generalizability of the study findings is limited by the response rate (56%) of PBRN directors polled. Second, as with all studies that rely on self-report, response bias remains a possibility. Third, the cross-sectional nature of the study limits causality. Last, reporting is second-hand; individual PBRN-member clinics and clinicians may have different perceptions of technology strategies than the PBRN director, particularly with regard to knowledge of HIPAA regulations.
Conclusion
Decision aids and risk assessments were the most commonly used types of technology-based patient engagement strategies within the PBRNs. Even in practices with access to portals and other technologies, few PBRNs are engaging in studies of technology implementation or related outcomes. IT support was the top-ranked barrier to incorporating technology into practice, though practice champions were also cited as being critical to successful implementation. For participant practices, workload and practice leadership were cited as major factors in physician participation in studies involving technology-based patient engagement strategies—more so than concerns about patient safety and patient privacy. Optimizing IT support and addressing workload concerns may facilitate increased use of technology-based patient engagement strategies within practice-based research.
Acknowledgments
The authors thank Jacqueline Grove for assistance with editing and manuscript preparation.
Appendix
Questions Regarding Technology-Based Patient Engagement Strategies
Below are some examples of technology-based patient engagement strategies. Has your PBRN conducted studies that relied on any of the following technology-based patient engagement strategies in the past 5 years? (Please select all that apply.)
Patient visits with primary care physicians remotely by audio/video
Electronic transmission of vital signs or clinical data (eg, blood pressure, weight, blood glucose)
Waiting room kiosk computers/tablets for risk assessments or decision aids
Web-based risk assessments or decision aids
Smartphones/personal tablet applications for risk assessments or decision aids
Electronic medical record portal-based risk assessments or decision aids
Texting to patients (eg, reminders, educational materials)
Texting from patients (eg, transmission of vital signs or clinical data)
E-mail
What proportion of studies within your PBRN have relied on technology-based patient engagement strategies in the past 5 years?
0%
1% to 25%
26% to 50%
51% to 75%
76% to 99%
100%
What proportion of practices within your PBRN have access to patient portals that could be incorporated for research purposes?
0%
1% to 25%
26% to 50%
51% to 75%
76% to 99%
100%
In your opinion, which of the following are the 3 most important factors in determining which technology-based patient engagement strategy to incorporate into your practice-based research?
Clinical utility
Ease of use for patients
Ease of use for clinicians
Ease of implementation for practices
Availability of a particular technology
Cost
Patient population
How familiar are your practices with HIPAA regulations surrounding the transmission of electronic data pertaining to:
Patient portals
E-mail
Texting
Videoconferencing
Responses to question 5 were rated on a Likert scale (1 to 5): not at all familiar, slightly familiar, somewhat familiar, moderately familiar, extremely familiar.
In your experience as a PBRN director, what are the 3 most critical barriers to successfully incorporating technology-based patient engagement strategies into clinical practice?
Lack of patient portals within electronic medical records
Low rates of portal enrollment among patients
Access to smartphones
Cost of health care technology
Staff comfort with use of technology
Patient willingness to use technology
Tools that interface with electronic medical records
Availability of tools in multiple languages
IT support
Lack of practice champions
In your experience as a PBRN director, what are the 3 most critical facilitators to successfully incorporating technology-based patient engagement strategies into clinical practice?
Patient portals within electronic medical records
Portal enrollment
Access to smartphones
Cost of health care technology
Staff comfort with use of technology
Patient willingness to use technology
Tools that interface with electronic medical records
Availability of tools in multiple languages
IT support
Practice champions
Across all studies incorporating technology-based patient engagement strategies in your PBRN, please describe the overall ease of recruitment of participant practices for the studies.
Poor
Fair
Good
Very good
Excellent
How likely are the following to affect physician participation in studies using technology-based patient engagement strategies?
Comfort with technology
Training
Practice leadership
Concerns about workload or time
Concerns about patient safety
Concerns about patient privacy
Sustainability of interventions
Responses to question 9 were rated on a Likert scale (1 to 5): extremely unlikely, unlikely, neutral, likely, extremely likely.
In your opinion, what practice ownership model is most likely to participate in studies using technology-based patient engagement strategies?
Individual practitioner or group practice
Hospital-owned, university-affiliated practice
Hospital-owned, community-based practice
Federally qualified health center
Federal or national government health care agency
Not sure
Notes
This article was externally peer reviewed.
Funding:none.
Conflict of interest:none declared.
Received for publication January 28, 2016.
Revision received April 18, 2016.
Accepted for publication April 22, 2016.
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| https://www.jabfm.org/content/29/5/581.full |
Publications - Global Disability Innovation Hub
The GDI Hub brings together academic excellence, innovative practice and co-creation; harnessing the power of technology for good.
Type
Conference Paper
Themes
Assistive & Accessible Technology
Culture and Participation
The Social Network: How People with Visual Impairment use Mobile Phones in Kibera, Kenya
Giulia Barbareschi,Catherine Holloway, Katherine Arnold, Grace Magomere, Wycliffe Ambeyi Wetende, Gabriel Ngare, Joyce Olenja
We present the findings of a case study of mobile technology use by People with Visual Impairment (VIPs) in Kibera, an informal settlement in Nairobi. We used contextual interviews, ethnographic observations and a co-design workshop to explore how VIPs use mobile phones in their daily lives, and how this use influences the social infrastructure of VIPs. Our findings suggest that mobile technology supports and shapes the creation of social infrastructure. However, this is only made possible through the existing support networks of the VIPs, which are mediated through four types of interaction: direct, supported, dependent and restricted.
CHI '20: Proceedings of the 2020 CHI Conference; 2020
Abstract
The Social Network: How People with Visual Impairment use Mobile Phones in Kibera, Kenya
Living in an informal settlement with a visual impairment can be very challenging resulting in social exclusion. Mobile phones have been shown to be hugely beneficial to people with sight loss in formal and high-income settings. However, little is known about whether these results hold true for people with visual impairment (VIPs) in informal settlements. We present the findings of a case study of mobile technology use by VIPs in Kibera, an informal settlement in Nairobi. We used contextual interviews, ethnographic observations and a co-design workshop to explore how VIPs use mobile phones in their daily lives, and how this use influences the social infrastructure of VIPs. Our findings suggest that mobile technology supports and shapes the creation of social infrastructure. However, this is only made possible through the existing support networks of the VIPs, which are mediated through four types of interaction: direct, supported, dependent and restricted.
Cite
The Social Network: How People with Visual Impairment use Mobile Phones in Kibera, Kenya
Giulia Barbareschi, Catherine Holloway, Katherine Arnold, Grace Magomere, Wycliffe Ambeyi Wetende, Gabriel Ngare, and Joyce Olenja. 2020. The Social Network: How People with Visual Impairment use Mobile Phones in Kibera, Kenya. In Proceedings of the 2020 CHI Conference on Human Factors in Computing Systems (CHI '20). Association for Computing Machinery, New York, NY, USA, 1–15.https://doi.org/10.1145/331383...
The Social Network: How People with Visual Impairment use Mobile Phones in Kibera, Kenya
Type
Conference Paper
Disability design and innovation in computing research in low resource settings
Dafne Zuleima Morgado-Ramirez,Giulia Barbareschi, Maggie Kate Donovan-Hall, Mohammad Sobuh, Nida' Elayyan, Brenda T Nakandi, Robert Tamale Ssekitoleko, joyce Olenja, Grace Nyachomba Magomere, Sibylle Daymond, Jake Honeywill, Ian Harris, Nancy Mbugua, Laurence Kenney,Catherine Holloway
80% of people with disabilities worldwide live in low resourced settings, rural areas, informal settlements and in multidimensional poverty. ICT4D leverages technological innovations to deliver programs for international development. But very few do so with a focus on and involving people with disabilities in low resource settings. Also, most studies largely focus on publishing the results of the research with a focus on the positive stories and not the learnings and recommendations regarding research processes.
ASSETS '20: Proceedings of the 22nd International ACM SIGACCESS Conference on Computers and Accessibility; 2020
Abstract
Disability design and innovation in computing research in low resource settings
80% of people with disabilities worldwide live in low resourced settings, rural areas, informal settlements and in multidimensional poverty. ICT4D leverages technological innovations to deliver programs for international development. But very few do so with a focus on and involving people with disabilities in low resource settings. Also, most studies largely focus on publishing the results of the research with a focus on the positive stories and not the learnings and recommendations regarding research processes. In short, researchers rarely examine what was challenging in the process of collaboration. We present reflections from the field across four studies. Our contributions are: (1) an overview of past work in computing with a focus on disability in low resource settings and (2) learnings and recommendations from four collaborative projects in Uganda, Jordan and Kenya over the last two years, that are relevant for future HCI studies in low resource settings with communities with disabilities. We do this through a lens of Disability Interaction and ICT4D.
Disability design and innovation in computing research in low resource settings
Dafne Zuleima Morgado-Ramirez, Giulia Barbareschi, Maggie Kate Donovan-Hall, Mohammad Sobuh, Nida' Elayyan, Brenda T Nakandi, Robert Tamale Ssekitoleko, joyce Olenja, Grace Nyachomba Magomere, Sibylle Daymond, Jake Honeywill, Ian Harris, Nancy Mbugua, Laurence Kenney, and Catherine Holloway. 2020. Disability design and innovation in computing research in low resource settings. In Proceedings of the 22nd International ACM SIGACCESS Conference on Computers and Accessibility (ASSETS '20). Association for Computing Machinery, New York, NY, USA, Article 11, 1–7.https://doi.org/10.1145/337362...
Disability design and innovation in computing research in low resource settings
Type
Workshop
Themes
Assistive & Accessible Technology
Research Group
Disability Interactions
Could AI Democratise Education? Socio-Technical Imaginaries of an EdTech Revolution
Sahan Bulathwela, María Pérez-Ortiz,Catherine Holloway, John Shawe-Taylor
This paper starts by synthesising how AI might change how we learn and teach, focusing specifically on the case of personalised learning companions, and then move to discuss some socio-technical features that will be crucial for avoiding the perils of these AI systems worldwide (and perhaps ensuring their success). This paper also discusses the potential of using AI together with free, participatory and democratic resources, such as Wikipedia, Open Educational Resources and open-source tools. We also emphasise the need for collectively designing human-centered, transparent, interactive and collaborative AI-based algorithms that empower and give complete agency to stakeholders, as well as support new emerging pedagogies.
Workshop on Machine Learning for the Developing World (ML4D) at the Conference on Neural Information Processing Systems 2021; 2021
Abstract
Could AI Democratise Education? Socio-Technical Imaginaries of an EdTech Revolution
Artificial Intelligence (AI) in Education has been said to have the potential for building more personalised curricula, as well as democratising education worldwide and creating a Renaissance of new ways of teaching and learning. Millions of students are already starting to benefit from the use of these technologies, but millions more around the world are not. If this trend continues, the first delivery of AI in Education could be greater educational inequality, along with a global misallocation of educational resources motivated by the current technological determinism narrative. In this paper, we focus on speculating and posing questions around the future of AI in Education, with the aim of starting the pressing conversation that would set the right foundations for the new generation of education that is permeated by technology. This paper starts by synthesising how AI might change how we learn and teach, focusing specifically on the case of personalised learning companions, and then move to discuss some socio-technical features that will be crucial for avoiding the perils of these AI systems worldwide (and perhaps ensuring their success). This paper also discusses the potential of using AI together with free, participatory and democratic resources, such as Wikipedia, Open Educational Resources and open-source tools. We also emphasise the need for collectively designing human-centered, transparent, interactive and collaborative AI-based algorithms that empower and give complete agency to stakeholders, as well as support new emerging pedagogies. Finally, we ask what would it take for this educational revolution to provide egalitarian and empowering access to education, beyond any political, cultural, language, geographical and learning ability barriers.
Could AI Democratise Education? Socio-Technical Imaginaries of an EdTech Revolution
Type
Workshop
Themes
Assistive & Accessible Technology
Towards Proactive Information Retrieval in Noisy Text with Wikipedia Concepts
Tabish Ahmed, Sahan Bulathwela
The informational needs of people are highly contextual and can depend on many different factors such as their current knowledge state, interests and goals [1, 2, 3]. However, an effective information retrieval companion should minimise the human effort required in i) expressing a human information need and ii) navigating a lengthy result set. Using topical representations of the user history (e.g. [4]) can immensely help formulating zero shot queries and refining short user queries that enable proactive information retrieval (IR). While the world has digital textual information in abundance, it can often be noisy (e.g. extracted through Automatic Speech Recognition (ASR), PDF text extraction etc.), leading to state-of-the-art neural models being highly sensitive to the noise producing sub-optimal results [5]. This demands denoising steps to refine both query and document representation. In this paper, we argue that Wikipedia, an openly available encyclopedia, can be a humanly intuitive knowledge base [6] that has the potential to provide the world view many noisy information Retrieval systems need.
Published at the First Workshop on Proactive and Agent-Supported Information Retrieval at CIKM 2022; 2022
Abstract
Towards Proactive Information Retrieval in Noisy Text with Wikipedia Concepts
Extracting useful information from the user history to clearly understand informational needs is a crucial feature of a proactive information retrieval system. Regarding understanding information and relevance, Wikipedia can provide the background knowledge that an intelligent system needs. This work explores how exploiting the context of a query using Wikipedia concepts can improve proactive information retrieval on noisy text. We formulate two models that use entity linking to associate Wikipedia topics with the relevance model. Our experiments around a podcast segment retrieval task demonstrate that there is a clear signal of relevance in Wikipedia concepts while a ranking model can improve precision by incorporating them. We also find Wikifying the background context of a query can help disambiguate the meaning of the query, further helping proactive information retrieval.
Towards Proactive Information Retrieval in Noisy Text with Wikipedia Concepts
Type
Book
Research Group
Disability Interactions
Disability Interactions Creating Inclusive Innovations
Catherine Holloway,Giulia Barbareschi
Abstract
Disability Interactions Creating Inclusive Innovations
Disability interactions (DIX) is a new approach to combining cross-disciplinary methods and theories from Human Computer Interaction (HCI), disability studies, assistive technology, and social development to co-create new technologies, experiences, and ways of working with disabled people. DIX focuses on the interactions people have with their technologies and the interactions which result because of technology use. A central theme of the approach is to tackle complex issues where disability problems are part of a system that does not have a simple solution. Therefore, DIX pushes researchers and practitioners to take a challenge-based approach, which enables both applied and basic research to happen alongside one another. DIX complements other frameworks and approaches that have been developed within HCI research and beyond. Traditional accessibility approaches are likely to focus on specific aspects of technology design and use without considering how features of large-scale assistive technology systems might influence the experiences of people with disabilities. DIX aims to embrace complexity from the start, to better translate the work of accessibility and assistive technology research into the real world. DIX also has a stronger focus on user-centered and participatory approaches across the whole value chain of technology, ensuring we design with the full system of technology in mind (from conceptualization and development to large-scale distribution and access). DIX also helps to acknowledge that solutions and approaches are often non-binary and that technologies and interactions that deliver value to disabled people in one situation can become a hindrance in a different context. Therefore, it offers a more nuanced guide to designing within the disability space, which expands the more traditional problem-solving approaches to designing for accessibility. This book explores why such a novel approach is needed and gives case studies of applications highlighting how different areas of focus—from education to health to work to global development—can benefit from applying a DIX perspective. We conclude with some lessons learned and a look ahead to the next 60 years of DIX.
Disability Interactions Creating Inclusive Innovations
Type
Conference Paper
Themes
Assistive & Accessible Technology
Value beyond function: analyzing the perception of wheelchair innovations in Kenya
Barbareschi, G; Daymond, S; Honeywill, J; Singh, A; Noble, D; Mbugua, N; Harris, I;Austin, V;Holloway, C
The World Health Organization (WHO) defines Assistive Technology (AT) as “an umbrella term covering the systems and services related to the delivery of assistive products and services” [6]. This definition highlights how AT encompasses not only the physical and digital products used by millions of persons with disabilities (PWDs) worldwide, but also the systems and services that accompany the provision of these devices [78].
ASSETS '20: The 22nd International ACM SIGACCESS Conference on Computers and Accessibility.; 2020
Abstract
Value beyond function: analyzing the perception of wheelchair innovations in Kenya
Innovations in the field of assistive technology are usually evaluated based on practical considerations related to their ability to perform certain functions. However, social and emotional aspects play a huge role in how people with disabilities interact with assistive products and services. Over a five months period, we tested an innovative wheelchair service provision model that leverages 3D printing and Computer Aided Design to provide bespoke wheelchairs in Kenya. The study involved eight expert wheelchair users and five healthcare professionals who routinely provide wheelchair services in their community. Results from the study show that both users and providers attributed great value to both the novel service delivery model and the wheelchairs produced as part of the study. The reasons for their appreciation went far beyond the practical considerations and were rooted in the fact that the service delivery model and the wheelchairs promoted core values of agency, empowerment and self-expression.
Value beyond function: analyzing the perception of wheelchair innovations in Kenya
Type
Conference Paper
Themes
Assistive & Accessible Technology
Culture and Participation
Inclusion and Independence: The impact of Mobile Technology on the Lives of Persons with Disabilities in Kenya and Bangladesh
Nusrat Jahan,Giulia Barbareschi, Clara Aranda Jan, Charles Musungu Mutuku, Naemur Rahman,Victoria Austin,Catherine Holloway
Worldwide it is estimated that there are over a billion people who live with some form of disability[1]. Approximately 80% of people with disabilities live in low-and-middle income countries (LMICs). The combination of an inaccessible environment compounded by socio-economic factors such as poverty and stigma, makes it more likely for people with disabilities to be marginalised and excluded from society[1]. Assistive Technologies (ATs) are known to bridge the accessibility gaps and allow for greater social inclusion. However, there is a lack of adequate access to ATs in LMICs, combined with often poorly designed services, which only magnifies these challenges, thus limiting the opportunities for persons with disabilities to live an independent life[2]. Despite the importance of AT, access to AT globally is inadequate with only 10 percent of those in need having access to the ATs that they need[2].
2020 IEEE Global Humanitarian Technology Conference
Abstract
Inclusion and Independence: The impact of Mobile Technology on the Lives of Persons with Disabilities in Kenya and Bangladesh
Globally, mobile technology plays a significant role connecting and supporting people with disabilities. However, there has been limited research focused on understanding the impact of mobile technology in the lives of persons with disabilities in low or middle- income countries. This paper presents the findings of a participatory photovoice study looking at the role that mobile phones play in the daily lives of 16 persons with disabilities in Kenya and Bangladesh. Participants used a combination of pictures and voice recordings to capture their own stories and illustrate the impact that mobile phone use has on their lives. Through thematic analysis, we categorized the benefits of mobile phones captured by participants as 1) Improved social connection; 2) Increased independence and 3) Access to opportunities. While mobile phones are ubiquitously used for communication, for persons with disabilities they become essential assistive technologies that bridge barriers to opportunities which are not accessible otherwise. Our paper adds evidence to the need for mobile phones for persons with disabilities to enable communication and connectivity in support of development.
Cite
Inclusion and Independence: The impact of Mobile Technology on the Lives of Persons with Disabilities in Kenya and Bangladesh
N. Jahan et al., "Inclusion and Independence: The impact of Mobile Technology on the Lives of Persons with Disabilities in Kenya and Bangladesh," 2020 IEEE Global Humanitarian Technology Conference (GHTC), Seattle, WA, USA, 2020, pp. 1-8, doi: 10.1109/GHTC46280.2020.9342934.
Inclusion and Independence: The impact of Mobile Technology on the Lives of Persons with Disabilities in Kenya and Bangladesh
Type
Conference Paper
Themes
Assistive & Accessible Technology
Research Group
Local Productions
A Preliminary Study to Understand How Mainstream Accessibility and Digital Assistive Technologies Reaches People in Lower- and Middle-Income Countries
Tigmanshu Bhatnagar, George Torrens, Ben Oldfrey, Priya MorjariaFelipe Ramos Barajas, Katherine PerryandCatherine Holloway
Access to information on digital platforms not only facilitates education, employment, entertainment, social interaction but also facilitates critical governmental services, ecommerce, healthcare services and entrepreneurship [1]. Article 9 of United Nations Convention on the Rights of Persons with Disabilities (UNCRPD) enforces its signatories to commit to provide full accessibility to every citizen of the nation [2]. This has helped to spearhead accessibility directives such as the European Accessibility Act [3] that aims to improve the functioning of markets for accessible products and services. Such directives contribute to ensure that mainstream digital technologies (smartphones, computers etc.) are accessible for everyone and without being socially remarkable, they are able to assist in daily living. Additionally, there is evidence that improving access in mainstream technologies improves product experience and usability for everyone [4]. However, mainstream access has not been fully realized, leading to inferior opportunities for people with disabilities, a disparity which is more prominent in lower and middle-income countries [5].
RESNA Annual Conference; 2021
A Preliminary Study to Understand How Mainstream Accessibility and Digital Assistive Technologies Reaches People in Lower- and Middle-Income Countries
Type
Toolkit
Innovate Now Toolkit
As an entrepreneur, learning how to solve problems by creating and experimenting with different strategies is a core pillar of the entrepreneurial mindset you need to succeed. However, there’s rarely a single correct way to solve problems as an entrepreneur, so you need to learn how to create and compare different solutions.
The open entrepreneurship toolkit is a set of learning materials that can help you and your team do just that. Covering the domains of user, product, market and business development, the set of cards have been designed to be used by two or more group members to actively experiment with different solutions.
Innovate Now
Type
PhD
Themes
Assistive & Accessible Technology
Research Group
Disability Interactions
Specifying a Hybrid, Multiple Material CAD System for Next Generation Prosthetic Design
Troy Bodkin
Doctoral Thesis. This work is one of four multidisciplinary research studies conducted by members of this research cluster, focusing on the area of Computer Aided Design (CAD) for improving the interface with Additive Manufacture (AM) to solve some of the challenges presented with improving prosthetic socket design, with an aim to improve and streamline the process to enable the involvement of clinicians and patients in the design process.
Loughborough University
Abstract
Specifying a Hybrid, Multiple Material CAD System for Next Generation Prosthetic Design
For many years, the biggest issue that causes discomfort and hygiene issues for patients with lower limb amputations have been the interface between body and prosthetic, the socket. Often made of an inflexible, solid polymer that does not allow the residual limb to breathe or perspire and with no consideration for the changes in size and shape of the human body caused by changes in temperature or environment, inflammation, irritation and discomfort often cause reduced usage or outright rejection of the prosthetic by the patient in their day to day lives. To address these issues and move towards a future of improved quality of life for patients who suffer amputations, Loughborough University formed the Next Generation Prosthetics research cluster. This work is one of four multidisciplinary research studies conducted by members of this research cluster, focusing on the area of Computer Aided Design (CAD) for improving the interface with Additive Manufacture (AM) to solve some of the challenges presented with improving prosthetic socket design, with an aim to improve and streamline the process to enable the involvement of clinicians and patients in the design process. The research presented in this thesis is based on three primary studies. The first study involved the conception of a CAD criteria, deciding what features are needed to represent the various properties the future socket outlined by the research cluster needs. These criteria were then used for testing three CAD systems, one each from the Parametric, Non Uniform Rational Basis Spline (NURBS) and Polygon archetypes respectively. The result of these tests led to the creation of a hybrid control workflow, used as the basis for finding improvements. The second study explored emerging CAD solutions, various new systems or plug-ins that had opportunities to improve the control model. These solutions were tested individually in areas where they could improve the workflow, and the successful solutions were added to the hybrid workflow to improve and reduce the workflow further. The final study involved taking the knowledge gained from the literature and the first two studies in order to theorise how an ideal CAD system for producing future prosthetic sockets would work, with considerations for user interface issues as well as background CAD applications. The third study was then used to inform the final deliverable of this research, a software design specification that defines how the system would work. This specification was written as a challenge to the CAD community, hoping to inform and aid future advancements in CAD software. As a final stage of research validation, a number of members of the CAD community were contacted and interviewed about their feelings of the work produced and their feedback was taken in order to inform future research in this area.
Cite
Specifying a Hybrid, Multiple Material CAD System for Next Generation Prosthetic Design
Bodkin, Troy L. (2017): Specifying a hybrid, multiple material CAD system for next-generation prosthetic design. Loughborough University. Thesis.https://hdl.handle.net/2134/25...;
Specifying a Hybrid, Multiple Material CAD System for Next Generation Prosthetic Design
Type
PhD
Themes
Assistive & Accessible Technology
Research Group
Disability Interactions
YouTransfer, YouDesign: A Participatory Approach to Design Assistive Technology for Wheelchair Transfers
Giulia Barbareschi
Doctoral Thesis. This thesis makes two contributions to facilitate wheelchair users’ engagement in the participatory design process for ATs, while being mindful of the burden of participation. The first contribution is a framework that provides a modular structure guiding the participatory design process from initial problem identification and analysis to facilitating collaborations between wheelchair users and designers. The framework identifies four factors determining the need and adoption process for ATs: (i) People focuses on the target population, (ii) Person includes personal characteristics, (iii) Activity refers to the challenges associated with the task, and (iv) Context encompasses the effect of the environment in which the activity takes place. The second contribution constitutes a rich picture of personal and external elements influencing real world wheelchair transfers that emerged from four studies carried out to investigate the effect of the framework factors on the design process for ATs.
UCL (University College London)
Abstract
YouTransfer, YouDesign: A Participatory Approach to Design Assistive Technology for Wheelchair Transfers
Transferring independently to and from their wheelchair is an essential routine task for many wheelchair users but it can be physically demanding and can lead to falls and upper limb injuries that reduce the person’s independence. New assistive technologies (ATs) that facilitate the performance of wheelchair transfers have the potential to allow wheelchair users to gain further independence. To ensure that users’ needs are addressed by ATs, the active involvement of wheelchair users in the process of design and development is critical. However, participation can be burdensome for many wheelchair users as design processes where users are directly involved often require prolonged engagement. This thesis makes two contributions to facilitate wheelchair users’ engagement in the participatory design process for ATs, while being mindful of the burden of participation. The first contribution is a framework that provides a modular structure guiding the participatory design process from initial problem identification and analysis to facilitating collaborations between wheelchair users and designers. The framework identifies four factors determining the need and adoption process for ATs: (i) People focuses on the target population, (ii) Person includes personal characteristics, (iii) Activity refers to the challenges associated with the task, and (iv) Context encompasses the effect of the environment in which the activity takes place. The second contribution constitutes a rich picture of personal and external elements influencing real world wheelchair transfers that emerged from four studies carried out to investigate the effect of the framework factors on the design process for ATs. A related outcome based on these contributions is a framing document to share knowledge between wheelchair users and designers to provide focus and promote an equal collaboration among participants.
Cite
YouTransfer, YouDesign: A Participatory Approach to Design Assistive Technology for Wheelchair Transfers
Barbareschi, Giulia. “YouTransfer, YouDesign : a Participatory Approach to Design Assistive Technology for Wheelchair Transfers / Giulia Barbareschi.” Thesis (Ph.D.)--University College London, 2018., 2018. Print.
YouTransfer, YouDesign: A Participatory Approach to Design Assistive Technology for Wheelchair Transfers
Type
PhD
Themes
Assistive & Accessible Technology
Research Group
Disability Interactions
Understanding wrist splint user needs and personalisation through codesign
Charlotte Pyatt
A Doctoral Thesis. Submitted in partial fulfilment of the requirements for the award of the degree of Doctor of Philosophy at Loughborough University.
Loughborough University
Abstract
Understanding wrist splint user needs and personalisation through codesign
Wrist splints are a common treatment for rheumatoid arthritis, however their effectiveness is compromised by patients not wearing splints as often as prescribed. Previous research has identified a number of reasons for non-compliance, but typically lacks insights that could lead to improved splint design.
This thesis investigates the motivators for patients to wear and not wear their wrist splints and, the impact of personalisation of splint appearance on patient wear. The work is based on the premise that digital design and manufacturing processes, such as Computer-Aided Design (CAD) and 3D Printing, can produce bespoke splints on demand.
The research begins with a literature review across the core areas of: splinting, additive manufacture, product appearance and personalisation. This literature review identifies gaps in knowledge from which research questions are established for the work.
The research employs a qualitative, generative design research approach and, follows a codesign framework employing telling, making and enacting tools. The thesis is made up of three studies. The first study is a sensitisation study and uses design probes to prepare the participants for the research and begin exploring the problem space. The second is a comprehensive study into participants splint wear behaviour and uses context mapping and scenario picture card tools to investigate the motivators for participants to wear and not wear wrist splints, along with positive and negative outcomes or wearing/not wearing splints. The final study uses a personalisation toolkit to elicit patient needs for a future wrist splint design and investigate self-reported expectations regarding compliance of patients who used the toolkit.
The research finds that patient compliance is affected by practical and aesthetic limitations of current splints. It identifies 4 motivating factors to wear a splint and 10 motivating factors to not wear a splint. Additionally, it identifies 6 positive outcomes of wearing splints, 6 negative outcomes of wearing splints, 3 positive outcomes of not wearing splints and 3 negative outcomes of not wearing splints. Requirements for an improved splint design are established and form the basis of the design for a prototype personalisation toolkit. Testing of this toolkit reveals that patients are keen to own more than one splint and personalise splints to match the scenario in which it is to be worn. Patients reported that they expected to be more compliant with a personalised splint when compared to their current splint.
Cite
Understanding wrist splint user needs and personalisation through codesign
Pyatt, Charlotte (2018): Understanding wrist splint user needs and personalisation through codesign. Loughborough University. Thesis.https://doi.org/10.26174/thesi...;
Understanding wrist splint user needs and personalisation through codesign
Type
PhD
Themes
Assistive & Accessible Technology
Shared Control for Wheelchair Interfaces
Dr Chinemelu Ejiamatu Muoma Ezeh
Doctoral Thesis. Independent mobility is fundamental to the quality of life of people with impairment. Most people with severe mobility impairments, whether congenital, e.g., from cerebral palsy, or acquired, e.g., from spinal cord injury, are prescribed a wheelchair. A small yet significant number of people are unable to use a typical powered wheelchair controlled with a joystick. Instead, some of these people require alternative interfaces such as a head- array or Sip/Puff switch to drive their powered wheelchairs. However, these alternative interfaces do not work for everyone and often cause frustration, fatigue and collisions. This thesis develops a novel technique to help improve the usability of some of these alternative interfaces, in particular, the head-array and Sip/Puff switch.
UCL (University College London)
Abstract
Shared Control for Wheelchair Interfaces
Independent mobility is fundamental to the quality of life of people with impairment. Most people with severe mobility impairments, whether congenital, e.g., from cerebral palsy, or acquired, e.g., from spinal cord injury, are prescribed a wheelchair. A small yet significant number of people are unable to use a typical powered wheelchair controlled with a joystick. Instead, some of these people require alternative interfaces such as a head- array or Sip/Puff switch to drive their powered wheelchairs. However, these alternative interfaces do not work for everyone and often cause frustration, fatigue and collisions. This thesis develops a novel technique to help improve the usability of some of these alternative interfaces, in particular, the head-array and Sip/Puff switch. Control is shared between a powered wheelchair user, using an alternative interface and a pow- ered wheelchair fitted with sensors. This shared control then produces a resulting motion that is close to what the user desires to do but a motion that is also safe. A path planning algorithm on the wheelchair is implemented using techniques in mo- bile robotics. Afterwards, the output of the path planning algorithm and the user’s com- mand are both modelled as random variables. These random variables are then blended in a joint probability distribution where the final velocity to the wheelchair is the one that maximises the joint probability distribution. The performance of the probabilistic approach to blending the user’s inputs with the output of a path planner, is benchmarked against the most common form of shared control called linear blending. The benchmarking consists of several experiments with end users both in a simulated world and in the real-world. The thesis concludes that probabilistic shared control provides safer motion compared with the traditional shared control for difficult tasks and hard-to-use interfaces.
Shared Control for Wheelchair Interfaces
Ezeh, Chinemelu Ejiamatu Muoma. Shared Control for Wheelchair Interfaces. UCL (University College London), 2018. Print.
Type
PhD
Themes
Assistive & Accessible Technology
Research Group
Disability Interactions
Materials For Facial Prostheses In Resource Limited Countries
Sophia Esther Liiba Tetteh
A Doctoral Thesis. Submitted in partial fulfilment of the requirements for the award of the degree of Doctor of Philosophy of Loughborough University
Loughborough University
Materials For Facial Prostheses In Resource Limited Countries
Facial prostheses are artificial devices that replace a missing body part in the facial and neck regions of the body. Defects or deformities in these regions can lead to functional deficiencies; social and psychological effects in addition to cosmetic defects. Restoration or rehabilitation in resource limited countries is usually provided by charities and organisations volunteering assistance overseas, with some training of local staff in the fabrication of these prostheses. Furthermore, these countries typically lack technical knowhow and trained personnel. In industrialised nations maxillofacial prosthetics has developed into a sophisticated medical speciality requiring highly skilled staff and expensive facilities. In resource limited countries surgical procedures may be an option for rehabilitation of these deformities/defects however, they tend to be unavailable or unaffordable and donated prostheses are not suitable. Hence, this research explores, from first principles, the appropriate and affordable local provision of maxillofacial prostheses in resource constrained regions. The investigation provides knowledge on identifying requirements for resource limited areas, resulting in the creation of a guideline constituting priorities, requirements and specifications. It further explores the viability of potentially cheaper, locally available candidate materials via weathering and antimicrobial methods in ascertaining material longevity.
Materials For Facial Prostheses In Resource Limited Countries
Tetteh, Sophia (2019): Materials for facial prostheses in resource-limited countries. Loughborough University. Thesis.https://doi.org/10.26174/thesi...;
Type
PhD
Themes
Assistive & Accessible Technology
Research Group
Disability Interactions
Exploring Thermal Discomfort Amongst Lower-Limb Prosthesis Wearers
Rhys James Williams
Thesis: Firstly, the research provides a methodological contribution showing how to conduct mixed-methods research to obtain rich insights into complex prosthesis phenomena. Secondly, the research highlights the need to appreciate psychological and contextual factors when researching prosthesis wearer thermal comfort. The research contributions are also converted into an implication for prosthesis design. The concept of 'regaining control' to psychologically mitigate thermal discomfort could be incorporated into technologies by using 'on-demand' thermal discomfort relief, rather than 'always-on' solutions, as have been created in the past.
UCL, ProQuest Dissertations Publishing
Exploring Thermal Discomfort Amongst Lower-Limb Prosthesis Wearers
Amongst lower-limb prosthesis wearers, thermal discomfort is a common problem with an estimated prevalence of more than 50%. Overheating does not just create discomfort to the user, but it has been linked to excessive sweating, skin damage caused by a moist environment and friction. Due to impermeable prosthetic components and a warm moist environment, minor skin damage can result in skin infections that can lead to prosthesis cessation, increased social anxiety, isolation and depression. Despite the seriousness of thermal discomfort, few studies explore the issue, with research predominantly constrained to controlled laboratory scenarios, with only one out of laboratory study. In this thesis, studies investigate how thermal discomfort arises and what are the consequences of thermal discomfort for lower-limb prosthesis wearers. Research studies are designed around the principles of presenting lived experiences of the phenomenon and conducting research in the context of participants' real-life activities. A design exploration chapter investigates modifying liner materials and design to create a passive solution to thermal discomfort. However, this approach was found to be ineffective and unfeasible. Study 1 presents a qualitative study which investigates the user experience of a prosthesis, thermal discomfort and related consequences. Study 2 explores limb temperature of male amputees inside and outside the laboratory, with the latter also collecting perceived thermal comfort (PTC) data. Finally, Study 3 investigates thermal discomfort in the real-world and tracks limb temperature, ambient conditions, activities, and experience sampling of PTC. While there were no apparent relationships presented in sensor data, qualitative data revealed that in situations where prosthesis wearers perceived a lack of control, thermal discomfort seemed to be worse. When combined, the studies create two knowledge contributions. Firstly, the research provides a methodological contribution showing how to conduct mixed-methods research to obtain rich insights into complex prosthesis phenomena. Secondly, the research highlights the need to appreciate psychological and contextual factors when researching prosthesis wearer thermal comfort. The research contributions are also converted into an implication for prosthesis design. The concept of 'regaining control' to psychologically mitigate thermal discomfort could be incorporated into technologies by using 'on-demand' thermal discomfort relief, rather than 'always-on' solutions, as have been created in the past.
Exploring Thermal Discomfort Amongst Lower-Limb Prosthesis Wearers
Williams, Rhys James. “Exploring Thermal Discomfort Amongst Lower-Limb Prosthesis Wearers.” ProQuest Dissertations Publishing, 2020. Print.
Type
PhD
Themes
Assistive & Accessible Technology
Research Group
Disability Interactions
Design rules for additively-manufactured wrist splints
Sarah Kelly
A Doctoral Thesis. Submitted in partial fulfilment of the requirements for the award of the degree of Doctor of Philosophy of Loughborough University.
Loughborough University
Design rules for additively-manufactured wrist splints
Additive Manufacturing (AM) often known by the term three-dimensional printing (3DP) has been acknowledged as a potential manufacturing revolution. AM has many advantages over conventional manufacturing techniques; AM techniques manufacture through the addition of material - rather than traditional machining or moulding methods. AM negates the need for tooling, enabling cost-effective low-volume production in high-wage economies and the design & production of geometries that cannot be made by other means. In addition, the removal of tooling and the potential to grow components and products layer-by-layer means that we can produce more from less in terms of more efficient use of raw materials and energy or by making multifunctional components and products. The proposed Centre for Doctoral Training (CDT) in Additive Manufacturing and 3D Printing has the vision of training the next generation of leaders, scientists and engineers in this diverse and multi-disciplinary field. As AM is so new current training programmes are not aligned with the potential for manufacturing and generally concentrate on the teaching of Rapid Prototyping principles, and whilst this can be useful background knowledge, the skills and requirements of using this concept for manufacturing are very different. This CDT will be training cohorts of students in all of the basic aspects of AM, from design and materials through to processes and the implementation of these systems for manufacturing high value goods and services. The CDT will also offer specialist training on aspects at the forefront of AM research, for example metallic, medical and multi-functional AM considerations. This means that the cohorts graduating from the CDT will have the background knowledge to proliferate throughout industry and the specialist knowledge to become leaders in their fields, broadening out the reach and appeal of AM as a manufacturing technology and embedding this disruptive technology in company thinking. In order to give the cohorts the best view of AM, these students will be taken on study tours in Europe and the USA, the two main research powerhouses of AM, to learn from their international colleagues and see businesses that use AM on a daily basis. One of the aims of the CDT in AM is to educate and attract students from complementary basic science, whether this be chemistry, physics or biology. This is because AM is a fast moving area. The benefits of having a CDT in AM and coupling with students who have a more fundamental science base are essential to ensure innovation & timeliness to maintain the UK's leading position. AM is a disruptive technology to a number of industrial sectors, yet the CDTs industrial supporters, who represent a breadth of industrial end-users, welcome this disruption as the potential business benefits are significant. Growing on this industry foresight, the CDT will work in key markets with our supporters to ensure that AM is positioned to provide a real and lasting contribution & impact to UK manufacturing and provide economic stability and growth. This contribution will provide societal benefits to UK citizens through the generation of wealth and employment from high value manufacturing activities in the UK.
Design rules for additively-manufactured wrist splints
Kelly, Sarah (2020): Design rules for additively-manufactured wrist splints. Loughborough University. Thesis.https://doi.org/10.26174/thesi...;
Type
PhD
Themes
Assistive & Accessible Technology
Emotionally driven Prostheses: Exploring the Effects on Users’ Lives and Societies’ Attitudes in the UK and Greece
Anna Vlachaki
The literature shows that research into the aesthetic aspects of prostheses is limited. Although there are suggestions that prostheses with high levels of emotionally-driven design may improve users’ well-being, they are based only on theoretical findings. Therefore, in this thesis the effects of emotionally-driven prostheses on users’ lives and society’s attitudes were explored, with respect to culture and more specifically, the theories of individualism/ collectivism. In order to investigate the effects of culture, the research was conducted in two countries with different cultures; the UK (individualistic) and Greece (collectivistic). The thesis began with a literature review across three core areas: user, product and environment, and revealed the importance of investigating an additional area; that of prosthetists. The research employed a qualitative approach and consisted of four studies.
Loughborough University
Abstract
Emotionally driven Prostheses: Exploring the Effects on Users’ Lives and Societies’ Attitudes in the UK and Greece
The literature shows that research into the aesthetic aspects of prostheses is limited. Although there are suggestions that prostheses with high levels of emotionally-driven design may improve users’ well-being, they are based only on theoretical findings. Therefore, in this thesis, the effects of emotionally-driven prostheses on users’ lives and society’s attitudes were explored, with respect to culture and more specifically, the theories of individualism/ collectivism. In order to investigate the effects of culture, the research was conducted in two countries with different cultures; the UK (individualistic) and Greece (collectivistic). The thesis began with a literature review across three core areas: user, product and environment, and revealed the importance of investigating an additional area; that of prosthetists. The research employed a qualitative approach and consisted of four studies. Study I was an online questionnaire to explore users’ preferences towards prostheses, with respect to their culture. Study II consisted of semi-structured interviews and informational probes to comprehend the role of prostheses on users’ lives, with respect to prosthetic appearance. In Study III, the aim was to investigate prosthetists’ attitudes towards the needs of prosthetic users by conducting semi-structured interviews. Finally, Study IV was an online questionnaire to explore non-users’ attitudes towards the design of prostheses. The research showed that the use of prostheses for the completion of users’ body was not an adequate factor to improve their well-being, and a shift on users’ desires towards emotionally-driven prostheses has occurred. From the variables that were tested, sex, age, cause and area of limb-loss may affect people’s attitudes towards the design of prostheses. Furthermore, the results showed that prostheses with high emotionally-driven design evoked emotions, in both users and non-users, with higher levels of pleasantness and arousal than the emotions that were elicited by the prostheses of lower emotionally-driven designs and thus, they may trigger a greater behavioural reaction. This suggested that emotionally-driven prostheses may eliminate users’ stigmatisation by increasing their self-confidence and altering society’s attitudes. However, attention needs to be paid in collectivistic countries, as emotionally-driven prostheses may enhance users’ stigmatisation.
Emotionally driven Prostheses: Exploring the Effects on Users’ Lives and Societies’ Attitudes in the UK and Greece
Vlachaki, Anna (2020): Emotionally-driven prostheses: exploring the effects on users’ lives and societies’ attitudes in the UK and Greece. Loughborough University. Thesis.https://doi.org/10.26174/thesi...;
Type
Workshop
Themes
Assistive & Accessible Technology
Culture and Participation
Rethinking the Senses: A Workshop on Multisensory Embodied Experiences and Disability Interactions
Maryam Bandukda, Aneesha Singh,Catherine Holloway,Nadia Berthouze, Emeline Brulé, Ana Tajadura-Jiménez, Oussama Metatla, Ana Javornik, and Anja Thieme
The emerging possibilities of multisensory interactions provide an exciting space for disability and open up opportunities to explore new experiences for perceiving one's own body, it's interactions with the environment and also to explore the environment itself. In addition, dynamic aspects of living with disability, life transitions, including ageing, psychological distress, long-term conditions such as chronic pain and new conditions such as long-COVID further affect people's abilities. Interactions with this diversity of embodiments can be enriched, empowered and augmented through using multisensory and cross-sensory modalities to create more inclusive technologies and experiences. To explore this, in this workshop we will explore three related sub-domains: immersive multi-sensory experiences, embodied experiences, and disability interactions and design.
CHI EA '21: Extended Abstracts of the 2021 CHI Conference on Human Factors in Computing Systems
Abstract
Rethinking the Senses: A Workshop on Multisensory Embodied Experiences and Disability Interactions
The emerging possibilities of multisensory interactions provide an exciting space for disability and open up opportunities to explore new experiences for perceiving one's own body, it's interactions with the environment and also to explore the environment itself. In addition, dynamic aspects of living with disability, life transitions, including ageing, psychological distress, long-term conditions such as chronic pain and new conditions such as long-COVID further affect people's abilities. Interactions with this diversity of embodiments can be enriched, empowered and augmented through using multisensory and cross-sensory modalities to create more inclusive technologies and experiences. To explore this, in this workshop we will explore three related sub-domains: immersive multi-sensory experiences, embodied experiences, and disability interactions and design. The aim is to better understand how we can re-think the senses in technology design for disability interactions and the dynamic self, constructed through continuously changing sensing capabilities either because of changing ability or because of the empowering technology. This workshop will: (i) bring together HCI researchers from different areas, (ii) discuss tools, frameworks and methods, and (iii) form a multidisciplinary community to build synergies for further collaboration.
Rethinking the Senses: A Workshop on Multisensory Embodied Experiences and Disability Interactions
Maryam Bandukda, Aneesha Singh, Catherine Holloway, Nadia Berthouze, Emeline Brulé, Ana Tajadura-Jiménez, Oussama Metatla, Ana Javornik, and Anja Thieme. 2021. Rethinking the Senses: A Workshop on Multisensory Embodied Experiences and Disability Interactions. Extended Abstracts of the 2021 CHI Conference on Human Factors in Computing Systems. Association for Computing Machinery, New York, NY, USA, Article 118, 1–5. DOI:https://doi.org/10.1145/341176...
Rethinking the Senses: A Workshop on Multisensory Embodied Experiences and Disability Interactions
Type
Conference Paper
Themes
Assistive & Accessible Technology
Opportunities for Supporting Self-efficacy through Orientation and Mobility Training Technologies for Blind and Partially Sighted People
Maryam Bandukda,Catherine Holloway, Aneesha Singh,Giulia Barbareschi, Nadia Berthouze
We conducted semi-structured interviews with 20 BPS people and 8 Mobility and Orientation Trainers (MOT). The interviews were thematically analysed and organised into four overarching themes discussing factors influencing the self-efficacy belief of BPS people: Tools and Strategies for O&M training, Technology Use in O&M Training, Changing Personal and Social Circumstances, and Social Influences. We further highlight opportunities for combinations of multimodal technologies to increase access to and effectiveness of O&M training.
ASSETS '21: Proceedings of the 23rd International ACM SIGACCESS Conference on Computers and Accessibility
Abstract
Opportunities for Supporting Self-efficacy through Orientation and Mobility Training Technologies for Blind and Partially Sighted People
Orientation and mobility (O&M) training provides essential skills and techniques for safe and independent mobility for blind and partially sighted (BPS) people. The demand for O&M training is increasing as the number of people living with vision impairment increases. Despite the growing portfolio of HCI research on assistive technologies (AT), few studies have examined the experiences of BPS people during O&M training, including the use of technology to aid O&M training. To address this gap, we conducted semi-structured interviews with 20 BPS people and 8 Mobility and Orientation Trainers (MOT). The interviews were thematically analysed and organised into four overarching themes discussing factors influencing the self-efficacy belief of BPS people: Tools and Strategies for O&M training, Technology Use in O&M Training, Changing Personal and Social Circumstances, and Social Influences. We further highlight opportunities for combinations of multimodal technologies to increase access to and effectiveness of O&M training.
Type
Conference Paper
Themes
Assistive & Accessible Technology
What difference does tech make? Conceptualizations of Disability and Assistive Technology among Kenyan Youth: Conceptualizations of Disability and AT
Giulia Barbareschi, Norah Shitawa Kopi,Ben Oldfrey,Catherine Holloway
In this paper, we examine how young Kenyans without disabilities view people with disabilities and AT users. Findings show that while the portrayal of disability is often shaped by negative emotion, participants felt that many of the barriers affecting people with disabilities were created by society. Perceptions of AT differed –devices were not only seen as a mark of disability but also as a sign of access to resources. Therefore, what we see is an emergent picture where social barriers can be reinforced by poverty, and where poverty reinforces social barriers faced by people with disabilities. We conclude that access to appropriate technology alongside societal interventions tackling incorrect beliefs about disability can help to overcome the stigma faced by people with disabilities.
ASSETS '21: Proceedings of the 23rd International ACM SIGACCESS Conference on Computers and Accessibility
Abstract
What difference does tech make? Conceptualizations of Disability and Assistive Technology among Kenyan Youth: Conceptualizations of Disability and AT
Most research which investigates stigma towards with people with disabilities and the use of Assistive Technology (AT) are based in the Global North and focus on the experiences of people with disabilities and the consequences that stigma has on choices surrounding AT. However, stigma is a societal construct rooted in the attitude and beliefs that people without disabilities hold on disability and AT. Furthermore, the portrayal of people with disabilities and AT is dependent on the social context. In this paper, we examine how young Kenyans without disabilities view people with disabilities and AT users. Findings show that while the portrayal of disability is often shaped by negative emotion, participants felt that many of the barriers affecting people with disabilities were created by society. Perceptions of AT differed –devices were not only seen as a mark of disability but also as a sign of access to resources. Therefore, what we see is an emergent picture where social barriers can be reinforced by poverty, and where poverty reinforces social barriers faced by people with disabilities. We conclude that access to appropriate technology alongside societal interventions tackling incorrect beliefs about disability can help to overcome the stigma faced by people with disabilities.
Cite
What difference does tech make? Conceptualizations of Disability and Assistive Technology among Kenyan Youth: Conceptualizations of Disability and AT
Giulia Barbareschi, Norah Shitawa Kopi, Ben Oldfrey, and Catherine Holloway. 2021. What difference does tech make? Conceptualizations of Disability and Assistive Technology among Kenyan Youth: Conceptualizations of Disability and AT. In The 23rd International ACM SIGACCESS Conference on Computers and Accessibility( ASSETS '21). Association for Computing Machinery, New York, NY, USA, Article 18, 1–13. DOI:https://doi.org/10.1145/3441852.3471226
What difference does tech make? Conceptualizations of Disability and Assistive Technology among Kenyan Youth: Conceptualizations of Disability and AT
Type
Workshop
Themes
Assistive & Accessible Technology
Research Group
Disability Interactions
Disability Design and Innovation in Low Resource Settings: Addressing Inequality Through HCI.
Giulia Barbareschi,Dafne Zuleima Morgado-Ramirez,Catherine Holloway, Swami Manohar Swaminathan, Aditya Vashistha, and Edward Cutrell.
Approximately 15% of the world's population has a disability and 80% live in low resource-settings, often in situations of severe social isolation. Technology is often inaccessible or inappropriately designed, hence unable to fully respond to the needs of people with disabilities living in low resource settings. Also lack of awareness of technology contributes to limited access. This workshop will be a call to arms for researchers in HCI to engage with people with disabilities in low resourced settings to understand their needs and design technology that is both accessible and culturally appropriate.
Extended Abstracts of the 2021 CHI Conference on Human Factors in Computing Systems.
Abstract
Disability Design and Innovation in Low Resource Settings: Addressing Inequality Through HCI.
Approximately 15% of the world's population has a disability and 80% live in low resource-settings, often in situations of severe social isolation. Technology is often inaccessible or inappropriately designed, hence unable to fully respond to the needs of people with disabilities living in low resource settings. Also lack of awareness of technology contributes to limited access. This workshop will be a call to arms for researchers in HCI to engage with people with disabilities in low resourced settings to understand their needs and design technology that is both accessible and culturally appropriate. We will achieve this through sharing of research experiences, and exploration of challenges encountered when planning HCI4D studies featuring participants with disabilities. Thanks to the contributions of all attendees, we will build a roadmap to support researchers aiming to leverage post-colonial and participatory approaches for the development of accessible and empowering technology with truly global ambitions.
Disability Design and Innovation in Low Resource Settings: Addressing Inequality Through HCI.
Giulia Barbareschi, Dafne Zuleima Morgado-Ramirez, Catherine Holloway, Swami Manohar Swaminathan, Aditya Vashistha, and Edward Cutrell. 2021. Disability Design and Innovation in Low Resource Settings: Addressing Inequality Through HCI. Extended Abstracts of the 2021 CHI Conference on Human Factors in Computing Systems. Association for Computing Machinery, New York, NY, USA, Article 124, 1–5. DOI:https://doi.org/10.1145/3411763.3441340
Type
Conference Paper
Themes
Assistive & Accessible Technology
Inclusive Educational Technology
Transforming a Monolithic Sheet of Nitinol into a Passive Reconfigurable Tactile Pixel Array Display at Braille Resolution
Tigmanshu Bhatnagar, Nicolai Marquardt, Mark Miodownik,Catherine Holloway
Shape changing materials create a unique opportunity to design reconfigurable tactile display actuators. In this paper, we present a method that transforms a single thin monolithic sheet of Nitinol into a passive reconfigurable tactile pixel array at Braille resolution. We have designed a 27x27 tactile pixel array in which each pixel can be selectively actuated with an external source of heat. The pixels rise 0.4mm vertically with a peak blocked force of 0.28kg and have an average blocked force of 0.23kg at room temperature. After cooling, the pixels can be mechanically reconfigured back to their flat state for repeatable actuation. We demonstrate this actuator’s interactive capabilities through a novel erasable tactile drawing interface.
IEEE World Haptics Conference; 2021
Abstract
Transforming a Monolithic Sheet of Nitinol into a Passive Reconfigurable Tactile Pixel Array Display at Braille Resolution
Shape changing materials create a unique opportunity to design reconfigurable tactile display actuators. In this paper, we present a method that transforms a single thin monolithic sheet of Nitinol into a passive reconfigurable tactile pixel array at Braille resolution. We have designed a 27x27 tactile pixel array in which each pixel can be selectively actuated with an external source of heat. The pixels rise 0.4mm vertically with a peak blocked force of 0.28kg and have an average blocked force of 0.23kg at room temperature. After cooling, the pixels can be mechanically reconfigured back to their flat state for repeatable actuation. We demonstrate this actuator’s interactive capabilities through a novel erasable tactile drawing interface.
Transforming a Monolithic Sheet of Nitinol into a Passive Reconfigurable Tactile Pixel Array Display at Braille Resolution
T. Bhatnagar, N. Marquardt, M. Miodownik and C. Holloway, "Transforming a Monolithic Sheet of Nitinol into a Passive Reconfigurable Tactile Pixel Array Display at Braille Resolution," 2021 IEEE World Haptics Conference (WHC), 2021, pp. 409-414, doi: 10.1109/WHC49131.2021.9517239.
| https://www.disabilityinnovation.com/publications?page=4&type=phd+book+conference-paper+toolkit+workshop |
Sustainability | Free Full-Text | Getting Involved with Vaccination. Swiss Student Teachers’ Reactions to a Public Vaccination Debate
Vaccination is an explicit topic of the United Nations’ 2030 Agenda for Sustainable Development. The present article explores a new way of involving student teachers into the vaccination debate. To this aim, 273 students at a Swiss university for teacher education were invited to read a debate between a vaccination proponent and a vaccination opponent that had been published in a free local newspaper. Then, they were asked to judge five of the main arguments of each discussant and to take a (hypothetical) general decision in favor or against vaccination. This decision, the judgements, and students’ comments were investigated with a mixed method approach in order to better understand the students’ needs and to refine the new approach. It was found that the students eagerly took part in the intervention, but that they were very ambivalent concerning the arguments. They could be classified into three groups. Two groups, called the acceptors and the rejectors, supported the proponent and the opponent, respectively, and decided accordingly in favor or against vaccination. However, there remained a considerably large group that was called the hesitators. They were particularly ambivalent towards both types of argumentation, but, as structural equation modelling revealed, they eventually were more influenced by the arguments in favor than by those against vaccination. In their comments, these students wanted to know more about the prevented diseases, and they often referred to their personal experience but not to the experts’ arguments. It was concluded that this group would benefit most from the new type of intervention. A shared-decision approach, as is today prominently discussed in medicine, could improve its impact, and ways should be found to more seriously and consistently include empathetic understanding in pedagogical settings—for example, by adapting the three-step model from medicine or the reflective equilibrium approach from applied ethics.
Department of Science; University of Teacher Education Lucerne, Pfistergasse 20, CH-6000 Lucerne 7, Switzerland
Sustainability 2019 , 11 (23), 6644; https://doi.org/10.3390/su11236644
Received: 6 October 2019 / Revised: 17 November 2019 / Accepted: 20 November 2019 / Published: 24 November 2019
(This article belongs to the Special Issue Teaching Sustainable Development Goals in Science Education )
Abstract
Keywords:
vaccination
vaccination hesitancy
decision making
teacher education
education
1. Introduction
Vaccines are a suggested topic of the education for sustainable development goals, as they are included in the educational part of the 2030 Agenda for Sustainable Development, which was adopted by all United Nations member states in 2015. Schools could be important places for improving vaccination acceptancy in society. Dubé et al. point out that “ensuring education and knowledge about vaccines in younger individuals (children, adolescents, young adults), possibly through school-based programs, may provide a good opportunity to encourage future vaccine acceptance by parents and adults and minimize the potential for development of hesitancy” [ 1 ]. These authors indicate that more research is needed to evaluate such a strategy.
The present research has been conducted in the context of a Swiss teacher education university. In this institution, one week per year is reserved for health issues in schools. In this special week (called “Impulswoche,” a week for new impulses), all future teachers for primary and lower secondary levels learn about a variety of health issues in school, such as the management of chronic diseases in school, first-aid issues, common health problems in daily school life, and issues of prevention and health promotion in school.
The basic idea of this study was to test an intervention about vaccination during this special week. To achieve this, a vaccination debate published in a free local newspaper was presented to the students. Choosing a population of future teachers met Dubé et al.’s request for more strategy evaluation in two ways. First, many of these student teachers will indeed be parents themselves in a few years. Second, once on the job, they will teach children and adolescents about health issues. Therefore, it is important to understand how they react to vaccination information in the media. This may allow teacher training to be tailored to their needs.
2. Theoretical Background
Today, according to many public health experts, vaccination hesitancy is increasing among parents [ 3 ]. A number of surveys over the past two decades have concluded that, although parents generally consider immunization to be important, a majority of them reported vaccine concerns [ 4 ]. There is a broad range of factors contributing to these concerns. For example, parents are uncomfortable about mandatory vaccination, they feel unable to control potential adverse reactions, they prefer “natural” risks to “manmade” risks, and they have little to no experience of diseases prevented by vaccines, such as polio, measles, and diphtheria [ 4 ].
However, contrary to some experts’ explanations, parents’ decision against vaccination is not simply thoughtless, irrational, or the result of a lack of knowledge about vaccines. Detailed studies have shown that vaccine-refusing parents are well-informed individuals with considerable interest in health-related issues and who actively seek information [ 5 ].
Many other communication tools that help healthcare providers to discuss vaccination with vaccine-hesitant parents have been published, but they have seldom been evaluated [ 1 ]. In fact, there is still a significant lack of solid empirical information on effective strategies to address vaccine hesitancy [ 4 ]. In light of this, the SAGE Working Group on Vaccine Hesitancy emphasizes the importance of understanding the specific concerns of the various groups of vaccine-hesitant individuals [ 1 ]. In particular, studies are needed that test the effectiveness of delivering information to parents through different media in order to better inform public health awareness initiatives [ 3 ].
Many motives for non-compliance have to do with deliberate avoidance. Extensive research literature has suggested that reasons for opposing vaccination in general include concerns about vaccine safety and efficacy, as well as a distrust of the conventional medical establishment and government as health information sources [ 6 , 7 ]. People also avoid vaccination against diseases that they perceive as not serious or eradicated in their areas.
A good example is the case of Human Papilloma Virus (HPV) vaccination. Here, individuals often express concerns about HPV vaccine being too new to have accumulated sufficient long-term safety data. Parents are also concerned about the perceived connection between HPV vaccination and early sexual activity [ 8 ]. As a result, many parents of children and adolescents are reluctant to vaccinate their children. For example, in the US, according to the Center for Disease Control, only 43% of adolescents are up-to-date on their HPV vaccination [ 9 ]. In Switzerland, the estimated HPV immunization rate is 57%, following the vaccination campaign of 2008/09, which is still unsatisfactorily low [ 10 ].
Public health brochures and websites typically discuss vaccination via factual statements about its safety, effectiveness, and benefits, and they provide practical vaccination information (e.g., places to get vaccination). Usually, these documents do not introduce biological concepts that may be essential to addressing safety information needs and dismantling misunderstandings around vaccination.
In a qualitative study, Zeyer and Sidler investigated the impact of reading a standard HPV vaccination information flyer on the participants’ attitudes towards HPV vaccination. They found that reading the flyer had no impact on the students’ interest in receiving the vaccine, with pre-test misconceptions not affected by the flyer [ 11 ]. This raises questions about the sufficiency of factual information for belief changes and asks for different approaches to vaccination education.
Another place where individuals may encounter information about vaccinations is the school system [ 12 ]. However, the science education systems of most countries do not include the coverage of microbiology and immunology that would constitute conceptual basis for understanding vaccination [ 13 ]. Studies have suggested that European and US students at all grade levels have a limited understanding of viruses, contagion, vaccination, and vaccine-preventable diseases. For example, in a study with a sample of 11-year-olds in the UK, Byrne and Grace found that while most participants knew that microorganisms could cause diseases, their understanding of vaccination-induced prevention was very limited [ 14 ]. Many thought that vaccines attacked and killed pathogens, thus essentially viewing vaccines as medicine. While these students were young, other studies suggest that misinformation about microorganisms, infection and vaccination persist into later school years [ 15 ]. Focusing on knowledge about influenza, Romine, Barrow, and Folk discovered that Midwestern US high school students (grades 9–12) hold a number of misconceptions about vaccine and vaccination, including the belief that a vaccine acts as medicine [ 16 ].
In this context, it is be essential to know the attitude of teachers towards vaccination and the role of education in this context. Unfortunately, these questions seem to have been widely neglected in research thus far, e.g., [ 12 ]. In a small qualitative study, Zeyer and Di Rocco investigated problems with HPV vaccination in a Swiss lower secondary school. Interviews with students, teachers and parents revealed, that—besides the well-known reluctance of parents, particularly mothers—about half of the interviewed teachers questioned this vaccination and, generally, their role in the vaccination issue. The authors concluded that involving student teachers with vaccination issues would be an important and rewarding task in the education for sustainability [ 17 ].
3. Research Context, Research Question and Hypothesis
This study made use of an article in a free local paper, distributed to more than a million Swiss households. This free paper, provided by a Swiss supermarket chain, is very popular in Switzerland, and it is read and shared within families, particularly among parents and grandparents. Besides containing advertisements and marketing information, it also includes highly appreciated articles about issues of daily life and health.
The article used in this study included a debate on vaccines between the pro and the contra vaccination community in Switzerland [ 18 ]. The pro vaccination exponent was a professor for pediatric infectious diseases at Basel University Hospital. The contra vaccination exponent was a Swiss general practitioner, well known in Switzerland for his pointed rejection of vaccines and for attracting a great number of vaccination rejecters around him. In the article, both exponents presented their viewpoints by answering an interviewer’s questions, and they also were given the opportunity to directly contest their opponent’s statements. The article included a biographical sketch of each person but refrains from making an editorial comment.
The approach taken in this study was to give the article to the student teachers and to let them read it. Then, the students had to judge five core statements of each expert and to answer the question of how they would decide if they were parents and had to vaccinate their child.
The research question with this procedure was:
(RQ1) How and to what extent do the judgements relate to each student’s vaccination decision?
It was hypothesized that the pro and the contra arguments would have an approximately equal but inverse influence, i.e., that agreement with the pro vaccination argumentation would entail a positive vaccination decision and vice versa. Structural equation modelling provided an appropriate method for testing this hypothesis.
At the end of this procedure, the students had the opportunity to make comments about their vaccination decision.
The research question in this context was the following:
(RQ2) Can students’ comments be qualitatively classified into groups of different attitudes, and how do these groups relate to the students’ vaccination decision?
4. Method
4.1. Questionnaire
Five core statements of both standpoints were identified by carefully reading the article and discussing it with students of another group in another university. Each statement had to be judged on a scale between −3 (full dissent) and +3 (full consent). In this way, a questionnaire with 10 items was created, with 5 items representing the construct pro vaccination and 5 questions representing the construct contra vaccination. In a pre-test with 35 students, a classical factor analysis was done. Both constructs showed a high face validity and a good statistical reliability [ 19 ].
The items of the questionnaire are displayed in Table 1 and Table 2 below. The questionnaire included an additional item (No. 11). In this item, students were asked to imagine that they were parents and how they would “generally” decide about their child’s vaccinations: “In general, would you rather accept or reject vaccination for your child?” The students had to choose between “rather accept” (1) and “rather reject” (0).
Table 1. Items of the “pro vaccination” construct, showing means and standard deviation (SD).
Table 2. Items of the “contra vaccination” construct, showing means and standard deviation (SD).
4.2. Sample and Procedure
Data were collected during two “special weeks” of two consecutive years at a Swiss university of teacher education (see introduction). The definitive sample comprised 272 student teachers (see descriptive measures below).
Permission for participation and ethical approval was given by the authority of the Lucerne University of Teacher Education (Prorektorat Forschung Pädagogische Hochschule Luzern), which, in Switzerland, is the institutional board responsible for approving minimal-risk research, conducted with adult participants in an established educational setting. Before data collection, all students were informed about their right not to participate. All participants were adults over 18 years of age. No personally identifiable information was collected in the survey. There was no key connecting the answers to students. The students read the vaccination debate in the article. The questionnaire was distributed. At the end of the session, the volunteers were invited to contribute their completed questionnaire for the present study. A proctor, not connected to the course, collected contributed materials. Students not willing to contribute their materials retained them.
According to the Swiss Coordination Office for Research on Human beings (Kofam), this research project did not come under the scope of application of the Human Research Act, because the health-related data were collected anonymously [ 20 ].
4.3. Statistical Analysis
A classical statistical analysis was done by means of IBM SPSS (Version 25) [ 21 ]. For structural equation modelling (SEM), IBM SPSS AMOS 21.0 and the maximum-likelihood estimation approach were used [ 22 ].
4.4. The Structural Model
Structural equation modelling (SEM) is a statistical method that takes a confirmatory approach to a structural theory underlying some phenomenon. Hypothesized causal relations between involved factors are modelled by structural graphs and statistically tested in a simultaneous analysis of the entire system of variables. Its particular strength is the testing of theoretical constructs which are represented by latent variables [ 23 ]. The modeling estimates impact factors of causal influences and calculates covariances between variables. Because this study was particularly interested in the impact of experts’ arguments (condensed in two latent variables) on students’ decision making, SEM, a widely used method in social sciences, was considered to be appropriate [ 24 ].
The tested structural model reflected the research hypothesis. Thus, the two endogenous variables, representing the pro vaccination construct (5 items) and the contra vaccination construct (5 items) were designed to model a symmetric causal impact on the variable vaccination decision (exogenous discrete variable). In other words, it was expected that the impact of the variable contra vaccination on the variable vaccination decision would be negative and the impact of pro vaccination on vaccination decision would be positive. Furthermore, SEM assumes as a standard—that the two variables pro vaccination and contra vaccination covary. The covariance was expected to be negative because the model represents a controversy between two experts of opposing opinion (see Figure 1 ).
Figure 1. Basic structure of the structural model.
A two-step process was established to test the model [ 23 ]. As a first step, the pro vaccination and contra variation measurement models were tested through a confirmatory factor analysis. The five items of each of these variables were then combined, not in a Likert scale, but rather with weighted factors that the program calculated. This allowed for a better fit of the full model. In a second step, the two measurement models and the decision variable were combined into the full model for the vaccination decision.
5. Results
Generally, it can be stated that the intervention was implemented without problems. The students were interested and focused. Though their participation in the study was explicitly declared as voluntary, the majority of the students filled in the questionnaire and completed the survey with a short comment.
5.1. Descriptive Measures
The data were collected from a total of 273 students. Data were excluded if a student had not answered every question or if answers could not definitively be identified. After this raw data cleaning, the sample included 255 students (18 omitted cases, 6.59%), 170 females (66.6%) and 85 males (33.3%). The mean age was M age = 23.2 years (SD = 3.26).
5.1.1. Statistics of the Pro and Contra Vaccination Statements and of the Vaccination Decision
Table 1 and Table 2 display the pro vaccination and the contra vaccination statements, their means, and their standard deviations.
The Cronbach’s alpha for the five pro vaccination statements was 0.797, and it was 0.682 for the five contra vaccination statements, i.e., both scales were of acceptable internal reliability. The mean of the pro vaccination statements was 0.92 (SD 1.16), i.e., these statements were, on average, judged as slightly positive by the students. The mean of the contra vaccination statements was 0.22 (SD 1.06), i.e., the average judgment of these items was almost neutral.
The average student mean for the pro vaccination arguments was 0.0922 (SD 1.16), i.e., the students, on average, agreed slightly with the pro vaccination arguments. The average student mean for the contra vaccination arguments was smaller (0.023, SD 1.06), but the students, on average, also slightly agreed with the contra vaccination arguments. All in all, the students were, on average, almost neutral towards both groups of arguments, with a small advantage for the pro argumentation.
Two hundred and eight students answered that they would, in principle, vaccinate their child (76.6%). Forty-six students answered that they would decide against vaccination of their child (16.8%). Eighteen students (6.6%) did not answer this question.
5.1.2. Qualitative Content Analysis of Students’ Open Answers
The qualitative content analysis of the open question yielded four different student groups of different sizes. In the following, each of these groups is shortly described.
The rejectors group (15 students, 5.6%) reproduced arguments provided by the contra vaccination expert. Examples include:
To me, it is important that a child would go through the real disease. That makes them more immune than vaccination would do (stud8#38).
I believe that one should vaccinate as little as possible. The body does it itself. It gets then stronger (stud8#59).
There are no studies that investigate which other diseases can be triggered by vaccination (immunodeficiency, allergies, children’s diseases, etc.) (stud8#116).
In their open answer, the acceptors group reproduced arguments provided by the pro vaccination expert. This group contained of 68 students (26.7% of the sample). Examples of argumentation include:
Complications of the original disease are too dangerous. Children should be protected (stud 8#14).
Additional security. Vaccination complications are smaller, less probable (stud8#33)
I’d never expose my child to the risk of long-term effects, if I can prevent these (stud8#79).
We call the third group the evaluators. This group included 49 students (19.2%) and conveyed that they would not want to decide “in principle” but their decision would be dependent on the (perceived) severity of the illness. Many of them referred to concrete diseases that they perceived as severe and others they perceived as harmless and did not see a need to vaccinate against them. Here are some examples:
I’d vaccinate against measles by all means. For all other diseases I’d apply only the minimum (stud10#93).
I’d vaccinate against hepatitis, etc. Against the measles, [I’d vaccinate] only when the child is getting older (stud10#58).
Vaccination against children’s diseases only in adulthood, if the child has not already gone through it. Yes for vaccination against polio (stud10#008).
Finally, the last group referred to personal experience for motivating their decisions (Label “experiencers,” 35 students, 13.7%). Examples are:
I’ve been vaccinated myself—and I never experienced complications (stud10#60).
I’ve never got into the issue deeply, but I’ve been vaccinated myself and it did no harm to me (stud8#149).
I’ve never been vaccinated and it did no harm to me (stud9#131).
92 (36.1%) students did not provide a statement that could be coded (Label “not coded”), either because they didn’t write an answer or because the answer was not readable.
Table 3 and Table 4 bring the four essential groups into relation to the statistical results. Table 3 provides the numbers and the percentage of pro vaccination and contra vaccination decisions for each group. The percentage was calculated “within group.” That is, within the group of rejectors (15 students), fourteen students, i.e., 93.3% of them, answered that, in general, they would not vaccinate their child. One student, i.e., 6.7%, answered that, in general, they would vaccinate their child.
Table 3. Numbers and the percentage of pro vaccination and contra vaccination decisions for each group.
Table 4. Mean averages for pro vaccination and contra vaccination arguments per group (z-values).
Table 4 displays how every group, on average, judged the core statements of the pro vaccination and the contra vaccination expert. In this table, we used the z-value, which shows how much each group, on average, deviated from the mean, as indicated in standard deviations. For example, if the z-value is −1, this shows, that the judgement of the respective group was one standard deviation more negative than the average judgement of all students. The same holds for the third column, which shows the z-values of the contra vaccination statements for each group.
Table 3
Table 4
Table 5 , finally, compares the distribution of the four groups in the general sample with the situation among those student teachers who had chosen science as one of their educational subjects. There were, in percentage terms, less acceptors within the science students (13.6%) than within the non-science students (26.8%), and less rejectors (2.3% vs. 6.1%). Among science students were more evaluators (27.3%) than among non-science students (16.2%). As to the experiencers, their percentage was approximately the same for both subgroups (13.6% vs. 12.7%).
Table 5. Group percentages. Comparison between non-science students and science students.
5.2. The Structural Model
Structural modelling can add more insights to these findings, because it combines calculated impacts between different variables in one model. The full structural model for vaccination decisions is displayed in Figure 2 . This figure includes all standardized regression weights.
Figure 2. Structural model for vaccination decisions.
As a first step, the fit of the model was investigated. The model was well-fitting and produced highly significant results. In technical terms, this means:
All factor loadings of the measurement model were statistically highly significant ( p < 0.001), except the factor loading of contra vaccination on vaccination decision. The corresponding signs concurred with the hypotheses. The standardized estimates confirmed the formal validity of the individual items [ 23 ].
Descriptively, the model worked well, which was first indicated by a highly acceptable goodness-of-fit index (GFI) of 0.95 (>0.9 for good fit; for fit measures, see [ 25 ] p. 551ff). Second, the baseline comparison, the comparative fit index (CFI), was excellent (CFI = 0.989 (>0.9)).
From an inferential point of view, the model was compatible with the data (CMIN/DF = 1.496, p = 0.023,). Finally, RMSEA = 0.048 (<0.05) and PCLOSE = 0.517 (>0.5) also indicated a good fit.
As a next step, the relations between the variables were evaluated. It was found that, in accordance with the hypothesis, the explanatory power of the variable pro vaccination was very high. Indeed, its standardized regression weight on the variable vaccination decision was very high and highly significant (.874, p < 0.001). This means that the variable pro vaccination explained more than half of the variance of the variable vaccination decision (64%).
However, in contrast to the hypothesis, there was only a low and not significant impact of the variable contra vaccination on the variable vaccination decision (−0.101, p = 0.06), i.e., this variable had no statistical impact on the decision.
Furthermore, and also different from the hypothesis, the covariance between the two variables pro vaccination and contra vaccination was positive (0.53, p < 0.001). This suggests that most people who agreed with the pro vaccination also did with the contra vaccination and vice versa.
In addition, during the confirmatory process, two error correlations were added in order to improve the model fit. Both may have a straight forward interpretations. The negative covariance between the errors of items 7 and item 8 takes into account that these two statements are directly opposed, while the positive covariance between item 2 and item 4 reflects that these two statements are related in content.
6. Discussion
This study aimed to model the vaccination decision of student teachers after reading a debate between a person who supports vaccination and one who opposes it. The tested structural model reflects the hypothesis that agreeing with the arguments of the pro vaccination proponent would have a direct positive impact on the (hypothetical) decision of student teachers to vaccinate their own child. Conversely, it was assumed that the belief in arguments of the contra vaccination proponent would have a negative impact on that decision.
The model strongly confirmed the first part of the hypothesis. The pro vaccination variable explains 48% of the variation of the variable vaccination decision. The second part of the hypothesis, however, was not confirmed. In fact, there was no effect at all of the contra vaccination variable on the decision. This result was unexpected. Since the contra vaccination expert strongly argued against vaccination, one could assume that agreement with his arguments would entail rejection of vaccination.
The situation found its explanation in the descriptive statistical results. They produced four different groups. We called them the acceptors, the rejectors, the evaluators and the experiencers. The acceptors, the group that strongly believed in the pro vaccination argumentation, generally decided pro vaccination. The rejectors, the group that decisively reproduced the contra vaccination argumentation, consistently decided against vaccination. However, there were two considerable groups of students, the evaluators and the experiencers, who tended to be pro vaccination but were deeply unsure. The evaluators, in particular, tended strongly towards the contra argumentation but indicated that, in general, they would decide to vaccinate their child. The experiencers tended towards the pro argumentation, but they did not clearly disapprove of the contra argumentation. They also, in general, would decide to vaccinate their child.
The structural equation model mirrored this insecurity of many students in a highly positive covariance between the pro vaccination and the contra vaccination variables. It confirms that many students who believed in the pro vaccination argumentation also accepted the contra vaccination argumentation and vice versa. The two groups together, the evaluators and the experiencers, seem to represent those people who often are called the hesitators (see Introduction). In our sample, this group was rather large (77 of 160 coded students), and it explained the unexpected finding of the lack of impact of contra vaccination on vaccination decision. Many of the hesitators were positive, or at least non-negative towards the argumentation of the vaccination opponent. However, when it comes to a general decision for or against vaccination, they seemed to make a positive decision towards vaccination.
We conclude from this constellation that the hesitators represent a high potential target group for pro vaccination persuasion work. Actually, they are, in principle, pro vaccination. However, the impact of both the pro vaccination and the contra vaccination arguments on their general vaccination decision was small. Obviously, since they accepted both types of argumentation, their decision remained vastly unimpressed by the debate between the two experts.
Other factors seemed to be important in their decision-making process. The decision of evaluators depended on the type of vaccinations and on the diseases they aim to prevent. Their remarks in the survey showed that they want to know more about these contexts—and not about the general vaccination process—in order to be able to make an informed decision.
The second group of hesitators, the experiencers, based their decision on their personal experience with vaccinations in the past. If these experiences with concrete vaccinations were problematic, they decided against vaccination. In the other case (which is more frequent), positive vaccination experiences entailed a positive general decision. Again, both experts’ argumentations did not seem to decisively impact the decision making process.
An interesting group, finally, were the future science teachers. The percentage of acceptors among them was only half as large as in the non-science teacher group. Almost none of them belonged to the rejectors. If they were hesitators, they tended to belong to the evaluators, i.e., they wanted to know more about the diseases prevented by the different types of vaccinations. Only a small minority of them decided based on personal experiences.
7. Limitations
There were some limitations with this study. One limitation was the sample, as it was a census of two consecutive school years in a university of teacher education. However, because these students come from every part of Central Switzerland, they very much represent the teacher population there, with students from rural and urban areas, as well as students from different socio-economic backgrounds. In addition, the majority of females in the sample reflects the fact that more women than men become teachers for primary and secondary one levels. This statistical weakness was also tolerated because in daily life, it is mainly mothers who decide the vaccination status of their children.
Another limitation was that the structural model represented a very basic decision between “acceptors” and “rejecters.” The students were forced to decide between these two alternatives, which reflect only the two extremal points of vaccination hesitancy. This simplification was a consequence of the approach of using an article that only presented arguments of acceptors and rejecters.
8. Conclusions
All in all, it can be stated that the presented intervention at the university of teacher education was able to involve students and to successfully spark reflection and discussion. However, the results show that there is space for more. Obviously, the four groups that were identified have different needs and may benefit from different approaches.
The acceptors, the group that identifies with the pro vaccination argumentation in the text, seemed to be fine with this intervention and did not need further information. Conversely, the rejectors apparently followed the contra vaccination argumentation and did not ask for more information. Both groups seemed to have made up their minds and may be difficult to persuade to move away from their standpoints.
This is not the case for the two other groups, the evaluators and the experiencers, which together formed the group of hesitaters in this population. Tending basically towards vaccination acceptance, they nevertheless were insecure about the pro and contra argumentation’s value, and they eventually relied upon other points of view than those presented by both experts. The first group, the evaluators, asked for more concrete information about the prevented diseases. The experiencers ultimately based their decision on personal experience.
These results suggest that the chosen strategies of both experts, be they pro or contra vaccination, are fairly inappropriate for promoting vaccination. Both appeal to one group of students that is already convinced of their arguments, and, thus, each of them fails to have an impact on the fluid group of the hesitators that is still ready to change position.
Indeed, our findings suggest that hesitators need a different approach that may be captured best by the shared decision-making model, which is probably today’s most popular model in patient-centered medicine [ 26 ]. Shared decision-making has been defined as an approach where clinicians and patients share the best available evidence when faced with the task of making decisions. However, patients are also supported to consider personal options and to achieve informed preferences [ 27 ]. This description has also been condensed to the formula of getting both evidence and preferences into health care [ 28 ] (p. 407). Actually, this is more than a nice label, as Elwyn et al.’s (2017) article in the influential British Medical Journal pointed out:
“Instead of assuming that decisions should be guided by scientific consensus about effectiveness, shared decision making proposes that informed preferences—by which is meant what matters to patients and families—should play a major role in decision making processes. Shared decision making is more than being attentive to patients’ needs or concerns—it represents an important shift in the roles of both patients and clinicians.” [ 29 ] (p. 1).
Interestingly, in our newspaper article, the two experts (who both are physicians), addressed the evidence side of shared decision making. Surely, from the point of view of school medicine, the evidence of the pro vaccination expert was much better than that of the contra vaccination expert. Nevertheless, the latter also referred to evidence in the sense of experience and observed cases.
The hesitators in the student teachers’ collective, however, were found to be concerned with preference questions and asked for the opportunity to find out more about them. An adequate approach could be inspired by the three-step model of shared decision making [ 29 ], which has been developed to help physicians and patients to find their way between evidence and preference. It starts with choice talk, wherein the importance of respecting individual preferences is underlined and the role of uncertainty in medicine is explained. In a second step, the options talk, options are listed and potential harms and benefits are clarified. The process ends with step 3, the decision talk, wherein preferences are elicited, and, eventually, a decision is made or else deferred.
In this three-step model, the choice between scientific evidence and alternative evidence should be supported. Students obviously feel disconcerted and unsure vis-a-vis two completely disparate epistemic claims. The finding that science teacher students opted three times more for scientific evidence than other evidence suggests that science education could have a role here.
In the field of public understanding and public engagement of science, two strategies for dealing with such conflicts are well known and hotly debated [ 30 ]. The first strategy, called “learning orientation,” typically focuses on learning and understanding scientific content that, at least in principle, can be understood by the non-expert public. This approach fits with the direct positive impact of the pro vaccination argumentation on the vaccination decision. The second strategy, called “communications orientation,” focuses on improving attitudes about science and trust in scientists. This approach seems to be particularly suitable for dealing with the indirect negative attitudinal effect of the contra vaccination argumentation.
The two orientations differ in a fundamental way and normally are conceived as controversial in the field of public understanding of science [ 31 ]. Interestingly, the presented model suggests that both orientations seem to be indispensable for a successful campaign to increase vaccination acceptance, as they complement each other. The learning orientation obviously is present in research on vaccination hesitancy [ 1 ]. Indeed, the learning and understanding of vaccination content is one of the factors that has been demonstrated to be efficient [ 2 ]. The learning orientation has been investigated in a number of disciplinary communities, including educational psychology, learning sciences, and science education.
However, the communications orientation, aimed at attitudes and perceptions about science (so-called “nature of science attitudes”), seems to be a fairly new perspective for vaccination hesitancy. Nevertheless, it also has a long research tradition in communication sciences, social psychology, and, to some degree, in sociology and science and technology studies [ 30 ].
This research has been carried out in the context of teacher education in Switzerland. Qualitative research in Swiss schools has already been able to document how teachers’ negative nature of science attitudes can have a negative impact on the HPV vaccination decision [ 12 , 17 , 32 ]. Thus, a communications-oriented teacher education could have a considerable impact on this goal of the education for sustainable development.
33
Science
34
35
Funding
The authors received no specific funding for this work.
Conflicts of Interest
The authors declare no conflict of interest.
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Figure 1. Basic structure of the structural model.
Figure 2. Structural model for vaccination decisions.
Table 1. Items of the “pro vaccination” construct, showing means and standard deviation (SD).
Number Item Mean SD Item p1 After two doses of the vaccine, the body’s immunity is equal to that after the illness. 0.39 1.767 Item p2 By vaccination, the illness, and thus severe complications and long-term consequences, are prevented. 1.28 1.447 Item p3 Vaccination does not trigger epilepsy. This has been shown in many studies. 0.36 1.524 Item p4 Complications of vaccination can be severe, and therefore vaccination is needed. 1.27 1.524 Item p5 Vaccination complications are much less probable than those of the illness itself. 1.26 1.505
Table 2. Items of the “contra vaccination” construct, showing means and standard deviation (SD).
Number Item Mean SD Item c1 Having the illness results in a better immunity than being vaccinated. 1.31 1.574 Item c2 Having the illness strengthens children’s immunity and fosters their development. 0.56 1.685 Item c3 In practice, you often experience that vaccination triggers epilepsy. −1.22 1.338 Item c4 If you strengthen your body, for example by homeopathy, then it can withstand the germs and you do not need vaccination. −0.32 1.762 Item c5 There are no studies demonstrating the safety of vaccination. 0.69 1.657
Table 3. Numbers and the percentage of pro vaccination and contra vaccination decisions for each group.
Group Label Contra Vaccination Pro Vaccination Total Rejectors Number 14 1 15 % within group 93.3% 6.7% 100.0% Acceptors Number 2 66 68 % within group 2.9% 97.1% 100.0% Evaluators Number 13 29 42 % within group 31.0% 69.0% 100.0% Experiencers Number 5 30 35 % within group 14.3% 85.7% 100.0% Not coded Number 12 83 92 % within group 12.2% 87.8% 100.0% Total Number 46 209 255 % within group 18.0% 82.0% 100.0%
Table 4. Mean averages for pro vaccination and contra vaccination arguments per group (z-values).
Group Pro Vaccination Contra Vaccination Not coded Mean Average (z-value) 0.082 −0.022 Rejectors Mean Average (z-value) −1.48 1.40 Acceptors Mean Average (z-value) 0.60 −0.55 Evaluators Mean Average (z-value) −0.63 0.47 Experiencers Mean Average (z-value) 0.21 −0.18
Table 5. Group percentages. Comparison between non-science students and science students.
Group Non-Science Students Science Students Not coded Number 75 17 % within subject 35.1% 43.2% Rejectors Number 14 1 % within subject 6.1% 2.3% Acceptors Number 61 6 % within subject 26.8% 13.6% Evaluators Number 37 12 % within subject 16.2% 27.3% Experiencers Number 29 6 % within subject 12.7% 13.6%
MDPI and ACS Style
Zeyer, A. Getting Involved with Vaccination. Swiss Student Teachers’ Reactions to a Public Vaccination Debate. Sustainability 2019, 11, 6644.
https://doi.org/10.3390/su11236644
AMA Style
Zeyer A. Getting Involved with Vaccination. Swiss Student Teachers’ Reactions to a Public Vaccination Debate. Sustainability. 2019; 11(23):6644.
https://doi.org/10.3390/su11236644
Chicago/Turabian Style
Zeyer, Albert. 2019. "Getting Involved with Vaccination. Swiss Student Teachers’ Reactions to a Public Vaccination Debate" Sustainability11, no. 23: 6644.
https://doi.org/10.3390/su11236644
Zeyer, Albert. 2019. "Getting Involved with Vaccination. Swiss Student Teachers’ Reactions to a Public Vaccination Debate" Sustainability11, no. 23: 6644.
https://doi.org/10.3390/su11236644
| https://www.mdpi.com/2071-1050/11/23/6644/html#B27-sustainability-11-06644 |
(PDF) Profiles of fatty acids and the main lipid peroxidation products of human atherogenic low density lipoproteins
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Article
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Profiles of fatty acids and the main lipid peroxidation products of human atherogenic low density lipoproteins
January 2016
Revista de Chimie -Bucharest- Original Edition-67(1)
Authors:
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Mariana Deleanu
Nicolae Simionescu Institute of Cellular Biology and Pathology
<here is a image f2779f7226f7d77e-4079804dc0de5159>
Gabriela M Sanda
Nicolae Simionescu Institute of Cellular Biology and Pathology
<here is a image 1a932a77dc103715-66a7398ce7b36ae5>
Camelia Sorina Stancu
Nicolae Simionescu Institute of Cellular Biology and Pathology
<here is a image 0f718d5abb60cf42-22b69b10ad958941>
Mona Elena Popa
University of Agricultural Sciences and Veterinary Medicine of Bucharest
Abstract and Figures
Cardiovascular diseases (CVD), a worldwide leading cause of mortality and morbidity, are generated mainly by atherosclerosis. The serum fatty acids (FA) and some of their peroxidation products, such as 4-hydroxy-trans-2-nonenal (4-HNE) and malondyaldehyde (MDA), are known risk factors for CVD. Our aim was to determine in atherogenically-modified low-density lipoproteins (LDL), either oxidized or glycated, the FA composition, quantify the levels of 4-HNE, MDA and of cholesterol’s main oxidation product, 7-kethocholesterol (7-KC). Profiles of FA, conjugated dienes , 4-HNE, MDA and 7-KC were determined in native LDL (nLDL) isolated from blood donors from the Hematology Center, Bucharest, copper-oxidized LDL (oxLDL) and non-enzymatically glycated LDL (gLDL). The FA composition was determined by Gas Chromatography with a flame ionization detector and the conjugated dienes by absorbtion in UV at 234 nm. Free 4-HNE and 7-KC levels were determined by Gas-Chromatography-Triple Quadrupol Mass Spectrometry in Electron Ionization mode and total MDA by reversed-phase Ultra High Performance Lichid Chromatography. Results showed that the polyunsaturated fatty acids (PUFAs) were totally reduced in oxLDL (except linoleic acid) and decreased in gLDL, while the monounsaturated fatty acids remained almost unchanged in both oxLDL and gLDL. Lipid peroxidation products increased as follows: conjugated dienes were significantly increased both in gLDL (29%, p<0.05) and oxLDL (1.5 fold higher, p<0.01) compared to nLDL; free 4-HNE level in oxLDL (2.75±1.01 nmoles/mg protein) was ~100 times the level in nLDL (0.02±0.01 nmoles/mg protein), while gLDL (0.05±0.02 nmoles/mg protein) had only twice the nLDL level; MDA levels in oxLDL were statistically increased (1.05±0.44 nmoles/mg protein) compared to nLDL (0.05± 0.02 nmoles/mg protein) and to gLDL (0.19±0.05 nmoles/mg protein); 7-KC level was significantly increased in oxLDL (674.39± 207.70 nmoles/mg protein) and gLDL (1.21± 0.32 nmoles/mg protein) compared to nLDL (0.13± 0.04 nmoles/mg protein). Our data demonstrate that the alteration of the FA composition of modified LDL has two negative consequences: (i) the reduction of PUFA levels, most importantly the essential w-3 and w-6 fatty acids, and (ii) the increase of the main peroxidation products of FA and cholesterol such as conjugated dienes, free 4-HNE, MDA and 7-KC, transforming LDL into atherogenic lipoproteins.
Keywords: Fatty acids, 4-HNE, oxidized LDL, glycated LDL, GC/MS/MS
<here is a image bfb0957792fa22b0-633996f21a117d16>
7-Ketocholesterol (7-KC) in native low density lipoproteins (nLDL), oxidized low density lipoproteins (oxLDL) and glycated low density lipoproteins (gLDL). The data are expressed as mean ± SD; n=3 samples for each histogram, **p<0.01 oxLDL versus nLDL, ##p<0.01 gLDL versus nLDL, && p<0.01 oxLDL versus gLDL. …
8
Profiles of Fatty Acids and the Main Lipid Peroxidation Products
of Human Atherogenic Low Density Lipoproteins
MARIANA DELEANU 1,2 , GABRIELA M. SANDA 1 , CAMELIA S. STANCU 1 , MONA E. POPA 2 , ANCA V. SIMA 1 *
1 “Nicolae Simionescu” Institute for Cellular Biology and Pathology of the Romanian Academy, 8 B.P. Hasdeu Str, 050568, Bucharest,
Romania
2 University of Agronomical Sciences and Veterinary Medicine Bucharest, Faculty of Biotechnology, 59 Marasti Blvd., 011464,
Bucharest, Romania
Cardiovascular diseases (CVD), a worldwide leading cause of mortality and morbidity, are generated mainly
by atherosclerosis. The serum fatty acids (FA) and some of their peroxidation products, such as 4-hydroxy-
trans-2-nonenal (4-HNE) and malondyaldehyde (MDA), areknown risk factors for CVD. Our aim was to determine
in atherogenically-modified low-density lipoproteins (LDL), either oxidized or glycated, the FA composition, quantify
the levels of 4-HNE, MDA and of cholesterol’s main oxidation product, 7-kethocholesterol (7-KC). Profiles of FA,
conjugated dienes , 4-HNE, MDA and 7-KC were determined in native LDL (nLDL) isolated from blood donors from
the Hematology Center, Bucharest, copper-oxidized LDL (oxLDL) and non-enzymatically glycated LDL (gLDL).
The FA composition was determined by Gas Chromatography with a flame ionization detector and the conjugated
dienes by absorbtion in UV at 234 nm. Free 4-HNE and 7-KC levels were determined by Gas-Chromatography-
Triple Quadrupol Mass Spectrometry in Electron Ionization mode and total MDA by reversed-phase Ultra High
Performance Lichid Chromatography. Results showed that the polyunsaturated fatty acids (PUFAs) were totally
reduced in oxLDL (except linoleic acid) and decreased in gLDL, while the monounsaturated fatty acids remained
almost unchanged in both oxLDL and gLDL. Lipid peroxidation products increased as follows: conjugated dienes
were significantly increased both in gLDL (29%, p<0.05) and oxLDL (1.5 fold higher, p<0.01) compared to
nLDL; free 4-HNE level in oxLDL (2.75±1.01 nmoles/mg protein) was ~100 times the level in nLDL (0.02±0.01
nmoles/mg protein), while gLDL (0.05 ±0.02 nmoles/mg protein) had only twice the nLDL level; MDA levels in
oxLDL were statistically increased (1.05±0.44 nmoles/mg protein) compared to nLDL (0.05± 0.02 nmoles/
mg protein) and to gLDL (0.19±0.05 nmoles/mg protein); 7-KC level was significantly increased in oxLDL
(674.39± 207.70 nmoles/mg protein) and gLDL (1.21± 0.32 nmoles/mg protein) compared to nLDL (0.13±
0.04 nmoles/mg protein). Our data demonstrate that the alteration of the FA composition of modified LDL has
two negative consequences: (i) the reduction of PUFA levels, most importantly the essential ω -3 and ω -6 fatty
acids, and (ii) the increase of the main peroxidation products of FA and cholesterol such as conjugated
dienes, free 4-HNE, MDA and 7-KC, transforming LDL into atherogenic lipoproteins.
Keywords: F atty acids, 4-HNE, oxidized LDL, glycated LDL, GC/MS/MS
* email: [email protected]; Tel.: +40(0)21.319.4518
Cardiovascular diseases (CVD) caused by athero-
sclerosis and their associated adverse complications are
major causes of morbidity and mortality in western
societies [1]. The non-enzymatic glycation of plasma
proteins, such as in diabetes, can increase their atherogenic
potential. During the last years a considerable amount of
research was focused on the susceptibility of low-density
lipoproteins (LDL) to oxidation. Modified LDL that cause
cellular lipid loading were proven to be atherogenic and
involved in the development of CVD [2]. Glycation of LDL
is significantly increased in diabetic patients even in the
case of good glycemic control [3]. LDL, either oxidized
and/or glycated, are present in the plasma and in the
affected vasculature of obese, diabetic and CVD patients
[4].
Fatty acids (FA) profiling of biological samples (plasma)
has a great importance for the understanding of the relation
between dietary lipids and the development of diabetes
and CVD [5]. Conventional methods for the profiling of FA
consist of several steps : lipids extraction with organic
solvents, hydrolysis, methylation/derivatization, and finally,
analysis and quantification by gas chromatography (GC).
Linoleic acid and arachidonic acid are the major
polyunsaturated fatty acids (PUF As) in LDL, the former being
present mostly in the cholesteryl esters (CE) core of the
lipoproteins. The FA composition varies between various
sources of LDL (different subjects) and depends on the
diet [2].
During the formation of hydroperoxides from
unsaturated FA, conjugated dienes are typically produced,
due to the rearrangement of the double bonds. The resulting
conjugated dienes exhibit a characteristic absorption at
234 nm. An increase in UV absorption theoretically reflects
the formation of primary oxidation products in lipids [6, 7].
The oxidation of PUFAs generates highly reactive α , β-
unsaturated hydroxyalkenals, such as 4-hydroxynonenal
(4-HNE), 4-hydroxyhexenal (4-HHE) and 4-hydroxy-
dodecadienal (4-HDDE) [6]. Oxidation of ω -6 PUFAs
(linoleic and arachidonic acids) leads to the formation of
4-HNE [8], whereas oxidation of ω -3 PUFAs (docosa-
hexaenoic acid, eicosapentaenoic acid and linolenic acid)
generates 4-HHE [9]. 4-HNE can react with histidine (His),
cysteine (Cys) or lysine (Lys) residues of proteins, leading
to the formation of stable Michael adducts with a
hemiacetal structure [10], modifying the proteins’ epitopes
that intereact with specific receptors. The hydroxy-alkenals
levels have been measured with high performance liquid
chromatography (HPLC) using the UV absorption detector.
REV.CHIM.(Bucharest) ♦ 67 ♦ No.1 ♦ 2016 http://www.revistadechimie.ro9
However, this method’s sensitivity is limited. Another
method far more sensitive for the determination of 4-HNE
and 4-HHE is the GC coupled to a mass spectrometer (MS)
[6].
MDA is one of the most abundant aldehydes, resulting
from the peroxidation of arachidonic, eicosapentaenoic
and docosahexaenoic acids [11]. MDA reacts with the Lys
residues of proteins to form Schiff bases [8] and plays a
major role in the LDL oxidative modifications [12-13]. The
oxidative hypothesis of atherosclerosis proposed by
Steinberg postulates that 4-HNE- and MDA-modified LDL
are taken up by macrophages in the artery wall, which
become foam cells and form fatty streaks, an early step of
the atherogenic process [14]. MDA can be measured in
biological fluids as well as in isolated cells by the
thiobarbituric acid (TBA) reaction and the resulting
absorbance at 532 nm or fluorescence can be determined
by HPLC [6].
Cholesterol may be oxidized by enzymatic or non-
enzymatic pathways [15]. Cholesterol oxidation products
have received increasing attention as diagnostic markers
of oxidative stress, intermediates in cholesterol transport
and messengers for cell signaling or intermediates in bile
acid biosynthesis [15]. 7-Ketocholesterol (7-KC), a major
cholesterol oxidation product (oxysterols), is found in high
concentrations in atherosclerotic plaques and contributes
to its development [16].
Experimental part
Materials and methods
4-HNE was purchased from Cayman Chemicals, 1,1,3,3-
tetramethoxypropan (malonaldehyde bis(dimethyl acetal)
99% (TMP), 5-cholesten-3 β -ol-7-one (7-ketocholesterol),
5 α -cholestane, hexane, sodium hydroxide, methanol
(HPLC grade), perchloric acid 70%, hydrochloric acid 37%
were purchased from Sigma-Aldrich. FAME MIX 37 and
hexamethyldisilazane:trimethylchlorosilane:pyridine 3:1:9
(Sylon HTP) were purchased from Supelco.
O
-(2,3,4,5,6-
Pentafluorobenzyl)hydroxylamine PFBHA HCl),
N,O-bis
(tri-
methylsilyl)trifluoroacetamide (BSTFA) + 1% tri-
methylchlorosilane (TMCS) and 2,4-dinitrophenyl-
hydrazine (DNPH) 50%, were purchased from Fluka.
Acetonitrile (HPLC grade), methanol (HPLC grade) and
toluene were purchased from Merck and acetic acid (HPLC
grade) was purchased from Panreac Quimica Spain.
LDL isolation, in vitro oxidation and glycation
LDL was isolated from human plasma of healthy donors
from the Blood Hematology Center, Bucharest by density
gradient ultracentrifugation in Optima LE-80 and XP-80
ultracentrifuges (Beckman Coulter International SA, Nyon,
Switzerland).
Oxidized LDL (oxLDL) was prepared by incubation for
24 h with 10 µ M CuSO 4 as previously described [17].
Non-enzymatically irreversibly glycated LDL (gLDL) was
prepared by incubation of LDL with 0.2 M D(+) glucose for
4 weeks at 37 °C , in the presence of antioxidants (1 mg/mL
EDTA and l M BHT) under sterile conditions and extensively
dialyzed before use [18].
Deter mination of P rotein
Protein concentration of LDL was measured by an
adapted Lowry method as modified for lipoproteins
employing bovine serum albumin as a standard [19].
A
nalysis of fatty acids distribution by GC-FID
Lipids were extracted by a modified Bligh and Dyer
method [20] from LDL samples. The fatty acids methyl
esters (FAMEs) were obtained by mild methanolysis with
8% HCl methanolic solution, according to the procedure
suggested by Ichihara and Fukubayashi [21].
GC-FID analyses were performed on an Agilent
Technologies gas chromatograph GC 7890A coupled with
FID detector. A fused-silica capillary column DB-225 ms
(60 m× 0.25 mm i.d., 0.25 µ m film thickness) from Agilent
J&W was used for separation FAMEs. Aliquots (each 1 µ L)
were injected in the split mode (1:100) with an auto injector.
Helium was used as the carrier gas, at a flow rate of 1 mL/
min. The initial temperature of 120 °C was maintained for 1
min and then increased to 220 °C at 4 °C /min. The
temperature of the injector was 260 °Cand the FID detector
was set at 280 °C . Identification of fatty acids methyl esters
was made with a standard mixture of 37 esters of fatty
acids (FAME MIX 37) from SUPELCO.
Determination of conjugated dienes
The formation of conjugated dienes was detected in UV
at λ =234 nm in native and modified LDL [6, 7].
Determination of free 4-HNE by GC/MS/MS
According to the procedure suggested by van Kuijk and
Rauli [22, 23], LDL sample was incubated for 30 min with
0.05 M PFBHA HCl in water with continuous stirring. The
pentafluorbenzyl-oxime (PFBO)-derivatives were
extracted with hexane and evaporated under nitrogen. The
sample was derivatised with 50 µ L of
N,O
-bis (trimethylsilyl)
trifluoroacetamide (BSTFA) + 1% trimethylchlorosilane
(TMCS) at 80 °C for 1 h and were transformed in PFBO-TMS
of 4-HNE derivatives ( 2 , scheme 2).
GC/MS/MS analyses were performed on an Agilent
Technologies 7000A GC/MS Triple Quad directly interfaced
with a gas chromatograph GC 7890A. A fused-silica
capillary column HP-5 ms (30 m× 0.25 mm i.d., 0.25 µ m
film thickness) from Agilent J&W was used for separation
of 4-HNE derivatives. Aliquots (each 2 µ L ) were injected in
the split less mode with an auto injector. Helium was used
as the carrier gas, at a flow rate of 1 mL/min. The initial
temperature of 85°C was maintained for 1 min and then
increased to 145°C at 20°C/min (3min), and to 300°C at
8°C/min (10 min). The temperature of the injector was
260°C and the transfer line was set at 280°C.
Mass spectrometry detection was performed in Electron
Ionization mode (EI) with a 70 eV electron energy, at 230°C
source temperature and 150°C MS1 and MS2 temperature.
The optimization of the collision energy voltage and the
selection of precursor ions to generate product ions will be
presented in the section Results and discussions.
The calibration curve was constructed with known
amounts of standard 4-HNE solution. The highest level of
target analyte was 2 nmoles/mL. Six calibration solutions
were prepared by 1:2:2:2:2:2 dilution ratios. The standard
solutions were derivatized in the same mode as samples.
Determination of total MDA by UHPLC
For the alkaline hydrolysis of protein bound MDA, a volum
of 6 M NaOH was added to the LDL sample and incubated
in a 60°C water bath for 45 min [24]. After protein
precipitation with 35% perchloric acid and centrifugation,
250 µ L supernatant were derivatizated with 25 µ L DNPH
solution 5 mM in 2 M HCl and incubated for 10 min at room
temperature. The samples were filtered through a 0.22 µ m
filter. Aliquots of 3 µ L were injected in an Ultra High
Performance Liquid Chromatography (UHPLC) system
(Agilent Technologies 1290 Infinity) equipped with binary
solvent delivery pump (with four channels), auto sampler,
thermostatic column compartment, a Diode Array Detector
and Agilent ChemStation software for data acquisition and
processing.
http://www.revistadechimie.ro REV.CHIM.(Bucharest) ♦ 67 ♦ No.1 ♦ 2016
10
The chromatographic separation was performed on a
ZORBAX Eclipse Plus C18 column narrow bore RR (150
mm x 2.1 mm, 3.5 µ m) with the mobile phase consisting
of a 0.2% aqueous acetic acid and acetonitrile (62:38) v/v
at a flow rate 0.25 mL/min. The detector wavelength was
set at 310 nm and the column was maintained at 25°C.
MDA standards were prepared from 1 mM stock solution
of TMP. The calibration curve was constructed in the range
0.625-10 nmol/mL TMP. 250 µ L of standards were mixed
with 25 µ L DNPH in the same condition as the samples.
Determination of 7-ketocholesterol by GC/MS/MS
The sample preparation method was an adapted
method after Matysik [25]. Briefly, to LDL sample/standard
were added 2000 ng of 5 α -cholestane internal standard
(IS) and freshly prepared 1 M potassium hydroxide in
ethanol to cleave the ester bonds for 60 min at 25 °C under
magnetic agitation. Afterwards, the reaction solution was
adjusted to
p
H 7 and s terols were extracted with hexane.
The solvent was evaporated to dryness under nitrogen and
the residue was dissolved in 100 µ L of the reagent Sylon
HTP for derivatization, 1 h at 60 °C . The derivatized samples
were transferred to GC vials for direct injections.
For separation of the trimethysilyl ether derivatives of 7-
ketocholesterol (TMS derivatives of 7-KC) ( 1 , scheme 1)
was used the same technology and the same column as
for determination of 4-HNE. Aliquots (each 2 µ L) were
injected in the splitless mode with an auto injector. Helium
was used as the carrier gas, at a flow rate of 1.2 mL/min.
The initial temperature of 180 °C was maintained for 1 min
and then increased to 250 at 20 °C /min, and to 295°C at 5 °C
/min and to 300 °C at 1 °C min (10 min). The temperature of
the injector was 275°C and the transfer line was set at
280 °C .
Mass spectrometry detection was performed in EI mode
with a 70 eV electron energy, at 230°C source temperature
and 150 °C MS1 and MS2 temperature. The collision energy
voltage was optimized to fragment the precursor ion
m/z
472.5 by collision-induced dissociation (CID) to generate
the product ions selected as quantification and qualifier
ions in the multiple reactions monitoring (MRM) method
for analyte. The quantification ion was
m/z
455.4 and
qualifier ion
m/z
382.6.
Precursor ion of 5 α -cholestane (IS) was
m/z
357.4. The
quantification ion was
m/z
189.2 and qualifier ion
m/z
203.1.
The calibration curve was constructed in the range 50-
5000 ng/mL in the same mode as samples.
Results and discussions
It is well known that the high saturated fat intake
generates high serum lipids levels and the development of
atherosclerosis. The analysis of serum and tissue FA
distribution was included in population studies on CVD and
their risk factors [26].
It has been determined the content of linoleic acid
(C18:2) (34.22±1.57, expressed as %( w/w) and
arachidonic acid (C20:4) (6.97±0.54), known as the most
abundant ω -6 PUFAs present in nLDL, and ω -3 PUFAs,
such eicosapentaenoic acid, EPA (C20:5) and docosa-
pentaenoic, DHA (C22:6), which occur only in minor
amounts (fig. 1).
The FA distribution in oxLDL (expressed as %w/w) was
altered after LDL oxidation with copper ions as compared
to the FA distribution in nLDL. The percent of saturated FA
in oxLDL increased compared to nLDL: the palmitic acid
(C16:0) (50.06±2.45
versus
23.99±0.69,
p<
0.001) and the
stearic acid (C18:0) (31.60±2.39
versus
13.39±0.46,
p<
0.01). The abundance of monounsaturated FA, such as
the palmitoleic acid (C16:1) (1.47±0.52
versus
1.51±0.59),
oleic acid (C18:1) (13.05±0.06
versus
12.66±1.79) and
(C18:1
cis
vaccenic) (1.41±0.17 versus 1.51±0.59)
remained statistically unchanged. The linoleic acid was
statistically decreased in oxLDL (1.94±0.56
versus
34.22±1.57
,
p<
0.001) compared to nLDL, while the ω -6
dihomogammalinolenic acid (C20:3) (1.72±0.04,
p<
0.001) and arachidonic acid (C20:4) (6.97±0.54,
p<
0.001) were completely oxidized in oxLDL ( fig. 1 ).
The ω -3 FA, EPA (1.16±0.23,
p
<0.001) and DHA
(1.71±0.54,
p
<0.001) were totally reduced, being
transformed in peroxidation products ( fig. 1 ).
In gLDL compared to nLDL, the decrease of linoleic acid
(27.03±2.31
versus
34.22±1.57,
p<
0.05), of dihomo-
gammalinolenic acid (0.97±0.29
versus
1.55±0.29,
p
<0.05) and arachidonic acid (3.98±1.03
versus
6.97±
0.54,
p<
0.05), was statistically significant.
There is a tendency for ω -3 FA abundance to decrease,
as they were reduced in half in gLDL compared to nLDL,
EPA (0.58 ±0.50
versus
1.16±0.23 and DHA (0.58±0.83
versus
1.71±0.54) (fig. 1).
In oxLDL compared to gLDL, the linoleic acid (1.94±0.56
versus
27.03±2.31,
p<
0.01) was significantly decreased.
Conjugated dienes, detected in UV at λ =234 nm, were
significantly increased in both gLDL and oxLDL with 29%,
p
<0.05 and ~ 1.5 fold higher,
p
<0.01, respectively,
compared to nLDL (fig. 2). Conjugated dienes detection
by UV is easy, but the method is neither very specific, nor
very sensitive.
Like other aldehydes, 4-HNE was derivatized into
pentafluorobenzyl oxime directly in the LDL sample as
previously described [22, 23]. Their derivatives were
extracted with hexane, and the hydroxyl group was
converted into trimethysilyl ether with
N,O
-
bis(trimethylsilyl)-trifluoroacetamide, and the penta-
Scheme 1. Chemical structure of TMS derivatives of
7-ketocholesterol (1)
Fig. 1. Composition of fatty acids (FA) in oxidized low density
lipoproteins (oxLDL) and glycated low density lipoproteins (gLDL)
compared to native low density lipoproteins (nLDL). The data are
expressed as mean ± SD; n=3 samples for each
histogram,**
p
<0.01 oxLDL
versus
nLDL , ∗∗∗
p
<0.001 oxLDL
versus
nLDL, #
p
<0.05 gLDL
versus
nLDL, ##
p
<0.01 gLDL
versus
nLDL, ###
p
<0.001 gLDL
versus
nLDL, &&
p
<0.01 oxLDL
versus
gLDL, &&&
p
<0.01 oxLDL
versus
gLDL.
REV.CHIM.(Bucharest) ♦ 67 ♦ No.1 ♦ 2016 http://www.revistadechimie.ro11
(0.19±0.05
versus
0.05±0.02 nmoles/mg protein,
p<
0.001)
( fig. 5 ).
The mean MDA level was ~3 fold lower in oxLDL
(1.05±0.44 nmoles/mg protein) than 4-HNE (2.75±1.01
nmoles/mg protein, while in gLDL, the MDA level
(0.19±0.05 nmoles/mg protein) was ~ 4-fold higher than
4-HNE level (0.05±0.02 nmoles/mg protein).
These differences of MDA levels
versus
4-HNE in gLDL
could be explained by the fact that our GC/MS/MS method
for quantification 4-HNE has a high degree of specificity
while the determination of MDA by HPLC with DNPH
Fig. 2. Conjugated dienes in native low density lipoproteins
(nLDL), oxidized low density lipoproteins (oxLDL) and glycated
low density lipoproteins (gLDL). The data are expressed as mean
± SD; n=6 samples for each histogram, **
p
<0.01 oxLDL
versus
nLDL, #
p
<0.05 gLDL
versus
nLDL, &
p
<0.05 oxLDL
versus
gLDL.
Scheme 2. Chemical structure of PFBO-TMS derivatives
of 4-HNE ( 2 )
fluorbenzyl oxime trimethysilyl ether derivatives (PFBO-
TMS) of 4-HNE ( 2 , scheme 2) were analyzed by negative
ion chemical ionization (NICI) GC-MS [22, 23].
A GC/MS/MS Triple Quad in EI mode method for
quantification of 4-HNE has been developed . First was
performed scan a quadrupole 1 (Q1) to produce a MS
pattern in EI mode for PFBO -TMS derivatives of 4-HNE from
standard solutions. The characteristic fragment ions ( fig.
3 ) corresponded well with those given in the literature [27].
Two precursor ions (
m/z
242 and
m/z
352) were chosen
for product scans and the most abundant product ions were
chosen to define specific multiple reaction monitoring
(MRM). The collision energy voltage was optimized in the
range 1-10 eV to fragment the most abundant precursor
ion
m/z
352 by collision-induced dissociation (CID) to
generate the product ions selected as quantification and
qualifier ions in the multiple reaction monitoring (MRM)
method for analyte. The optimum collision energy voltage
was 10 eV and the dwell time was fixed at 150 ms for
MRM transition. The quantification ion was
m/z
155.9 and
the qualifier ion,
m/z
180.9 ( fig. 4 ).
The 4-HNE levels were significantly increased in oxLDL
compared to both nLDL and gLDL (2.75±1.01
versus
0.02±0.01 nmoles/mg protein,
p<
0.001, and 0.05±0.02
nmoles/mg protein,
p<
0.05, respectively) ( fig. 4).
The mean MDA level in oxLDL was significantly
increased compared to nLDL (1.05±0.44 v
ersus
0.05±0.02
nmoles/mg protein,
p<
0.001) and to gLDL (0.19±0.05
nmoles/mg protein,
p<
0.001). The increase of MDA in
gLDL compared to nLDL was statistically significant
Fig. 3. Mass spectra of Q1 scan after
positive electron ionization (EI) of the
PFBO-TMS-derivatives of 4-HNE
standards.
Fig. 4. MRM chromatograms of quantifier,
qualifier and peak spectrum of PFBO-TMS
derivatives of 4-HNE standards.
Fig. 5. Free 4-HNE and total MDA in native low density lipoproteins
(nLDL), oxidized low density lipoproteins (oxLDL) and glycated
low density lipoproteins (gLDL). The data are expressed as mean
± SD; n=6 samples for each histogram, ***
p
<0.001 oxLDL
versus
nLDL, #
p
<0.05 gLDL
versus
nLDL, ###
p
<0.001 gLDL
versus
nLDL, &&&
p
<0.001 oxLDL
versus
gLDL.
http://www.revistadechimie.ro REV.CHIM.(Bucharest) ♦ 67 ♦ No.1 ♦ 2016
12
Fig. 6. 7-Ketocholesterol (7-KC) in native low density lipoproteins
(nLDL), oxidized low density lipoproteins (oxLDL) and glycated
low density lipoproteins (gLDL). The data are expressed as mean
± SD; n=3 samples for each histogram, **
p
<0.01 oxLDL
versus
nLDL, ##
p
<0.01 gLDL
versus
nLDL, &&
p
<0.01 oxLDL
versus
gLDL.
derivatization is specific for all carbonyl groups and gLDL
have a high number of carbonyl groups.
Next to 27-hydroxycholesterol, 7-ketocholesterol is the
next most abundant oxysterol in advanced human
atherosclerotic lesion [29]. During the
in vitro
oxidation of
LDL, a substantial loss of free and esterified cholesterol
occurs as both these molecules are oxidized [15].
The mean 7-KC level was significantly increased in
oxLDL compared to both nLDL and gLDL (674.39±207.70
versus
0.13± 0.04 nmoles/mg protein,
p<
0.01, 1.21±0.32
nmoles/mg protein,
p<
0.01, respectively) ( fig. 6). The
mean 7-KC level was ~ 550-fold higher in oxLDL
(674.39±207.70 nmoles/mg protein) than in gLDL
(1.21±0.32 nmoles/mg protein).
Conclusions
The experimental results demonstrate that the glycation
and mostly the oxidation of LDL have negative
consequences on the particles biochemical composition
involving the following processes: (i) the reduction of
PUFAs levels, most importantly the essential ω -3 and ω -6
fatty acids and (ii) the increase of the main peroxidation
products of FA and cholesterol, such as conjugated dienes,
free 4-HNE, MDA and 7-KC, which taken together transform
LDL into atherogenic lipoproteins.
Acknowledgments: This work was supported by the UEFISCDI project
PN-II-PT-PCCA-2011-3.1-0184 and by the Romanian Academy. Dr.
Gabriela M. Sanda acknowledges the support of the strategic grant
„POSDRU/159/1.5/S/133391-financed by the European Social Found
within the Sectorial Operational Program Human Resources
Development 2007 – 2013".
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Manuscript received: 4.05.2015
... Modified LDL were then centrifuged at 10,000xg for 10 min and the precipitated fraction composed of 100% agLDL was added to cell cultures [26,27]. In vitro oxLDL was prepared by incubating nLDL with 10 μM CuSO 4 for 24 h at 37˚C in the absence of antioxidant protection, and characterized as described [25,
28]
. The lipid peroxides levels in LDL were measured as thiobarbituric acid reactive substances (TBARS) by Ultra High Pressure Liquid Chromatography (UHPLC) method [29] and expressed as malondialdehyde (MDA) pmoles/mg LDL protein. ...
... Free cholesterol (FC) and total cholesterol (TC) content of nLDL, agLDL and oxLDL, and of the macrophages exposed to nLDL, agLDL or oxLDL were analyzed by gas chromatographymass spectrometry (GC-MS), as previously reported
[28]
. ...
Aggregated LDL turn human macrophages into foam cells and induce mitochondrial dysfunction without triggering oxidative or endoplasmic reticulum stress
Uptake of modified lipoproteins by macrophages turns them into foam cells, the hallmark of the atherosclerotic plaque. The initiation and progression of atherosclerosis have been associated with mitochondrial dysfunction. It is known that aggregated low-density lipoproteins (agLDL) induce massive cholesterol accumulation in macrophages in contrast with native LDL (nLDL) and oxidized LDL (oxLDL). In the present study we aimed to assess the effect of agLDL on the mitochondria and ER function in macrophage-derived foam cells, in an attempt to estimate the potential of these cells, known constituents of early fatty streaks, to generate atheroma in the absence of oxidative stress. Results show that agLDL induce excessive accumulation of free (FC) and esterified cholesterol in THP-1 macrophages and determine mitochondrial dysfunction expressed as decreased mitochondrial membrane potential and diminished intracellular ATP levels, without generating mitochondrial reactive oxygen species (ROS) production. AgLDL did not stimulate intracellular ROS (superoxide anion or hydrogen peroxide) production, and did not trigger endoplasmic reticulum stress (ERS) or apoptosis. In contrast to agLDL, oxLDL did not modify FC levels, but stimulated the accumulation of 7-ketocholesterol in the cells, generating oxidative stress which is associated with an increased mitochondrial dysfunction, ERS and apoptosis. Taken together, our results reveal that agLDL induce foam cells formation and mild mitochondrial dysfunction in human macrophages without triggering oxidative or ERS. These data could partially explain the early formation of fatty streaks in the intima of human arteries by interaction of monocyte-derived macrophages with non-oxidatively aggregated LDL generating foam cells, which cannot evolve into atherosclerotic plaques in the absence of the oxidative stress.
... Similarly to the results observed in the current experiment Bessa et al. [32] using sunflower oil in a study carried out with lambs, observed an increase in CLA t10,c12 in response to soybean oil supplementation to high-concentrate diets. Although C18:1 trans-11 seems to play a more important role than the trans-10 isomer in modulating plasma lipid and lipoprotein metabolism, C18:2 c9,t11 and CLA t10,c12 have potential beneficial effects for human health
[36]
. ...
... In the present study, the n-6/n-3 ratio was more beneficial in intramuscular fat of lambs compared of subcutaneous fat. It can be considered a beneficial property for human nutrition
[36]
. However, this value is higher for control and SO samples than the recommendation of nutritionists [27]. ...
Research Regarding Fatty Acid Profile and Health Lipid Indices in the Lambs Meat of Employing Feed Supplemented with Different Vegetable Oils
Enhancing healthy fatty acids (FA) in lamb tissues is a important research issue in meat science. The present study examined the effects of feeding-protected lipid supplements rich in linoleic acid or linolenic acid on the lipid composition of muscle and adipose tissues of lambs. Thirty, 10-week-old Tsigai breed ram lambs were assigned to one of three experimental diets (forage/concentrate ratio 40:60): no oil Ca soap (CControl), with 4% sunflower oil Ca soap (SO-high in 18:2n-6), with 4% camelina oil Ca soap (CO-high in 18:3n-3). The diet high in a-linolenic acid (CO diet) produced the highest levels of n-3 FAs: 18:3n-3 (ALA), 20:5n-3 (EPA) and 22:6n-3 (DHA) intramuscular fat. In addition, the animals fed with the diet CO have intramuscular fat the lowest n-6/n-3 ratio, atherogenic (AI) and thrombogenic index (TI). In the intramuscular fat of the animals fed with the diet high in linoleic acid (SO diet), conjugated linoleic acid (CLA) isomers and trans 18:1 reached their highest concentrations. The results of this study indicated that linoleic acid was more effective in enhancing contents of CLA in muscle and adipose tissue than linolenic acid, which contributes to the enrichment of n-3 FA lamb meat. Feeding camelina oil Ca soap has been shown to be the most effective dietary management to improve health lipid indices (n-6/n-3 ratio, AI, TI) in lambs' meat.
... Native LDL (nLDL) were isolated from human plasma of healthy donors from the Blood Transfusion Center, Bucharest, by density gradient ultracentrifugation in Optima LE-80 or XP-80 ultracentrifuges (Beckman Coulter International SA, Nyon, Switzerland). Copper-oxidized LDL (oxLDL) was prepared and characterized as previously described [Sima et al., 2010;
Deleanu et al., 2016]
. ...
... Free cholesterol (FC), total cholesterol (TC), and 7-ketocholesterol (7-KC) content of oxLDL and of macrophages exposed to oxLDL for 24 h was analyzed by gas chromatography-mass spectrometry (GS-MS) on an Agilent Technologies 7000 A GC/MS Triple Quad direct interfaced with a gas chromatograph GC 7890A, as previously reported [Ahmida et al., 2006;
Deleanu et al., 2016]
. ...
Oxidized LDL-Exposed Human Macrophages Display Increased MMP-9 Expression and Secretion Mediated by Endoplasmic Reticulum Stress
| https://www.researchgate.net/publication/292315360_Profiles_of_fatty_acids_and_the_main_lipid_peroxidation_products_of_human_atherogenic_low_density_lipoproteins |
The molecular chaperone Hsp90 is required for high osmotic stress response in Saccharomyces cerevisiae | Request PDF
Request PDF | The molecular chaperone Hsp90 is required for high osmotic stress response in Saccharomyces cerevisiae | Exposure of Saccharomyces cerevisiae to high osmotic stress evokes a number of adaptive changes that are necessary for its survival. These... | Find, read and cite all the research you need on ResearchGate
The molecular chaperone Hsp90 is required for high osmotic stress response in Saccharomyces cerevisiae
April 2006
FEMS Yeast Research6(2):195-204
DOI: 10.1111/j.1567-1364.2006.00026.x
Authors:
Xiao-Xian Yang
Xiao-Xian Yang
Kick C T Maurer
Michiel Molanus
Michiel Molanus
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Willem H Mager
Vrije Universiteit Amsterdam
Abstract
Exposure of Saccharomyces cerevisiae to high osmotic stress evokes a number of adaptive changes that are necessary for its survival. These adaptive responses are mediated via multiple mitogen-activated protein kinase pathways, of which the high-osmolarity glycerol (HOG) pathway has been studied most extensively. Yeast strains that bear the hsp82T22I or hsp82G81S mutant alleles are osmosensitive. Interestingly, the osmosensitive phenotype is not due to inappropriate functioning of the HOG pathway, as Hog1p phosphorylation and downstream responses including glycerol accumulation are not affected. Rather, the hsp82 mutants display features that are characteristic for cell-wall mutants, i.e. resistance to Zymolyase and sensitivity to Calcofluor White. The osmosensitivity of the hsp82T22I or hsp82G81S strains is suppressed by over-expression of the Hsp90 co-chaperone Cdc37p but not by other co-chaperones. Hsp90 is shown to be required for proper adaptation to high osmolarity via a novel signal transduction pathway that operates parallel to the HOG pathway and requires Cdc37p.
<here is a image 175d1bd4b7439d95-754927124da715c1>
... For example, the induction of osmostress specific genes is regulated by the activation of the high osmolarity glycerol (HOG) pathway MAPK, Hog1, Saito and Posas 2012), whereas, the increased expression of environmental stress responsive genes involved in metabolic pathways is regulated by the activation of glycogen synthase kinase 3 (GSK3) (Hirata et al. 2003;Stankiewicz and Mayer 2012). Hsp90 has been found to be directly involved in the activation or maturation of both of these kinases and the transcription factor, Hsf1 is involved in promoting the induction of heat shock proteins
(Yang et al. 2006;
Stankiewicz and Mayer 2012). Therefore, in the following chapters we investigate the effects of Hsp90 mutations on yeast short-term adaptation to conditions directly associated with increased expression of Hsp90 including, thermal stress (37°C), oxidative stress (H 2 0 2 or diamide), ethanol stress and nitrogen depletion (Gasch et al. 2000) or conditions associated with Hsp90 client binding-maturation function in stress response pathways such as, the HOG pathway induced by hyperosmotic stress (NaCl or sorbitol) (Gasch et al. 2000;Yang et al. 2006). ...
... Hsp90 has been found to be directly involved in the activation or maturation of both of these kinases and the transcription factor, Hsf1 is involved in promoting the induction of heat shock proteins (Yang et al. 2006;Stankiewicz and Mayer 2012). Therefore, in the following chapters we investigate the effects of Hsp90 mutations on yeast short-term adaptation to conditions directly associated with increased expression of Hsp90 including, thermal stress (37°C), oxidative stress (H 2 0 2 or diamide), ethanol stress and nitrogen depletion (Gasch et al. 2000) or conditions associated with Hsp90 client binding-maturation function in stress response pathways such as, the HOG pathway induced by hyperosmotic stress (NaCl or sorbitol) (Gasch et al. 2000;
Yang et al. 2006
). ...
... Hsp90 levels were monitored by western blotting. Specifically, Hsp90 is required to buffer proteotoxic and deleterious fitness effects that arise during short-term environmental stress and can disrupt protein and cellular function, ultimately affecting organismal fitness and survival (Gasch et al. 2000;
Yang et al. 2006;
Richter et al. 2010 Middle-C terminal domain and regulation of ATPase-Chaperone activity (Nathan and Lindquist 1995;Nathan et al. 1997;Meyer et al. 2003;Hawle et al. 2006;Hagn et al. 2011). As a result, mutations within this region could impact diverse aspects of Hsp90 such as, relative affinity and priority of different clients involved in different stress response pathways, which may provide an adaptive benefit to specific environments. ...
Investigating Evolutionary Innovation in Yeast Heat Shock Protein 90
Article
Full-text available
Jul 2020
Pamela A. Cote-Hammarlof
The Heat Shock Protein 90 (Hsp90) is an essential and highly conserved chaperone that facilitates the maturation of a wide array of client proteins, including many kinases. These clients in turn regulate a wide array of cellular processes, such as signal transduction, and transcriptional reprogramming. As a result, the activity of Hsp90 has the potential to influence physiology, which in turn may influence the ability to adapt to new environments. Previous studies using a deep mutational scanning approach, (EMPIRIC) identified multiple substitutions within a 9 amino acid substrate-binding loop of yeast Hsp90 that provides a growth advantage for yeast under elevated salinity conditions and costs of adaptation under alternate environments. These results demonstrate that genetic alterations to a small region of Hsp90 can contribute to evolutionary change and promote adaptation to specific environments. However, because Hsp90 is a large, highly dynamic and multi-functional protein the adaptive potential and evolutionary constraints of Hsp90 across diverse environments requires further investigation. In this dissertation I used a modified version of EMPIRIC to examine the impact of environmental stress on the adaptive potential, costs and evolutionary constraints for a 118 amino acid functional region of the middle domain of yeast Hsp90 under endogenous expression levels and the entire Hsp90 protein sequence under low expression levels. Endogenous Hsp90 expression levels were used to observe how environment may affect Hsp90 mutant fitness effects in nature, while low expression levels were used as a sensitive readout of Hsp90 function and fitness. In general, I found that mutations within the middle domain of Hsp90 have similar fitness effects across many environments, whereas, under low Hsp90 expression I found that the fitness effects of Hsp90 mutants differed between environments. Under individual conditions multiple variants provided a growth advantage, however these variants exhibited growth defects in other environments, indicating costs of adaptation. When comparing experimental results to 261 extant eukaryotic sequences I find that natural variants of Hsp90 support growth in all environments. I identified protein regions that are enriched in beneficial, deleterious and costly mutations that coincides with residues involved in co-chaperone-client-binding interactions, stabilization of Hsp90 client-binding interfaces, stabilization of Hsp90 interdomains and ATPase chaperone activity. In summary, this thesis uncovers the adaptive potential, costs of adaptation and evolutionary constraints of Hsp90 mutations across several environments. These results complement and extend known structural and functional information, highlighting potential adaptive mechanisms. Furthermore, this work elucidates the impact environment can have on shaping Hsp90 evolution and suggests that fluctuating environments may have played a role in the long-term evolution of Hsp90.
... It has ∼70 % of its kinome destabilised, revealing that S14 phosphorylation of Cdc37 is important for protecting nascent kinase chains against degradation and maintaining appropriate in vivo levels of protein kinases (Mandal et al. 2007). We and others have shown that this Ser14 phosphorylation is essential for the functionality of several stress-responsive, mitogen-activated protein kinase (MAPK) pathways in yeast, the cdc37(S14A) mutation causing loss of Cdc37 interaction with key signalling components of these pathways, notably the kinases Ste11, Kss1, Hog1 and Slt2 (Abbas-Terki et al. 2000;Hawle et al. 2007;
Yang et al. 2006)
. Here, we describe our discovery, through yeast two-hybrid (Y2H) screening, of a Cdc37 client kinase whose stable association with Cdc37 and in vivo expression level appears not to depend upon this Ser14 phosphorylation of Cdc37. ...
... Except for the two-hybrid screen (see below), yeast cells were routinely grown at 24°C in either yeast peptone dextrose (YPD) or synthetic yeast nitrogen base (YNB) medium supplemented with the required amino acids. Analysis of the rescue of osmosensitivity by Cdc37 constructs was as previously described
(Yang et al. 2006;
Vaughan et al. 2008). ...
... Amongst the Cdc37 proteins of distantly related species, it is only the 20-30 amino acids at the extreme N-terminus of Cdc37 that are highly conserved in sequence (MacLean and Picard 2003), indicating that this N-terminal region is important for the functionality of Cdc37. Consistent with this, we have noted that, while Cdc37 overexpression will normally rescue the osmosensitive growth of the hsp90-G81S mutant
(Yang et al. 2006)
, overexpressions of N-terminally green fluorescent protein (GFP)-or glutathione transferase (GST)tagged forms of Cdc37 cannot provide any rescue of this mutant in the presence of 2 M sorbitol ( Fig. 1a). Contrasting with this are the experiences of placing sequences at the Cterminus of Cdc37. ...
Cdc37 engages in stable, S14A mutation-reinforced association with the most atypical member of the yeast kinome, Cdk-activating kinase (Cak1)
Article
Full-text available
Jan 2014
CELL STRESS CHAPERON
<here is a image 1937ee36a50dd27a-fa33d150fae83bfe> Patricija Van Oosten
Mohammed A Alkuriji
<here is a image ce1d5550b9b9c9cc-237b52e706a03cf2> Stefan Millson
<here is a image 186ed615fcbadcba-a39f27a298c27efc> Peter Piper
In most eukaryotes, Cdc37 is an essential chaperone, transiently associating with newly synthesised protein kinases in order to promote their stabilisation and activation. To determine whether the yeast Cdc37 participates in any stable protein interactions in vivo, genomic two-hybrid screens were conducted using baits that are functional as they preserve the integrity of the conserved N-terminal region of Cdc37, namely a Cdc37-Gal4 DNA binding domain (BD) fusion in both its wild type and its S14 nonphosphorylatable (Cdc37(S14A)) mutant forms. While this failed to identify the protein kinases previously identified as Cdc37 interactors in pull-down experiments, it did reveal Cdc37 engaging in a stable association with the most atypical member of the yeast kinome, cyclin-dependent kinase (Cdk1)-activating kinase (Cak1). Phosphorylation of the conserved S14 of Cdc37 is normally crucial for the interaction with, and stabilisation of, those protein kinase targets of Cdc37, Cak1 is unusual in that the lack of this Cdc37 S14 phosphorylation both reinforces Cak1:Cdc37 interaction and does not compromise Cak1 expression in vivo. Thus, this is the first Cdc37 client kinase found to be excluded from S14 phosphorylation-dependent interaction. The unusual stability of this Cak1:Cdc37 association may partly reflect unique structural features of the fungal Cak1.
... Since Hsp90 is a chaperone involved in the response to thermal stress as well as in the regulation of osmotic stress
(Yang et al., 2006;
Boucher et al., 2014), we tested which factors can explain variation in codon fitness effects. For that we performed model selection using the leaps package (Lumley, 2017). ...
... Overall differences between synonymous mutations are higher than two random draws of the posterior. On average, the effects of synonymous mutations are larger in the 36N environment (Table S4, Fig. S10), where Hsp90 is expected to be more important for organism survival
(Yang et al., 2006;
Boucher et al., 2014;Mishra et al., 2016). ...
The fitness landscape of the codon space across environments
Fitness landscapes map the relationship between genotypes and fitness. However, most fitness landscape studies ignore the genetic architecture imposed by the codon table and thereby neglect the potential role of synonymous mutations. To quantify the fitness effects of synonymous mutations and their potential impact on adaptation on a fitness landscape, we use a new software based on Bayesian Monte Carlo Markov Chain methods and reestimate selection coefficients of all possible codon mutations across 9 amino-acid positions in Saccharomyces cerevisiae Hsp90 across 6 environments. We quantify the distribution of fitness effects of synonymous mutations and show that it is dominated by many mutations of small or no effect and few mutations of larger effect. We then compare the shape of the codon fitness landscape across amino-acid positions and environments, and quantify how the consideration of synonymous fitness effects changes the evolutionary dynamics on these fitness landscapes. Together these results highlight a possible role of synonymous mutations in adaptation and indicate the potential mis-inference when they are neglected in fitness landscape studies.
... Since Hsp90 is a chaperone involved in the response to thermal stress as well as in the regulation of osmotic stress (Boucher et al. 2014;
Yang et al. 2006)
, we tested which factors can explain variation in codon fitness effects. For that we performed model selection using the leaps package (Lumley 2017). ...
... Overall differences between synonymous mutations are higher than two random draws of the posterior. On average, the effects of synonymous mutations are larger in the 36N environment (Table S4, Fig. S10), where Hsp90 is expected to be more important for organism survival (Boucher et al. 2014;Mishra et al. 2016;
Yang et al. 2006)
. ...
The fitness landscape of the codon space across environments
HEREDITY
<here is a image d2578e0e6e04eed8-f0d241f643793e08> Inês Fragata
Sebastian Matuszewski
Mark A. Schmitz
Claudia Bank
Fitness landscapes map the relationship between genotypes and fitness. However, most fitness landscape studies ignore the genetic architecture imposed by the codon table and thereby neglect the potential role of synonymous mutations. To quantify the fitness effects of synonymous mutations and their potential impact on adaptation on a fitness landscape, we use a new software based on Bayesian Monte Carlo Markov Chain methods and re-estimate selection coefficients of all possible codon mutations across 9 amino acid positions in Saccharomyces cerevisiae Hsp90 across 6 environments. We quantify the distribution of fitness effects of synonymous mutations and show that it is dominated by many mutations of small or no effect and few mutations of larger effect. We then compare the shape of the codon fitness landscape across amino acid positions and environments, and quantify how the consideration of synonymous fitness effects changes the evolutionary dynamics on these fitness landscapes. Together these results highlight a possible role of synonymous mutations in adaptation and indicate the potential mis-inference when they are neglected in fitness landscape studies.
... Hsp82p, which belongs to Hsp90 protein family in S. cerevisiae, is highly conserved among eukaryotes. Experimental evidences showed that the molecular chaperone Hsp82p is required for high osmotic stress response in S. cerevisiae and its mutation results in osmosensitive phenotype
[58]
. Human Hsp90, Hsp90p, is involved in the activation of an important set of cell regulatory proteins, including many whose disregulation drives cancer. ...
... For example, Hsp82p and Hsc82p are two hub proteins in the signaling regulatory pathway. Hsp82p and Hsc82p, which are redundant in function and nearly identical with each other, are essential for osmotic and heat shock stresses
[58,
67]. They are also required for the activation of many key cellular regulatory and signaling proteins like kinases and transcription factors [68]. ...
Integrated cellular network of transcription regulations and protein-protein interactions
BMC SYST BIOL
<here is a image 99fd8ba21bab5b20-39ebbcfbcefce7ab> Yu-Chao Wang
<here is a image e188fbf4effaea1f-82f854abf543493c> B. S. Chen
With the accumulation of increasing omics data, a key goal of systems biology is to construct networks at different cellular levels to investigate cellular machinery of the cell. However, there is currently no satisfactory method to construct an integrated cellular network that combines the gene regulatory network and the signaling regulatory pathway.
In this study, we integrated different kinds of omics data and developed a systematic method to construct the integrated cellular network based on coupling dynamic models and statistical assessments. The proposed method was applied to S. cerevisiae stress responses, elucidating the stress response mechanism of the yeast. From the resulting integrated cellular network under hyperosmotic stress, the highly connected hubs which are functionally relevant to the stress response were identified. Beyond hyperosmotic stress, the integrated network under heat shock and oxidative stress were also constructed and the crosstalks of these networks were analyzed, specifying the significance of some transcription factors to serve as the decision-making devices at the center of the bow-tie structure and the crucial role for rapid adaptation scheme to respond to stress. In addition, the predictive power of the proposed method was also demonstrated.
We successfully construct the integrated cellular network which is validated by literature evidences. The integration of transcription regulations and protein-protein interactions gives more insight into the actual biological network and is more predictive than those without integration. The method is shown to be powerful and flexible and can be used under different conditions and for different species. The coupling dynamic models of the whole integrated cellular network are very useful for theoretical analyses and for further experiments in the fields of network biology and synthetic biology.
... In addition, pkc1 mutant yeast are sensitive to the cell-wall dye CW (Schmitz et al. 2001), which binds and perturbs the architectural integrity of this structure. Since the introduction of additional copies of MID2 and PKC1 affect the growth of ydj1D and hsp82 yeast, it is possible that these mutant strains also have cell-wall defects, as hinted at by previous studies (Lussier et al. 1997;
Yang et al. 2006)
. ...
... First, it was observed that strains containing mutations in KAR2, which encodes an ER Hsp70, have decreased amounts of b1,6-glucan in the cell wall when ER-resident glucanases are disabled (Simons et al. 1998). Second, some but not all hsp82 mutant alleles exhibit sensitivity to growth on medium containing high sorbitol, which was interpreted as a connection between Hsp90 function and the HOG signaling pathway even though other hsp82 mutants were sensitive to CW
(Yang et al. 2006
). On the basis of the growing importance of chaperones in nearly every aspect of cell function and maintenance, we anticipate that additional connections between chaperone function and cell-wall architecture will be uncovered. ...
The Hsp40 Molecular Chaperone Ydj1p, Along With the Protein Kinase C Pathway, Affects Cell-Wall Integrity in the Yeast Saccharomyces cerevisiae
Molecular chaperones, such as Hsp40, regulate cellular processes by aiding in the folding, localization, and activation of multi-protein machines. To identify new targets of chaperone action, we performed a multi-copy suppressor screen for genes that improved the slow-growth defect of yeast lacking the YDJ1 chromosomal locus and expressing a defective Hsp40 chimera. Among the genes identified were MID2, which regulates cell-wall integrity, and PKC1, which encodes protein kinase C and is linked to cell-wall biogenesis. We found that ydj1delta yeast exhibit phenotypes consistent with cell-wall defects and that these phenotypes were improved by Mid2p or Pkc1p overexpression or by overexpression of activated downstream components in the PKC pathway. Yeast containing a thermosensitive allele in the gene encoding Hsp90 also exhibited cell-wall defects, and Mid2p or Pkc1p overexpression improved the growth of these cells at elevated temperatures. To determine the physiological basis for suppression of the ydj1delta growth defect, wild-type and ydj1delta yeast were examined by electron microscopy and we found that Mid2p overexpression thickened the mutant's cell wall. Together, these data provide the first direct link between cytoplasmic chaperone function and cell-wall integrity and suggest that chaperones orchestrate the complex biogenesis of this structure.
... Hsp70, the highly conserved 70kDa family of heat shock proteins aids in the re-folding of misfolded proteins (Verghese et al., 2012;Lotz et al., 2019). Hsp90 proteins specialise in the assembly of macromolecular structures and maturation of proteins such as transcription factors and kinases
(Yang et al., 2006)
. Hsp104 recognises misfolded aggregates of proteins, effectively separating these aggregates and facilitating the correct folding (Verghese et al., 2012). ...
Heterogeneity in brewing yeast populations
During brewing fermentations, yeast cells are subjected to a range of stress factors including ethanol, osmotic and oxidative stress. These have an impact on population health, affecting fermentation consistency, efficiency, and quality of the product. Typically, the tolerance of a yeast culture to stress is assessed via analysis of the entire population generating mean data, assuming each cell has broadly equivalent characteristics. This can mask detail at the cellular level which can only be obtained by analysing individual cells. In this study, a range of yeast strains significant to the brewing industry were investigated for tolerance to a variety of environmental challenges. This was performed using a novel high throughput assay for investigating ‘population heterogeneity’, based on cell cytotoxicity. This revealed that some cells within a population were more tolerant to stresses than others. Furthermore, the dynamics of the stress response differed between strains in both the maximum tolerance and degree of heterogeneity. To identify potential sources of variation within populations, key cell organelles were analysed for variation in structural integrity. Yeast cells were also separated according to replicative age, by sorting based on bud scar material, this allowed for the physiological differences between daughter and aged cells to be investigated. Based on this analysis, we provide evidence to suggest that population variation is an innate inheritable characteristic. Subsequently, cell metabolites upregulated under stressed conditions were identified using metabolomics, this data was used this to conduct targeted single cell gene expression analysis, using a highly heterogenous and a less heterogeneous strain. From this, we were able to conclude that genes upregulated in response to stress were heterogenous in nature, matching the phenotypic data observed previously. We also demonstrate that the cause of phenotypic heterogeneity was likely a result of an accumulation of many heterogeneous gene expression events. Clusters were identified in specific groups of cells, implying the presence of population organisation, likely to be a ‘division of labour’ survival strategy. This data has implications for our understanding of strain specific fermentation limits and the techniques developed here may facilitate screening and prediction of the suitability of yeast strains for specific fermentation types.
... Present research revealed that heat shock protein-82 (HSP82) locus is present on chromosome number 13 and shows up-regulation under the organic and inorganic chemical stresses. These important proteins may involve in mediating adaptive responses to high osmolarity in S. cerevisiae, or for functionality of the targets of osmoadaptive signaling
(Yang et al., 2006)
. ...
In-silico identification and characterization of organic and inorganic chemical stress responding genes in yeast (Saccharomyces cerevisiae)
<here is a image 1937ee36a50dd27a-fa33d150fae83bfe> Muhammad ZEESHAN Younas
<here is a image 741cab5351473008-a5139027d4c474d7> Muhammad Younas Khan Barozai
<here is a image 1937ee36a50dd27a-fa33d150fae83bfe> Farrukh Bashir
<here is a image b4dd391572c85a15-d5bfa03b61c95fb2> Muzaffar Khan
... These compounds protect cells against toxic metabolites such as ethanol and acetaldehyde (Li et al., 2017). Other proteins reported, such as Hsp82p and Hsc82p, from the HSP90 cytoplasmic chaperones family, work in conjunction with trehalose (Tps1p) to withstand this stress (Li et al., 2017;
Yang et al., 2006)
. First, trehalose prevents proteins denaturation, then chaperones difficult their aggregation (Li et al., 2017). ...
Effect of endogenous CO2 overpressure on the yeast “stressome” during the “prise de mousse” of sparkling wine
<here is a image f9cfd2af1902bd38-1fccf03e7ee3033c> Juan Antonio Porras Agüera
<here is a image 8fef26f6fdc20958-f34d819db494919e> Juan J. Román-Camacho
<here is a image 00e93749f653db02-e180e45c8f619309> Jaime Moreno-García
<here is a image 1937ee36a50dd27a-fa33d150fae83bfe> Teresa García-Martínez
Sparkling wines elaboration by the "Champenoise" method involves a second fermentation of a base wine in hermetically sealed bottles and a subsequent aging period. The whole process is known as "prise de mousse". The endogenous CO2 pressure produced during the second fermentation by the yeast Saccharomyces cerevisiae could modify the sub-proteome involved in the response to different stresses, or "stressome", and cell viability thus affecting the wine organoleptic properties. This study focuses on the stressome evolution along the prise de mousse under CO2 overpressure conditions in an industrial S. cerevisiae strain. The results reveal an important effect of endogenous CO2 overpressure on the stress sub-proteome, cell viability and metabolites such as glycerol, reducing sugars and ethanol. Whereas the content of glycerol biosynthesis-related proteins increased in sealed bottle, those involved in the response to toxic metabolites like ROS, ethanol, acetaldehyde and acetic acid, decreased in content. Proteomic profile obtained in this study may be used to select suitable wine yeast strains for sparkling wine elaboration and improve their stress tolerance.
... In the early fermentation stages, the greatest environmental constraint is osmotic stress, which generates a water flow from inside to outside the cytoplasmic membrane. Later, the yeast cell adapts itself through multi-level specific response mechanisms ( Hohmann, 2002;Tapia, Young, Fox, Bertozzi, & Koshlanda, 2015;
Yang et al., 2006;
Zuzuarregui, Monteoliva, Gil, & Del Olmo, 2006). However, the main response of yeast cells to high-osmolarity is the production of glycerol, the best osmotic balance stabilizer ( Hohmann, 2002). ...
Enhanced arginine biosynthesis and lower proteolytic profile as indicators of Saccharomyces cerevisiae stress in stationary phase during fermentation of high sugar grape must: A proteomic evidence
FOOD RES INT
<here is a image 9bd65ccf78c2c5a3-e20d1e42b4f5f260> Olta Noti
<here is a image 47d4605874dd7ab6-7208c296029d3458> Enrico Vaudano
<here is a image df6f7570efea9029-6a1cc13e54ac4987> Maria Gabriella Giuffrida
<here is a image 1937ee36a50dd27a-fa33d150fae83bfe> Enrica Pessione
A strain of Saccharomyces (S) cerevisiae (ISE19), which displayed an initial good adaptation to a high sugar medium with increased acetate and glycerol production but weak overall growth/fermentation performances, was selected during the alcoholic fermentation of Cortese grape must. To obtain insights into the metabolic changes that occur in the must during growth in particular conditions (high ethanol, high residual sugars and low nitrogen availability) leading to a sluggish fermentation or even fermentation arrest, comparative in-gel proteomic analyses were performed on cells grown in media containing 200 g/L and 260 g/L of glucose, respectively, while the YAN (Yeast Assimilable Nitrogen) concentration was maintained as it was. Two post-translationally different arginine synthases (pIs 5.6 and 5.8) were found in higher abundances in the high glucose-grown cells, together with an increased abundance of a glycosyltransferase involved in cell-wall mannans synthesis, and of two regulatory proteins (K7_Bmh1p and K7_Bmh2p) that control membrane transport. In parallel, a proteinase K-like proteolytic enzyme and three other protein fragments (Indolepyruvate decarboxylase 1, Fba1p and Eno1p) were present in lower abundances in the high glucose condition, where oxidative stress and cell cycle involved enzymes were also found to be less abundant. The overall results suggest that in stationary phase stress conditions, leading to stuck fermentation, S. cerevisiae ISE19 decreases cell replication, oxidative stress responses and proteolytic activity, while induces other metabolic modifications that are mainly based on cell-wall renewal, regulation of the solute transport across the cell membrane and de novo arginine synthesis.
... The mutants exhibit defects in cell-wall synthesis during osmotic stress. This phenotype is probably not caused by an impaired HOG pathway, as HOG1 phosphorylation and glycerol accumulation still function in the mutant strains, but by another pathway, designated as the filamentous growth pathway, which regulates osmoadaptation parallel to the HOG pathway [38,
39]
. Imai and Yahara [40] have shown that a decrease of HSP90 expression level to below 30% of normal is accompanied by hypersensitivity of S. cerevisae cells to salt stress. ...
The conserved protective function of heat shock protein expression during osmotic stress
Cells respond to an increased extracellular tonicity initially with a net uptake of inorganic electrolytes to restore ionic balance with the environment and to counteract cell shrinkage. However, high intracellular concentrations of inorganic ions may lead to enhanced accumulation of misfolded or aggregated proteins. To prevent excess protein denaturation, cells induce various osmoprotective mechanisms. One of the most conserved mechanisms is the expression of protein-stabilizing heat shock proteins (HSPs). Elevated cellular levels of HSPs (or their homologues) have been found in numerous organisms during osmotic stress, such as the enterobacterium Escherichia coli, the yeast strain Saccharomyces cerevisiae, the plant Arabidopsis thaliana (Thale cress), the nematode Caenorhabditis elegans, the fish Sparus sarba (silver sea bream) as well as in mammals like mice or rats, illustrating the important osmoprotective function of HSPs in the whole alive nature. The present article provides an overview of HSP function during osmotic stress in various pro-and eukaryotic organisms. The main focus lies on the role of HSPs in mammalian cells and especially in cells of the mammalian kidney, where cells are routinely exposed to high osmolarities in the renal medulla. The abundance of these HSPs in the kidney often correlates with the corticomedullary osmotic gradient, with low amounts in the isoosmotic cortex and highest amounts in the inner medulla, contributing to the remarkable abillity of these cells to deal with the high osmolarities observed in these tissues.
... Based on the observation that substrate binding mutants of ERdj3 were unable to rescue hlj1∆ydj1-151 phenotypes ( Figure 28 and 29), and that hlj1∆ yeast do not exhibit slow growth and cell wall phenotypes (data not shown) but ydj1∆ do 126,355 , I surmise that cell wall function and robust growth at elevated temperature are linked to the ability of Ydj1 to bind to specific substrates. Formally, the cell wall phenotypes may also arise from the ability of Ydj1 to partner with Hsp82, the cytosolic Hsp90 which plays a role in high osmotic stress response in yeast 355,370,
371
and functions in conjunction with Ydj1 in the folding and maturation of certain client proteins 368,372,373 . The cell wall phenotype may additionally arise from altered association with Sse1, the cytosolic Hsp110 370 , which has previously been shown to genetically interact with 261 , it appears that for many cellular processes, the JDP-stimulated high affinity binding of partner Hsp70s to substrates is sufficient. ...
Genetic and biochemical analyses of Hsp70-Hsp40 interactions in Saccharomyces cerevisiae provide insights into specificity and mechanisms of regulation
<here is a image 132d0d7ab8eba599-1d09475bc1436aee> Shruthi Vembar
Heat shock proteins of 70kDa (Hsp70s) and their J domain-containing Hsp40 cofactors are conserved chaperone pairs that facilitate diverse cellular processes. One essential Hsp70 in the endoplasmic reticulum (ER) lumen, BiP (Kar2p in yeast), participates in polypeptide translocation into the ER, protein folding, and ER-associated degradation (ERAD). Like other Hsp70s, BiP contains an N-terminal ATPase domain, followed by a substrate binding domain and a C-terminal lid domain. To better define how substrate affinity and Hsp40 interaction affect BiP function, I constructed and characterized a mutation, R217A, in the putative J domain-interacting surface of yeast BiP. The mutation compromises ATPase stimulation by Sec63p, an Hsp40 required for translocation, but stimulation by Jem1p, an Hsp40 required for ERAD, is robust. In accordance with these data, yeast expressing R217A BiP exhibit translocation defects, but no ERAD defects, and a genetic interaction study using this mutant yielded data consistent with defects in translocation. In contrast, mutations in the substrate binding domain that either disrupt an ionic contact with the lid or remove this domain are deficient for peptide-stimulated ATPase activity. Expression of these mutants in yeast results in varying translocation and ERAD defects. Taken together, these data indicate that BiP can distinguish between its ER-resident cochaperones, and that optimal substrate binding is a key determinant of BiP function.Next, I tested the hypothesis that the functional specificity of Hsp70s is regulated by cognate Hsp40s. If this is true, one might expect divergent Hsp70-Hsp40 pairs to be unable to function in vivo. However, I discovered that a mammalian ER-lumenal Hsp40, ERdj3, when directed to the yeast cytosol, was able to rescue the temperature-sensitive growth phenotype of yeast containing mutant alleles in two cytosolic Hsp40s, HLJ1 and YDJ1. Moreover, ERdj3 activated the ATPase activity of Ssa1p, the yeast cytosolic Hsp70 that partners with Hlj1p and Ydj1p. Intriguingly, ERdj3 mutants that were compromised for substrate binding were unable to rescue the hlj1ydj1 growth defect, even though they stimulated Ssa1p ATPase activity. These data suggest that the substrate binding properties of certain Hsp40s—not simply the formation of unique Hsp70-Hsp40 pairs—is critical to specify in vivo function.
... Both KCl and sorbitol activate the MAPK-regulated stress response pathway, which has been shown to mediate resistance to azoles in yeast (reviewed in [21]). Inhibition of the heat shock protein Hsp90, a molecular chaperone and downstream target of the MAPK pathway has been shown to enhance sensitivity to fluconazole in both S. cerevisiae and C. albicans [21,49,
50]
. KCl and sorbitol may thus influence sensitivity to azoles via activation of the MAPK-regulated stress response pathway. ...
Suppression of Sensitivity to Drugs and Antibiotics by High External Cation Concentrations in Fission Yeast
Potassium ion homeostasis plays an important role in regulating membrane potential and therefore resistance to cations, antibiotics and chemotherapeutic agents in Schizosaccharomyces pombe and other yeasts. However, the precise relationship between drug resistance in S. pombe and external potassium concentrations (particularly in its natural habitats) remains unclear. S. pombe can tolerate a wide range of external potassium concentrations which in turn affect plasma membrane polarization. We thus hypothesized that high external potassium concentrations suppress the sensitivity of this yeast to various drugs.
We have investigated the effect of external KCl concentrations on the sensitivity of S. pombe cells to a wide range of antibiotics, antimicrobial agents and chemotherapeutic drugs. We employed survival assays, immunoblotting and microscopy for these studies.
We demonstrate that KCl, and to a lesser extent NaCl and RbCl can suppress the sensitivity of S. pombe to a wide range of antibiotics. Ammonium chloride and potassium hydrogen sulphate also suppressed drug sensitivity. This effect appears to depend in part on changes to membrane polarization and membrane transport proteins. Interestingly, we have found little relationship between the suppressive effect of KCl on sensitivity and the structure, polarity or solubility of the various compounds investigated.
High concentrations of external potassium and other cations suppress sensitivity to a wide range of drugs in S. pombe. Potassium-rich environments may thus provide S. pombe a competitive advantage in nature. Modulating potassium ion homeostasis may sensitize pathogenic fungi to antifungal agents.
... Interestingly, Znf1 was recently reported in a high-throughput ChIP-chip and gene knockout study of transcription factors and it appears to co-operate in the network of regulators that mediate stress tolerance (Yang et al., 2010). Despite it remains unknown whether regulation of some osmotic stress genes (Fig. 8) is directly governed by Znf1 or indirectly via other regulatory proteins of stress responsive pathways (Rep et al., 1999a;
Yang et al., 2006)
. It is clear that Znf1 is another regulator that mediates transcriptional activation in response to osmotic stress and provides a connection to the HOG pathway. ...
Zinc cluster protein Znf1, a novel transcription factor of non-fermentative metabolism in Saccharomyces cerevisiae
Pitchya Tangsombatvichit
<here is a image 9dcd8ee1ea295240-f22dedb0d03502e8> Marta Semkiv
Andriy A. Sibirny
<here is a image c60f3cda8e309d0f-0ea9c2e1bb482f08> Nitnipa Soontorngun
The ability to rapidly respond to nutrient changes is a fundamental requirement for cell survival. Here, we show that the zinc cluster regulator Znf1 responds to altered nutrient signals following glucose starvation through the direct control of genes involved in non-fermentative metabolism, including those belonged to the central pathways of gluconeogenesis (PCK1, FBP1 and MDH2), glyoxylate shunt (MLS1 and ICL1) and the tricarboxylic acid cycle (ACO1), which is demonstrated by Znf1-binding enrichment at these promoters during the glucose-ethanol shift. Additionally, reduced Pck1 and Fbp1 enzymatic activities correlate well with the data obtained from gene transcription analysis. Cells deleted for ZNF1 also display defective mitochondrial morphology with unclear structures of the inner membrane cristae when grown in ethanol, in agreement with the substantial reduction in the ATP content, suggesting for roles of Znf1 in maintaining mitochondrial morphology and function. Furthermore, Znf1 also plays a role in tolerance to pH and osmotic stress, especially during the oxidative metabolism. Taken together, our results clearly suggest that Znf1 is a critical transcriptional regulator for stress adaptation during non-fermentative growth with some partial overlapping targets with previously reported regulators in Saccharomyces cerevisiae.
© FEMS 2015. All rights reserved. For permissions, please e-mail: [email protected].
... Present research revealed that heat shock protein-82 (HSP82) locus is present on chromosome number 13 and shows up-regulation under the organic and inorganic chemical stresses. These important proteins may involve in mediating adaptive responses to high osmolarity in S. cerevisiae, or for functionality of the targets of osmoadaptive signaling
(Yang et al., 2006)
. ...
In-silico identification and characterization of organic and inorganic chemical stress responding genes in yeast (Saccharomyces cerevisiae)
<here is a image 741cab5351473008-a5139027d4c474d7> Muhammad Younas Khan Barozai
<here is a image 1937ee36a50dd27a-fa33d150fae83bfe> Farrukh Bashir
<here is a image 1937ee36a50dd27a-fa33d150fae83bfe> Shafia Muzaffar
<here is a image b4dd391572c85a15-d5bfa03b61c95fb2> Muzaffar Khan
... Hsp82 is upregulated up to 20 times under heat stress [12]. The expression of Heat Shock Protein 90 is upregulated under diverse stressful situations as oxidative stress [13], osmotic stress
[14]
, elevated acetic acid concentrations [15] or especially at elevated temperatures [12]. Under these conditions, many proteins are prone to aggregation and subsequent degradation if there is no rescue system. ...
NMR Methyl Chemical Shift Assignments of the Hsp90 Chaperone
<here is a image a0b100e972729157-469dd62a71374054> Maximilian Brackmann
Protein folding and maintenance of the cellular function of proteins are central tasks of
chaperones. Although some chaperones such as Heat Shock Protein 90 (Hsp90) are essential in
eukaryotes and in some prokaryotes, their exact mechanism remains not well understood. For a
better understanding of the mode of function of Hsp90 a better insight into the dynamics of the
structure and the binding of client proteins and cochaperones is necessary. NMR-spectroscopy
provides a high potential to address these questions as it is suited to discover binding sites. In
this work, NMR spectra of methyl groups of two out of three individual domains were partially
assigned, which serves as a base for binding studies and further analysis.
... Three additional treatments consisted of the addition of 0.5 M sodium chloride (NaCl) at each temperature (hereafter referred to as the 25S, 30S, and 36S treatments). Elevated NaCl does not induce increased Hsp90 levels (Gasch et al. 2000;Causton et al. 2001;Berry and Gasch 2008), although its basal activity is required for activation of the high-osmolarity glycerol pathway that provides for efficient growth in elevated salinity environments (Hohmann 2002;
Yang et al. 2006
Yang et al. , 2007Hawle et al. 2007). Based on these observations and the absolute growth rates of wild-type yeast in the six environments (Table 1), we state the following (cf. ...
A Bayesian MCMC Approach To Assess the Complete Distribution of Fitness Effects of New Mutations: Uncovering the Potential for Adaptive Walks in Challenging Environments.
The role of adaptation in the evolutionary process has been contentious for decades. At the heart of the century-old debate between neutralists and selectionists lies the distribution of fitness effects (DFE) - that is, the selective effect of all mutations. Attempts to describe the DFE have been varied, occupying theoreticians and experimentalists alike. New high-throughput techniques stand to make important contributions to empirical efforts to characterize the DFE, but the usefulness of such approaches depends on the availability of robust statistical methods for their interpretation. We here present and discuss a Bayesian MCMC approach to estimate fitness from deep sequencing data, and use it to assess the DFE for the same 560 point mutations in a coding region of Hsp90 in Saccharomyces cerevisiae across six different environmental conditions. Using these estimates, we compare the differences in the DFEs resulting from mutations covering 1, 2 and 3 nucleotide steps from the wild type - showing that multiple-step mutations harbor more potential for adaptation in challenging environments, but also tend to be more deleterious in the standard environment. All observations are discussed in the light of expectations arising from Fisher's geometric model.
... DnaJ-domain proteins are molecular chaperones that aid protein folding, prevent aggregation and repair damaged proteins following cellular stress [62]. They are members of the heat shock protein (Hsp) family, which have been shown to play important roles in the response to numerous stress conditions including osmotic stress and also can act as cochaperones by stimulating the activity of other chaperones such as DnaK [63][64]
[65]
. TM2 domain proteins are composed of a pair of alpha helices connected by a short linker. The function of this domain is unknown; however it occurs in a wide range of protein contexts. ...
Functional Environmental Screening of a Metagenomic Library Identifies stlA; A Unique Salt Tolerance Locus from the Human Gut Microbiome
Functional environmental screening of metagenomic libraries is a powerful means to identify and assign function to novel genes and their encoded proteins without any prior sequence knowledge. In the current study we describe the identification and subsequent analysis of a salt-tolerant clone from a human gut metagenomic library. Following transposon mutagenesis we identified an unknown gene (stlA, for "salt tolerance locus A") with no current known homologues in the databases. Subsequent cloning and expression in Escherichia coli MKH13 revealed that stlA confers a salt tolerance phenotype in its surrogate host. Furthermore, a detailed in silico analysis was also conducted to gain additional information on the properties of the encoded StlA protein. The stlA gene is rare when searched against human metagenome datasets such as MetaHit and the Human Microbiome Project and represents a novel and unique salt tolerance determinant which appears to be found exclusively in the human gut environment.
... For example, elevated salinity (0.7 or 1 M sodium chloride ) does not cause a statistically significant change in Hsp90 mRNA levels in yeast over either short or long time periods (Gasch et al. 2000; Causton et al. 2001; Berry and Gasch 2008). Although Hsp90 is not upregulated in response to elevated salinity, its basal function is required for robust growth under hyperosmotic conditions (
Yang et al. 2006
). Indeed Hsp90 and its co-chaperone Cdc37 are both required for activation of the high osmolarity glycerol pathway (Hawle et al. 2007; Yang et al. 2007) that yeast require for growth under conditions of elevated salinity (Hohmann 2002). ...
Shifting Fitness Landscapes In Response To Altered Environments
The role of adaptation in molecular evolution has been contentious for decades. Here, we shed light on the adaptive potential in Saccharomyces cerevisiae by presenting systematic fitness measurements for all possible point mutations in a region of Hsp90 under four environmental conditions. Under elevated salinity, we observe numerous beneficial mutations with growth advantages up to 7% relative to the wild type. All of these beneficial mutations were observed to be associated with high costs of adaptation. We thus demonstrate that an essential protein can harbor adaptive potential upon an environmental challenge, and report a remarkable fit of the data to a version of Fisher's geometric model that focuses on the fitness trade-offs between mutations in different environments.
... Importantly, the different mutant forms of Hsp82p that have been studied have different genetic interactions with the cochaperone proteins. Genetic interactions have been identified between some of these Hsp82p mutants and certain co-chaperones but these interactions have not been extensively characterized [32,35,
36]
. Of the Hsp82p mutants identified that confer ts phenotypes to yeast, only Hsp82p G170D is thought to be thermolabile [34] and biochemical studies have confirmed that several of these Hsp82p mutants do not lose activity at elevated temperatures [22,37]. ...
The Co-Chaperone Hch1 Regulates Hsp90 Function Differently than Its Homologue Aha1 and Confers Sensitivity to Yeast to the Hsp90 Inhibitor NVP-AUY922
<here is a image d69e900cecafd1e6-9ee6e9d9d19300a4> Heather Armstrong
<here is a image d2e49bcbad02e7b9-a197aa403a86d8a7> Annemarie Wolmarans
Rebecca Mercier
<here is a image 1937ee36a50dd27a-fa33d150fae83bfe> Paul LaPointe
Hsp90 is a dimeric ATPase responsible for the activation or maturation of a specific set of substrate proteins termed 'clients'. This molecular chaperone acts in the context of a structurally dynamic and highly regulated cycle involving ATP, co-chaperone proteins and clients. Co-chaperone proteins regulate conformational transitions that may be impaired in mutant forms of Hsp90. We report here that the in vivo impairment of commonly studied Hsp90 variants harbouring the G313S or A587T mutation are exacerbated by the co-chaperone Hch1p. Deletion of HCH1, but not AHA1, mitigates the temperature sensitive phenotype and high sensitivity to Hsp90 inhibitor drugs observed in Saccharomyces cerevisiae that express either of these two Hsp90 variants. Moreover, the deletion of HCH1 results in high resistance to Hsp90 inhibitors in yeast that express wildtype Hsp90. Conversely, the overexpression of Hch1p greatly increases sensitivity to Hsp90 inhibition in yeast expressing wildtype Hsp90. We conclude that despite the similarity between these two co-chaperones, Hch1p and Aha1p regulate Hsp90 function in distinct ways and likely independent of their roles as ATPase stimulators. We further conclude that Hch1p plays a critical role in regulating Hsp90 inhibitor drug sensitivity in yeast.
... The client proteins, Hsp90, Hsp70 and the regulatory proteins assemble into a large multichaperone machine to regulate the client protein function and turnover [14,19]. In Saccharomyces cerevisiae, Hsp90 is found to be required for the high osmotic stress response and regulates a novel signaling pathway via the co-chaperone Cdc37p parallel to the HOG pathway
[20,
21]. Considering that Hsp70-and Hsp90-like proteins were upregulated in Dunaliella under halophilic conditions [11] and the importance of Hsp90 in the stress response of eukaryotic cells, it is possible that Dunaliella Hsp90 (DsHsp90) is involved in the halotolerance of Dunaliella. ...
DsHsp90 Is Involved in the Early Response of Dunaliella salina to Environmental Stress
Heat shock protein 90 (Hsp90) is a molecular chaperone highly conserved across the species from prokaryotes to eukaryotes. Hsp90 is essential for cell viability under all growth conditions and is proposed to act as a hub of the signaling network and protein homeostasis of the eukaryotic cells. By interacting with various client proteins, Hsp90 is involved in diverse physiological processes such as signal transduction, cell mobility, heat shock response and osmotic stress response. In this research, we cloned the dshsp90 gene encoding a polypeptide composed of 696 amino acids from the halotolerant unicellular green algae Dunaliella salina. Sequence alignment indicated that DsHsp90 belonged to the cytosolic Hsp90A family. Further biophysical and biochemical studies of the recombinant protein revealed that DsHsp90 possessed ATPase activity and existed as a dimer with similar percentages of secondary structures to those well-studied Hsp90As. Analysis of the nucleotide sequence of the cloned genomic DNA fragment indicated that dshsp90 contained 21 exons interrupted by 20 introns, which is much more complicated than the other plant hsp90 genes. The promoter region of dshsp90 contained putative cis-acting stress responsive elements and binding sites of transcriptional factors that respond to heat shock and salt stress. Further experimental research confirmed that dshsp90 was upregulated quickly by heat and salt shock in the D. salina cells. These findings suggested that dshsp90 might serve as a component of the early response system of the D. salina cells against environmental stresses.
... This has three probable causes.First, Melamed et al. (2008)used high osmotic stress (1 M NaCl). High or severe hyperosmotic stress is known to activate other signal transduction chains beside the HOG pathway, and functions outside of the HOG pathway are required for survival under such conditions (
Yang et al., 2006
). Second, activation of stress responses is slower and less distinct under high osmostress than under moderate hyperosmotic shock as in our work (Van Wuytswinkel et al., 2000). ...
ADP Ribosylation Factors 1 and 4 and Group VIA Phospholipase A2 Regulate Morphology and Intraorganellar Traffic in the Endoplasmic Reticulum–Golgi Intermediate Compartment
Organelle morphology of the endomembrane system is critical for optimal organelle function. ADP ribosylation factors (Arfs), a family of small GTPases, are required for maintaining the structure of the Golgi and endosomes. What determines the discontinuous nature of the endoplasmic reticulum (ER)-Golgi intermediate compartment (ERGIC) as tubulovesicular clusters is unknown. In search of morphological determinants for the ERGIC, we found that a double knockdown of Arf1+Arf4 induced dynamic ERGIC tubules that connect ERGIC clusters, indicating that the tubules mediated lateral intraERGIC traffic. Tubule formation was inhibited by an antagonist of group VI calcium-independent phospholipase A₂ (PLA2G6) and by silencing the A isoform of PLA2G6 (PLA2G6-A). Arf1+Arf4 depletion altered the expression of PLA2G6-A splice variants and relocalized PLA2G6-A from the cytosol to ERGIC clusters and tubules, suggesting that the enzyme became locally active. We show that changes in Arf1 can modulate the activity of PLA2G6-A. We propose that a concerted action of Arf1, Arf4, and PLA2G6-A controls the architecture of the ERGIC in a way that is predicted to impact the rate and possibly the destination of cargos. Our findings have identified key components in the molecular mechanism underlying the regulation of tubules in the ERGIC and uncover tubular carriers as tightly controlled machinery.
... This situation poses the question of the specificity of Sho1 sensor in signaling different stimuli, with the additional complication that elements of the SVG cascade are in common with the pheromone cascade (Schwartz & Madhani, 2004; Seet & Pawson, 2004). In parallel to the Sln1 and Sho1 branches, the osmotic response seems to have additional signaling pathways, which may lead or not lead to Hog1 phosphorylation (Van Wuytswinkel et al., 2000;
Yang et al., 2006
). Besides the regular top-down signaling, also lateral inputs to or from other pathways might play a role in response to certain stimuli. ...
... In mammalian cells, Hsp90 is an important component of the transcriptional arm of the unfolded protein response (UPR) and plays important roles in the cellular response to cytoplasmic stresses (Marcu et al. 2002). Hsp90 could protect mammal cells from 3-hydroxykynurenine (3HK)induced oxidative stress by reducing reactive oxygen species (ROS) levels (Lee et al. 2005), and be required for yeast cells to adapt to high osmotic stress
(Yang et al. 2006)
. ...
(66)
| https://www.researchgate.net/publication/7290480_The_molecular_chaperone_Hsp90_is_required_for_high_osmotic_stress_response_in_Saccharomyces_cerevisiae |
Shadrach's Ex Battery and Rescued chickens thread. | Page 1479 | BackYard Chickens - Learn How to Raise Chickens
Oh my, this sounds like a great Tom Waits song. Or a Charles Bukowski poem. Goes with Henry's nicotine stained feathers ... Tom Waits is one of my...
Shadrach's Ex Battery and Rescued chickens thread.
TropicalChickies said:
BDutch said:
Oh boy my chickens were nervous this morning. The chicken door didn’t open up automatically. 6 adults and 9 chicks is toooooo much in such a small coop ( 2,5 m2 floor space + 2 laying nests + 2 small platforms/roost areas. After work I tried to fix the problem. My Chicken Guard finally broke down, Thought the batteries were empty last evening. The door closed only half and the red light for trouble was on. Changed the batteries. Closed the pop door. But the door didn’t open again this morning. Did another calibration. But the system didn’t work again. After the calibration the door wont open as it sais in the manual. While I worked on the chicken guard I let the chicks out on the grass. 5 of them managed to escape. The rabbit fences are easy peasy to jump over now. View attachment 3539027 MDH: “A giant chicken in the coop” in the coop trying to fix the chicken guard. View attachment 3539028 The results of no mow may is too nice to mow now it’s June. The chicks in the background (photo taken yesterday).
Warm with a bit of morning rain. Had domestic stuff to do today and only managed two hours at the allotments. What's more I was busy and then chatting to one of my favourite plot holders and forgot to take pictures until the chickens were heading for home.
I've got a friend coming to stay for a couple of days and my spare bed is out on loan. It's coming back tomorrow but at an unspecified time in the afternoon. Hopefully it will be early and my friend and I can go and talk chicken at the allotments with time to spare. The bed is particulary important because I'm the one going to be sleeping on it. My friend is disabled so he gets my bed. He's a chicken keeper with two tribes.
Stuff is still growing. The recent rain has made a difference.
I'll just leave this here...
fuzzi said:
I'll just leave this here... View attachment 3539632
Adorable! Are they Sussex?
@Shadrach
i hope you enjoy visiting with your friend!
Iluveggers said:
Adorable! Are they Sussex? @Shadrach i hope you enjoy visiting with your friend!
Speckled Sussex, bantams.
Rahab is on the left, Martha is on the right.
Shadrach said:
How long have you had the chicken guard for?
I bought it 7.5 years ago.
Have been reading a bit more. Vaguely remembering something about a reset.
I found some more info on the internet why it’s possibly not opening again. Seems that the older chickens guard from before 2017 work a bit different . I’ll try if I can make it work once more today (unscrewing, checking cord, reset) and keep you updated.
fuzzi said:
Speckled Sussex, bantams. Rahab is on the left, Martha is on the right.
I love the colouring.
Thats one of the reasons why I bought bantam Red Speckled Sussex hatching eggs.
This is what the bantam Sussex look like when they are young.
The person I bough the eggs from suspects that the first photo is of a cockerel wit a perfect comb. The second a pullet.
Shadrach said:
The term coop almost always needs some clarification. I've always built what I describe as coops. The recycled plastic construction I now have is a coop. Some other people have constructions that could be described as aviaries. Some people have buildings that may be better described as sheds, or outhouses. When I write about coops I have a quite specific construction in mind. Royalchick for example has what I would describe as an aviary. You have an outhouse. It's a definition problem. Perhaps the easiest resolution to the inaccuracies of language when it comes to coops is to take the chicken bit out of the description and consider what it is one has left.
Interesting perspective. You're right that we are probably comparing things that shouldn't be. On the other hand one of the first very good advice almost always given on BYC to people who ask about coops, is to take into account their climate and local setting before deciding what will be the right coop for them.
The problem I have with being an idealist is everything falls short, including myself. There is no acceptable way of turning back, Pol Pot had a try and despite what some may consider his initial good intentions, he's remembered by history as a bad thing.
TropicalChickies said:
Hi @ManueB , thanks for the mention... I just want to say I don't mean to come off as all 'woke" and "virtuous" over here on my off grid mud house. There's nothing worse than sanctimonious holier-than-thou posturing on the internet. Our lifestyle isn't perfect. We have a jeep, for example. Living out here without a vehicle would be more difficult than I can handle right now. I use the internet. In many ways, I have to in order to keep the farm going by having visitors and programs to supplement our income. But I also use it recreationally, and thank goodness I'm limited by the sometimes poor satellite connection. And after living like this, in relatively splendid isolation for seven years, I'm not sure I even could go back to urban or "normal" life, not without some serious psychological problems... But, yes, the way my partner and I live is very different. I'm not optimistic that we can really change the destructive trajectory humans are on, but perhaps we can leave a roadmap for future generations to say, "ah now, these people were on to something..." I don't think people in rich countries will necessarily be completely sheltered from climate crisis. But they can certainly act like they are "in their bubble" for a longer time. Just the other day I saw a photo of a suburban house renovation underway in California USA with an eerie orange sky in the background from an approaching wildfire. I mean, who does this? Comfortably middle class people who don't think this crisis will touch them. For people in Southeast Asia and Central America, however, it has already begun in earnest. Over a billion people have already been displaced by rising ocean levels, heat, and drought. Mexico has its own border crisis as people from Nicaragua, Honduras and Guatemala flee their scorched farmlands. Cities in SE Asia now have new ghettos of refugees whose homes are underwater. These stories don't often make the news, but they are happening. Plus, to be honest, I have reasons for living like I do, and not all of them are altruistic. I like animals, trees, and books more than people. enjoy the satisfaction of building structures with dirt, pulling food put of the ground. Hand washing clothes, not so much. But it's part of the package. And I don't overestimate how much individual actions like mine can really impact the situation. The nefarious actors, the big banks, the multilateral institutions, the mega corporations, the one percent -- they are a much bigger problem than your plastic freezer bags or my Jeep. We need a real uprising, a revolution, and the people willing to go to the front lines.
I apologize if I sounded ironic or judgemental, english isn't my language and I guess what I write doesn't sound exactly like what I think. I sincerely admire what both of you are doing in your different ways, and I believe if more of us acted in accordance to our beliefs like you both do, things could get better. I'm just feeling totally despaired and angry and also guilty as to why our specie has such a tendency to do everything to destroy the world we live in. And I don't want to look at the splinter in my neighbor's eye, ignoring the log in mine
.
BDutch said:
Oh boy my chickens were nervous this morning. The chicken door didn’t open up automatically. 6 adults and 9 chicks is toooooo much in such a small coop ( 2,5 m2 floor space + 2 laying nests + 2 small platforms/roost areas. After work I tried to fix the problem. My Chicken Guard finally broke down, Thought the batteries were empty last evening. The door closed only half and the red light for trouble was on. Changed the batteries. Closed the pop door. But the door didn’t open again this morning. Did another calibration. But the system didn’t work again. After the calibration the door wont open as it sais in the manual. While I worked on the chicken guard I let the chicks out on the grass. 5 of them managed to escape. The rabbit fences are easy peasy to jump over now. View attachment 3539027 MDH: “A giant chicken in the coop” in the coop trying to fix the chicken guard. View attachment 3539028 The results of no mow may is too nice to mow now it’s June. The chicks in the background (photo taken yesterday).
What a day, sounds like you all had quite the adventure ! I'm sure the chicks enjoyed it if not the adults.
Warm with a bit of morning rain. Had domestic stuff to do today and only managed two hours at the allotments. What's more I was busy and then chatting to one of my favourite plot holders and forgot to take pictures until the chickens were heading for home. I've got a friend coming to stay for a couple of days and my spare bed is out on loan. It's coming back tomorrow but at an unspecified time in the afternoon. Hopefully it will be early and my friend and I can go and talk chicken at the allotments with time to spare. The bed is particulary important because I'm the one going to be sleeping on it. My friend is disabled so he gets my bed. He's a chicken keeper with two tribes. View attachment 3539420 View attachment 3539419 View attachment 3539421 View attachment 3539417 View attachment 3539414 Stuff is still growing. The recent rain has made a difference. View attachment 3539415
Well, let's hope the bed makes it on time, by whatever means of transportation it intends to reach your place
. Nice that you have some visit of a chicken keeper friend. Maybe you'll tell us more about it.
Am I seeing an attempt at growing a few tomatoes ?
Preening mamma tax
Mr Grumpy.
Shadrach said:
… I've got a friend coming to stay for a couple of days and my spare bed is out on loan. It's coming back tomorrow but at an unspecified time in the afternoon. Hopefully it will be early and my friend and I can go and talk chicken at the allotments with time to spare. The bed is particulary important because I'm the one going to be sleeping on it. My friend is disabled so he gets my bed. He's a chicken keeper with two tribes. View attachment 3539420 View attachment 3539419 View attachment 3539421 View attachment 3539417 View attachment 3539414 Stuff is still growing. The recent rain has made a difference. View attachment 3539415
Enjoy this day with your friend. Maybe he can make some nice pictures of you holding Henri and your other tribe members.
After reading about boiling water for tea: I have an electric water kettle that lasts for at least 10 years now. Because it has a flat bottom , it can cook one cup of water. It’s 1,7 liter, switches of automatically. Brand Tefal (imported stuff and labeled as if it is Dutch). I bought it in a housewares shop.
Also use it to boil water for (pre)cooking because we have many solar panels and its better (cheaper) to use that energy, than it is to use fossil gas.
Furthermore about A-mazon: I never buy from A.mazon because the company is too big, the owner spills his money on fossil fuels to go halfway to the moon and labourers are underpaid. My husband did buy something from Bezos once because it was so cheap compared to other sellers - but it had no warranty and it broke down within 2 years. … fourth reason. It sells cheap crap.
| https://www.backyardchickens.com/threads/shadrachs-ex-battery-and-rescued-chickens-thread.1502267/page-1479 |
Portrait of Dr. P.J.H. Cuypers (1827-1921) [Thérèse Schwartze] | Sartle - Rogue Art History
Painting by Thérèse Schwartze
Artworks
Portrait of Dr. P.J.H. Cuypers
Thérèse Schwartze
Rijksmuseum
Museumstraat 1Amsterdam,Netherlands
Arty Fact
The Rijksmuseumgives a 33-year window for the creation of this work: 1885-1918, perhaps getting all the whiskers in his beard took a long time.
Mr. Cuypers was the architect of the Rijksmuseum, where this work is now housed.
The sitter's nephew and protegé, Eduard Cuypers, was commissioned by Schwartze to build a studio.
More about Portrait of Dr. P.J.H. Cuypers
Type Painting Year 1885 View all
Medium Canvas, Oil paint Genre Portraiture View all
Catalog Number SK-A-4948 Collection Rijksmuseum View all
Credit Line Gift of Cuypers-archief View all
Considering the prominence of Thérèse Schwartze, the wealthiest artist in turn-of-the-century Amsterdam, and the fame of her sitter, who has both a street and a museum named for him, it's quite odd that there is so little published literature about the Portrait of Pierre J.H. Cuypers .
The owners of the work, the sprawling, Gothic Rijksmuseum inAmsterdam, situate their collection in buildings designed by Cuypers. They received the work as a donation from the Cuypers archives in 1919. Art historians consider the precise dating of works to be thebread and butterof the profession, like speech-giving to a mayor or carrying plastic bags to a dog walker. And yet the Rijksmuseum offers a window which covers most of Schwartze's professional career, up until her final year of life, for the dating of this painting: 1885-1918. In fact, the research of Cora Hollema, the reigning dean of Schwartze studies, gives only seven works as "autograph," or painted in the artist's own hand without assistance, prior to 1885. The artist commissioned the sitter's nephew and protegé, Eduard Cuypers, to build her new studio when she moved out of her late dad's workshop in the attic of the Schwartze home.
Born in Roermond in 1827 to Joannes Hubertus Cuypers and Maria Joanna Bex, Pierre J.H. Cuypers was one of the most famous architects in Dutch history, building dozens of churches and other important landmarks. If you want to sound sufficiently Dutch, you'd pronounce his name somewhat like "kye-purzsh," with that distinctive buzzing "zzh" sound unique to the Dutch "s." The Netherlands was still recovering from its colonization by the Spanish Habsburg empire, which had ended just over a century before the architect's birth. The state religion of the Spanish Netherlands was Roman Catholicism, and the vibe in the Netherlands was tense between Catholics and Protestants. Maybe almost as tense as the vibe betweenRepublicans and Democratsin the 2016 U.S. Presidential election. For instance, just before the Habsburgs took over, the family of the artist John de Critzhad fled the Netherlands for Protestant England, where de Critz became a spy for the Protestant cause. Cuypers made no apologies for his Catholic background, which made him many adversaries who shared the "Protestant and liberal view." For them, Cuypers' Gothic, Romanesque architecture threatened to bring the Netherlands "back to the dark Middle Ages and the infinitehedonismof Rome." Bas Kromhout uses the Dutch term vleespottento describe the Protestant view of the sexual attitudes of the Romans in this sentence, which literally means "fleshpots." For the Dutch Roman Catholics, however, Kromhout writes, "Cuypers was almost a saint, whose buildings radiated the self-confidence of cultural revival."
Sources
Sources
Hollema, Cora. "Thérèse Schwartze, 19th Century Amsterdam Painter." YouTube video, Dec. 20, 2015, 37:02, https://youtu.be/61lqsJ2MzEA .
Hollema, Cora, and Pieternel Kouwenhoven. Thérèse Schwartze (1851-1918). Een vorstelijk portrettiste. Zutphen: Walberg, 1998.
Jensen, Lotte Eilskov, Joseph Theodoor Leerssen, and Marita Mathijsen. Free Access to the Past: Romanticism, Cultural Heritage and the Nation. Leiden: Brill, 2010.
Kromhout, Bas. "Pierre Cuypers." Historische Nieuwsblad, https://www.historischnieuwsblad.nl/pierre-cuypers/ .
"Rijksmuseum Amsterdam." Werkgroep Pierre Cuypers, Roermond, https://www.cuypersroermond.nl/rijksmuseum.html .
"Wie was Pierre Cuypers?" Cuypershuis, https://www.cuypershuisroermond.nl/nl/ontdek/cuypers-en-het-cuypershuis… .
| https://www.sartle.com/artwork/portrait-of-dr.-p.j.h.-cuypers-1827-1921-therese-schwartze |
EC:1.2.1.4 - FACTA Search
Gene/Protein
Disease
Symptom
Drug
Enzyme
Compound
Pivot Concepts:
Target Concepts:
Query: EC:1.2.1.4 (
aldehyde dehydrogenase
)
Recently, the principles of density gradient cell separation have been transferred to the marrow fractionation, and the Ficoll technique by using a COBE 2991 blood cell processor has been developed and widely employed as well. This method is particularly useful in view of a chemical antineoplastic purging intended for autologous marrow transplantation. Forty marrows, which derived from patients suffering with leukemia and lymphoma, were fractionated with Ficoll on a COBE machine and in vitro purged with Mafosfamide at a dose of 50 micrograms/ml/1 x 10e7 MN cells. The density gradient separation enables to reduce the initial volume to 10%, the contaminating RBC to less than 1%, the total nucleated cells to 25% (greater than 80% of MNC) sparing about 80% of the CFU-GM. After purging, the surviving hemopoietic progenitor cells were 2.5%. The clinical effects of the fractionated purged cells were studied in 11 autotransplanted patients and compared with 14 transplants performed with untreated buffy-coat marrow derived cells. Ficoll cells produced less adverse effects at the time of reinfusion, while, as expected, the time of hematopoietic recovery was delayed in these patients (mafosfamide treated cells). These results confirm the usefulness of the gradient density cell separation to reduce the side effects of the DMSO and to make reliable the Mafosfamide purging manoeuvre, preventing the interference of contaminating RBC aldehyde dehydrogenase .
...
PMID:Density gradient separation of hematopoietic stem cells in autologous bone marrow transplantation. 167 10
Resistance to multiple chemotherapeutic agents is a common clinical problem in the treatment of cancer: such resistance may occur in primary therapy or be acquired during treatment. The most commonly used antineoplastic agents in the treatment of disseminated breast cancer are adriamycin, methotrexate and cyclophosphamide. Cell lines selected for resistance to adriamycin often develop cross-resistance to structurally dissimilar antineoplastic drugs with different mechanisms of cytotoxic action; this phenomenon has been called pleiotropic or multidrug resistance (MDR). In vitro models of MDR have shown that this type of resistance is accompanied by a decrease in cellular drug accumulation, mediated by the over-expression of a 170 kD plasma membrane glycoprotein referred to as P170. Glycoprotein P170 is an energy-dependent multidrug efflux pump, whose activity can be inhibited in vitro by a variety of agents including verapamil, quinidine and reserpine. P170 is over-expressed also in some human malignancies, and evidence exists about its role in examples of clinical resistance in vitro. Clinical trials using verapamil, a calcium channel blocker which selectively enhances drug cytotoxicity in MDR cell lines, have been prompted for leukemia and ovarian cancer. In addition other approaches are the subject of current preclinical investigations. Several observations as well the phenomenon of "atypical" MDR in cell lines which do not overexpress P170, suggest that also other factors are involved in multidrug resistance. Qualitative or quantitative changes in the activity of topoisomerases, protein kinase-related systems and glutathione S-transferase, may confer pleiotropic resistance. As the role of these genes and their regulation is clarified, they may also serve as useful targets for pharmacologic intervention in the treatment of drug-resistant human tumors. The mechanisms involved in resistance to methotrexate and cyclophosphamide are less studied, particularly in vivo samples. Methotrexate resistance is probably a complex multifactorial phenomenon; in some cases it is due to an increase in the expression of the drug target dihydrofolate reductase, often as a result of gene amplification, but in other cases a transport defect of the methotrexate or alterations of the activity of different enzymes have been reported. Cyclophosphamide (CP) resistance has been attributed to an increased activity of two different enzymes, glutathione S-transferase, also involved in MDR phenotype, and aldehyde dehydrogenase , which catalyzes inactivation of CP in non cytotoxic metabolites. This paper reviews the current state of our knowledge of chemo-resistance and the utility of available markers to identify potentially resistant tumors in vivo; the strategies that might be used to overcome this phenomenon are also described.
...
PMID:Chemoresistance in breast tumors. 168 Jun 89
These investigations were performed to clarify the molecular basis for the enhanced expression of cytosolic aldehyde dehydrogenase (ALDH-1) enzymatic activity in the cyclophosphamide-resistant L1210/CPA murine leukemia cell line, as compared to the parental L1210/O strain. Western immunoblot analysis was performed using a 15-fold greater quantity of cytosolic protein from the L1210/O as compared to the L1210/CPA cell line. Nevertheless, ALDH-1 immunoreactive protein could be detected only in the L1210/CPA cells. Northern analyses, performed using total cellular and polyadenylated RNA, again demonstrated ALDH-1-specific transcripts only in the L1210/CPA cell line. This transcript was identical in size to the ALDH-1 message expressed by normal murine hepatocytes. On Southern analysis, no evidence of gene amplification, gene rearrangement, or significant mutations of length was detected. These studies suggest that the ALDH-1 protein produced by the L1210/CPA cell line is structurally normal. Moreover, overexpression of the gene does not appear to have arisen as a result of an incremental process, such as gene amplification. Rather, a qualitative abnormality in the regulation of this gene appears to exist in the L1210/CPA cells, which distinguishes them from L1210/O cells and from normal murine lymphocytes.
...
PMID:Structure and expression of the cytosolic aldehyde dehydrogenase gene in cyclophosphamide-resistant murine leukemia L1210 cells. 174 71
Several mouse aldehyde dehydrogenases catalyze the detoxification of aldophosphamide, the pivotal metabolite of the prodrugs cyclophosphamide, mafosfamide, and other oxazaphosphorines. N-Isopropyl-p-formylbenzamide, a major metabolite of procarbazine, was found to be an excellent substrate (Km = 0.84 microM) for at least one of these enzymes, namely, mouse aldehyde dehydrogenase -2. The Km for mouse aldehyde dehydrogenase -2-catalyzed detoxification of aldophosphamide is 16 microM. Thus, competition between N-isopropyl-p-formylbenzamide and aldophosphamide for the catalytic site on the enzyme should strongly favor the former, and the rate at which aldophosphamide is detoxified should be markedly retarded. Mouse L1210/OAP and P388/CLA leukemia cells are relatively insensitive to the oxazaphosphorines because they contain large amounts of mouse aldehyde dehydrogenase -2. As predicted, N-isopropyl-p-formylbenzamide markedly potentiated the cytotoxic action of mafosfamide against these cells. Mouse L1210/0 and P388/0 lack the enzyme. Again as expected, N-isopropyl-p-formylbenzamide essentially did not potentiate the cytotoxic action of mafosfamide against these cells. Certain mouse and human hematopoietic progenitor cells also contain an aldehyde dehydrogenase that catalyzes the detoxification of aldophosphamide, but the specific identity of this enzyme remains to be established. N-Isopropyl-p-formylbenzamide potentiated the cytotoxic action of mafosfamide against these cells as well. Clinically, procarbazine and the oxazaphosphorines are used to treat certain neoplastic diseases. Frequently, they are used in combination. Our findings demonstrate the potential for both desirable and undesirable drug interactions when these agents are used concurrently. Similar drug interactions can be expected when other substrates for, or inhibitors of, the relevant aldehyde dehydrogenases, e.g., chloramphenicol, chloral hydrate, and methyltetrazolethiol-containing cephalosporins, are co-administered with the oxazaphosphorines.
...
PMID:Potentiation of the cytotoxic action of mafosfamide by N-isopropyl-p-formylbenzamide, a metabolite of procarbazine. 186 38
4-amino-4-methyl-2-pentyne-1-al (AMPAL), a new irreversible inhibitor of aldehyde dehydrogenase ( ALDH ) has been assayed for its in vitro and in vivo antitumor activity. In vitro, AMPAL inhibits the proliferation and the ALDH activity of L1210 and RBL5 cell lines. In vivo, AMPAL significantly increases the mean survival time of mice i.p. grafted with leukemia (L1210, P815, MBL2, EL4, RBL5 cell lines) or carcinoma cells (Krebs cell line), without haematopoetic toxicity. No carcinostatic effect was observed against the P388 leukemia and the 3LL Lewis lung carcinoma. A possible relationship between the ALDH isoenzyme activity of the tumor and its sensitivity to AMPAL is discussed in the light of previous reports concerning the role of aldehydes in cell growth control.
...
PMID:In vivo antitumor activity of 4-amino 4-methyl 2-pentyne 1-al, an inhibitor of aldehyde dehydrogenase. 251 73
A cyclophosphamide-resistant L1210 cell line has been shown to have unusually high aldehyde dehydrogenase activity. The sensitivity of this cell line to 4-methylcyclophosphamide and phosphoramide mustard in vivo and corresponding sensitivities in vitro indicate that 4-hydroxycyclophosphamide and/or aldophosphamide is the form in which cyclophosphamide reaches these tumor cells in mice and that intracellular aldehyde dehydrogenase activity is an important determinant of cyclophosphamide sensitivity in these leukemia cell lines.
...
PMID:Role of aldehyde dehydrogenase in cyclophosphamide-resistant L1210 leukemia. 648 75
The development of drug resistance is an important factor contributing to failure of chemotherapy in cancer patients. Cyclophosphamide (CP) is a cytostatic drug widely used in the treatment of haematological malignancies and solid tumours. Because CP requires bioactivation to become cytotoxic, an in vivo approach was chosen to generate a subline of the Brown Norway rat acute myelocytic leukaemia (BNML/CPR) highly resistant to CP to serve as a model to investigate the molecular mechanism(s) of cyclophosphamide resistance. The role of the CP-detoxifying enzyme aldehyde dehydrogenase ( ALDH ) in the molecular mechanism of CP resistance in this subline of the BNML has been investigated. Compared to the parent BNML cell line, the BNML/CPR cell line displayed an approximately 6-fold higher level of ALDH enzyme activity. Pretreatment of leukaemic rats with the ALDH inhibitor disulfiram resulted in a restoration of CP sensitivity of animals carrying the BNML/CPR cells. Furthermore, in vitro incubation of BNML/CPR cells with disulfiram prior to incubation with the activated CP derivative mafosfamide resulted in an extra 2-3 log cell kill as indicated by the survival time of rats which were injected with disulfiram pretreated BNML/CPR cells compared to non-pretreated BNML/CPR cells. Data on the glutathione S-transferases (GSTs) isozyme profiles of cytoplasmic liver and spleen extracts of BNML- and BNML/CPR-carrying leukaemic rats indicated that the total GST enzyme amount was lower in BNML/CPR cells than in parent BNML cells. Furthermore, the BNML/CPR subline proved to be sensitive to phosphoramide mustard, both in vivo and in vitro.
...
PMID:Aldehyde dehydrogenase involvement in a variant of the brown Norway rat acute myelocytic leukaemia (BNML) that acquired cyclophosphamide resistance in vivo. 785 14
The compound 4-(diethylamino)benzaldehyde (DEAB) is a potent inhibitor of cytosolic (class 1) aldehyde dehydrogenase ( ALDH ) in vitro and can overcome cyclophosphamide resistance in murine leukemia cells characterized by their high content of ALDH . In this study, we examined the in vivo effect of DEAB in mice on ethanol metabolism and on antipyrine clearance as a measure of the microsomal mixed function oxidase activity. DEAB administered in doses of 50 and 100 mg/kg increased the blood acetaldehyde concentration and decreased the plasma acetate concentration in mice treated with ethanol. A pharmacokinetic approach demonstrated that DEAB in doses of 50 and 100 mg/kg inhibited the fraction of ethanol converted to acetate by 32.5 and 67.5%, respectively. This inhibition was comparable with that produced by disulfiram. DEAB produced optimal inhibition of ALDH 10-15 min after administration. DEAB did not change the half-life or the total clearance of antipyrine. We conclude that DEAB is a potent inhibitor of ALDH in vivo and has no effect on the mixed function oxidase activity as determined by antipyrine clearance.
...
PMID:Effect of 4-(diethylamino)benzaldehyde on ethanol metabolism in mice. 811 35
The bovine leukaemia inhibitory factor was isolated from a phage library and sequences for the gene, in addition to 1213 bp of 5' and 432 bp of 3' sequences, were obtained and compared with other mammalian leukaemia inhibitory factor genes. Comparisons indicated amino acid homologies ranging from 89.6% to 77.2% with the human and mouse homologues, respectively. Analysis of 500 bp of 5' regulatory regions indicated homologies ranging from 83.6% to 74.4% with the corresponding human and sheep sequences, respectively. Additionally, bovine leukaemia inhibitory factor-specific primers were prepared, and a panel of bovine x hamster somatic cell lines were analysed by the polymerase chain reaction (PCR). Data indicated 93% concordance of leukaemia inhibitory factor with aldehyde dehydrogenase 2 located on bovine chromosome 17, and concordance of 81% with myelin basic protein situated on bovine chromosome 24. Southern analysis of selected hybrids confirmed the PCR results, thus conclusively assigning the bovine leukaemia inhibitory factor gene to chromosome 17. Sequence analysis also revealed a microsatellite in intron 2 of the bovine leukaemia inhibitory factor. Analysis of this region by PCR in 22 unrelated Bos taurus and 19 unrelated Bos indicus cattle detected nine different alleles. Polymorphic information content values were 0.53 and 0.80 in B. taurus and B. indicus, respectively. Additionally, the same leukaemia inhibitory factor primers successfully detected allelic variants at this locus in Bos javanicus, Bos guarus and Bison bison but not in Odocoileus virginianus.
...
PMID:Genetic characterization of the bovine leukaemia inhibitory factor (LIF) gene: isolation and sequencing, chromosome assignment and microsatellite analysis. 912 2
Previously, we have reported the successful expression of human aldehyde dehydrogenase class-1 (ALDH-1) in K562 leukemia cells using a retroviral vector and demonstrated low expression that resulted in up to three-fold increase in resistance to 4-hydroperoxycyclophosphamide (4-HC), an active derivative to cyclophosphamide. The purpose of this study was to investigate whether in vitro treatment with 4-HC will allow selection of K562 cells expressing higher levels of ALDH-1, and whether these selected cells are more resistant to 4-HC. Stably transfected or transduced K562 cells with retroviral pLXSN vector containing ALDH-1 cDNA (ALDH-1 cells) were treated repeatedly with 4-HC and then allowed to grow to confluence in liquid culture. Subsequently, the resistance to 4-HC of ALDH-1 cells treated once (ALDH-1+) or twice (ALDH-1++) with 4-HC was compared to ALDH-1 cells or wild-type K562 cells (WT cells). The results show significant increase in 4-HC resistance of ALDH-1+ (2- to 16-fold, p < 0.005) over ALDH-1 or WT cells. No difference was detected between ALDH-1+ and ALDH-1++. In addition, higher ALDH-1 mRNA and enzyme activity were found in ALDH-1+ compared to ALDH-1 cells. Southern analysis of DNA extracted from the different experimental groups demonstrated an eight-fold increase in ALDH-1 cDNA in ALDH-1+ versus the ALDH-1 cells. This was confirmed by sequential FISH analysis using biotin labeled pLXSN/ALDH-1 vector. Positive signals consistently localized to the centromeric region of chromosome 9 and the long arm of chromosome 17 were demonstrated only in the ALDH-1+ cells and represented a fusion product of multiple copies of the pLXSN/ALDH-1 vector. In summary, we have demonstrated that in vitro treatment with 4-HC results in the selection of K562 cells with multiple copies of ALDH-1 gene that are clustered in two main integration sites. These cells demonstrate significantly higher resistance to 4-HC when compared to previously untreated cells. Such successful in vitro selection could have significant implications for future cancer gene therapy protocols.
...
PMID:In vitro selection for K562 cells with higher retrovirally mediated copy number of aldehyde dehydrogenase class-1 and higher resistance to 4-hydroperoxycyclophosphamide. 955 9
| http://www.nactem.ac.uk/facta/cgi-bin/facta3.cgi?query=EC%3A1.2.1.4%7C111111%7C0%7C0%7C107119%7C0%7C10 |
The Dangers of Privatizing Tax Collection: Priceline.com, Inc. v. City of Anaheim | Tax Foundation
Improving Lives Through Smart Tax Policy
The Dangers of Privatizing Tax Collection: Priceline.com, Inc. v. City of Anaheim
IntroductionThe city of Anaheim, California argues that they are owed hotel occupancytaxes from online travel booking services such as Priceline.com, Expedia.com, and Orbitz.com. The city’s hotel tax, which is charged to anyone who rents a room, is based on the retail price of the hotel room. The online companies facilitate transactions and receive from consumers a payment that is not included in calculating the hotel tax the consumer must pay. The city filed a lawsuit to challenge this practice.
The litigation is not being managed by city lawyers but rather by outside private contingency fee lawyers. Contingency fee lawyers are not paid for their services unless they win the case, in which case they receive a percentage share of the winnings. If the contingency fee lawyers succeed in winning the case, the city may collect substantial revenue from the online companies, with a share going to the private lawyers.
In a case pending before the California Court of Appeal, Priceline.com, Inc. v. City of Anaheim, the online travel companies argue that the private lawyers cannot impartially enforce the city’s tax laws because of their significant financial interest in the outcome of the case. Further, they argue that the city has failed to maintain sufficient control over the lawyers’ activities.
The Tax Foundation’s amicus curiaebrief argues that Anaheim must even-handedly enforce its tax code, precluding the city’s use of contingency fee attorneys. The brief also urges the court to evaluate the sufficiency of the Anaheim’s oversight mechanisms, particularly in light of the recent failure and termination of the federal Internal Revenue Service’s private debt collection program.
Private Debt Collectors at the Federal Level Went Overboard Despite IRS OversightIn an attempt to cut costs and increase revenue from back-taxes, the IRS contracted with private debt collection agencies to collect tax debts for the United States. These companies were paid by the United States on a contingency fee basis, based on the amount of tax debt that they collected.
When the IRS deals directly with taxpayers, it has governmental discretion to negotiate settlements with taxpayers, including the power to suspend or cancel debts. Private collections cannot make such offers, so the IRS limited private debt collectors to “easy” cases that did not require any governmental discretion to resolve.
Unfortunately, it has become clear that few if any cases do not require governmental discretion to resolve, so the private collectors were often assigned cases that they could not resolve. Much to the exasperation of taxpayers, people were pressured into sending their payments instead of being referred to the IRS where they could have received a more beneficial settlement. This practice was attributed to the private debt collectors’ financial interest in payments.
The failure of the program occurred despite extensive oversight of the private debt collection agencies’ practices by the IRS. The IRS mobilized: (1) a taxpayer complaint process; (2) ongoing reviews of private collector actions; (3) rules regulating referrals back to the IRS in cases where taxpayers were found to be unable to pay; (4) a dispute appeals process; (5) comprehensive training materials; (6) active regulation of private collector training programs; (7) direct oversight by IRS employees meant to ensure that cases were handled properly; and (8) active procedural and legal review of the private collection processes. Nevertheless, these abuses occurred, and the program’s inefficiency led to its termination in early 2009.
Lessons of the IRS’s Experience for AnaheimThe IRS’s experience with its private debt collection program revealed that despite even the most ardent attempts to ensure that private parties performing government functions act neutrally, it can still occur. The IRS employed an impressive array of oversight mechanisms, which still did not completely prevent the private debt collection agencies’ self interests from undermining the neutrality of the IRS’s tax debt collection.
The Tax Foundation’s argues that the court should be critical of the Anaheim’s claim that its oversight has been completely effective. The IRS’s experience conveys the idea that to ensure absolute neutrality, governmental oversight would have to be nearly flawless and it is difficult to imagine such a system in light of the failure of the IRS’s efforts.
The authors would like to acknowledge the assistance of Edward Teyssier for acting as pro bono local counsel for the Tax Foundation in the filing of this amicus curiae brief.
Topics
Center for Federal Tax Policy
California
Amicus Briefs
Excise Taxes
Hotel and Tourism Taxes
Tax Law
Tags
State Tax and Spending Policy
| https://taxfoundation.org/dangers-privatizing-tax-collection-pricelinecom-inc-v-city-anaheim/ |
Financial Services (Miscellaneous Amendments) Regulations 2022 - Motion to Approve: 15 Nov 2022: House of Lords debates - TheyWorkForYou
& ndash; in the House of Lords at 7:02 pm 15 November 2022
Financial Services (Miscellaneous Amendments) Regulations 2022 - Motion to Approve
– in the House of Lords at 7:02 pm on15 November 2022.
Baroness Penn:
Moved by Baroness Penn
That the draft Regulations laid before the House on
17 October
be approved.
Baroness Penn The Parliamentary Secretary, HM Treasury
My Lords, this statutory instrument comprises two sets of provisions relating to Gibraltarian firms operating in the UK market and to securitisation. The proposed legislation will remedy technical deficiencies identified in financial services legislation that was put in place to help manage our withdrawal from theEU.
In relation to Gibraltar, this instrument will fix temporary market access arrangements put in place to ensure that Gibraltarian firms did not face a cliff-edge loss of market access into the UK when we left the EU. In particular, these amendments will complete the intended transfer of powers to the Treasury and theFinancial Conduct Authorityin three specific areas. This transfer will give the UK authorities powers in relation to Gibraltarian firms where operating in the UK market, consistent with their powers over domestic firms.
It is worth remembering that financial services legislation was amended on withdrawal from the EU to adjust the treatment ofEEAfirms; in particular, to remove passporting rights, which were a function of the EU’s single market. At this time, because Gibraltarian firms had benefited from equivalent rights, separate provisions were necessary to preserve the existing arrangements supporting market access for financial services between the UK and Gibraltar. These arrangements were always intended to be temporary. Through theFinancial ServicesAct 2021, we are working to replace them with a new permanent regime designed specifically for Gibraltar that reflects our unique history and relationship.
The temporary regime that the Government put in place for Gibraltarian firms unintentionally prevented the transfer of powers to the Treasury and the Financial Conduct Authority being completed in certain areas, leaving gaps in UK law. This SI will exclude provisions from this temporary regime to remove these gaps in the powers available to the Treasury and theFCA. This is equitable and proportionate, as it will enable the treatment of Gibraltarian firms to be brought in line with that of UK firms. Closing these gaps will provide for a more consistent legal and regulatory environment, as intended.
This SI will have an impact on three regulations that affect Gibraltarian firms operating in our market. Under the Short Selling Regulation, the Treasury’s power to modify the reporting threshold relating to net short positions will extend to Gibraltarian firms trading shares on a UK trading venue. Under the Markets in Financial Instruments Regulation, the FCA will be able to apply technical standards relating to post-trade disclosure obligations to Gibraltarian investment firms in the UK. Similarly, under the Packaged Retail and Insurance-based Investment Products Regulation, the FCA will be able to apply technical standards to Gibraltar firms selling, advising on or manufacturing PRIIPs to retail investors in the UK.
I turn now to the second area the SI covers, securitisation provisions. Securitisation is the packaging up of assets or loans and selling them on to investors. This allows lenders such as banks to transfer the risks of assets to other banks and investors to free up their balance sheets and allow for further lending to the real economy.The UKsupports the implementation of international standards to promote simple, transparent and standardised—orSTS—securitisations. STS securitisations are easier for investors to understand and assess the risks of. As a result, some STS investors will benefit from lower capital requirements.
Generally, only firms established in the UK can designate their securitisations as STS. However, transitional arrangements were put in place to allow for certain EU STS securitisations issued prior to the end of 2022 to be recognised in the UK. These arrangements were extended to the end of 2024 by another set of EU exit regulations earlier this year. The instrument being debated today will simply extend the end date of two requirements for EU STS securitisations to the end of 2024, rather than 2022. This will ensure that UK investors do the appropriate due diligence checks when investing in EU STS securitisations, and that these securitisations remain exempt from clearing requirements, to prevent unnecessary administrative burden. The amendments thus maintain the current requirements as long as the transitional arrangements last. I beg to move.
Lord Jones Labour
My Lords, I thank theMinisterfor her lucid introduction. I refer to paragraph 7.26 of the Explanatory Memorandum. Will she tell us just how busy Gibraltar firms are? How many of them are there—that is, those that are
“acting as sellers, advisers or manufacturers of PRIIPs to retail investors in the UK”?
Gibraltar is a very small place. We might ask, with regard to the Explanatory Memorandum, what is going on in Gibraltar? There is a plethora of technical terms, a multitude of abbreviations in capital letters and specialist vocabulary, and it is all a blizzard of necessitous complexity, the House might agree. Of course, the Minister is a master of it all and, again, I thank her for her lucid introduction.
Baroness Bowles of Berkhamsted Liberal Democrat
My Lords, I thank theMinisterfor the introduction. It does not matter how many times I read these kinds of explanations about what is going on, I still find them totally incomprehensible and I doubt I am alone.
I have two very short questions. First, does this mean that for a period there was a lacuna when neitherEUnor UK regulators held sway and Gibraltar was doing its own thing while having access to the UK as it always had done? If that was the case, did the Gibraltarian financial services authorities know? I cannot tell whether there was such a lacuna or not.
Secondly, on the temporary permissions relating toSTS—I declare an interest as an erstwhile director of Prime Collateralised SecuritiesASBL, which looked over such things as STS to check them out—is this how it will be for ever? Will we extend this by another two years every two years? Does this happen until the UK regulators think they need a change and do something different? It seems to me that we did an awful lot of temporary permissions. I do not like to think that we will have to do them all over again every two years, because that will take an awful lot of parliamentary time. I would like to get a handle on whether this is the way of the future or whether there will be an end to these temporary permissions.
Lord Tunnicliffe Shadow Spokesperson (Defence), Shadow Spokesperson (Treasury), Shadow Minister (Transport)
My Lords, I thank theMinisterfor introducing this SI. It seems that she and I agree that it is really two SIs, covering Gibraltar and securitisation.
To take Gibraltar first, as far as I can tell, the SI simply clarifies the application of UK regulation to Gibraltar. The Money Laundering and
Terrorist Financing
(High-Risk Countries) (
Amendment
) (No. 2) Regulations 2022 set out a new list of high-risk third countries in relation to which enhanced due diligence requirements apply under the principal money laundering regulations. Gibraltar has been added and Malta removed; the changes apply from
12 July
2022. Will this SI assist Gibraltar in getting off the high-risk list? If so, how will the UK regulatory authorities be involved? I am trying to understand this; how different will the regulation of financial services firms in Gibraltar be from, for example, the regulation of a financial services firm in Birmingham?
The second part of this SI seems solely about extending the present transitional arrangements for a further two years. The clearest statement of this is in the de minimis assessment—I like the assessments, when I get round to reading them, because they tend to be written in easier language:
“This SI is required to address this misalignment of dates in order to prevent looser due diligence requirements forEUSTSsecuritisations than UK ones. This SI will also prevent additional administrative burdens on firms which could arise from the absence of an exemption for EU STS securitisations from the clearing obligation. This instrument will help”—
I would quibble with that word—
“bridge this gap until a permanent framework for designating equivalent jurisdictions with regard to securitisation regimes is in effect and an assessment of the EU can be undertaken under it.”
Am Iright in my precis? When and how will
“a permanent framework for designating equivalent jurisdictions” be determined?
Lord Teverson Liberal Democrat Lords Spokesperson (Energy and Climate Change), Chair, EU Environment Sub-Committee, Chair, EU Environment Sub-Committee
My Lords, I apologise for speaking slightly out of order. As part of the European Union Committee, I took a great interest in the Gibraltarian situation. As theMinisterwill know, Gibraltar was not covered by the trade and co-operation agreement. At the moment, negotiations are still going on between the UK and theEUon Gibraltar’s status—I think we are on round nine. Can the Minister be clear on whether financial services are included in trying to reach a final agreement between the EU and the UK on Gibraltar and its relationship with the EU? If that is the case, will these SIs become redundant and be replaced by another regime completely? I would be interested to understand that from a strategic point of view.
Baroness Penn The Parliamentary Secretary, HM Treasury 7:15,
15 November 2022
My Lords, I thank all noble Lords for their contributions to this debate. With this SI, the Government aim to remedy technical deficiencies identified in financial services legislation arising from the UK’s withdrawal from theEU. Nevertheless, a number of pertinent questions were asked.
To give the noble Lord, Lord Jones, a better picture of Gibraltarian firms operating in the UK and their involvement in our financial services sector, data from theGovernment of Gibraltarhighlights that approximately 95% of Gibraltar’s financial services business is with the UK. From the other end of the telescope, around 29% of motor insurance policies in the UK—some 8.5 million—are provided by Gibraltar-based insurers. According to 2022 data from theFCA, over 100 Gibraltarian firms are operating in the UK, including insurance firms, banks, asset managers and e-money firms. The number of firms that might be affected by this SI is roughly 18, but in practice we think it will be fewer. Although there is large-scale involvement of Gibraltarian firms in UK financial services, the impact of this SI would be more limited.
The noble Lord, Lord Tunnicliffe, asked whether this SI will assist Gibraltar in getting off the high-risk list from theFATF. This statutory instrument will not have a direct bearing on Gibraltar’s status in that respect.The UKis a supportive and strong member of the FATF and the Government are committed to making the UK a hostile place for illicit finance and economic crime. We are also committed to supporting Gibraltar to achieve full implementation of the FATF standards by addressing the weaknesses in its regime to tackle illicit finance.
The noble Lord also asked how different the regulation of financial services firms in Gibraltar will be compared to the regulation of financial firms in the UK—for example, in Birmingham. As members of the EU, Gibraltar and the UK implemented the same EU rules on financial services, so we start from the same place. The current temporary regime maintains market access on that basis while we implement the new regime provided for in theFinancial ServicesAct 2021. That will require alignment with UK law and practice. In effect, firms in Gibraltar and the UK will be subject to the same rules under the new system.
Lord Tunnicliffe Shadow Spokesperson (Defence), Shadow Spokesperson (Treasury), Shadow Minister (Transport)
The same rules and the same regulators?
(Citation: HL Deb, 15 November 2022, c843)
Baroness Penn The Parliamentary Secretary, HM Treasury
I will double-check that for the noble Lord. I believe so, but I would prefer to write and confirm it.
In the noble Lord’s precis, he asked whether this simply extends the status quo for two years. Yes, that is the correct interpretation of this SI. The noble Baroness, Lady Bowles, asked whether we are in a process of extending it in another two years, and then another two years after that. TheFinancial Servicesand Markets Bill, which has just finished Committee in theother place, has introduced a permanent equivalence regime to allow the Treasury to recogniseSTS-equivalent securitisations issued by firms in other countries. The temporary recognition ofEUSTS will help bridge the gap until we can undertake assessments under this new regime in the Bill currently going through. We have a plan and the legislation is passing; we fully expect that the extension to 2024 would be the last such extension and that we would have a new regime up and running by that point.
The noble Baroness asked about the regulation of these firms in the intervening period. I will write to her on that point to ensure that I do not get anything wrong, and I will also write to the noble Lord, Lord Teverson, on his question. To reassure the noble Baroness, looking at the data in terms of the specific regulations in this area, about five Gibraltar firms could fall within the scope of the 0.1% reporting threshold in the short selling regulation, theSSR. We are giving the regulators here the power to change that threshold to align with the EU. It is a small number. No Gibraltar PRIIPs manufacturers operate in the UK, so the power we have to change the provisions there currently would not bite. Five Gibraltar firms in the UK are using branch passports underMiFIR. I know that does not directly answer the noble Baroness’s question, so I will write to her. However, to give a sense of the scale of the gap—if there was any such gap—we believe it to have been small.
(Citation: HL Deb, 15 November 2022, c844)
Lord Tunnicliffe Shadow Spokesperson (Defence), Shadow Spokesperson (Treasury), Shadow Minister (Transport)
Will theMinisterensure that all letters are copied to all participants?
(Citation: HL Deb, 15 November 2022, c844)
Baroness Penn The Parliamentary Secretary, HM Treasury
I will ensure that all letters are copied to all participants in the debate andplaced in the Libraryof the House.
Motion agreed.
(Citation: HL Deb, 15 November 2022, c844)
| https://www.theyworkforyou.com/lords/?id=2022-11-15d.840.1 |
Sending single transmission to multiple nodes?
Sending single transmission to multiple nodes?
Sending single transmission to multiple nodes?
I'm currently creating an automated blind system. Right now I have a Wifi to RF gateway controlling the different blinds separately. One of my stretch goals is to add the ability to control a group of blinds at once. Instead of sending a value (0-180) to a single blind, I want to send it to a range or subset of them. Is this possible or will I have to manually trigger each one separately?
That's easily possible: just send the packet to node address 255 and all nodes will receive. The problem with broadcasts is ACKs which would collide. The typical approach to deal with that weakness is to just send the data redundantly. So instead of one packet you send 3 and hope that at least one makes it to every destination. joe
I agree with Joe and would add that the packet that you broadcast could contain flags related to each of your nodes so, instead of sending to a node, whose blinds you want to adjust, you set the corresponding flag in the packet. Each receiving node can then check to see if the broadcast affects them.
So that almost gets me where I need to be, the problem is that at this point I'm going to have 5 blinds connected but only three of them would function as a group. Are the only options all or one?
blebson, I would add a "group" field to your packet. That way, you could still send a broadcast to node 255. Everyone would receive the message, but they would only respond if they were in the group ID.
If you are going to have 5 blinds why not just use a byte or bit in the payload to correspond to each blind? As others have said, broadcast to node 255 so they all receive the packet and then within the packet if I find 01000 000 in a byte and that 1 is my bit, then I change from open/close. If I find a 0, I do nothing. Or the 0s and 1s could be closed and open and I make my state whatever the flag calls for. Just don't request an ack when your gateway broadcasts to node 255 so you don't have to handle collisions. EDIT: Or I could have said exactly what Tom suggested, oops! Flags is the way to go here.
Quote from: blebson on March 16, 2017, 11:26:57 AM
So that almost gets me where I need to be, the problem is that at this point I'm going to have 5 blinds connected but only three of them would function as a group. Are the only options all or one?
am/are saying:
Code: [Select]
struct PACKET { uint8_t flags, openness; } packetOut; # define BLINDS_1 0b00000001 # define BLINDS_2 0b00000010 # define BLINDS_3 0b00000100 # define BLINDS_4 0b00001000 # define BLINDS_5 0b00010000 # define LIVING_ROOM_GROUP (BLINDS_1 | BLINDS_2 | BLINDS_3) # define DINING_ROOM_GROUP (BLINDS_4 | BLINDS_5) ... // open up the livingroom blinds packetOut.flags = LIVING_ROOM_GROUP; packetOut.openness = FULL_OPEN; // whatever FULL Open value is... // do three sends like Joe suggested radio.send(RFM69_BROADCAST, &packetOut, sizeof(packetOut); delay(40); radio.send(RFM69_BROADCAST, &packetOut, sizeof(packetOut); delay(40); radio.send(RFM69_BROADCAST, &packetOut, sizeof(packetOut); delay(40); ... // close the dining room blinds packetOut.flags = DINNG_ROOM_GROUP; packetOut.openness = FULL_CLOSE; // whatever FULL Close value is... // do three sends like Joe suggested radio.send(RFM69_BROADCAST, &packetOut, sizeof(packetOut); delay(40); radio.send(RFM69_BROADCAST, &packetOut, sizeof(packetOut); delay(40); radio.send(RFM69_BROADCAST, &packetOut, sizeof(packetOut); delay(40); ...
And in each of the nodes:
Code: [Select]
# define MY_NODE_FLAG BLINDS_3 if (radio.receiveDone()) { if (radio.DATALEN==sizeof(struct PACKET) && radio.TARGET == RFM69_BROADCAST) { struct PACKET *myPacket = (struct PACKET *)radio.DATA; if (myPacket->flags & MY_NODE_FLAG) { openBlinds( myPacket->openness); } } }
or some such...
So I'm currently using the Low Power Listening fork of the RFM69 library. All of my blinds are battery powered so I wanted to ensure they can be sustained but a small solar panel in cloudy Seattle... This means that all of my transmissions will be the wake-up burst. Will this packet-based ID still work in this application?
Quote from: blebson on March 16, 2017, 07:39:04 PM
So I'm currently using the Low Power Listening fork of the RFM69 library. All of my blinds are battery powered so I wanted to ensure they can be sustained but a small solar panel in cloudy Seattle... This means that all of my transmissions will be the wake-up burst. Will this packet-based ID still work in this application?
Yes, the content is still the same, regardless of transmission method.
Tom
Quote from: TomWS on March 16, 2017, 07:33:50 PM
Here is an example of what I (and apparently ChemE and syrinxtech
am/are saying:
Code: [Select]
struct PACKET { uint8_t flags, openness; } packetOut; # define BLINDS_1 0b00000001 # define BLINDS_2 0b00000010 # define BLINDS_3 0b00000100 # define BLINDS_4 0b00001000 # define BLINDS_5 0b00010000 # define LIVING_ROOM_GROUP (BLINDS_1 | BLINDS_2 | BLINDS_3) # define DINING_ROOM_GROUP (BLINDS_4 | BLINDS_5) ... // open up the livingroom blinds packetOut.flags = LIVING_ROOM_GROUP; packetOut.openness = FULL_OPEN; // whatever FULL Open value is... // do three sends like Joe suggested radio.send(RFM69_BROADCAST, &packetOut, sizeof(packetOut); delay(40); radio.send(RFM69_BROADCAST, &packetOut, sizeof(packetOut); delay(40); radio.send(RFM69_BROADCAST, &packetOut, sizeof(packetOut); delay(40); ... // close the dining room blinds packetOut.flags = DINNG_ROOM_GROUP; packetOut.openness = FULL_CLOSE; // whatever FULL Close value is... // do three sends like Joe suggested radio.send(RFM69_BROADCAST, &packetOut, sizeof(packetOut); delay(40); radio.send(RFM69_BROADCAST, &packetOut, sizeof(packetOut); delay(40); radio.send(RFM69_BROADCAST, &packetOut, sizeof(packetOut); delay(40); ...
And in each of the nodes:
# define MY_NODE_FLAG BLINDS_3 if (radio.receiveDone()) { if (radio.DATALEN==sizeof(struct PACKET) && radio.TARGET == RFM69_BROADCAST) { struct PACKET *myPacket = (struct PACKET *)radio.DATA; if (myPacket->flags & MY_NODE_FLAG) { openBlinds( myPacket->openness); } } }
or some such...
TomWS, that's a sweet piece of code you provided. I like your method better than my "group" idea. Bit fiddling is a lost art in a lot of today's world...thanks for reminding us.
TomWS, I ended up using your packet idea and it worked great. I am now working on the response from the Moteino back to the base station. I wanted to use the same 'Packet' technique but add different data types. There would be three types of data, a battery percentage (int), a battery voltage (float), and a solar charging status (char or String). Is there any way to use this struct to send all three data types at once?
I currently have it defined as the following:
Code: [Select]
struct PACKET { uint8_t percent; float voltage; String charger; } packetOut;
however the float and String value don't seem to be transmitting correctly, is this a limitation of the packet concept or am I doing something wrong?
Quote from: blebson on May 10, 2017, 11:30:24 PM
TomWS, I ended up using your packet idea and it worked great. I am now working on the response from the Moteino back to the base station. I wanted to use the same 'Packet' technique but add different data types. There would be three types of data, a battery percentage (int), a battery voltage (float), and a solar charging status (char or String). Is there any way to use this struct to send all three data types at once?
I currently have it defined as the following:
Code: [Select]
struct PACKET { uint8_t percent; float voltage; String charger; } packetOut;
however the float and String value don't seem to be transmitting correctly, is this a limitation of the packet concept or am I doing something wrong?
A String 'type' is actually an instance of a class and has beaucoup stuff hidden behind the 'scenes'. Use fixed length char array and you'll be fine. Also, you can represent the battery voltage in uint16_t and get millivolt resolution and save two bytes (and a bunch of floating point code overhead).
As long as both ends know the structure of the packet and its based on primitive types, sending structures is trivial.
Tom
PS: I'll wager that if you search this forum for 'readvcc' you'll find a number of examples on how to read the processor's VCC in exactly uint16_t resolution.
So at this point I'm stuck trying to send the 4 digit int for the milivolt value of the battery. I've tried sending as uint16_t and uint8_t but get garbage values from the receiving arduino. my packet definition looks as follows;
struct PACKET { uint8_t percent; uint16_t voltage; char charger; } packetOut;
Where percent is a 2 digit int, voltage is a 4 digit int and charger is a single char.
Quote from: blebson on May 11, 2017, 10:12:35 PM
So at this point I'm stuck trying to send the 4 digit int for the milivolt value of the battery. I've tried sending as uint16_t and uint8_t but get garbage values from the receiving arduino. my packet definition looks as follows;
Code: [Select]
struct PACKET { uint8_t percent; uint16_t voltage; char charger; } packetOut;
Where percent is a 2 digit int, voltage is a 4 digit int and charger is a single char.
There's nothing wrong with the structure definition, there must be a problem with the way you're sending it and/or processing it on the receiving end. If you post those code snippets, we'll take a look.
Tom
I can try to post the code tonight. I'm using low power listening mode on the moteino but I'm not sure if that matters. The base station is receiving the battery percentage correctly but then gets a garbage value for voltage and nothing for charger.
| https://lowpowerlab.com/forum/rf-range-antennas-rfm69-library/sending-single-transmission-to-multiple-nodes/msg19673/ |
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Burden of bacterial bloodstream infection – A brief update on epidemiology and significance of multidrug-resistant pathogens | Request PDF
Request PDF | Burden of bacterial bloodstream infection – A brief update on epidemiology and significance of multidrug-resistant pathogens | Background: Bloodstream infections comprise a wide variety of pathogens and clinical syndromes with considerable overlap with similar syndromes... | Find, read and cite all the research you need on ResearchGate
November 2019 Clinical Microbiology and Infection 26(2)
DOI: 10.1016/j.cmi.2019.10.031
Authors:
Winfried V Kern
University Medical Center Freiburg
Siegbert Rieg
Siegbert Rieg
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Abstract
Background:
Bloodstream infections comprise a wide variety of pathogens and clinical syndromes with considerable overlap with similar syndromes of non-bacteremic infections and quite diverse risk factors, therapeutic implications and outcomes. Yet, this heterogenous "entity" has the advantage to be pathogen-defined compared with the broad and even more heterogenous entity "sepsis", and thus has become helpful for clinicians and epidemiologists for research and surveillance purposes. The increasing availability of population-based and large multicenter well-defined cohort studies should allow to assess with much confidence and details its burden, the significance of antimicrobial resistance, and areas of uncertainty regarding the further epidemiologic evolution and optimized treatment regimens.
Aim:
To review key aspects of bloodstream infection epidemiology and burden and summarize recent news and questions concerning critical developments.
Sources:
Peer-reviewed articles based on the search terms 'bloodstream infection' and 'bacteremia' combined with the terms 'epidemiology' and 'burden'. The emphasis was on new information from studies in adult patients and on the added burden due to pathogen resistance to first- and second-line antimicrobial agents.
Content:
Topics covered include recent developments in the epidemiology of bloodstream infection due to key pathogens and published information about the relevance of resistance for patient outcomes.
Implications:
Despite the availability of population-based and an increasing number of large well-defined multicenter cohort studies, more surveillance and systematic data on BSI epidemiology at regional level and in resource-limited settings may be needed to better design new ways for prevention and define the need for and further develop optimized therapeutic strategies.
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... A recent systematic review established that the most important predictors of mortality in patients with MRSA (Methicillin-Resistant Staphylococcus aureus) bloodstream infection are age, patient condition, timing and appropriateness of antimicrobial treatment, surgical intervention and disease severity as evaluated by the APACHE II score [5]. The incidence of BSI due to Escherichia coli is higher than that of Staphylococcus aureus bacteremia, but the mortality is lower: the in-hospital and 30-day case-fatality is approximately 10-15%; mortality is highly dependent on age, hospital acquisition and co-morbidity, initial presentation with septic shock/severe disease and resistance to fluoroquinolones and third-generation cephalosporin resistance [1]
. Although less frequent than E. coli among bacteremia isolates, BSI due to extended-spectrum beta-lactamase (ESBL)-positive K. pneumoniae carries a worse prognosis, including more frequent intensive care unit admission and higher 30-day case-fatality or in-hospital mortality. ...
... Although less frequent than E. coli among bacteremia isolates, BSI due to extended-spectrum beta-lactamase (ESBL)-positive K. pneumoniae carries a worse prognosis, including more frequent intensive care unit admission and higher 30-day case-fatality or in-hospital mortality. Many European and North American studies show an association between ESBL-positive Enterobacterales and both excess length of stay and increased mortality rate [1,
[6][7][8]. Klebsiella pneumoniae is also the most prominent among carbapenem-resistant Gram-negative bacteria causing BSI. The case-fatality of BSI due to carbapenem-resistant Klebsiella is higher than that due to carbapenem-susceptible K. pneumoniae, and the likelihood of initially inappropriate therapy and of suboptimal definitive therapy was significant and a major prognostic factor for poor outcomes before the availability of newer antibiotics. ...
... The case-fatality of BSI due to carbapenem-resistant Klebsiella is higher than that due to carbapenem-susceptible K. pneumoniae, and the likelihood of initially inappropriate therapy and of suboptimal definitive therapy was significant and a major prognostic factor for poor outcomes before the availability of newer antibiotics. A particularly high risk of fatal outcome after BSI due to carbapenem-resistant Gram-negative bacteria in general has been reported for immunocompromised patients [1]
. ...
Development and Validation of a Prognostic Model for Multi-Drug-Resistant Non-Hospital-Acquired Bloodstream Infection Article Full-text available
May 2023
Emanuele Pivetta Silvia Corcione Paolo Peasso Giuseppe Montrucchio
Bloodstream infections (BSI) are an increasing cause of admissions to hospitals. Non-hospital-acquired BSI are defined by blood cultures that are positive less than 48 hours after admission, but a relevant difference exists between community-acquired and healthcare-associated (HCA) BSI in terms of risk of multidrug resistance (MDR). We planned a retrospective study in three different cohorts in order to develop and to temporally and spatially validate an easy and rapid prognostic model for identifying MDR non-hospital-acquired (non-HA) BSI. The pathogens most involved in BSI are Staphylococcus spp. and Escherichia coli, responsible for about 75% of all MDR isolated. The model includes age, gender, long-term care facility admission, immunocompromise, any recent invasive procedures and central line placement, recent intravenous treatment and antibiotic treatment. It shows an acceptable performance, especially for intermediate probabilities of MDR infection, with a C-index of 70%. The model was proposed in a nomogram that could allow better targeting of antibiotic therapy for non-HA BSI admitted in hospital. However, it should be further validated to determine its applicability in other populations.
View Show abstract
... In many studies, E. coli and S. aureus are numerically the most frequent, and with P. aeruginosa, constitute the most prevalent reported organisms causing mortality [16, 18]
. P. aeruginosa, K. pneumoniae and staphylococci are typically associated with healthcare acquisition, while E. coli is more frequent among community-acquired cases [18]. ...
... In many studies, E. coli and S. aureus are numerically the most frequent, and with P. aeruginosa, constitute the most prevalent reported organisms causing mortality [16,18]. P. aeruginosa, K. pneumoniae and staphylococci are typically associated with healthcare acquisition, while E. coli is more frequent among community-acquired cases [18]
. Our data are consistent with these observations. ...
... This observation that mortality was irrespective of methicillin resistance status perhaps advances a case towards novel interventions such as decolonisation strategies [24]. In general, AMR levels in this study were similarly high as those reported in the Mediterranean, including Italy and Israel [7, 18]
. However, except for A. baumannii, none of the other pathogens presented an XDR phenotype. ...
Burden of multidrug and extensively drug-resistant ESKAPEE pathogens in a secondary hospital care setting in Greece Article Full-text available
Sep 2022 EPIDEMIOL INFECT
Evangelos I Kritsotakis Dimitra Lagoutari
Efstratios Michailellis Achilleas Gikas
Bacterial antibiotic resistance (AMR) is a significant threat to public health, with the sentinel "ESKAPEE" pathogens, being of particular concern. A cohort study spanning 5.5 years (2016 to 2021) was conducted at a provincial general hospital in Crete, Greece, to describe the epidemiology of ESKAPEE-associated bacteraemia regarding levels of AMR and their impact on patient outcomes. In total, 239 bloodstream isolates were examined from 226 patients (0.7% of 32,996 admissions) with a median age of 75 years, 28% of whom had severe comorbidity, and 46% with prior stay in ICU. Multidrug resistance (MDR) was lowest for Pseudomonas aeruginosa (30%) and Escherichia coli (33%), and highest among Acinetobacter baumannii (97%); the latter included 8 (22%) with extensive drug-resistance (XDR), half of which were resistant to all antibiotics tested. MDR bacteraemia was more likely to be healthcare-associated than community-onset (RR 1.67, 95%CI 1.04-2.65). Inpatient mortality was 22%, 35% and 63% for non-MDR, MDR and XDR episodes, respectively (p=0.004). Competing risks survival analysis revealed increasing mortality linked to longer hospitalization with increasing AMR levels, as well as differential pathogen-specific effects. A.baumannii bacteraemia was the most fatal (14-day death hazard ratio 3.39, 95%CI 1.74-6.63). Differences in microbiology, AMR profile and associated mortality compared to national and international data emphasize the importance of similar investigations of local epidemiology.
View Show abstract
... Staphylococcus aureus is a major human pathogen associated with a large range of infections [1]. It is one of the most common causes of bloodstream infections (BSI) worldwide, causing bacteremia with incidence ranging from 3 to 50 episodes per 100,000 person-years, with large geographical variations [2][3] [4]
. Methicillin-resistant S. aureus (MRSA) is challenging in terms of therapeutic strategies, and the occurrence of bacteremia is associated with metastatic infections, recurrence, and high mortality rates (ranging from 15% to 40%). MRSA has a global prevalence ranging from less than 5% to over 80%, being a prominent burden in many countries [5,6]. ...
... MRSA was mostly considered a healthcare-related pathogen, although an increase in the number of community-acquired MRSA (CA-MRSA) infections is being observed in several regions. Current studies suggest that MRSA is a particularly important pathogen in developing countries
[4,
7]. Several factors, such as pathogen virulence determinants, antimicrobial resistance, patients' characteristics, and clinical management, have been studied to understand a patient's prognosis upon MRSA bacteremia [1,8]. ...
Epidemiology and risk factors for mortality among methicillin-resistant Staphylococcus aureus bacteremic patients in Southern Brazil Article Full-text available
Apr 2023 PLOS ONE
Cezar Vinícius Würdig Riche Renato Cassol
Diego Rodrigues Falci Cícero Armídio Gomes Dias
This study aimed to evaluate the epidemiology and 30-day mortality of adult patients with methicillin-resistant Staphylococcus aureus (MRSA) bacteremia. We retrospectively reviewed the demographic and clinical data of adult patients with S. aureus bloodstream infections (BSI), admitted to a tertiary public teaching medical center in Porto Alegre, Southern Brazil, from January 2014 to December 2019. A total of 928 patients with S. aureus BSI were identified in the study period (68.5 per 100,000 patient-years), and the proportion of MRSA isolates was 22% (19-27%). Thus, 199 patients were included in the analyses. The median age was 62 (IQR: 51-74) years, Charlson Comorbidity Index (CCI) median was 5 (IQR: 3-6), the Pitt bacteremia score (PBS) median was 1 (IQR: 1-4), and the most common site of infection was skin and soft tissue (26%). Most infections were hospital-acquired (54%), empirical anti-MRSA treatment was initiated in 34% of the cases, and in 44% vancomycin minimum inhibitory concentration was 1.5mg/L or above. Sixty-two (31.2%) patients died up to 30 days after the bacteremia episode. Patients with more comorbid conditions (higher CCI; aOR 1.222, p = 0.006) and a more severe presentation (higher PBS; aOR 1.726, p<0.001) were independently associated with mortality. Empiric antimicrobial therapy with an anti-MRSA regimen was associated with reduced mortality (aOR 0.319, p = 0.016). Our study identified significant risk factors for 30-day mortality in patients with MRSA BSI in a population with a high incidence of S. aureus bacteremia. Empiric treatment with an anti-MRSA drug was a protective factor. No significant variation in the incidence of S. aureus BSI was recorded throughout the period.
View Show abstract
... Antimicrobial resistance develops from antibiotics misuse and micro-organisms evolving many different resistance mechanisms. [1, 3]
BSI caused by resistant micro-organisms frequently fail to respond to treatment, thus leading to septicaemia, prolonged hospital admission, increased costs of treatment and worsening morbidity and mortality. [1,3] There is accumulated evidence that BSI and sepsis are important triggers for stroke and its reoccurrence. ...
... [1,3] BSI caused by resistant micro-organisms frequently fail to respond to treatment, thus leading to septicaemia, prolonged hospital admission, increased costs of treatment and worsening morbidity and mortality. [1, 3]
There is accumulated evidence that BSI and sepsis are important triggers for stroke and its reoccurrence. Haemodynamic instability, atrial fibrillation, prolonged systemic inflammatory responses and coagulopathy have been the possible linkage between sepsis and stroke. ...
Blood Stream Infection in Stroke Patients: Spectrum of Microbial Isolates and Antimicrobial Resistance Article Full-text available
Mar 2023
FE Odiase PV Lofor
Background: Bloodstream infection (BSI) is frequent in stroke, with poorer outcomes when microbial isolates are multi-drug resistant. There is a shortage of published data on BSI amongst stroke patients in Nigeria. Objective: To describe the microbial isolates and the antimicrobial resistance pattern among microbial isolates in BSI in stroke patients. Methods: This retrospective study of all hospitalized stroke patients with BSI at the University of Benin Teaching Hospital, Benin City, Nigeria covered July 2018 to June 2022. The demographics, stroke type, microbial isolates and antimicrobial resistance patterns were studied. Results: Blood culture studies were conducted among 834 stroke patients with infections; 410 (49.2%) had positive growth for microbial organisms. Amongst those with positive blood cultures, 53% (217/410) were females, while 56% had a haemorrhagic stroke. The mean age was 76.9±13.9 years, with about 80% of them aged ≥ 65. Infections of the respiratory tract (45%) and the urinary tract (33%) were the possible primary sources of BSI. The leading isolates included Enterococcus faecalis (18.5%), Klebsiella oxotyca (12.9%), Proteus mirabilis (12.9%), Staphylococcus aureus (11.5%), and Escherichia coli (11.2%). Approximately 88% of the isolates were multi-drug resistant, with 100% resistance to cefuroxime, ceftazidime, and co-trimoxazole, 83.3% to erythromycin and 75% resistance to ampicillin. The elderly patients were significantly more likely to acquire multi-drug resistant micro-organisms (p = 0.007). Conclusion: Stroke patients, especially the older ones, are susceptible to bloodstream infection from multi-drug-resistant micro-organisms, contributing to increased morbidity and mortality among stroke patients.
View Show abstract
... Page 2 of 21 Khankhel et al. Ann Clin Microbiol Antimicrob (2022) 21:42 Background Bloodstream infections (BSIs), also referred to as bacteremia, are responsible for considerable disease burden worldwide with incidence estimated to be 189 per 100,000 persons in the United States (US) and to range between 168 and 220 persons per 100,000 across various Northern European nations [1]
[2][3]. BSIs or positive blood cultures can be considered primary (i.e., the sole source of infection) or secondary to another source of infection, such as the respiratory tract. Both grampositive (e.g. ...
... Further, many of the pathogens causing bacteremia are multi-drug resistant (MDR), extensively-drug resistant (XDR), or pan drug-resistant (PDR). Delays in appropriate treatment of bacteremia are associated with increasing morbidity, mortality, and costs [1]
[2][3]. To optimize management of the infection it is imperative to promptly identify the causative pathogen, susceptibility status, and physical source(s) of infection. ...
Ceftolozane/tazobactam for the treatment of bacteremia: a systematic literature review (SLR) Article Full-text available
Oct 2022
Z. S. Khankhel Ryan J Dillon M. Thosar
Laura Puzniak
Background
Bloodstream infections (BSIs), or bacteremia, are responsible for considerable disease burden. Increasing rates of antibiotic resistance and delays in selection of appropriate treatment lead to increased morbidity, mortality, and costs. Due to limitations of current standard treatments, especially for bacteremia caused by resistant pathogens, a systematic literature review (SLR) was conducted to understand the utilization of ceftolozane/tazobactam (C/T) in bacteremia.
Methods
Electronic database searches of EMBASE®, MEDLINE®, CCTR and Northern Lights, as well as hand searches of conference proceedings from the last two annual meetings (i.e., 2018, 2019) of the European Congress of Clinical Microbiological and Infectious Diseases (ECCMID) and the Infectious Diseases Society of America’s annual meeting (IDWeek) were conducted. A total of 23 studies reporting on patients with bacteremia receiving C/T were included in the review.
Results
Most studies were observational (k = 20 studies), though few interventional studies were also identified (k = 3). Heterogeneity was ubiquitous with respect to source of bacteremia (i.e., primary or secondary), source of infection (for secondary bacteremia), pathogen type, antibiotic resistance, C/T dose, and outcome definitions. This heterogeneity, along with limited data, and small sample sizes (n = 1 to 31) made it difficult to draw any substantial conclusions, though overall results were favorable to C/T with respect to the outcomes of interest. Nineteen studies reported clinical cure or success (primary bacteremia: k = 6, reported range: 33.3% to 100%; secondary bacteremia: k = 8, 60% to 100%; mixed/unspecified bacteremia: k = 10, 50% to 91.7%). Eight studies reported microbiological cure or eradication rates (primary: k = 3, all reporting 100%; secondary: k = 4, 68% to 80%; mixed/unspecified: k = 5, 60% to 80%). Thirteen studies reported mortality (primary: k = 4, 0% to 14%; secondary: k = 7, 0% to 100%; or mixed/unspecified bacteremia: k = 7, 0% to 51.6%). One study each also reported composite clinical response, relapse, hospital re-admission, and hospital length of stay.
Conclusions
Although the available evidence and observed trends for C/T in bacteremia should be interpreted with caution, the direction of effect would support the utilization of C/T for these difficult to treat infections. Future research should supplement the existing evidence by considering the impact of key treatment effect modifiers without contributing to the observed heterogeneity.
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... Page 2 of 10 Augusto et al. Antimicrobial Resistance & Infection Control (2022) 11:114 Background Staphylococcus aureus is one of the most common causes of bloodstream infections (BSI) worldwide [1, 2]
. The presence of an indwelling device or a skin and soft tissue infection (SSTI) associated to hospital (HA) or community (CA) BSI are the most common sources of this pathogen [3]. ...
... Although daptomycin resistance among S. aureus remains rare worldwide (< 0.1%) [1], Silva et al. [46] also found isolates non-susceptible to daptomycin (4.7%) in a Brazilian study involving 128 clinical S. aureus isolates. We have already described BSI caused by non-susceptible daptomycin S. aureus isolates (MIC of 2 and 4 mg/L) among MRSA-VISA isolates in the hospital of the present study [2]
. This data is of great concern because of its impact on the patient's outcome. ...
Pandemic clone USA300 in a Brazilian hospital: detection of an emergent lineage among methicillin-resistant Staphylococcus aureus isolates from bloodstream infections Article Full-text available
Sep 2022
Mariana Fernandes Augusto Débora Cristina da Silva Fernandes
Tamara Lopes Rocha de Oliveira
Kátia Regina Netto dos Santos
Background
Staphylococcus aureus is one of the leading causes of bloodstream infections (BSI) worldwide. In Brazil, the hospital-acquired methicillin-resistant S. aureus USA100/SCC mec II lineage replaced the previously well-established clones. However, the emergence of community-associated (CA) MRSA lineages among hospitalized patients is an increasing issue.
Methods
Consecutive S. aureus isolates recovered from BSI episodes of patients admitted between January 2016 and December 2018 in a Brazilian teaching hospital were tested for antimicrobial resistance, their genotypic features were characterized, and the clinical characteristics of the patients were evaluated.
Results
A total of 123 S. aureus isolates were recovered from 113 patients. All isolates were susceptible to linezolid, teicoplanin and vancomycin and 13.8% were not susceptible to daptomycin. Vancomycin MIC 50 and MIC 90 of 2 mg/L were found for both MRSA and MSSA isolates. The MRSA isolation rate was 30.1% (37/123), and 51.4% of them carried the SCC mec type II, followed by SCC mec IV (40.5%). Among the 37 MRSA isolates, the main lineages found were USA100/SCC mec II/ST5 and ST105 (53.7%) and USA800/ST5/SCC mec IV (18.9%). Surprisingly, six (16%) CA-MRSA isolates, belonging to USA300/ST8/SCC mec IVa that carried PVL genes and the ACME cassette type I, were detected. These six patients with USA300 BSI had severe comorbidities, including cancer, and most had a Charlson score ≥ 5; furthermore, they were in wards attended by the same health professionals. MRSA isolates were associated with hospital acquired infections ( p = 0.02) in more elderly patients ( p = 0.03) and those diagnosed with hematologic cancer ( p = 0.04). Among patients diagnosed with MRSA BSI, 19 (54.3%) died.
Conclusions
The pandemic MRSA USA300 was detected for the first time in the Brazilian teaching hospital under study, and its cross-transmission most probably occurred between patients with BSI. This lineage may already be circulating among other Brazilian hospitals, which highlights the importance of carrying out surveillance programs to fight multidrug resistant and hypervirulent isolates.
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... E. coli is one of the most clinically important bacterial pathogens worldwide 74
. Its ubiquitous presence in the human intestinal tract 75 , capacity to cause diverse intestinal and extraintestinal infections and the emergence of MDR have made the control of E. coli infections a major public health priority 76 . ...
Evolutionary and functional history of the Escherichia coli K1 capsule
Article Full-text available
Jun 2023
Sergio Arredondo-Alonso George Blundell Zuyi Fu Alex Mccarthy
Escherichia coli is a leading cause of invasive bacterial infections in humans. Capsule polysaccharide has an important role in bacterial pathogenesis, and the K1 capsule has been firmly established as one of the most potent capsule types in E. coli through its association with severe infections. However, little is known about its distribution, evolution and functions across the E. coli phy-logeny, which is fundamental to elucidating its role in the expansion of successful lineages. Using systematic surveys of invasive E. coli isolates, we show that the K1-cps locus is present in a quarter of bloodstream infection isolates and has emerged in at least four different extraintestinal pathogenic E. coli (ExPEC) phylogroups independently in the last 500 years. Phenotypic assessment demonstrates that K1 capsule synthesis enhances E. coli survival in human serum independent of genetic background, and that therapeutic targeting of the K1 capsule re-sensitizes E. coli from distinct genetic backgrounds to human serum. Our study highlights that assessing the evolutionary and functional properties of bacterial virulence factors at population levels is important to better monitor and predict the emergence of virulent clones, and to also inform therapies and preventive medicine to effectively control bacterial infections whilst significantly lowering antibiotic usage.
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... As antimicrobial resistance rates rise globally, extended-spectrum βlactamase-producing Enterobacterales (ESBL-E) have emerged as one of the most clinically threatening bacteria, causing community-onset infections [2][3][4]. BSIs due to ESBL-E are associated with increased mortality, hospital length of stay, and overall healthcare costs
[5,
6]. This is particularly relevant as the incidence rate of infections due to ESBL-E has recently increased in the studied community [7,8]. ...
Optimization of Empirical Antimicrobial Therapy in Enterobacterales Bloodstream Infection Using the Extended-Spectrum Beta-Lactamase Prediction Score Article Full-text available
Jun 2023
Brian J. Haimerl Rodrigo Encinas Julie Ann Justo Majdi Al-Hasan
Clinical tools for the prediction of antimicrobial resistance have been derived and validated without examination of their implementation in clinical practice. This study examined the impact of utilization of the extended-spectrum beta-lactamase (ESBL) prediction score on the time to initiation of appropriate antimicrobial therapy for bloodstream infection (BSI). The quasi-experimental cohort study included hospitalized adults with BSI due to ceftriaxone-resistant (CRO-R) Enterobacterales at three community hospitals in Columbia, South Carolina, USA before (January 2010 to December 2013) and after (January 2014 to December 2019) implementation of an antimicrobial stewardship intervention. In total, 45 and 101 patients with BSI due to CRO-R Enterobacterales were included before and after the intervention, respectively. Overall, the median age was 66 years, 85 (58%) were men, and 86 (59%) had a urinary source of infection. The mean time to appropriate antimicrobial therapy was 78 h before and 46 h after implementation of the antimicrobial stewardship intervention (p = 0.04). Application of the ESBL prediction score as part of an antimicrobial stewardship intervention was associated with a significant reduction in time to appropriate antimicrobial therapy in patients with BSI due to CRO-R Enterobacterales. Utilization of advanced rapid diagnostics may be necessary for a further reduction in time to appropriate antimicrobial therapy in this population.
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... Enterobacterales are a family of Gram-negative rods, which include E. coli, the most prevalent cause of BSI worldwide [37]
. Beta-lactamase production is the most prominent mechanism of resistance among Enterobacterales, while third-generation cephalosporins and carbapenems are the main targets of beta-lactamases producing multi-drug resistant (MDR) organisms [38]. ...
The Hidden Cost of COVID-19: Focus on Antimicrobial Resistance in Bloodstream Infections Article Full-text available
May 2023
Giulia Micheli Flavio Sangiorgi Francesca Catania Rita Murri
Antibiotic resistance is one of the greatest growing public health threats and a worldwide priority. According to the WHO, drug-resistant diseases may cause 10 million deaths a year by 2050 and have a substantial impact on the global economy, driving up to 24 million people into poverty. The ongoing COVID-19 pandemic has exposed the fallacies and vulnerability of healthcare systems worldwide, displacing resources from existing programs and reducing funding for antimicrobial resistance (AMR) fighting efforts. Moreover, as already seen for other respiratory viruses, such as flu, COVID-19 is often associated with superinfections, prolonged hospital stays, and increased ICU admissions, further aggravating healthcare disruption. These events are accompanied by widespread antibiotic use, misuse, and inappropriate compliance with standard procedures with a potential long-term impact on AMR. Still, COVID-19-related measures such as increasing personal and environmental hygiene, social distancing, and decreasing hospital admissions could theoretically help the AMR cause. However, several reports have shown increased antimicrobial resistance during the COVID-19 pandemic. This narrative review focuses on this “twindemic”, assessing the current knowledge of antimicrobial resistance in the COVID-19 era with a focus on bloodstream infections and provides insights into the lessons learned in the COVID-19 field that could be applied to antimicrobial stewardship initiatives.
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... di-and triacyl lipopeptides, lipoteichoic acids, macrophage-activating peptide-2 (MALP2) or intact Gram-positive bacteria are also capable to induce the tolerant cell state in monocytes via the TLR1/TLR2 or TLR2/TLR6 signaling pathways and epigenetic alterations (13)(14)(15)(16)(17)(18) with protective effects during sepsis in mouse models (15,19). S. aureus is a Gram-positive pathogen that can cause superficial skin infections, serious invasive infections such as septic arthritis, osteomyelitis or endocarditis and is one of the leading causes of life-threatening bloodstream infections, such as sepsis (20,
21). It is ranked second after Escherichia coli causing community-acquired and nosocomial bloodstream infections with 10 to 30 cases per 100.000 ...
Staphylococcus aureus induces tolerance in human monocytes accompanied with expression changes of cell surface markers Article Full-text available
Mar 2023
Mario Marco Müller Christian Baldauf
Stella Hornischer Hortense Slevogt
Exposure of human monocytes to lipopolysaccharide (LPS) or other pathogen-associated molecular pattern (PAMPs) induces a temporary insensitivity to subsequent LPS challenges, a cellular state called endotoxin tolerance (ET), associated with the pathogenesis of sepsis. In this study, we aimed to characterize the cellular state of human monocytes from healthy donors stimulated with Staphylococcus aureus in comparison to TLR2-specific ligands. We analyzed S. aureus induced gene expression changes after 2 and 24 hours by amplicon sequencing (RNA-AmpliSeq) and compared the pro-inflammatory response after 2 hours with the response in re-stimulation experiments. In parallel, glycoprotein expression changes in human monocytes after 24 hours of S. aureus stimulation were analyzed by proteomics and compared to stimulation experiments with TLR2 ligands Malp-2 and Pam3Cys and TLR4 ligand LPS. Finally, we analyzed peripheral blood monocytes of patients with S. aureus bloodstream infection for their ex vivo inflammatory responses towards S. aureus stimulation and their glycoprotein expression profiles. Our results demonstrate that monocytes from healthy donors stimulated with S. aureus and TLR ligands of Gram-positive bacteria entered the tolerant cell state after activation similar to LPS treatment. In particular reduced gene expression of pro-inflammatory cytokines (TNF, IL1β) and chemokines (CCL20, CCL3, CCL4, CXCL2, CXCL3 and CXCL8) could be demonstrated. Glycoprotein expression changes in monocytes tolerized by the different TLR agonists were highly similar while S. aureus -stimulated monocytes shared some of the PAMP-induced changes but also exhibited a distinct expression profile. 11 glycoproteins (CD44, CD274, DSC2, ICAM1, LAMP3, LILRB1, PTGS2, SLC1A3, CR1, FGL2, and HP) were similarly up- or downregulated in all four comparisons in the tolerant cell state. Monocytes from patients with S. aureus bacteremia revealed preserved pro-inflammatory responsiveness to S. aureus stimulation ex vivo, expressed increased CD44 mRNA but no other glycoprotein of the tolerance signature was differentially expressed.
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... The incidence of bloodstream infections (BSI) is estimated to be between 113 and 204 per 100,000 persons per year [1]
, corresponding to a burden of 1,200,000 episodes each year in Europe alone [2]. With mortality rates ranging from 10-40% [3,4], appropriate and expeditious antimicrobial therapy is of paramount importance [5]. ...
EUCAST rapid antimicrobial susceptibility testing (RAST) compared to conventional susceptibility testing: implementation and potential added value in a tertiary hospital in Belgium Article
Mar 2023
Gregory Strubbe Anne-Sophie Messiaen
Stien Vandendriessche Jerina Boelens
Objectives:
EUCAST breakpoints for short incubation disk diffusion allow rapid antimicrobial susceptibility testing (RAST) directly from positive blood cultures. We evaluate the RAST methodology and assess its potential added value in a setting of low prevalence of multidrug-resistant (MDR) organisms.
Methods:
In our two-part study, we performed RAST on 127 clinical blood cultures at 6 and 8 h and determined categorical agreement with direct susceptibility testing. We also measure the impact of susceptibility results on antimicrobial therapy compared to empirical treatment.
Results:
Categorical agreement was 96.2% at 6 h (575/598 isolate-drug combinations) and 96.6% at 8 h (568/588 combinations). Major errors involved piperacillin/tazobactam in 16 of 31 cases. The second part of our study shows that AST reporting proved essential in correcting ineffective empirical therapy in 6.3% of the patients (8/126).
Conclusion:
EUCAST RAST is an inexpensive and reliable method of susceptibility testing, although care must be taken with reporting piperacillin/tazobactam. In support of RAST implementation, we show that AST remains of great importance in providing effective therapy, even in a setting of low MDR prevalence and elaborate antibiotic guidelines.
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... 8,9 During infections, it causes a diverse range of infections such as pimples, boils, impetigo, folliculitis, cellulitis, carbuncles, abscesses, lifethreatening endocarditis, bacteremia, sepsis, pneumonia, meningitis, osteomyelitis, toxic shock syndrome, surgical site infection, and catheter-associated bloodstream infections. [10][11][12] [13]
Most of these infections emerged due to evolving drug resistance commonly to methicillin. 12 The World Health Organization (WHO) report of 2019 suggested that antimicrobial resistance causes 700,000 deaths each year. ...
Antimicrobial effect of pimozide by targeting ROS-mediated killing in Staphylococcus aureus Article Full-text available
Mar 2023 BIOTECHNOL APPL BIOC
Siddhartha Kumar Kumar Sandeep
Rakesh Kumar Antresh Kumar
In spite of the higher nosocomial and community-acquired infections acquired by Staphylococcus aureus, emerging drug resistance is a leading cause of increased mortality and morbidity associated with the overuse of antimicrobials. It is an emergent need to find out new molecules to combat such infections. In the present study, we analyzed the antibacterial effect of pimozide (PMZ) against Gram +ve and Gram -ve bacterial strains including methicillin-sensitive (MSSA) and methicillin resistance (MRSA) S. aureus. The growth of MSSA and MRSA was completely inhibited at concentrations of 12.5 μg/ml and 100 μg/ml, respectively which is referred to as 1x MIC. The cell viability was completely eliminated within 90 min of PMZ treatment (2x MIC) through ROS-mediated killing without affecting cell membrane permeability. It suppressed α-hemolysin biofilm formation of different S. aureus strains by almost 50% at 1x MIC concentration and was found to detach matured biofilm. PMZ treatment effectively eliminates S. aureus infection in C. elegans and improves its survival by 90% and found safe to use with no hemolytic effect on human and chicken blood tissues. Taken together, it is concluded that PMZ may turn out to be an effective antibacterial for treating bacterial infections including MSSA and MRSA. This article is protected by copyright. All rights reserved.
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... Even in developed countries, 30-day death rates range from 3 to 47% when a definitive diagnosis of clinically significant bacteraemia caused by Staphylococcus aureus, Escherichia coli, Klebsiella spp., and Pseudomonas spp. is made [7, 8]
. In most cases of bacteraemia, the bacteria are rapidly eliminated from the bloodstream; however, patients with sepsis have a poor prognosis due to systemic infection and damage to several organs. ...
Clinical and Microbiological Features of Fulminant Haemolysis Caused by Clostridium perfringens Bacteraemia: Unknown Pathogenesis Article Full-text available
Mar 2023
Ai Suzaki Satoshi Hayakawa
Bacteraemia brought on by Clostridium perfringens has a very low incidence but is severe and fatal in fifty per cent of cases. C. perfringens is a commensal anaerobic bacterium found in the environment and in the intestinal tracts of animals; it is known to produce six major toxins: α-toxin, β-toxin, ε-toxin, and others. C. perfringens is classified into seven types, A, B, C, D, E, F and G, according to its ability to produce α-toxin, enterotoxin, and necrotising enterotoxin. The bacterial isolates from humans include types A and F, which cause gas gangrene, hepatobiliary infection, and sepsis; massive intravascular haemolysis (MIH) occurs in 7–15% of C. perfringens bacteraemia cases, resulting in a rapid progression to death. We treated six patients with MIH at a single centre in Japan; however, unfortunately, they all passed away. From a clinical perspective, MIH patients tended to be younger and were more frequently male; however, there was no difference in the toxin type or genes of the bacterial isolates. In MIH cases, the level of θ-toxin in the culture supernatant of clinical isolates was proportional to the production of inflammatory cytokines in the peripheral blood, suggesting the occurrence of an intense cytokine storm. Severe and systemic haemolysis is considered an evolutionary maladaptation as it leads to the host’s death before the bacterium obtains the benefit of iron utilisation from erythrocytes. The disease’s extraordinarily quick progression and dismal prognosis necessitate a straightforward and expedient diagnosis and treatment. However, a reliable standard of diagnosis and treatment has yet to be put forward due to the lack of sufficient case analysis.
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... It is a systemic infectious disease that can develop into sepsis in severe cases, causing shock, disseminated intravascular coagulation and multiple organ failure. The BSI's incidence ranges from 113 to 204 per 100,000 population (1, 2)
. With the widespread application of broad-spectrum antibiotics and hormones andthe development of invasive diagnosis and treatment techniques, the incidence of bloodstream infections has been increasing yearly (3,4). ...
Comparison of metagenomic next-generation sequencing and blood culture in patients with suspected bloodstream infection Preprint Full-text available
Feb 2023
Wen Shi Yuhua Zhou Yi Wen Tongtian Ni
Background
The application of metagenomic next-generation sequencing (mNGS) has gradually been carried out by clinical practitioner. However, few studies have compared it with blood cultures in patients suffering from suspected bloodstream infections. The purpose of this study was to compare the detection of pathogenic microorganisms by these two assays in patients with suspected bloodstream infection.
Methods
We retrospectively studied patients with fever, chills, antibiotic use for more than 3 days, suspected bloodstream infection, and admission to the emergency department of Ruijin Hospital from January 2020 to June 2022. All patients had blood drawn on the same day for blood mNGS and blood cultures. Clinical and laboratory parameters were collected on the day blood was drawn. The detection of pathogenic microorganisms by the two methods was compared. Risk factors and in-hospital mortality in patients with bloodstream infections were analysed separately for these two assays.
Results
In all 99 patients, the pathogenic microorganisms detection rate in blood mNGS was significantly higher than that in blood culture. Blood mNGS was consistent with blood culture in only 12.00% of all positive bacterial and fungal test results. The level of CRP is related to bacteraemia, fungaemia and viraemia detected by blood mNGS. No clear risk factors could be found in patients with a positive blood culture. In critically ill patients, both tests failed to improve patient outcomes.
Conclusion
In patients with suspected bloodstream infection, mNGS is not yet a complete replacement for blood cultures. The results of both tests could not improve in-hospital mortality.
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... Staphylococcus aureus bacteraemia (SAB) is one of the most common bloodstream infections worldwide
[1,
2]. In 2019, S. aureus was amongst the top three pathogens responsible for global deaths associated with antimicrobial resistance (AMR), with methicillin-resistant S. aureus (MRSA) causing more than 100,000 annual deaths [3]. ...
Epidemiology and clinical presentation of community-acquired Staphylococcus aureus bacteraemia in children under 5 years of age admitted to the Manhiça District Hospital, Mozambique, 2001-2019 Article Full-text available
Mar 2023 EUR J CLIN MICROBIOL
Marcelino Garrine Llorenç Quintó Sofia Santos Costa Inácio Mandomando
Staphylococcus aureus bacteraemia (SAB) is one of the most common bloodstream infections globally. Data on the burden and epidemiology of community-acquired SAB in low-income countries are scarce but needed to define preventive and management strategies. Blood samples were collected from children < 5 years of age with fever or severe disease admitted to the Manhiça District Hospital for bacterial isolation, including S. aureus. Between 2001 and 2019, 7.6% (3,197/41,891) of children had bacteraemia, of which 12.3% corresponded to SAB. The overall incidence of SAB was 56.1 episodes/100,000 children-years at risk (CYAR), being highest among neonates (589.8 episodes/100,000 CYAR). SAB declined significantly between 2001 and 2019 (322.1 to 12.5 episodes/100,000 CYAR). In-hospital mortality by SAB was 9.3% (31/332), and significantly associated with infections by multidrug-resistant (MDR) strains (14.7%, 11/75 vs. 6.9%, 14/204 among non-MDR, p = 0.043) and methicillin-resistant S. aureus (33.3%, 5/15 vs. 7.6%, 20/264 among methicillin-susceptible S. aureus, p = 0.006). Despite the declining rates of SAB, this disease remains an important cause of death among children admitted to MDH, possibly in relation to the resistance to the first line of empirical treatment in use in our setting, suggesting an urgent need to review current policy recommendations.
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... An elevated risk of S. aureus bloodstream infection in patients undergoing general, orthopedic, or thoracic surgery, being treated in the intensive care unit, or undergoing hemodialysis or continuous peritoneal dialysis has been reported in many studies (1,5). S. aureus-induced bloodstream infections are characterized by high mortality rates despite appropriate treatment (20 to 50%, depending on infection severity), frequent recurrence (5 to 10%), and lasting impairments in .33% of survivors
(6)
. ...
Oral Vaccination with Engineered Probiotic Limosilactobacillus reuteri Has Protective Effects against Localized and Systemic Staphylococcus aureus Infection Article Full-text available
Feb 2023
Na Pan Yang Liu Haochi Zhang Xiao Wang
Staphylococcus aureus is a Gram-positive bacterium responsible for most hospital-acquired (nosocomial) and community-acquired infections worldwide. The only therapeutic strategy against S. aureus-induced infections, to date, is antibiotic treatment. A protective vaccine is urgently needed in view of the emergence of antibiotic-resistant strains associated with high-mortality cases; however, no such vaccine is currently available. In our previous work, the feasibility of implementing a Lactobacillus delivery system for development of S. aureus oral vaccine was first discussed. Here, we describe systematic screening and evaluation of protective effects of engineered Lactobacillus against S. aureus infection in terms of different delivery vehicle strains and S. aureus antigens and in localized and systemic infection models. Limosilactobacillus reuteri WXD171 was selected as the delivery vehicle strain based on its tolerance of the gastrointestinal environment, adhesion ability, and antimicrobial activities in vitro and in vivo. We designed, constructed, and evaluated engineered L. reuteri strains expressing various S. aureus antigens. Among these, engineered L. reuteri WXD171-IsdB displayed effective protection against S. aureus-induced localized infection (pneumonia and skin infection) and, furthermore, a substantial survival benefit in systemic infection (sepsis). WXD171-IsdB induced mucosal responses in gut-associated lymphoid tissues, as evidenced by increased production of secretory IgA and interleukin 17A (IL-17A) and proliferation of lymphocytes derived from Peyer's patches. The probiotic L. reuteri-based oral vaccine appears to have strong potential as a prophylactic agent against S. aureus infections. Our findings regarding utilization of Lactobacillus delivery system in S. aureus vaccine development support the usefulness of this live vaccination strategy and its potential application in next-generation vaccine development. IMPORTANCE We systematically screened and evaluated protective effects of engineered Lactobacillus against S. aureus infection in terms of differing delivery vehicle strains and S. aureus antigens and in localized and systemic infection models. Engineered L. reuteri was developed and showed strong protective effects against both types of S. aureus-induced infection. Our findings regarding the utilization of a Lactobacillus delivery system in S. aureus vaccine development support the usefulness of this live vaccination strategy and its potential application in next-generation vaccine development.
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... Finally, the present study only involved the rapid identification of pathogens and lacked important antimicrobial susceptibility markers. Exploring the ability of this PCR-QDFA method to detect drug resistance genes has become particularly important because of the worldwide increase in bacterial multidrug resistance
(Kern & Rieg, 2020)
. ...
Clinical evaluation of polymerase chain reaction coupled with quantum dot fluorescence analysis in the identification of bacteria and yeasts in patients with suspected bloodstream infections Article Full-text available
Feb 2023
Jie Li Wenjia Fan Xuehan Zou Huang Haijun
Bloodstream infections are serious and complex infectious diseases that often require a rapid diagnosis. Polymerase chain reaction coupled with quantum dot fluorescence analysis (PCR-QDFA) is a novel diagnostic technique. This study aimed to evaluate the diagnostic performance of PCR-QDFA for pathogen detection in patients with suspected bloodstream infections (BSIs). It evaluates 29 kinds of common pathogens (24 bacteria and 5 yeasts) from blood culture bottles. The results of PCR-QDFA identification and traditional microbial laboratory identification were compared, and the latter was used as the 'gold standard' to analyse the diagnostic performance of the PCR-QDFA. In total, 517 blood culture bottles were included in this study. The PCR-QDFA identified microorganisms in 368/422 (87.2%) samples with monomicrobial growth. For the pathogens on the PCR-QDFA list, the assay showed a higher sensitivity of 97.4% (368/378). When polymicrobial growth was analysed, the PCR-QDFA successfully detected 19/25 (76%) microorganisms on the PCR-QDFA list. In addition, 82/82 negative blood culture bottles also showed no pathogens by PCR-QDFA with a specificity of 100%. In conclusion, the PCR-QDFA assay could identify a majority of the common pathogens encountered in clinical practice, showing excellent diagnostic performance for pathogen detection in patients with suspected BSIs.
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... This finding is consistent with the previous reports from Saudi Arabia, in which the majority of K. pneumoniae were isolated from blood and respiratory specimens [12]. The present finding relies on the fact that K. pneumoniae is one of the main causative agents of bloodstream infection and respiratory tract infection, and it should be taken into consideration during the diagnosis of respiratory infection [24, 25]
. ...
Prevalence and Antibiogram Pattern of Klebsiella pneumoniae in a Tertiary Care Hospital in Makkah, Saudi Arabia: An 11-Year Experience Article Full-text available
Jan 2023
Naif A. Jalal Abdulrahman M Al-Ghamdi
Aiman M Momenah Hani Faidah
View
... This finding is consistent with the previous reports from Saudi Arabia, in which the majority of K. pneumoniae were isolated from blood and respiratory specimens [12]. The present finding relies on the fact that K. pneumoniae is one of the main causative agents of bloodstream infection and respiratory tract infection, and it should be taken into consideration during the diagnosis of respiratory infection [24, 25]
. ...
Prevalence and Antibiogram Pattern of Klebsiella pneumoniae in a Tertiary Care Hospital in Makkah, Saudi Arabia: An 11-Year Experience Article Full-text available
Jan 2023
Faez Bahuwayrith
Infectious disease is one of the greatest causes of morbidity and mortality worldwide, and with the emergence of antimicrobial resistance, the situation is worsening. In order to prevent this crisis, antimicrobial resistance needs to be monitored carefully to control the spread of multidrug-resistant bacteria. Therefore, in this study, we aimed to determine the prevalence of infection caused by Klebsiella pneumoniae and investigate the antimicrobial profile pattern of K. pneumoniae in the last eleven years. This retrospective study was conducted in a tertiary hospital in Makkah, Saudi Arabia. Data were collected from January 2011 to December 2021. From 2011 to 2021, a total of 61027 bacterial isolates were collected from clinical samples, among which 14.7% (n = 9014) were K. pneumoniae. The antibiotic susceptibility pattern of K. pneumoniae revealed a significant increase in the resistance rate in most tested antibiotics during the study period. A marked jump in the resistance rate was seen in amoxicillin/clavulanate and piperacillin/tazobactam, from 33.6% and 13.6% in 2011 to 71.4% and 84.9% in 2021, respectively. Ceftazidime, cefotaxime, and cefepime resistance rates increased from 29.9%, 26.2%, and 53.9%, respectively, in 2011 to become 84.9%, 85.1%, and 85.8% in 2021. Moreover, a significant increase in the resistance rate was seen in both imipenem and amikacin, with an average resistance rate rise from 6.6% for imipenem and 11.9% for amikacin in 2011 to 59.9% and 62.2% in 2021, respectively. The present study showed that the prevalence and drug resistance of K. pneumoniae increased over the study period. Thus, preventing hospital-acquired infection and the reasonable use of antibiotics must be implemented to control and reduce antimicrobial resistance .
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... 1,2 These infections have a high morbidity rate and often require revision surgeries which burden the healthcare system with increased costs. 1,3,4 With the increased prevalence of multidrug-resistant pathogens, [5]
[6][7] common antibiotics are becoming less effective at inhibiting pathogen growth, necessitating the development of alternative antimicrobial treatments. 6,8 This need for alternative antimicrobial therapies is additionally heightened by the challenges of biofilms and persister cells. ...
Silver Carboxylate as an Antibiotic-Independent Antimicrobial: A Review of Current Formulations, in vitro Efficacy, and Clinical Relevance Article Full-text available
Dec 2022
Makena Mette Liam Connolly Neel Vishwanath Dioscaris R. Garcia
The increasing prevalence of multi-drug resistant pathogens has led to a renewed focus on the use of silver as an antibiotic-independent antimicrobial. Unfortunately, the use of many silver formulations may be limited by an uncontrolled release of silver with the potential for significant cytotoxic effects. Silver carboxylate (AgCar) has emerged as an alternative formulation of silver with the potential to mitigate these concerns while still displaying significant bactericidal activity. This article reviews the efficacy of silver carboxylate formulations as a promising novel antibiotic-independent antimicrobial. This study was conducted through a search of five electronic databases (PubMed, Embase, MEDLINE, Cochrane Library, and Web of Science) for relevant studies up to September 2022. Searches were conducted for types of “silver carboxylate” formulations. Sources were compiled based on title and abstract and screened for inclusion based on relevance and study design. A review of the antimicrobial activity and cytotoxicity of silver carboxylate was compiled based on this search. Current body of data suggests that silver carboxylate shows promise as an emerging antibiotic-independent antimicrobial, with significant bactericidal effects while minimizing cytotoxicity. Silver carboxylate addresses several of the limitations of more primitive formulations, including controlled dosing and fewer negative effects on eukaryotic cell lines. These factors are concentration-dependent and largely rely on the vehicle system used to deliver it. Although several silver carboxylate-based formulations like titanium dioxide/ polydimethylsiloxane (TiO2/PDMS) matrix-eluting AgCar have shown promising results in vitro, and could potentially be utilized independently or in conjunction with current and future antimicrobial therapies, there is a need for further in vivo studies to validate their overall safety and efficacy profile.
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... Blood culture is the laboratory gold standard for the diagnosis of blood stream infection; it guides antimicrobial treatment and monitoring of antimicrobial resistant patterns [1]. BSI has emerged as a public health concern with especially rising drug resistance, morbidity and mortality worldwide [2]
. Low-and middle-income countries bear disproportionately the burden of BSI [3] [4] [5]. ...
Transitioning to Automated Microbiologic Era: Blood Culture Isolates in Children and Adults in Federal Teaching Hospital in Gombe, North East Nigeria 2016-2020 Article Full-text available
Jan 2022
Elon Warnow Isaac Iliya Jalo
Mohammed M Manga Muhammad Saminu Charanci
View
... While individuals of all ages are prone to infection, immune-compromised neonates, children and adults mostly succumb to sepsis. Though any opportunistic pathogen can trigger sepsis, among bacteria, Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae (Kp), Acinetobacter baumannii (Acb), Pseudomonas aeruginosa and Enterobacter sp. are the prominent drivers [5][6][7] [8]
[9]. In LMICs, the bulk of the neonatal blood culture-positive sepsis cases (45-55%) are triggered by two Gram-negative septicemia-and pneumonia-causing bacterial pathogens, Acb and Kp [10][11][12][13]. ...
Genomic islands and their role in fitness traits of two key sepsis-causing bacterial pathogens Article
Dec 2022 Brief Funct Genomics
Mohd Ilyas Dyuti Purkait Krishnamohan Atmakuri
To survive and establish a niche for themselves, bacteria constantly evolve. Toward that, they not only insert point mutations and promote illegitimate recombinations within their genomes but also insert pieces of ‘foreign’ deoxyribonucleic acid, which are commonly referred to as ‘genomic islands’ (GEIs). The GEIs come in several forms, structures and types, often providing a fitness advantage to the harboring bacterium. In pathogenic bacteria, some GEIs may enhance virulence, thus altering disease burden, morbidity and mortality. Hence, delineating (i) the GEIs framework, (ii) their encoded functions, (iii) the triggers that help them move, (iv) the mechanisms they exploit to move among bacteria and (v) identification of their natural reservoirs will aid in superior tackling of several bacterial diseases, including sepsis. Given the vast array of comparative genomics data, in this short review, we provide an overview of the GEIs, their types and the compositions therein, especially highlighting GEIs harbored by two important pathogens, viz. Acinetobacter baumannii and Klebsiella pneumoniae, which prominently trigger sepsis in low- and middle-income countries. Our efforts help shed some light on the challenges these pathogens pose when equipped with GEIs. We hope that this review will provoke intense research into understanding GEIs, the cues that drive their mobility across bacteria and the ways and means to prevent their transfer, especially across pathogenic bacteria.
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... Staphylococcus aureus (SA) is a leading cause of bacteremia. High mortality rates from 20% to 50%, frequent recurrences from 5% to 10%, and lasting impairment in more than one-third of the survivors characterize S. aureus bloodstream infections (BSI) (Asgeirsson et al. 2018;
Kern and Rieg 2020)
. S. aureus infections are particularly problematic due to the frequent antibiotic resistance, among which methicillin resistance is the most clinically relevant (Turner et al. 2019). ...
Rapid and Simple Approaches for Diagnosis of Staphylococcus aureus in Bloodstream Infections Article Full-text available
Dec 2022 Pol J Microbiol
Rui Duan Pei Wang
Staphylococcus aureus is an important causative pathogen of bloodstream infections. An amplification assay such as real-time PCR is a sensitive, specific technique to detect S. aureus. However, it needs well-trained personnel, and costs are high. A literature review focusing on rapid and simple methods for diagnosing S. aureus was performed. The following methods were included: (a) Hybrisep in situ hybridization test, (b) T2Dx system, (c) BinaxNow Staphylococcus aureus and PBP2a, (d) Gram staining, (e) PNA FISH and QuickFISH, (f) Accelerate PhenoTM system, (g) MALDI-TOF MS, (h) BioFire FilmArray, (i) Xpert MRSA/SA. These rapid and simple methods can rapidly identify S. aureus in positive blood cultures or direct blood samples. Furthermore, BioFire FilmArray and Xpert MRSA/SA identify methicillin-resistant S. aureus (MRSA), and the Accelerate PhenoTM system can also provide antimicrobial susceptibility testing (AST) results. The rapidity and simplicity of results generated by these methods have the potential to improve patient outcomes and aid in the prevention of the emergence and transmission of MRSA.
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... Here, we focused on the role of livestock keeping within households across Nairobi, Kenya, as a highrisk urban interface for the emergence and transmission of AMR bacteria between humans and animals. We use Escherichia coli, a common commensal and pathogenic bacterium [6]
in vertebrates, to investigate the dispersal of AMR between human and animal hosts in 99 households across Nairobi using an epidemiologically structured analytical framework. ...
Genomic epidemiology of Escherichia coli: antimicrobial resistance through a One Health lens in sympatric humans, livestock and peri-domestic wildlife in Nairobi, Kenya Article Full-text available
Dec 2022 BMC MED
Dishon Muloi James M. Hassell Bryan A. Wee M. E. J. Woolhouse
Background
Livestock systems have been proposed as a reservoir for antimicrobial-resistant (AMR) bacteria and AMR genetic determinants that may infect or colonise humans, yet quantitative evidence regarding their epidemiological role remains lacking. Here, we used a combination of genomics, epidemiology and ecology to investigate patterns of AMR gene carriage in Escherichia coli, regarded as a sentinel organism.
Methods
We conducted a structured epidemiological survey of 99 households across Nairobi, Kenya, and whole genome sequenced E. coli isolates from 311 human, 606 livestock and 399 wildlife faecal samples. We used statistical models to investigate the prevalence of AMR carriage and characterise AMR gene diversity and structure of AMR genes in different host populations across the city. We also investigated household-level risk factors for the exchange of AMR genes between sympatric humans and livestock.
Results
We detected 56 unique acquired genes along with 13 point mutations present in variable proportions in human and animal isolates, known to confer resistance to nine antibiotic classes. We find that AMR gene community composition is not associated with host species, but AMR genes were frequently co-located, potentially enabling the acquisition and dispersal of multi-drug resistance in a single step. We find that whilst keeping livestock had no influence on human AMR gene carriage, the potential for AMR transmission across human-livestock interfaces is greatest when manure is poorly disposed of and in larger households.
Conclusions
Findings of widespread carriage of AMR bacteria in human and animal populations, including in long-distance wildlife species, in community settings highlight the value of evidence-based surveillance to address antimicrobial resistance on a global scale. Our genomic analysis provided an in-depth understanding of AMR determinants at the interfaces of One Health sectors that will inform AMR prevention and control.
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... Populationbased studies estimated that there were 575,000-677,000 episodes of BSI and 79,000-94,000 deaths per year in North America, more than 1,200,000 episodes of BSI and 157,000 deaths per year in Europe [1,2]. A good progress has been achieved in the diagnosis and treatment of BSIs, but the mortality associated with some pathogens such as methicillin-resistant Staphylococcus aureus, vancomycinresistant enterococci, carbapenem-resistant Enterobacteriaceae is still high [3]
. ...
Development of a risk prediction model for bloodstream infection in patients with fever of unknown origin Article Full-text available
Dec 2022 J TRANSL MED
Teng Xu Shi Wu Jingwen Li Haihui Huang
Background
Bloodstream infection (BSI) is a significant cause of mortality among patients with fever of unknown origin (FUO). Inappropriate empiric antimicrobial therapy increases difficulty in BSI diagnosis and treatment. Knowing the risk of BSI at early stage may help improve clinical outcomes and reduce antibiotic overuse.
Methods
We constructed a multivariate prediction model based on clinical features and serum inflammatory markers using a cohort of FUO patients over a 5-year period by Least Absolute Shrinkage and Selection Operator (LASSO) and logistic regression.
Results
Among 712 FUO patients, BSI was confirmed in 55 patients. Five independent predictors available within 24 h after admission for BSI were identified: presence of diabetes mellitus, chills, C-reactive protein level of 50–100 mg/L, procalcitonin > 0.3 ng/mL, neutrophil percentage > 75%. A predictive score incorporating these 5 variables has adequate concordance with an area under the curve of 0.85. The model showed low positive predictive value (22.6%), but excellent negative predictive value (97.4%) for predicting the risk of BSI. The risk of BSI reduced to 2.0% in FUO patients if score < 1.5.
Conclusions
A simple tool based on 5 variables is useful for timely ruling out the individuals at low risk of BSI in FUO population.
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... Multidrug-resistant ExPEC strains have been implicated in several recent infections, especially UTI and BSI worldwide (Antimicrobial Resistance Collaborators, 2022;
Kern and Rieg, 2020)
. The continuing global rise of multidrug-resistant ExPEC clones is not only found in clinical settings (Giufrè et al., 2012;Ranjan et al., 2017) but also in food animals (Johnson et al., 2012;Zou et al., 2021). ...
Urinary tract infection and sepsis causing potential of multidrug-resistant Extraintestinal pathogenic E. coli isolated from plant-origin foods Article
Dec 2022 INT J FOOD MICROBIOL
Priyanka Priyanka Prem R. Meena Ph.D Dharma Raj Arvind Pratap Singh
The dissemination of Extraintestinal pathogenic Escherichia coli (ExPEC) in food is a critical concern for human health and food safety. The present study is the first to systematically examine the diverse plant-origin foods such as cucumber, carrot, tomato, radish, chilli, fenugreek, coriander, peppermint, spring onion, cabbage, and spinach for the presence of ExPEC or specific putative ExPEC pathotypes with an in-depth assessment of their phylogenetics, virulence, and drug resistance. A total of 77 (15.9 %) ExPEC isolates were recovered from 1780 samples of the diverse plant-origin foods of distinct environments. Specific putative ExPEC pathotypes such as Uropathogenic E. coli (UPEC, 23.3 %) and Septicemia-associated E. coli (SEPEC, 24.6 %) were identified among ExPEC isolates. The Clermont revisited new phylotyping method revealed the varied distribution (1–27 %) of specific putative ExPEC pathotypes in the different phylogenetic lineages such as A, D/E, B1, and Clade 1, etc. All putative ExPEC pathotypes possess multiple genes (4.3–92.8 %) or phenotypes (3.3–100 %) associated with their virulence. In-vitro antimicrobial susceptibility testing of all putative ExPEC pathotypes demonstrated the presence of 100 % multidrug resistance with moderate to high (52–100 %) resistance to drugs used as last-resorts (chloramphenicol, colistin) or frontline (nitrofurantoin, sulfamethoxazole, ampicillin, gentamicin) in ExPEC-associated infections in humans. Overall, the present findings significantly contribute to our better understanding of the presence of ExPEC in the non-clinical niche, such as plant-origin foods with a possible consequence on human health and food safety.
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... Due to the high mortality of BSIs and sepsis, early administration of empiric broadspectrum antimicrobials is normally the first step in the treatment of these infections, but in many occasions this it is not accurate for the actual bacterial pathogen causing BSI or sepsis, leading to therapeutic failure and death [1][2][3] 5]
. Therefore, it is imperative to identify, in a timely manner, the infectious agent causing BSI or infection leading to sepsis (bacteria, fungi, or virus) as well as possible associated antimicrobial resistances [2,4], in order to administer tailored antimicrobial therapy. ...
Quantification of bacterial DNA in blood using droplet digital PCR: a pilot study
Preprint Full-text available
Dec 2022
Ana P. Tedim Irene Merino Alicia Ortega Jesus F Bermejo-Martin
Aim
To use genus/species-specific genes droplet digital PCR (ddPCR) assays to detect/quantify bacterial DNA from Escherichia coli , Klebsiella pneumoniae , Staphylococcus aureus and Enterococcus spp in blood samples.
Methods and Results
Bacterial DNA from clinical strains (4<n<12) was extracted, quantified and diluted (10-0.0001ng/μL) and ddPCR assays were performed in triplicate. These ddPCR assays showed low replication variability, low detection limit (1–0.1pg/μL) and high genus/species specificity. ddPCR assays were also used to quantify bacterial DNA obtained from spiked blood (1×104-1CFU/mL) of each bacterial genus/species. Comparison between ddPCR assays and bacterial culture was performed by Pearson correlation. There was an almost perfect correlation (r≥0.997, p≤0.001) between the number of CFU/mL from bacterial culture and the number of gene copies/mL detected by ddPCR. The time from sample preparation to results was determined to be 3.5-4h.
Conclusions
The results demonstrated the quantification capacity and specificity of the ddPCR assays to detect/quantify four of the most important bloodstream infection (BSI) bacterial pathogens directly from blood.
Significance and Impact
This pilot study results reinforce the potential of ddPCR for the diagnosis and/or severity stratification of BSI. Applied to patients’ blood samples it can improve diagnosis and diminish sample-to-results time, improving patient care.
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... Overall, the articles in this Research Topic highlight a spectrum of research encompassing the importance of pursuing work to explore new ways of treating multidrug resistant bacteria. Despite the availability of a range of antimicrobials, multidrug resistant (MDR) bacterial infections continue to have a significant impact, contributing to the burden on the public health sector of various countries (Cerceo et al., 2016;Jabbour et al., 2020;Jernigan et al., 2020;Karaman et al., 2020;
Kern and Rieg, 2020;
Jean et al., 2022). The discovery of antibiotics, starting with the introduction of penicillin in the 1940s, dramatically improved outcomes of bacterial infections, however increasing incidence of infections with multidrug resistant organisms has created an impending healthcare crisis associated with escalating patient morbidity, mortality and health care costs (Medina and Pieper, 2016;Campanini-Salinas et al., 2018;Escolà-Vergé et al., 2020). ...
Editorial: Novel approaches to the treatment of multidrug-resistant bacteria, Volume II Article Full-text available
Nov 2022
Priyia Pusparajah Vengadesh Letchumanan Bey Hing Goh Lyndy Mcgaw
View
... At present, the incidence of bacteremia is already high worldwide, and the incidence, mortality and medical costs of bacteremia are still increasing (Kern and Rieg, 2020)
. Blood culture is still the "gold standard" for the diagnosis of bacteremia (Adrie et al., 2017), but it always has a low positive rate and a long time. ...
Microbiological characteristics and risk factors on prognosis associated with Acinetobacter baumannii bacteremia in general hospital: A single-center retrospective study Article Full-text available
Nov 2022
Zhiyong Wei Shuai Zhou Ying Zhang
Keliang Xie
Objective
Acinetobacter baumannii is one of the most important pathogenic bacteria causing nosocomial infections and has a high mortality rate. Assessment of the microbiological characteristics and risk factors on prognosis associated with A.baumannii is essential. In this study, we aimed to investigate the clinical characteristics and prognostic risk factors of patients with A.baumannii bacteremia.
Patients and Methods
This study retrospectively analyzed the antibiotic resistance of pathogens based on the clinical data of A.baumannii bacteremia patients presented in a tertiary teaching hospital from 2017 to 2022. Logistic regression and decision tree identified the prognostic risk factors for patients with baumannemia. Kaplan-Meier method was used for survival analysis between MDR and Non-MDR groups. The area under receiver-operating characteristic curve (ROC curve) was used to compare the predictive value of the APACHE II score and Sequential Organ Failure Assessment (SOFA) score.
Results
A total of 110 patients with positive A. Baumannii blood cultures were included. Most of the patients were from intensive care unit (ICU) wards. The drug sensitivity results showed that the resistance rate of A. baumannii to colistin was the lowest (1.1%), followed by tigecycline (3.6%).
The survival time of MDR group was significantly shorter than that of Non-MDR group. Multivariate analysis showed that, APACHE II score and SOFA score were independent risk factors affecting the prognosis of 28 days of A.baumannii bacteremia. And both scores displayed excellent AUROCs (SOFA: 0.909, APACHE II: 0.895 in predicting 28-day mortality). The two scoring systems were highly correlated and predicted no significant difference ( r ² = 0.4410, P < 0.001). We found that SOFA > 7 and APACHE II > 21 are associated with significantly higher mortality rates.
Conclusion
A.baumannii bacteremia have the highest incidence in the ICU, with high drug resistance and mortality rates. The survival time of patients with MDR A. Baumannii bacteremia was significantly shortened. The SOFA score and APACHE II score can reflect the severity of A.baumannii bacteremia patients and evaluate the 28-day prognosis. In addition, for the convenience of calculation, the SOFA score may be more clinically useful than the APACHE II score in predicting the mortality rate of A.baumannii bacteremia.
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... Bloodstream infection rates were estimated to reach two million episodes yearly in North America and Europe combined, with an estimated one-quarter of a million deaths [2]. Escherichia coli has the highest incidence, whereas Staphylococcus aureus and Pseudomonas aeruginosa cause higher mortality rates [3]
. ...
Development of a Multiplex Polymerase Chain Reaction-Based DNA Lateral Flow Assay as a Point-of-Care Diagnostic for Fast and Simultaneous Detection of MRSA and Vancomycin Resistance in Bacteremia Article Full-text available
Nov 2022
Mona Kashef Omneya Mohamed Helmy
To reduce high mortality and morbidity rates, timely and proper treatment of methicillin-resistant Staphylococcus aureus (MRSA) bloodstream infection is required. A multiplex polymerase reaction (mPCR)-based DNA lateral flow assay (MBDLFA) was developed as a point-of-care diagnostic for simultaneous identification of S. aureus, methicillin resistance, and vancomycin resistance directly from blood or blood cultures. A mPCR was developed to detect nuc, mecA, and vanA/B; its sensitivity, specificity, and limit of detection (LOD) were determined. The developed reaction was further modified for use in MBDLFA and its sensitivity for detection of target genes from artificially inoculated blood samples was checked. The optimized mPCR successfully detected nuc, mecA, and vanA/B from genomic DNA of bacterial colonies with LODs of 107, 107, and 105 CFU/mL, respectively. The reaction was sensitive and specific. The optimized mPCR was used in MBDLFA that detected nuc, mecA, and vanA/B with LODs of 107, 108, and 104 CFU/mL, respectively, directly from artificially inoculated blood. The developed MBDLFA can be used as a rapid, cheap point-of-care diagnostic for detecting S. aureus, MRSA, and vancomycin resistance directly from blood and blood cultures in ~2 h with the naked eye. This will reduce morbidity, mortality, and treatment cost in S. aureus bacteremia.
View Show abstract
... Bloodstream infections (BSI) are the leading cause of morbidity and mortality worldwide and as a life-threatening condition require prompt diagnosis and treatment. In Europe and North America BSI incidence ranges between 113 and 204 per 100,000 people [1] [2]
[3][4]. Furthermore, the incidence of BSI is rising, probably related to an aging population and an increasing prevalence of underlying conditions and invasive procedures [5]. Mortality estimates vary with country from 15.3% to 40.0% [6]. ...
Sepsityper® Kit versus In-House Method in Rapid Identification of Bacteria from Positive Blood Cultures by MALDI-TOF Mass Spectrometry Article Full-text available
Oct 2022
Gabrijela Perše Ivana Samošćanec
Zrinka bošnjak Ivana Marekovic
In order to further accelerate pathogen identification from positive blood cultures (BC), various sample preparation protocols to identify bacteria with MALDI-TOF MS directly from positive BCs have been developed. We evaluated an in-house method in comparison to the Sepsityper® Kit (Bruker Daltonics, Bremen, Germany) as well as the benefit of an on-plate formic acid extraction step following positive signal by the BACTECTM FX system. Confirmation of identification was achieved using subcultured growing biomass used for MALDI-TOF MS analysis. A total of 113 monomicrobial positive BCs were analyzed. The rates of Gram-positive bacteria correctly identified to the genus level using in-house method and Sepsityper® Kit were 63.3% (38/60) and 81.7% (49/60), respectively (p = 0.025). Identification rates at species level for Gram-positive bacteria with in-house method and Sepsityper® kit were 30.0% (18/60) and 66.7% (40/60), respectively (p < 0.001). Identification rates of Gram-negative bacteria were similar with the in-house method and Sepsityper® Kit. Additional on-plate formic acid extraction demonstrated significant improvement in the identification rate of Gram-positive bacteria at both genus and species level for both in-house (p = 0.001, p < 0.001) and Sepsityper® Kit methods (p = 0.007, p < 0.001). Our in-house method is a candidate for laboratory routines with Sepsityper® Kit as a back-up solution when identification of Gram-positive bacteria is unsuccessful.
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... Staphylococcus aureus menyebabkan BSI dengan insiden tahunan sekitar 30-40 per 100.000 populasi dan tingkat fatalitas kasus terkait sebesar 20% (1, 2)
. ...
Antibacterial Effect Combination of Moringa Leaf Extract (Moringa oleifera Lam.) and Amoxicillin against Staphylococcus aureus and Escherichia coli in Vitro Article Full-text available
Apr 2022
Setiadi Abdillah Pratama Tri Widyawati
Muhammad Ichwan Dian Dwi Wahyuni
Staphylococcus aureus and Escherichia coli often infect humans and risky cause antibiotics resistance including amoxicillin. This encourages us finding alternative active ingredients: Moringa oleifera leaf. This study evaluated antibacterial activity of combination of Moringa leaf extract (KDK) and amoxicillin (KA) against S. aureus and E. coli in vitro. The research methods with true experimental research with post-test control group design. KDK obtained by maceration. Four concentrations of KDK test materials (20, 30, 40, 50%) and 1 concentration of KA (3 mg/mL). Disc diffusion test method taken and the parameter measured: the diameter of the disc inhibition zone. Data analyzed by One-way ANOVA and further Tukey’s test. KDK+KA against S. aureus (20.77±1.79 – 21.33±1.74 mm)>KDK (11.45±0.21 – 12.45±0.28 mm) or KA (14.50±0.42 mm). KDK+KA against E. coli (15.53±0.71 – 17.87±0.42 mm)>KDK (9.00±0.28 – 10.30±0.42 mm) or KA (13.45±0.35 mm). A significant (p<0.05) was obtained between the combination group (KDK+KA) versus a group (KDK or KA). The combination of Moringa leaf ethanol extract and amoxicillin synergistically effected as antibacterial against S. aureus and E. coli in vitro.
View Show abstract
... aeruginosa), and coagulase-negative staphylococci [5]. Several studies have reported the highest incidence for E. coli especially as regards hospital-acquired infections, while S. aureus and P. aeruginosa are among the prominent causes of mortality [6]
. Major dramatic changes have emerged with E. coli and K. pneumoniae epidemiology in BSIs owing to their resistance to third-generation cephalosporins, which is primarily due to the production of the extended-spectrum beta-lactamase (ESBL) enzymes. ...
BioFire FilmArray BCID2 Versus VITEK-2 System in Determining Microbial Etiology and Antibiotic-Resistant Genes of Pathogens Recovered from Central Line-Associated Bloodstream Infections Article Full-text available
Oct 2022
Heba M. El Sherif Mahitab Elsayed Mona El-Ansary Khaled M. Elsayed
Central line-associated bloodstream infection (CLABSI) is among the most serious hospital acquired infections. Therefore, the rapid detection of the causative microorganism is of crucial importance to allow for the appropriate antimicrobial therapy. In the present study, we analyzed the clinical performance of the BioFire FilmArray Blood Culture Identification 2 (BCID2) panel in the identification of 33 microbial species and 10 antibiotic resistance genes in comparison to the VITEK-2 system. A total of 104 blood specimens were included. The FilmArray BCID2 results were concordant with the VITEK-2 system in 69/97 specimens (71.1%). Non-concordance was either due to the detection of more pathogens by the FilmArray BCID2 23/28 (82%) or microbial species were misidentified 5/28 (18%). Hence, in comparison to the VITEK-2 system, the FilmArray BCID2 panel showed an overall sensitivity of 75.8% (95% CI, 66–83%) and an overall specificity of 98% (95% CI, 97–98.8%) in detecting microbial species. For the resistance genes, the FilmArray BCID was able to detect the presence of blaCTX-M gene in 23 Gram-negative isolates, blaNDM and blaOXA-48- like genes in 14 and 13 isolates, respectively. The mecA and mecC genes were found in 23 Staphylococcus species, while mecA, mecC and MREJ genes were found in 4 Staphylococcus aureus isolates. The sensitivity and specificity for detecting resistance genes by the FilmArray BCID2 was 90% (95% CI, 81.4–95%) and 99.6% (95% CI, 99–100%), respectively. As concluded, the present study emphasizes the high sensitivity and specificity of the FilmArray BCID2 in the rapid and reliable detection of different bacteria and fungi from positive blood culture bottles, as well as the accurate detection of various antibiotic resistance markers.
View Show abstract
... Bloodstream infection (BSI) is generally defined by the presence of viable bacterial or fungal microorganisms in the bloodstream confirmed by blood cultures, which include a wide variety of pathogens and clinical syndromes [1]. Although epidemiology of BSI from well-designed population-based surveillance is lacking, especially at a regional level and in resourcelimited settings [2]
, the incidence of BSI is estimated to be similar to stroke or venous thrombosis (about 100-200 per 100,000 population) in the general population [3,4], of which nosocomial BSI accounts for about 30-50% [5,6]. This has become a heavy burden for healthcare, as the presence of BSI is often associated with both worse prognosis (including prolonged lengths of hospital stay and increased mortality risk) and increased cost, especially for critically ill patients [7][8][9]. ...
Incidence, Clinical Features, and Association with Prognosis of Bloodstream Infection in Pediatric Patients After Percutaneous or Surgical Treatment for Ventricular Septal Defect or Atrial Septal Defect: A Retrospective Cohort Study Article Full-text available
Oct 2022
Qinchang Chen Jinjin Yu Pingchuan Huang Shushui Wang
Introduction
Bloodstream infection (BSI) may occur after cardiac procedures, but this has rarely been investigated specifically in pediatric patients after percutaneous or surgical treatment for ventricular septal defect (VSD) or atrial septal defect (ASD) with recent data. The current study aimed to investigate the incidence, clinical features, and association with prognosis of BSI in this patient population.
Methods
Pediatric patients who received percutaneous or surgical procedure for VSD or ASD between 2010 and 2018 in a large children’s hospital in China were retrospectively enrolled via the Pediatric Intensive Care database, but only those who had blood culture records within 24 h after the procedure and who had no prior positive blood culture records were included. BSI after the procedure was identified by reviewing blood culture records, and baseline characteristics associated with BSI were explored by univariable logistic regression. In-hospital mortality and length of hospitalization were studied as prognostic outcomes and compared between patients with and without BSI.
Results
A total of 1340 pediatric patients were included. Among them, 46 (3.43%) patients had BSI within 24 h after the procedure, of which the majority (78.26%, 36/46) were caused by Gram-positive bacteria and 65.22% (30/46) had antibiotic-resistant organisms. Age [odds ratio (OR) 0.98 per 1-month increase, 95% confidence interval (CI) 0.97–1.00, P = 0.021] and antibiotic use within 72 h before the procedure (OR 1.81, 95% CI 1.00–3.26, P = 0.049) were statistically significantly associated with developing BSI. Compared with patients without BSI, there was no statistically significant difference in in-hospital mortality (0.00% versus 0.54%, P = 1.000), but patients with BSI had statistically significantly longer length of hospitalization (median 14.51 versus 12.94 days, P = 0.006), while the association was not statistically significant after adjustment for baseline characteristics by multivariable linear regression (β = 1.73, 95% CI −0.59 to 4.04, P = 0.144).
Conclusion
BSI is relatively uncommon in pediatric patients after procedures for VSD or ASD, but a younger age seems a risk factor. Developing BSI appears to be associated with increased length of hospitalization but not in-hospital mortality.
View Show abstract
... BSI are caused by a broad spectrum of pathogens and the emergence and spread of multidrug resistant pathogens has complicated treatment of the disease. Therefore, understanding the epidemiology of the disease can be useful in informing effective public health interventions
[2]
. Surveillance to understand the epidemiology of BSI is important for local and global comparisons and for advising standardized empirical treatment regimens; however, there is heterogeneity in the global data due to geographic and demographic differences [3]. ...
Bloodstream infections and antibiotic resistance patterns: a six-year surveillance study from southern Italy Article Full-text available
Oct 2022
Francesco Foglia Maria Teresa Della Rocca Colombina Melardo Massimiliano Galdiero
Bloodstream infections (BSI) are associated with high morbidity and mortality. This study aimed to describe the epidemiology of BSI and antimicrobial resistance patterns amongst its common bacterial causes. We conducted a retrospective record review of blood culture results of patients hospitalized with BSI at University Hospital 'L. Vanvitelli' from 2016 to 2021. For each patient records were obtained from the database using microbiological information. Gram-positive bacteria were the most predominant pathogens followed by Gram-negative bacteria. Among all isolates, bacterial pathogens most frequently identified included coagulase-negative Staphylococci (CoNS), Klebsiella pneumoniae, Staphylococcus aureus, Pseudomonas aeruginosa, Escherichia coli, and enterococci. We noted a general decrease in antimicrobial resistance amongst BSI pathogens in the latter years of the study. High levels of macrolide and aminoglycoside resistance amongst CoNS were reported. Carbapenem resistance amongst E. coli was barely reported, while resistance rates amongst K. pneumoniae declined considerably between 2018 and 2021. The prevalence of methicillin-resistant S. aureus decreased during the study period while that of methicillin-resistant CoNS remained relatively high throughout. The prevalence of extended spectrum ß-lactamase - producing E. coli increased considerably between 2016 and 2018 but showed a slight decrease thereafter. Conversely, there was a general decline in the resistant rates of extended spectrum ß-lactamase - producing K. pneumoniae between 2016 and 2018 with a similar trend being noted for carbapenem resistance in K. pneumoniae. Continuously monitoring the changes in the trends in BSI microbiological profiles, including pathogen profiles and the associated antibiotic resistance patterns, can help diagnostic approaches, treatment strategies and prevention programs.
View Show abstract
... The estimated average annual incidence of BSI in multi-year population-based studies conducted in North America (USA and Canada) and Europe (Sweden, Norway, Denmark, England, Finland, Switzerland, and Spain) ranged between 91 and 220 per 100,000 population. 1,
2 Higher incidence rates were reported in recent years from Switzerland and Finland, reaching 240 and 309 cases/100,000, respectively. 3,4 The case fatality rate (CFR) of BSI varied greatly by the affected population (i. ...
One-year mortality and years of potential life lost following bloodstream infection among adults: A nation-wide population based study Article Full-text available
Dec 2022
Vered Schechner Liat Wulffhart
Elizabeth Temkin Yehuda Carmeli
Background
Limited data exist on long-term consequences of bloodstream infections (BSIs). We aimed to examine incidence, 1-year mortality, and years of potential life lost (YPLL) following BSI. We estimated the relative contribution of hospital-onset BSI (HO-BSI) and antibiotic-resistant BSI to incidence, mortality and YPLL.
Methods
We used data from Israel's national BSI surveillance system (covering eight sentinel bacteria, comprising 70% of all BSIs) and the national death registry. Adults with BSI between January 2018 and December 2019 were included. The outcomes were all-cause 30-day and 1-year mortality, with no adjustment for co-morbidities. We calculated the age-standardized mortality rate and YPLL using the Global Burden of Disease reference population and life expectancy tables.
Findings
In total, 25,376 BSIs occurred over 2 years (mean adult population: 6,068,580). The annual incidence was 209·1 BSIs (95% CI 206·5–211·7) per 100,000 population. The case fatality rate was 25·6% (95% CI 25·0-26·2) at 30 days and 46·4% (95% CI 45·5-47·2) at 1 year. The hazard of death increased by 30% for each decade of age (HR=1·3 [95% CI 1·2-1·3]). The annual age-standardized mortality rate and YPLL per 100,000 were 50·8 (95% CI 49·7-51·9) and 1,012·6 (95% CI 986·9-1,038·3), respectively. HO-BSI (6,962 events) represented 27·4% (95% CI 26·9-28·0) of BSIs, 33·9% (95% CI 32·6-35·0) of deaths and 39·9% (95% CI 39·5-40·2) of YPLL. HO-BSI by drug-resistant bacteria (3,072 events) represented 12·1% (95% CI 11·7-12·5) of BSIs, 15·6% (95% CI 14·7-16·5) of deaths, and 18·4% (95% CI 18·1-18·7) of YPLL.
Interpretation
One-year mortality following BSI is high. The burden of BSI is similar to that of ischemic stroke. HO-BSI and drug-resistant BSI contribute disproportionately to BSI mortality and YPLL.
Funding
None.
View Show abstract
... The majority of infections result in self-limiting gastroenteritis, but invasive bloodstream infections can also occur, with children, the elderly, and immunocompromised individuals at highest risk of developing life-threatening illness (GBD 2017(GBD , 2019. The medical treatment of severe Salmonella infections can also become complicated by the presence of antimicrobial resistance (AMR; ; resistant infections contribute to an increased risk of complications and death, as well as prolonged recovery times (Kern & Rieg, 2020;
Tanwar et al., 2014). The widespread use of antimicrobials in agriculture and in humans is thought to drive the selection of resistance and virulence among pathogenic organisms such as Salmonella (Kumar et al., 2020;Bawn et al., 2020), and although wildlife species are increasingly being examined for their potential role in zoonotic diseases (Torres et al., 2020), their role in the epidemiology of Salmonella and AMR is not entirely clear. ...
Using whole-genome sequencing and a One Health approach to understand the epidemiology of zoonotic pathogens and antimicrobial resistance at the human, wildlife, environmental, and livestock interface in southern Ontario Thesis Full-text available
Jun 2021
Nadine A. Vogt
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... To our knowledge, this is the first study that evaluated the MicroScan Dried MICs on clinical isolates with typical LRS pathogens [57, 58]
. Furthermore, we assessed robustness and ease of use. ...
Validation of Three MicroScan® Antimicrobial Susceptibility Testing Plates Designed for Low-Resource Settings Article Full-text available
Aug 2022
J.-B. Ronat Saoussen Oueslati
Alessandra Natale Thierry Naas
Easy and robust antimicrobial susceptibility testing (AST) methods are essential in clinical bacteriology laboratories (CBL) in low-resource settings (LRS). We evaluated the Beckman Coulter MicroScan lyophilized broth microdilution panel designed to support Médecins Sans Frontières (MSF) CBL activity in difficult settings, in particular with the Mini-Lab. We evaluated the custom-designed MSF MicroScan Gram-pos microplate (MICPOS1) for Staphylococcus and Enterococcus species, MSF MicroScan Gram-neg microplate (MICNEG1) for Gram-negative bacilli, and MSF MicroScan Fastidious microplate (MICFAST1) for Streptococci and Haemophilus species using 387 isolates from routine CBLs from LRS against the reference methods. Results showed that, for all selected antibiotics on the three panels, the proportion of the category agreement was above 90% and the proportion of major and very major errors was below 3%, as per ISO standards. The use of the Prompt inoculation system was found to increase the MIC and the major error rate for some antibiotics when testing Staphylococci. The readability of the manufacturer’s user manual was considered challenging for low-skilled staff. The inoculations and readings of the panels were estimated as easy to use. In conclusion, the three MSF MicroScan MIC panels performed well against clinical isolates from LRS and provided a convenient, robust, and standardized AST method for use in CBL in LRS.
View Show abstract
... Intestinal E. coli pathotypes are strongly linked to diarrheal diseases as well as other clinical manifestations such as haemolytic uraemic syndrome and haemorrhagic colitis (Ameer et al., 2021). In some areas, the proportion of resistant E. coli isolates from bloodstream infections to routinely used antibiotics such as fluoroquinolones and third-generation cephalosporins (3GC) might be as high as 60% (Kern & Rieg, 2020)
. Resistance to ciprofloxacin, trimethoprimsulphamethoxazole and fluoroquinolone has also been identified in E. coli urine isolates (Kaye et al., 2021). ...
Antimicrobial betalains
Article Full-text available
Aug 2022
Vindya Nilakshi Wijesinghe Wee-Sim Choo
Betalains are nitrogen‐containing plant pigments that can be red‐violet (betacyanins) or yellow‐orange (betaxanthins), currently employed as natural colorants in the food and cosmetic sectors. Betalains exhibit antimicrobial activity against a broad spectrum of microbes including multi‐drug resistant bacteria, as well as single‐species and dual‐species biofilm‐producing bacteria, which is highly significant given the current antimicrobial resistance issue reported by The World Health Organization. Research demonstrating antiviral activity against dengue virus, in silico studies including SARS‐CoV‐2, and anti‐fungal effects of betalains highlight the diversity of their antimicrobial properties. Though limited in vivo studies have been conducted, antimalarial and anti‐infective activities of betacyanin have been observed in living infection models. Cellular mechanisms of antimicrobial activity of betalains are yet unknown; however existing research has laid the framework for a potentially novel antimicrobial agent. This review covers an overview of betalains as antimicrobial agents and discussions to fully exploit their potential as therapeutic agents to treat infectious diseases.
View Show abstract
Genetic and immune determinants of E. coli liver abscess formation
Preprint Full-text available
Jun 2023
Karthik Hullahalli Katherine G Dailey Yuko Hasegawa Matthew K Waldor
Systemic infections can yield distinct outcomes in different tissues. In mice, intravenous inoculation of E . coli leads to bacterial replication within liver abscesses while other organs such as the spleen largely clear the pathogen. Abscesses are macroscopic necrotic regions that comprise the vast majority of the bacterial burden in the animal, yet little is known about the processes underlying their formation. Here, we characterize E. coli liver abscesses and identify host determinants of abscess susceptibility. Spatial transcriptomics revealed that liver abscesses are associated with heterogenous immune cell clusters comprised of macrophages, neutrophils, dendritic cells, innate lymphoid cells, and T-cells that surround necrotic regions of the liver. Susceptibility to liver abscesses is heightened in the C57BL/6 lineage, particularly in C57BL/6N females. Backcross analyses demonstrated that abscess susceptibility is a polygenic trait inherited in a sex-dependent manner without direct linkage to sex chromosomes. As early as one day post infection, the magnitude of E. coli replication in the liver distinguishes abscess-susceptible and abscess-resistant strains of mice, suggesting that the immune pathways that regulate abscess formation are induced within hours. We characterized the early hepatic response with single-cell RNA sequencing and found that mice with reduced activation of early inflammatory responses, such as those lacking the LPS receptor TLR4, are resistant to abscess formation. Experiments with barcoded E. coli revealed that TLR4 mediates a tradeoff between abscess formation and bacterial clearance. Together, our findings define hallmarks of E. coli liver abscess formation and suggest that hyperactivation of the hepatic innate immune response drives liver abscess susceptibility.
Importance
Animal models of disseminating bacterial infections are critical for developing therapeutic interventions. Following systemic dissemination in mice, E. coli undergo dramatic replication within abscesses in the liver but not in other organs. Although liver abscesses are the largest reservoir of bacteria within the animal, the processes that lead to abscess formation are not known. Here, we characterize E. coli liver abscess formation and identify several determinants of abscess susceptibility, including sex, mouse genotype, and innate immune factors. By combining spatial and single-cell transcriptomics with genetic and phenotypic analyses, we delineate critical host pathways that underlie abscess formation. Our findings define several avenues for future studies to unravel how abscess susceptibility determinants interact to modulate clearance of systemic infections and govern tissue-specific bacterial replication.
View Show abstract
Comparison of pathogen detection consistency between metagenomic next-generation sequencing and blood culture in patients with suspected bloodstream infection Article Full-text available
Jun 2023
Yuhua Zhou Wen Shi Yi Wen Tongtian Ni
The application of metagenomic next-generation sequencing (mNGS) has gradually been carried out by clinical practitioner. However, few studies have compared it with blood cultures in patients suffering from suspected bloodstream infections. The purpose of this study was to compare the detection of pathogenic microorganisms by these two assays in patients with suspected bloodstream infection. We retrospectively studied patients with fever, chills, antibiotic use for more than 3 days, suspected bloodstream infection, and admission to the emergency department of Ruijin Hospital from January 2020 to June 2022. All patients had blood drawn on the same day for blood mNGS and blood cultures. Clinical and laboratory parameters were collected on the day blood was drawn. The detection of pathogenic microorganisms by the two methods was compared. Risk factors and in-hospital mortality in patients with bloodstream infections were analysed separately for these two assays. In all 99 patients, the pathogenic microorganisms detection rate in blood mNGS was significantly higher than that in blood culture. Blood mNGS was consistent with blood culture in only 12.00% of all positive bacterial and fungal test results. The level of CRP is related to bacteraemia, fungaemia and viraemia detected by blood mNGS. No clear risk factors could be found in patients with a positive blood culture. In critically ill patients, both tests failed to improve patient outcomes. In patients with suspected bloodstream infection, mNGS is not yet a complete replacement for blood cultures.
View Show abstract
Impact on clinical outcome of follow-up blood cultures and risk factors for persistent bacteraemia in patients with gram-negative bloodstream infections: a systematic review with meta-analysis Article
Mar 2023 CLIN MICROBIOL INFEC
Milo Gatti Cecilia Bonazzetti Beatrice Tazza Maddalena Giannella
Background:
The clinical usefulness of follow-up blood cultures (FUBCs) in Gram-negative bloodstream infections (GN-BSIs) represents a debated issue.
Objective:
To assess the impact on clinical outcome of FUBCs in patient with GN-BSI and to predict risk factors for persistent bacteremia.
Data source:
PubMed-MEDLINE, Scopus, and Cochrane Library Database were independently searched until 24 June 2022.
Study eligibility criteria:
Randomized controlled trials or prospective/retrospective observational studies including patients affected by GN-BSIs. Primary endpoints were in-hospital mortality rate, and persistent BSI defined as FUBC positive for the same pathogen isolated from index BCs.
Participants:
Hospitalized patients with documented GN-BSIs.
Intervention:
Performance of FUBCs (defined as subsequent BCs collected at least 24 hours after index BCs).
Assessment of risk of bias:
Quality of included studies was independently assessed according to ROB 2.0 and ROBINS-I tools.
Methods:
Of data synthesis: Meta-analysis was performed by pooling odds ratio (OR) retrieved from studies providing adjustment for confounders using random-effect model with inverse variance method. Risk factors for persistent BSIs were also assessed.
Results:
3,747 articles were screened, and eleven observational studies (six assessing impact on outcome [N=4,631], and five investigating risk factors for persistent GN-BSI [N=2,566]), conducted between 2002-2020 were included. Execution of FUBCs were associated with significant lower risk of mortality (OR 0.58; 95%CI 0.49-0.70; I2=0.0%). Presence of end-stage renal disease (OR 2.99; 95%CI 1.77-5.05), central venous catheter (OR 3.30; 95%CI 1.82-5.95), infections due to ESBL-producing strains (OR 2.25; 95%CI 1.18-4.28), resistance to empirical treatment (OR 2.70; 95%CI 1.65-4.41), and unfavourable response at 48 hours (OR 2.99; 95%CI 1.44-6.24) emerged as independent risk factors for persistent bacteremia.
Conclusions:
The execution of FUBCs is associated with a significant lower risk of mortality in patients with GN-BSIs. Our analysis could be useful to stratify patients at high-risk for persistent bacteraemia to optimize the use of FUBCs.
View Show abstract
Risk of Bloodstream Infection in Patients with Systemic Lupus Erythematosus Exposed to Prolonged Medium-to-High-Dose Glucocorticoids Article
Mar 2023 LUPUS
Mi Hyeon Kim Se Rim Choi Jin Kyun Park
Jun Won Park
Objectives:
This study aimed to investigate the incidence rate and risk factors of bloodstream infection (BSI) in patients with systemic lupus erythematosus (SLE) exposed to medium to high doses of glucocorticoids.
Methods:
This study included 1109 treatment episodes with prolonged (≥4 weeks) medium-to-high-dose glucocorticoids (≥15 mg/day prednisolone) in 612 patients with SLE for over 14 years. Clinical features regarding systemic lupus erythematosus disease activity index 2000 (SLEDAI-2K), immunosuppressant use, and laboratory results were obtained from the electronic medical database. The primary outcome of this study was the 1-year incidence of BSI. The effect of clinical factors on the outcome was investigated using a generalized estimating equation.
Results:
During a total of 1078.64 person-years, 30 cases of BSI occurred, with an incidence rate of 2.78 (95% confidence interval (CI) 1.88-3.97) per 100 person-years. Mortality rate of the treatment episodes with BSI was 16.7%, which was significantly higher than that in the other episodes (incidence rate ratio (IRR) 19.59, 95% CI 7.33-52.44). When the incidence rate of BSI was stratified by baseline glucocorticoid dose and SLEDAI-2K score, a higher incidence rate of BSI occurred as disease activity or baseline glucocorticoid dose increased. In the multivariable analysis, SLEDAI-2K ≥20 (adjusted IRR (aIRR) 4.66, 95% CI 2.17-10.00), initial baseline prednisolone ≥ 60 mg/day (aIRR 2.42, 95% CI 1.11-5.32), and cumulative prednisolone dose ≥15 mg/day during the previous 6 months (aIRR 2.13, 95% CI 1.03-4.40) significantly increased the risk of BSI.
Conclusion:
In patients with SLE exposed to prolonged medium-to-high-dose glucocorticoids, the 1-year incidence rate of BSI was significantly higher than previously reported in the general patients with SLE. Severe disease activity, and high-dose glucocorticoid treatment previously or at baseline increased the risk of BSI.
View Show abstract
Oral stepdown in Gram-positive bloodstream infections: A step in the right direction Article
Feb 2023 PHARMACOTHERAPY
Kaylee Caniff Nicholas Rebold
Michael Rybak
Bloodstream infections (BSIs) due to Gram-positive organisms have traditionally been treated with prolonged courses of intravenous antimicrobials. However, this dogma is associated with substantial burden to the patient and health care system. Consequently, there is growing interest in the utilization of oral stepdown therapy, defined as the transition of intravenous therapy to an active oral agent, for this indication. This review highlights available literature examining oral stepdown in adult patients with BSI due to commonly encountered Gram-positive pathogens, including Staphylococcus aureus, Streptococcus spp., and Enterococcus spp. Support for oral stepdown in this setting is primarily derived from observational studies subject to selection bias. Nevertheless, this treatment strategy exhibits promising potential in carefully selected patients as it is consistently associated with reductions in hospital length of stay without jeopardizing clinical cure or survivability. Prospective, randomized trials are needed for validation of oral stepdown in Gram-positive BSI and to identify the optimal patient population and regimen.
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Concordance of the Filmarray Blood Culture Identification Panel 2 and Classical Microbiological Methods in a Bacteriemia Diagnostic Unit Article
Jan 2022
Celia García Rivera Monica Parra Grande
Esperanza Merino Juan Carlos Rodriguez Díaz
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Uncorrected Preoperative Infection Causing the Death of a Patient with a Thoracic Aortic Aneurysm Article Full-text available
Jan 2023
Xin-Qi He Hui-Qing Qiu Meng Wang Le Wang
Background:
A thoracic aortic aneurysm (TAA) is a known condition seen in cardiovascular practice. A TAA rupture and postoperative infection may result in death. Preoperative infections leading to death are extremely rare.
Case study:
A 62-year-old Chinese female was admitted to The First Hospital of Hebei Medical University with a two-day history of abdominal pain. She was diagnosed with a TAA rupture and underwent immediate surgery. The preoperative urine analysis indicated that the positive bacteria and white blood cell count suggested a urinary tract bacterial infection. The patient was administered the empiric antibiotics, cefazolin; however, her blood pressure continued to drop during the perioperative period and she died of uncorrectable acidosis 8 h after the operation. On the second day after death, both the blood and urine cultures were positive for Pseudomonas aeruginosa.
Conclusion:
Given that this patient with a TAA rupture died of uncorrected acidosis caused by preoperative infection, it is important to evoke the diagnosis in the context of TAA. Routine laboratory indicators are valuable factors for surgeons and physicians in assessing a patient's condition and improving their prognosis.
View Show abstract
Resolving colistin resistance and heteroresistance in Enterobacter species Article Full-text available
Jan 2023
Swapnil Prakash Doijad Nicolas Gisch
Renate Frantz Trinad Chakraborty
Species within the Enterobacter cloacae complex (ECC) include globally important nosocomial pathogens. A three-year study of ECC in Germany identified Enterobacter xiangfangensis as the most common species (65.5%) detected, a result replicated by examining a global pool of 3246 isolates. Antibiotic resistance profiling revealed widespread resistance and heteroresistance to the antibiotic colistin and detected the mobile colistin resistance (mcr)−9 gene in 19.2% of all isolates. We show that resistance and heteroresistance properties depend on the chromosomal arnBCADTEF gene cassette whose products catalyze transfer of L-Ara4N to lipid A. Using comparative genomics, mutational analysis, and quantitative lipid A profiling we demonstrate that intrinsic lipid A modification levels are genospecies-dependent and governed by allelic variations in phoPQ and mgrB, that encode a two-component sensor-activator system and specific inhibitor peptide. By generating phoPQ chimeras and combining them with mgrB alleles, we show that interactions at the pH-sensing interface of the sensory histidine kinase phoQ dictate arnBCADTEF expression levels. To minimize therapeutic failures, we developed an assay that accurately detects colistin resistance levels for any ECC isolate. Taxonomical complexity has muddled the classification of clinically relevant Enterobacter species. Authors carry out a genome-based study on clinical isolates to investigate colistin resistance and heteroresistance in Enterobacter.
View Show abstract
Impact of 18F-FDG-PET/CT on the management of Staphylococcus aureus bacteraemia: a retrospective observational study Article
Oct 2022
Paula Suanzes Rein Willekens Mireia Puig-Asensio Benito Almirante
Objectives
To assess the impact of ¹⁸F-FDG-PET/CT on the diagnosis and management of patients with Staphylococcus aureus bacteraemia (SAB).
Methods
Post hoc analysis of a prospective cohort of consecutive adult patients diagnosed with SAB (January 2013–December 2017). Patients who underwent ¹⁸F-FDG-PET/CT at the discretion of the attending physician were included. Endpoints were the identification of previously unknown infectious foci and changes in clinical management, defined as changes in the duration or class of antibiotic therapy, a surgical procedure on the source of infection or a change in the decision to remove or retain an implantable device.
Results
We included 39 patients (median age: 69 years, IQR:60–79). Fifteen (39%) patients did not have an infectious focus identified before ¹⁸F-FDG-PET/CT). Thirty new infectious foci were detected in 22/39 (56%) patients. In 11/15 (73%) patients without an identified focus at least one infectious focus was detected by ¹⁸F-FDG-PET/CT. In 22/26 (85%) patients with implantable devices, ¹⁸F-FDG-PET/CT confirmed or ruled out infection or detected local complications. Out of 13 device infections, 10 were detected by ¹⁸F-FDG-PET/CT (7/10 for the first time). In 19/39 (49%) patients ¹⁸F-FDG-PET/CT results led to changes in clinical management (15 changes in antibiotic therapy, 2 device removals, 2 surgical procedures, 1 avoidance of a surgical procedure).
Conclusions
¹⁸F-FDG-PET/CT may be a useful asset in the management of selected SAB cases, allowing the identification of previously undetected infectious foci and optimization of therapy, particularly in patients with endovascular devices. Indication should be made on a case-by-case basis.
View Show abstract
Molecular Mechanisms Involved in Pseudomonas aeruginosa Bacteremia
Chapter
Oct 2022 ADV EXP MED BIOL
Stéphane Pont Manon Janet-Maitre Eric Faudry Ina Attree
Bloodstream infections (BSI) with Pseudomonas aeruginosa account for 8.5% of all BSIs, their mortality rate, at about 40%, is the highest among causative agents. For this reason and due to its intrinsic and acquired resistance to antibiotics, P. aeruginosa represents a threat to public health systems. From the primary site of infection, often the urinary and respiratory tracts, P. aeruginosa uses its arsenal of virulence factors to cross both epithelial and endothelial barriers, ultimately reaching the bloodstream. In this chapter, we review the main steps involved in invasion and migration of P. aeruginosa into blood vessels, and the molecular mechanisms governing bacterial survival in blood. We also review the lifestyle of P. aeruginosa "on" and "in" host cells. In the context of genomic and phenotypic diversity of laboratory strains and clinical isolates, we underline the need for more standardized and robust methods applied to host-pathogen interaction studies, using several representative strains from distinct phylogenetic groups before drawing general conclusions. Finally, our literature survey reveals a need for further studies to complete our comprehension of the complex interplay between P. aeruginosa and the immune system in the blood, specifically in relation to the complement system cascade(s) and the Membrane Attack Complex (MAC), which play crucial roles in counteracting P. aeruginosa BSI.
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Strategies on Reducing Blood Culture Contamination and Improving Differential Diagnostic Accuracy Among Cancer Patients Article
Jan 2022
Jia Lu Enlv Hong Wenbin Gao Chun Huang
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Strong correlation between the rates of intrinsically antibiotic-resistant species and the rates of acquired resistance in Gram-negative species causing bacteraemia, EU/EEA, 2016 Article Full-text available Sep 2019 Vincent Jarlier Ole E Heuer Maja Subelj Liselotte Diaz Högberg EARS-Net participants. Strong correlation between the rates of intrinsically antibiotic-resistant species and the rates of acquired resistance in Gram-negative species causing bacteraemia, EU/EEA, 2016. Background: Antibiotic resistance, either intrinsic or acquired, is a major obstacle for treating bacterial infections. Aim: Our objective was to compare the country-specific species distribution of the four Gram-negative species Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa and Acinetobacter species and the proportions of selected acquired resistance traits within these species. Method: We used data reported for 2016 to the European Antimicrobial Resistance Surveillance Network (EARS-Net) by 30 countries in the European Union and European Economic Area. Results: The country-specific species distribution varied considerably. While E. coli accounted for 31.9% to 81.0% (median: 69.0%) of all reported isolates, the two most common intrinsically resistant species P. aeruginosa and Acinetobacterspp. combined (PSEACI) accounted for 5.5% to 39.2% of isolates (median: 10.1%). Similarly, large national differences were noted for the percentages of acquired non-susceptibility to third-generation cephalospor-ins, carbapenems and fluoroquinolones. There was a strong positive rank correlation between the country-specific percentages of PSEACI and the percentages of non-susceptibility to the above antibiotics in all four species (rho > 0.75 for 10 of the 11 pairs of variables tested). Conclusion: Countries with the highest proportion of P. aeruginosa and Acinetobacter spp. were also those where the rates of acquired non-susceptibility in all four studied species were highest. The differences are probably related to national differences in antibiotic consumption and infection prevention and control routines. 2 www.eurosurveillance.org View Show abstract Changing Characteristics of Staphylococcus aureus Bacteremia: Results From a 21-Year, Prospective, Longitudinal Study Article Full-text available Apr 2019 CLIN INFECT DIS Maria Souli Felicia Ruffin Seong-Ho Choi Vance G Fowler Background:
We conducted a longitudinal study to evaluate changes in the clinical presentation and epidemiology of Staphylococcus aureus bacteremia (SAB) in an academic, US medical center.
Methods:
Consecutive patients with monomicrobial SAB were enrolled from January 1995 to December 2015. Each person's initial bloodstream S. aureus isolate was genotyped using spa typing. Clonal complexes (CCs) were assigned using Ridom StaphType software. Changes over time in both the patient and bacterial characteristics were estimated with linear regression. Associations between genotypes or clinical characteristics and complications were estimated using multivariable regression models.
Results:
Among the 2348 eligible participants, 54.2% had an implantable, foreign body of some type. This proportion increased significantly during the 21-year study period, by 0.96% annually (P = .002), as did comorbid conditions and acquisition outside of the hospital. Rates of any metastatic complication also significantly increased, by 0.94% annually (P = .019). Among the corresponding bloodstream S. aureus isolates, spa-CC012 (multi-locus sequence type [MLST] CC30), -CC004 (MLST CC45), -CC189 (MLST CC1), and -CC084 (MLST CC15) all significantly declined during the study period, while spa-CC008 (MLST CC8) significantly increased. Patients with SAB due to spa-CC008 were significantly more likely to develop metastatic complications in general, and abscesses, septic emboli, and persistent bacteremia in particular. After adjusting for demographic, racial, and clinical variables, the USA300 variant of spa-CC008 was independently associated with metastatic complications (odds ratio 1.42; 95% confidence interval 1.02-1.99).
Conclusions:
Systematic approaches for monitoring complications of SAB and genotyping the corresponding bloodstream isolates will help identify the emergence of hypervirulent clones and likely improve clinical management of this syndrome. View Show abstract Epidemiology and Outcome Determinants of Staphylococcus aureus Bacteremia Revisited: A Population-Based Study Article Full-text available Dec 2019 INFECTION John C. Lam Daniel Gregson Stephen Robinson Michael D. Parkins Purpose
Staphylococcus aureus bacteremia (SAB) is associated with significant morbidity and mortality. We sought to re-define the burden, epidemiology and mortality-associated risk factors of SAB in a large Canadian health region.
Methods
Residents (> 18 years) experiencing SAB from 2012 to 2014 were assessed. Incidence rates were calculated using civic census results. Factors associated with 30-day mortality were determined through multivariate logistic regression. Incidence and risk factors for SAB were compared to 2000–2006 data.
Results
780 residents experienced 840 episodes of SAB (MRSA; 20%). Incidence rates increased from 23.5 to 32.0 cases/100,000 from 2012 to 2014; [IRR 1.15 (95% CI 1.07–1.23); p < 0.001]. Compared to a decade ago, incidence of SAB has increased [IRR 1.28 (95% CI 1.21–1.36); p < 0.001] despite minimal change in nosocomial SAB. MRSA proportion did not change through the study (p = 0.3), but did increase relative to a decade ago (20.0% vs 11.0%, p < 0.001). Thirty-day mortality rates were 30.6% and 21.3% for MRSA and MSSA, respectively (p = 0.01), similar to rates from 2000 to 2006. Several clinical, demographic, and biochemical factors were independently associated with SAB mortality.
Conclusions
SAB is common within our population resulting in significant mortality. Incidence rates of SAB are increasing in our health region; however, 30-day mortality rates remain stable. View Show abstract Antimicrobial resistance trends in bloodstream infections at a large teaching hospital in China: A 20-year surveillance study (1998-2017) Article Full-text available May 2019 Lei Tian Zhen Zhang Ziyong Sun Background:
Bacterial bloodstream infections (BSIs) cause high morbidity and mortality worldwide in humans, but the pathogenic spectrum varies from region to region. Long-term monitoring of the pathogenic spectrum and changes in bacterial antibiotic resistance is hugely important for effective clinical therapy and infection control. This study examined the data for BSIs in Tongji Hospital, one of the largest teaching hospitals in China, in an attempt to gain better understanding of bacterial antibiotic resistance in China, focusing on central China.
Methods:
Data from Tongji Hospital for a 20-year period (1998-2017) were used for a retrospective analysis to understand the pathogenic spectrum of BSIs and the changes occurring in antimicrobial resistance in central China. The disk diffusion and E test methods were used for antimicrobial susceptibility testing according to Clinical & Laboratory Standards Institute methodologies, and the data were analyzed by WHONET 5.6 software.
Results:
The isolated pathogens mainly came from hospitalized patients not treated in intensive care units (ICUs), and accounted for 81.5% of the total (9130/11200). The most common Gram-negative and Gram-positive bacterial BSI-causing pathogens were Escherichia coli and Staphylococcus aureus, respectively. The detection rate for methicillin-resistant S. aureus (MRSA) in the hospitalized non-ICU patients increased from 8.4% in 1998-2002 to 63% in 2013-2017, while the detection rate for carbapenem-resistant (CR) Klebsiella pneumoniae was below 5% in 1998-2012 but increased to 34.9% in 2013-2017. In contrast, worryingly, the detection rate for CR K. pneumoniae in ICU patients increased from 0% in 2013 to 75% in 2016. E. coli displayed the highest sensitivity rates to imipenem, meropenem and amikacin, all of which were > 90%, followed by cefoxitin at > 80%, and cefoperazone/sulbactam at > 70%. K. pneumoniae isolates were most sensitive to imipenem, meropenem and amikacin antibiotics, with sensitivity rates exceeding 60%. S. aureus isolates were most sensitive to vancomycin, teicoplanin and trimethoprim/sulfamethoxazole, with sensitivity rates exceeding 90%.
Conclusions:
BSIs caused by CR K. pneumoniae clearly posed a severe challenge to infection control and treatment of ICU and non-ICU patients in this retrospective study, while MRSA was an issue for non-ICU patients. View Show abstract Age-Dependent Increase in Incidence of Staphylococcus aureus Bacteremia, Denmark, 2008–2015 Article Full-text available May 2019 EMERG INFECT DIS Louise Thorlacius-Ussing Håkon Sandholdt Anders Rhod Larsen Thomas Benfield Staphylococcus aureus bacteremia (SAB) is a major cause of illness and death worldwide. We analyzed temporal trends of SAB incidence and death in Denmark during 2008-2015. SAB incidence increased 48%, from 20.76 to 30.37 per 100,000 person-years, during this period (p<0.001). The largest change in incidence was observed for persons >80 years of age: a 90% increase in the SAB rate (p<0.001). After adjusting for demographic changes, annual rates increased 4.0% (95% CI 3.0-5.0) for persons <80 years of age, 8.4% (95% CI 7.0-11.0) for persons 80-89 years of age, and 13.0% (95% CI 9.0-17.5) for persons >90 years of age. The 30-day case-fatality rate remained stable at 24%; crude population death rates increased by 53% during 2008-2015 (p<0.001). Specific causes and mechanisms for this rapid increase in SAB incidence among the elderly population remain to be clarified. View Show abstract The Microbiology of Bloodstream Infection: 20-Year Trends from the SENTRY Antimicrobial Surveillance Program Article Full-text available Apr 2019 Po-Ren Hsueh Rodrigo E Mendes Daniel Diekema Ronald Jones Bloodstream infection (BSI) organisms were consecutively collected from >200 medical centers in 45 nations between 1997 and 2016. Species identification and susceptibility testing followed Clinical and Laboratory Standards Institute broth microdilution methods at a central laboratory. Clinical data and isolates from 264,901 BSI episodes were collected. The most common pathogen overall was Staphylococcus aureus (20.7%), followed by Escherichia coli (20.5%), Klebsiella pneumoniae (7.7%), Pseudomonas aeruginosa (5.3%), and Enterococcus faecalis (5.2%). S. aureus was the most frequent pathogen overall in the 1997–2004 period, but E. coli was the most common after 2005. Pathogen frequency varied by geographic region, hospital-onset or community-onset status, and patient age. The prevalence of S. aureus resistant to oxacillin (MRSA) increased until 2005–08, then declined among hospital-onset and community-acquired BSI in all regions. The prevalence of vancomycin-resistant enterococci (VRE) was stable after 2012 (16.4% overall). Daptomycin resistance among S. aureus and enterococci (DRE) remained rare (<0.1%). In contrast, the prevalence of multidrug-resistant (MDR) Enterobacteriaceae increased from 6.2% in 1997–2000 to 15.8% in 2013–16. MDR rates were highest among non-fermentative Gram-negative bacilli (GNB), and colistin was the only agent with predictable activity against Acinetobacter baumannii-calcoaceticus complex (97% susceptible). In conclusion, S. aureus and E. coli were the predominant causes of BSI worldwide during this 20-year surveillance period. Important resistant phenotypes among Gram-positive pathogens (MRSA, VRE, or DRE) were stable or declining, whereas the prevalence of MDR-GNB increased continuously during the monitored period. MDR-GNB pose the greatest therapeutic challenge among common bacterial BSI pathogens. View Show abstract Shifting trends and age distribution of ESKAPEEc resistance in bloodstream infection, Southwest China, 2012–2017 Article Full-text available Mar 2019 Shuangshuang Yang Haofeng Xu Jide Sun Shan Sun Background
ESKAPEEc contribute to a majority of bloodstream infections (BSIs) and their antibiogram have changed overtime, while data concerning about these alterations are lacking in China. Added that a paucity of studies referred to ESKAPEEc in pediatric BSIs, our study aimed to demonstrate the longitudinal alterations of ESKAPEEc distribution and antibiogram in adult and pediatric BSIs in Southwest China.
Methods
A multicenter retrospective surveillance study was launched from 2012 to 2017. Data of China Antimicrobial Resistance Surveillance System (CARSS) was analyzed by Whonet 5.6 and Graphpad Prism 6 Software. Chi-square test or Fisher’s exact test was used to examine and compare temporal changes.
Results
A total of 32,259 strains was isolated, with 17.4% from pediatric BSIs. ESKAPEEc contributed to 58.67% (18,924/32,259) of BSIs, with 65.3% of adult BSIs and 27.2% of pediatric BSIs. Escherichia coli (E. coli) and Klebsiella pneumoniae (K. pneumoniae) were the two predominant species. Carbapenem resistance was prevalent in 0.76, 4.60, 9.47,13.66, 59.47% of E. coli, K. pneumoniae, Enterobacter cloacae, Pseudomonas aeruginosa (P. aeruginosa) and Acinetobacter baumannii (A. baumannii), respectively. The proportions of methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococcus faecium (VREFM) were 28.91% and 2.20%, respectively. Between 2012-2014 and 2015–2017, E. coli and K. pneumonia showed significantly increased resistance rates to imipenem but decreased to ceftriaxone and ceftazidime, while A. baumannii exhibited reduced resistances to almost all the beta-lactams tested. The prevalence of antimicrobial resistance to most of agents against Gram-positive ESKAPEEc did not significantly varied during the same timeframe. In comparison with those from adult BSIs, K. pneumoniae from pediatric BSIs exhibited high resistance rates to all the beta-lactams tested, especially to carbapenems (12.79% vs 3.87%), while A. baumannii showed low resistance rates to all the agents.
Conclusions
Ongoing burden of ESKAPEEc in BSIs and increasing trend of imipenem resistance in E. coli and K. pneumoniae call for continued surveillance. Carbapenems are still active against Gram-negative ESKAPEEc, except for A. baumannii and vancomycin or linezolid is still effective against Gram-positive ESKAPEEc. Carbapenem-resistant K. pneumoniae in children and carbapenem-resistant A. baumannii in adults necessitate effective antimicrobial strategies in consideration of age stratification. View Show abstract A Cohort Study of the Impact of Carbapenem-Resistant Enterobacteriaceae Infections on Mortality of Patients Presenting with Sepsis Article Full-text available Apr 2019 Sabrina Sabino Silvia Soares Fabiano Ramos Maria Helena Rigatto The objective of this study is to evaluate the impact of carbapenemresistant Enterobacteriaceae (CRE) infection on sepsis 30-day mortality. A retrospective cohort of patients > 18 years old with sepsis and organ dysfunction or septic shock was conducted. Univariate analysis was done for variables potentially related to 30-day mortality, and the ones with P values of < 0.05 were included in a backward stepwise hierarchic Cox regression model. Variables that remained with P values of < 0.05 were retained in the model. A total of 1,190 sepsis episodes were analyzed. Gram-negative bacterial infections occurred in 391 (68.5%) of 571 patients with positive cultures, of which 69 (17.7%) were caused by a CRE organism. Patients with CRE infections had significantly higher 30-day mortality: 63.8% versus 33.4% (P < 0.01). CRE infection was also associated with a lower rate of appropriate empirical therapy (P < 0.01) and with the presence of septic shock (P < 0.01). In the hierarchic multivariate model, CRE remained significant when controlling for demographic variables, comorbidities, and infection site but lost significance when controlling for septic shock and appropriate empirical therapy. Older age (P < 0.01), HIV-positive status (P < 0.01), cirrhosis (P < 0.01), septic shock (P < 0.01), higher quick sepsisrelated organ failure assessment (quick-SOFA) (P < 0.01), and appropriate empirical therapy (P=0.01) remained in the final model. CRE infections were associated with higher crude mortality rates. A lower rate of appropriate empirical therapy and late diagnosis were more frequent in this group, and improvement of stewardship programs is needed. View Show abstract Moving beyond unsolicited consultation: additional impact of a structured intervention on mortality in Staphylococcus aureus bacteraemia Article Full-text available Apr 2019 María Teresa Pérez-Rodríguez Adrián Sousa Luis Eduardo López Cortés Jesús Rodríguez-Baño Background
Some evidence-based bundles have tried to standardize the management of Staphylococcus aureus bacteraemia (SAB) to improve the outcome. The aim of our study was to analyse the additional impact on mortality of a structured intervention in patients with SAB.
Methods
Compliance with the bundle was evaluated in an ambispective cohort of patients with SAB, which included a retrospective cohort [including patients treated before and after the implementation of a bacteraemia programme (no-BP and BP, respectively)] and a prospective cohort (i-BP), in which an additional specific intervention for bundle application was implemented. Multivariate logistic regression was used to measure the influence of the independent variables including compliance with the bundle on 14 and 30 day crude mortality.
Results
A total of 271 adult patients with SAB were included. Mortality was significantly different among the three groups (no-BP, BP and i-BP): mortality at 14 days was 18% versus 7% versus 2%, respectively, P = 0.002; and mortality at 30 days was 20% versus 12% versus 5%, respectively, P = 0.011. The factors associated with 14 and 30 day mortality in multivariable analysis were heart failure (OR = 7.63 and OR = 2.27, respectively), MRSA infection (OR = 4.02 and OR = 4.37, respectively) and persistent bacteraemia (OR = 11.01 and OR = 7.83, respectively); protective factors were catheter-related bacteraemia (OR = 0.16 and OR = 0.19, respectively) and >75% bundle compliance (OR = 0.15 and OR = 0.199, respectively). Time required to perform the intervention and the follow-up was 50 min (IQR 40–55 min) per patient.
Conclusions
High-level compliance with a standardized bundle of intervention for management of SAB that requires little time was associated with lower mortality at 14 and 30 days. View Show abstract Increasing incidence of invasive nontyphoidal Salmonella infections in Queensland, Australia, 2007-2016 Article Full-text available Mar 2019 PLOS NEGLECT TROP D Andrea Parisi Russell J Stafford Martyn D Kirk John Crump Nontyphoidal Salmonella is a major contributor to the global burden of foodborne disease, with invasive infections contributing substantially to illnesses and deaths. We analyzed notifiable disease surveillance data for invasive nontyphoidal Salmonella disease (iNTS) in Queensland, Australia. We used Poisson regression to estimate incidence rate ratios by gender, age group, and geographical area over 2007-2016. There were 995 iNTS cases, with 945 (92%) confirmed by blood culture. Salmonella Virchow accounted for 254 (25%) of 1,001 unique iNTS isolates. Invasive NTS disease notification rates peaked among infants, during the summer months, and in outback Queensland where the notification rate (95% CI) was 17.3 (14.5-20.1) cases per 100,000 population. Overall, there was a 6,5% annual increase (p<0.001) in iNTS disease incidence. In conclusion, high iNTS rates among males, infants, and the elderly require investigation of household level risk factors for NTS infection. Controlling Salmonella Virchow infections is a public health priority. View Show abstract Prognostic Power of Pathogen Cell-Free DNA in Staphylococcus aureus Bacteremia Article Full-text available Mar 2019 Johnny Gutierrez Stacey A Maskarinec Alessander O Guimaraes Carrie M. Rosenberger Background
Staphylococcus aureus is a leading global cause of bacteremia leading to invasive tissue infections with high morbidity and mortality despite appropriate antibiotic therapy. Clinicians lack sufficient tools to rapidly identify patients with a poor prognosis to guide diagnostic workup and treatment decisions. Host cell-free DNA provides valuable prognostic value across a spectrum of critical illnesses, including S. aureus bacteremia and sepsis. Metrics of high bacterial load are associated with disease severity in S. aureus bacteremia, and the objective of this study was to evaluate whether incorporating quantitation of cell-free bacterial DNA would provide additive prognostic value when combined with biomarkers of the inflammatory response.
Methods
S. aureus cell-free DNA was measured by quantitative PCR in baseline serum samples from an observational cohort of 111 patients with complicated S. aureus bacteremia and correlated with host inflammatory markers and clinical outcomes.
Results
High levels of S. aureus cell-free DNA at the time of positive index blood culture was prognostic for all-cause and attributable mortality, persistent bacteremia, and associated with infective endocarditis. However, it did not provide additive value to biomarkers of the host response to infection in multivariate analysis.
Conclusions
Measurements of bacterial load by PCR is a clinically feasible candidate biomarker for stratifying patients at higher risk for complications and poor outcomes. Its diagnostic and prognostic value for identifying foci of infection and influencing treatment remains to be evaluated in additional cohorts. View Show abstract Twenty-Year Trends in Antimicrobial Susceptibilities Among Staphylococcus aureus From the SENTRY Antimicrobial Surveillance Program Article Full-text available Mar 2019 Daniel Diekema Michael A. Pfaller Dee Shortridge Ronald Jones Background
Staphylococcus aureus is among the most common human pathogens, with therapy complicated by the epidemic spread of methicillin-resistant Staphylococcus aureus (MRSA).
Methods
The SENTRY Antimicrobial Surveillance Program evaluated the in vitro activity of >20 antimicrobials against 191 460 clinical S. aureus isolates collected from 427 centers in 45 countries from 1997 to 2016. Each center contributed isolates and clinical data for consecutive episodes of bacteremia, pneumonia in hospitalized patients, urinary tract infection, and skin and skin structure infection.
Results
Overall, 191 460 S. aureus isolates were collected, of which 77 146 (40.3%) were MRSA, varying geographically from 26.8% MRSA in Europe to 47.0% in North America. The highest percentage of MRSA was in nosocomial isolates from patients aged >80 years. Overall, MRSA occurrences increased from 33.1% in 1997–2000 to a high of 44.2% in 2005–2008, then declined to 42.3% and 39.0% in 2009–2012 and 2013–2016, respectively. S. aureus bacteremia had a similar trend, with nosocomial and community-onset MRSA rates peaking in 2005–2008 and then declining. Vancomycin activity against S. aureus remained stable (minimum inhibitory concentration [MIC]90 of 1 mg/L and 100% susceptibility in 2016; no increase over time in isolates with a vancomycin MIC >1 mg/L). Several agents introduced during the surveillance period exhibited in vitro potency against MRSA.
Conclusions
In a large global surveillance program, the rise of MRSA as a proportion of all S. aureus peaked a decade ago and has declined since, consistent with some regional surveillance program reports. Vancomycin maintained high activity against S. aureus, and several newer agents exhibited excellent in vitro potencies. View Show abstract Epidemiology and Antimicrobial Susceptibility of Salmonella enterica Bloodstream Isolates Among Febrile Children in a Rural District in Northeastern Tanzania: A Cross-sectional Study Article Full-text available Mar 2019 Omari Abdul Msemo Joyce Mbwana Coline Mahende John P. A. Lusingu Background
Salmonella enterica including Salmonella Typhi and nontyphoidal Salmonella (NTS) are the predominant cause of community-acquired bloodstream infections in sub-Saharan Africa (sSA). Multiple-drug resistance and emerging fluoroquinolone resistance are of concern. Data on the age distribution of typhoid fever in sSA are scarce but essential for typhoid conjugate vaccine policy. We sought to describe Salmonella bloodstream infections, antimicrobial resistance, and age distribution at a rural district hospital in northeastern Tanzania.
Methods
From 2008 to 2016, febrile children or children with a history of fever aged 1 month to 5 years admitted to Korogwe District Hospital were enrolled. Demographic, clinical data and blood cultures were collected. Organisms were identified by conventional microbiological methods, and antimicrobial susceptibility test was done by disc diffusion.
Results
Of 4176 participants receiving blood cultures, 383 (9.2 %) yielded pathogens. Of pathogens, 171 (44.6%) were Salmonella enterica of which 129 (75.4%) were Salmonella Typhi, and 42 (24.6%) were NTS. The median (interquartile range age of participants was 13.1 (6.3–28.0) months for those with Salmonella Typhi and 11.5 (8.5–23.4) months for NTS. Of 129 Salmonella Typhi, 89 (89.9%) were resistant to amoxicillin, 85 (81.0%) to chloramphenicol, and 93 (92.1%) to trimethoprim-sulfamethoxazole compared with 22 (62.9%), 15 (39.4%), and 27 (79.4%), respectively, for NTS. Multidrug resistance was present in 68 (81.0%) of Salmonella Typhi and 12 (41.4%) of NTS.
Conclusion
Salmonella Typhi was the leading cause of bloodstream infection among infants and young children <2 years of age admitted to Korogwe District Hospital. Multidrug resistance was common, highlighting a role for typhoid conjugate vaccine into routine infant vaccine schedules. View Show abstract Global Typhoid Fever Incidence: A Systematic Review and Meta-analysis Article Full-text available Mar 2019 CLIN INFECT DIS Christian S. Marchello Chuen Yen Hong John Crump Background:
Contemporary incidence estimates of typhoid fever are needed to guide policy decisions and control measures and to improve future epidemiological studies.
Methods:
We systematically reviewed 3 databases (Ovid Medline, PubMed, and Scopus) without restriction on age, country, language, or time for studies reporting the incidence of blood culture-confirmed typhoid fever. Outbreak, travel-associated, and passive government surveillance reports were excluded. We performed a meta-analysis using a random-effects model to calculate estimates of pooled incidence, stratifying by studies that reported the incidence of typhoid fever and those that estimated incidence by using multipliers.
Results:
Thirty-three studies were included in the analysis. There were 26 study sites from 16 countries reporting typhoid cases from population-based incidence studies, and 17 sites in 9 countries used multipliers to account for underascertainment in sentinel surveillance data. We identified Africa and Asia as regions with studies showing high typhoid incidence while noting considerable variation of typhoid incidence in time and place, including in consecutive years at the same location. Overall, more recent studies reported lower typhoid incidence compared to years prior to 2000. We identified variation in the criteria for collecting a blood culture, and among multiplier studies we identified a lack of a standardization for the types of multipliers being used to estimate incidence.
Conclusions:
Typhoid fever incidence remains high at many sites. Additional and more accurate typhoid incidence studies are needed to support country decisions about typhoid conjugate vaccine adoption. Standardization of multiplier types applied in multiplier studies is recommended. View Show abstract Salmonella Typhi From Blood Cultures in the Democratic Republic of the Congo: A 10-Year Surveillance Article Full-text available Mar 2019 CLIN INFECT DIS Bieke Tack Marie-France Phoba Sandra Van Puyvelde Jan Jacobs Background:
This study gives an overview of a decade (2007-2017) of hospital-based Salmonella Typhi bloodstream infection (BSI) surveillance in the Democratic Republic of the Congo (DRC), at 4 main sampling sites.
Methods:
Blood cultures were sampled in hospital-admitted patients with suspected BSI, according to standardized clinical indications. The results of the surveillance period 2015-2017 were compiled with those of previous surveillance periods (2007-2010 and 2011-2014). Whole genome sequencing of isolates with decreased ciprofloxacin susceptibility (DCS) was performed.
Results:
Salmonella Typhi was isolated in 1.4% (531/37 388) and 10.3% (531/5177) of suspected and culture-confirmed BSI episodes, respectively. Salmonella Typhi ranked first among the BSI pathogens in adults (n = 220), but was mostly (n = 301 [56.7%]) isolated from children, of which 72.1% (217/301) and 31.6% (95/301) were <10 years and <5 years old, respectively. Multidrug resistance (MDR), DCS, and combined MDR/DCS were found in 38.3% (n = 180), 24.5% (n = 115), and 11.9% (n = 56) of 470 first isolates, respectively. MDR and DCS rates had increased since 2007, but remained stable during 2015-2017 with no geographical clustering at the province level. Most (91/93 [97.8%]) DCS isolates sequenced belonged to Genotyphi genotype 2.5.1, and gyr S83 was the most frequent DCS mutation (76/93 [81.7%]). Infections occurred perennially, but increased during the rainy season.
Conclusions:
Salmonella Typhi was a frequent cause of BSI in adults and children in DRC, with high rates of antibiotic resistance. Sustainable surveillance and implementation of vaccination are compelling. View Show abstract Vital Signs : Trends in Staphylococcus aureus Infections in Veterans Affairs Medical Centers — United States, 2005–2017 Article Full-text available Mar 2019 Makoto Jones John A Jernigan Martin Evans Matthew Samore Introduction:
By 2007, all Department of Veterans Affairs medical centers (VAMCs) had initiated a multifaceted methicillin-resistant Staphylococcus aureus (MRSA) prevention program. MRSA and methicillin-susceptible S. aureus (MSSA) infection rates among VAMC inpatients from 2005 to 2017 were assessed.
Methods:
Clinical microbiology data from any patient admitted to an acute-care VAMC in the United States from 2005 through 2017 and trends in hospital-acquired MRSA colonization were examined.
Results:
S. aureus infections decreased by 43% overall during the study period (p<0.001), driven primarily by decreases in MRSA, which decreased by 55% (p<0.001), whereas MSSA decreased by 12% (p = 0.003). Hospital-onset MRSA and MSSA infections decreased by 66% (p<0.001) and 19% (p = 0.02), respectively. Community-onset MRSA infections decreased by 41% (p<0.001), whereas MSSA infections showed no significant decline. Acquisition of MRSA colonization decreased 78% during 2008-2017 (17% annually, p<0.001). MRSA infection rates declined more sharply among patients who had negative admission surveillance MRSA screening tests (annual 9.7% decline) compared with those among patients with positive admission MRSA screening tests (4.2%) (p<0.05).
Conclusions and implications for public health practice:
Significant reductions in S. aureus infection following the VAMC intervention were led primarily by decreases in MRSA. Moreover, MRSA infection declines were much larger among patients not carrying MRSA at the time of admission than among those who were. Taken together, these results suggest that decreased MRSA transmission played a substantial role in reducing overall S. aureus infections at VAMCs. Recent calls to withdraw infection control interventions designed to prevent MRSA transmission might be premature and inadvisable, at least until more is known about effective control of bacterial pathogen transmission in health care settings. Effective S. aureus prevention strategies require a multifaceted approach that includes adherence to current CDC recommendations for preventing not only device- and procedure-associated infections, but also transmission of health care-prevalent strains. View Show abstract Vital Signs: Epidemiology and Recent Trends in Methicillin-Resistant and in Methicillin-Susceptible Staphylococcus aureus Bloodstream Infections — United States Article Full-text available Mar 2019 Athena Kourtis Kelly M Hatfield James Baggs Denise Cardo Introduction:
Staphylococcus aureus is one of the most common pathogens in health care facilities and in the community, and can cause invasive infections, sepsis, and death. Despite progress in preventing methicillin-resistant S. aureus (MRSA) infections in health care settings, assessment of the problem in both health care and community settings is needed. Further, the epidemiology of methicillin-susceptible S. aureus (MSSA) infections is not well described at the national level.
Methods:
Data from the Emerging Infections Program (EIP) MRSA population surveillance (2005-2016) and from the Premier and Cerner Electronic Health Record databases (2012-2017) were analyzed to describe trends in incidence of hospital-onset and community-onset MRSA and MSSA bloodstream infections and to estimate the overall incidence of S. aureus bloodstream infections in the United States and associated in-hospital mortality.
Results:
In 2017, an estimated 119,247 S. aureus bloodstream infections with 19,832 associated deaths occurred. During 2005-2012 rates of hospital-onset MRSA bloodstream infection decreased by 17.1% annually, but the decline slowed during 2013-2016. Community-onset MRSA declined less markedly (6.9% annually during 2005-2016), mostly related to declines in health care-associated infections. Hospital-onset MSSA has not significantly changed (p = 0.11), and community-onset MSSA infections have slightly increased (3.9% per year, p<0.0001) from 2012 to 2017.
Conclusions and implications for public health practice:
Despite reductions in incidence of MRSA bloodstream infections since 2005, S. aureus infections account for significant morbidity and mortality in the United States. To reduce the incidence of these infections further, health care facilities should take steps to fully implement CDC recommendations for prevention of device- and procedure-associated infections and for interruption of transmission. New and novel prevention strategies are also needed. View Show abstract The global burden of typhoid and paratyphoid fevers: a systematic analysis for the Global Burden of Disease Study 2017 Article Full-text available Feb 2019 LANCET INFECT DIS Jeffrey D Stanaway Robert Charles Reiner Brigette F Blacker Simon Iain Hay Background:
Efforts to quantify the global burden of enteric fever are valuable for understanding the health lost and the large-scale spatial distribution of the disease. We present the estimates of typhoid and paratyphoid fever burden from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017, and the approach taken to produce them.
Methods:
For this systematic analysis we broke down the relative contributions of typhoid and paratyphoid fevers by country, year, and age, and analysed trends in incidence and mortality. We modelled the combined incidence of typhoid and paratyphoid fevers and split these total cases proportionally between typhoid and paratyphoid fevers using aetiological proportion models. We estimated deaths using vital registration data for countries with sufficiently high data completeness and using a natural history approach for other locations. We also estimated disability-adjusted life-years (DALYs) for typhoid and paratyphoid fevers.
Findings:
Globally, 14·3 million (95% uncertainty interval [UI] 12·5-16·3) cases of typhoid and paratyphoid fevers occurred in 2017, a 44·6% (42·2-47·0) decline from 25·9 million (22·0-29·9) in 1990. Age-standardised incidence rates declined by 54·9% (53·4-56·5), from 439·2 (376·7-507·7) per 100 000 person-years in 1990, to 197·8 (172·0-226·2) per 100 000 person-years in 2017. In 2017, Salmonella enterica serotype Typhi caused 76·3% (71·8-80·5) of cases of enteric fever. We estimated a global case fatality of 0·95% (0·54-1·53) in 2017, with higher case fatality estimates among children and older adults, and among those living in lower-income countries. We therefore estimated 135·9 thousand (76·9-218·9) deaths from typhoid and paratyphoid fever globally in 2017, a 41·0% (33·6-48·3) decline from 230·5 thousand (131·2-372·6) in 1990. Overall, typhoid and paratyphoid fevers were responsible for 9·8 million (5·6-15·8) DALYs in 2017, down 43·0% (35·5-50·6) from 17·2 million (9·9-27·8) DALYs in 1990.
Interpretation:
Despite notable progress, typhoid and paratyphoid fevers remain major causes of disability and death, with billions of people likely to be exposed to the pathogens. Although improvements in water and sanitation remain essential, increased vaccine use (including with typhoid conjugate vaccines that are effective in infants and young children and protective for longer periods) and improved data and surveillance to inform vaccine rollout are likely to drive the greatest improvements in the global burden of the disease.
Funding:
Bill & Melinda Gates Foundation. View Show abstract Risk Factors for Elizabethkingia Acquisition and Clinical Characteristics of Patients, South Korea Article Full-text available Jan 2019 EMERG INFECT DIS Min Hyuk Choi Myungsook Kim Sujin Jeong Kwang jo Lee Elizabethkingia infections are difficult to treat because of intrinsic antimicrobial resistance, and their incidence has recently increased. We conducted a propensity score-matched case-control study during January 2016-June 2017 in South Korea and retrospectively studied data from patients who were culture positive for Elizabethkingia species during January 2009-June 2017. Furthermore, we conducted epidemiologic studies of the hospital environment and mosquitoes. The incidence of Elizabethkingia increased significantly, by 432.1%, for 2016-2017 over incidence for 2009-2015. Mechanical ventilation was associated with the acquisition of Elizabethkingia species. Because Elizabethkingia infection has a high case-fatality rate and is difficult to eliminate, intensive prevention of contamination is needed. View Show abstract Attributable deaths and disability-adjusted life-years caused by infections with antibiotic-resistant bacteria in the EU and the European Economic Area in 2015: a population-level modelling analysis Article Full-text available Nov 2018 LANCET INFECT DIS Alessandro Cassini Liselotte Diaz Högberg Diamantis Plachouras Susan Hopkins Background
Infections due to antibiotic-resistant bacteria are threatening modern health care. However, estimating their incidence, complications, and attributable mortality is challenging. We aimed to estimate the burden of infections caused by antibiotic-resistant bacteria of public health concern in countries of the EU and European Economic Area (EEA) in 2015, measured in number of cases, attributable deaths, and disability-adjusted life-years (DALYs).
Methods
We estimated the incidence of infections with 16 antibiotic resistance–bacterium combinations from European Antimicrobial Resistance Surveillance Network (EARS-Net) 2015 data that was country-corrected for population coverage. We multiplied the number of bloodstream infections (BSIs) by a conversion factor derived from the European Centre for Disease Prevention and Control point prevalence survey of health-care-associated infections in European acute care hospitals in 2011–12 to estimate the number of non-BSIs. We developed disease outcome models for five types of infection on the basis of systematic reviews of the literature.
Findings
From EARS-Net data collected between Jan 1, 2015, and Dec 31, 2015, we estimated 671 689 (95% uncertainty interval [UI] 583 148–763 966) infections with antibiotic-resistant bacteria, of which 63·5% (426 277 of 671 689) were associated with health care. These infections accounted for an estimated 33 110 (28 480–38 430) attributable deaths and 874 541 (768 837–989 068) DALYs. The burden for the EU and EEA was highest in infants (aged <1 year) and people aged 65 years or older, had increased since 2007, and was highest in Italy and Greece.
Interpretation
Our results present the health burden of five types of infection with antibiotic-resistant bacteria expressed, for the first time, in DALYs. The estimated burden of infections with antibiotic-resistant bacteria in the EU and EEA is substantial compared with that of other infectious diseases, and has increased since 2007. Our burden estimates provide useful information for public health decision-makers prioritising interventions for infectious diseases. View Show abstract Management and outcome of bloodstream infections: a prospective survey in 121 French hospitals (SPA-BACT survey) Article Full-text available Aug 2018 Olivier Robineau Jerome Robert C. Rabaud Serge Alfandari Background
Bloodstream infections (BSIs) are severe infections that can be community or hospital acquired. Effects of time to appropriate treatment and impact of antimicrobial management team are discussed in terms of outcome of BSI. We sought to evaluate the impact of initial BSI management on short-term mortality.
Patients and methods
A prospective, multicenter survey was conducted in 121 French hospitals. Participants declaring BSI during a 1-month period were included consecutively. Data on patient comorbidities, illness severity, BSI management, and resistance profile of bacterial strains were collected. Predictors of 10-day mortality were identified by multivariate regression for overall BSI, health care-related and hospital-acquired BSI.
Results
We included 1,952 BSIs. More than a third of them were hospital acquired (39%). Multidrug resistance was identified in 10% of cases, mainly in health care-related BSI. Empirical therapy and targeted therapy were appropriate for 61% and 94% of cases, respectively. Increased 10-day mortality was associated with severe sepsis, septic shock, increasing age, and any focus other than the urinary tract. Decreased mortality was associated with receiving at least one active antibiotic within the first 48 hours. Intervention of antimicrobial management team during the acute phase of BSI was associated with a decreased mortality at day 10 in the overall population and in health care-related BSI.
Conclusion
Optimizing BSI management by increasing rapidity of appropriate treatment initiation may decrease short-term mortality, even in countries with low rate of multidrug-resistant organisms. Early intervention of antimicrobial management team is crucial in terms of mortality. View Show abstract Treatment options and clinical outcomes for carbapenem-resistant Enterobacteriaceae bloodstream infection in a Chinese university hospital Article Full-text available Aug 2018 Chen Li Yi Li Zhichang Zhao Bin Li Background:
Carbapenem resistant Enterobacteriaceae (CRE) has become a serious public health problem. Limited information is available about the treatment options that physicians used to fight CRE infections and related clinical outcomes in China. The aim of the present study was to explore the treatment options and clinical outcomes of patients with CRE bloodstream infection (BSI) in a Chinese teaching hospital.
Methods:
A retrospective study was conducted during 2011 to 2015 in one Chinese teaching hospital. Demographic, microbiological and clinical characteristics of enrolled subjects were collected from medical records. Data were analyzed by Kaplan-Meier graphs, log-rank test, and Cox regression.
Results:
A total of 98 inpatients with CRE BSI were enrolled in this study. For empirical therapy, 26 patients (26.5%) received at least one active drug within 48h after the onset of bacteremia. For definitive treatment, 59.2% (49/82) patients received at least one active drug and 40.2% (33/82) patients received therapy with no active drug. The overall 30-day mortality was 53.1% (52/98). Adverse outcome appeared to be more likely among patients with previous carbapenem exposure, neutropenia, severity of septic and time to initiation of BSIs. There was no significant difference in the mortality between the two groups of patients with combination therapy versus monotherapy (p=0.105). Severity of sepsis and neutropenia were identified as independent predictors of mortality.
Conclusions:
Our study demonstrated a high mortality associated with CRE BSI and a high percentage of inappropriate empirical treatment for CRE BSI patients in a Chinese teaching hospital. Particular attention should be given to the patients with CRE BSI. View Show abstract Incidence and antimicrobial resistance trends in bloodstream infections caused by ESKAPE and Escherichia coli at a large teaching hospital in Rome, a 9-year analysis (2007–2015) Article Full-text available Sep 2018 EUR J CLIN MICROBIOL Giulia De Angelis Barbara Fiori Giulia Menchinelli Teresa Spanu The proportion of antimicrobial resistance (AMR) among the ESKAPE and Escherichia coli (ESKAPEEc) pathogens causing bloodstream infection (BSI) increased worldwide. We described longitudinal trends in ESKAPEEc BSI and AMR over 9 years (2007–2015) at a large teaching hospital in Italy. Of 9720 unique BSI episodes, 6002 (61.7%) were caused by ESKAPEEc pathogens. The majority of these episodes (4374; 72.9%) were hospital-onset infections. The most frequent pathogen was E. coli (32.8%), followed by Staphylococcus aureus (20.6%), Klebsiella pneumoniae (16.1%), and Pseudomonas aeruginosa (11.6%). There was a significant increase of hospital-onset K. pneumoniae (from 2.3 to 5.0 per 10,000 patient-days; P = 0.001) and community-onset E. coli (from 3.3 to 9. 1 per 10,000 emergency admissions; P = 0.04) BSIs. Among hospital-onset BSIs, increases of extended-spectrum β-lactamase (ESBL)-producing E. coli (from 25.4 to 35.2%, P = 0.006), carbapenemase-producing K. pneumoniae (from 4.2 to 51.6%, P < 0.001), and methicillin-resistant S. aureus (from 33.9 to 44.4%, P < 0.001) BSIs were observed between the 2007–2009 and 2010–2012 study periods. In contrast, a decrease of BSIs caused by P. aeruginosa resistant to ceftazidime (from 45.5 to 28.2%, P < 0.001), ciprofloxacin (from 46 to 36.3%, P = 0.05), and meropenem (from 55 to 39.9%, P = 0.03) was observed through all 9 years of the study period. Among community-onset BSIs, increases of BSIs caused by ESBL-producing E. coli (from 28.6 to 42.2%, P = 0.002) and carbapenemase-producing K. pneumoniae (from 0 to 17.6%) were observed between the 2007–2009 and 2010–2012 study periods. Our findings show increased rates of BSI and relative AMR for specific pathogen-health care setting combinations, and call for continued active surveillance and infection control policies. View Show abstract National Costs Associated with Methicillin-susceptible and Methicillin-resistant S. aureus Hospitalizations in the United States, 2010-2014 Article Full-text available May 2018 CLIN INFECT DIS Eili Y Klein Wendi Jiang Nestor Mojica Trish M Perl Background:
Infections caused by methicillin-resistant Staphylococcus aureus (MRSA) have been associated with worse patient outcomes and higher costs of care than susceptible (MSSA) infections. However, the healthcare landscape has changed since prior studies found these differences, including widespread dissemination of community-associated strains of MRSA. Our objective was to provide updated estimates of the excess costs of resistant S. aureus infections.
Methods:
We conducted a retrospective analysis using data from the National Inpatient Sample from the Agency for Healthcare Research and Quality for the years 2010 to 2014. We calculated costs for hospitalizations including MRSA- and MSSA-related septicemia and pneumonia infections, as well as MRSA- and MSSA-related infections from conditions classified elsewhere and of an unspecified site ("other infections"). Differences in the costs of hospitalization were estimated using propensity score adjusted mortality outcomes for 2010 through 2014.
Results:
In 2014, estimated costs were highest for pneumonia and sepsis-related hospitalizations. Propensity score-adjusted costs were significantly higher for MSSA-related pneumonia ($40,725 vs $38,561; p=0.045) and other hospitalizations ($15,578 vs $14,792; p<0.001) than for MRSA-related hospitalizations. Similar patterns were observed from 2010 to 2013, though crude cost differences between MSSA- and MRSA-related pneumonia hospitalizations rose from 25.8% in 2010 to 31.0% in 2014. MRSA-related hospitalizations had a higher adjusted mortality rate than MSSA-related hospitalizations.
Conclusions:
Though MRSA infections had been previously associated with higher hospitalization costs, our results suggest that in recent years, costs associated with MSSA-related infections have converged with and may surpass costs of similar MRSA-related hospitalizations. View Show abstract Staphylococcus aureus Bacteremia Incidence and Methicillin Resistance in Rural Thailand, 2006–2014 Article Full-text available May 2018 Julia Rhodes Toni Whistler Ornuma Sangwichian Henry C. Baggett Staphylococcus aureus is a common cause of bloodstream infection and methicillin-resistant S. aureus (MRSA) is a growing threat worldwide. We evaluated the incidence rate of S. aureus bacteremia (SAB) and MRSA from population-based surveillance in all hospitals from two Thai provinces. Infections were classified as community-onset (CO) when blood cultures were obtained ≤ 2 days after hospital admission and as hospital-onset (HO) thereafter. The incidence rate of HO-SAB could only be calculated for 2009-2014 when hospitalization denominator data were available. Among 147,524 blood cultures, 919 SAB cases were identified. Community-onset S. aureus bacteremia incidence rate doubled from 4.4 (95% confidence interval [CI]: 3.3-5.8) in 2006 to 9.3 per 100,000 persons per year (95% CI: 7.6-11.2) in 2014. The highest CO-SAB incidence rate was among adults aged 50 years and older. Children less than 5 years old had the next highest incidence rate, with most cases occurring among neonates. During 2009-2014, there were 89 HO-SAB cases at a rate of 0.13 per 1,000 hospitalizations per year (95% CI: 0.10-0.16). Overall, MRSA prevalence among SAB cases was 10% (90/911) and constituted 7% (55/736) of CO-SAB and 20% (22/111) of HO-SAB without a clear temporal trend in incidence rate. In conclusion, CO-SAB incidence rate has increased, whereas MRSA incidence rate remained stable. The increasing CO-SAB incidence rate, especially the burden on older adults and neonates, underscores the importance of strong SAB surveillance to identify and respond to changes in bacteremia trends and antimicrobial resistance. View Show abstract Current and future burden of venous thrombosis: Not simply predictable Article Full-text available Apr 2018 Luuk Scheres Willem M. Lijfering Suzanne C. Cannegieter Essentials
• The incidence of venous thrombosis has remained stable over the past decade.
• Risk factors and diagnostic and prophylaxis strategies are determinants of the overall incidence.
• Given current trends of the determinants, we are making progress in reducing the burden.
• More progress can be made by implementing validated risk assessment models.
Venous thrombosis is a major contributor to the global disease burden. In this review we aim to answer two important questions: (1) are we making progress in reducing this disease burden and (2) how can we further improve? To answer these questions, we first evaluated the disease burden, that is, the incidence of first venous thrombosis over the past decade(s) and discuss its most important determinants. We found that the incidence of first venous thrombosis remained relatively unchanged, despite an increase in risk factor prevalence and a rise in identification of subsegmental pulmonary emboli due to enhanced image quality and utilization. This is, however, balanced by improved thromboprophylaxis strategies, resulting in an overall unchanged venous thrombosis incidence. We can further improve by developing, validating, and implementing risk assessment strategies, allowing us to identify persons at high or low risk in whom thromboprophylaxis can be provided or withheld, respectively. View Show abstract Presentation of life-threatening invasive nontyphoidal Salmonella disease in Malawian children: A prospective observational study Article Full-text available Dec 2017 PLOS NEGLECT TROP D Calman Maclennan Chisomo L Msefula Esther N. Gondwe Stephen M Graham Nontyphoidal Salmonellae commonly cause invasive disease in African children that is often fatal. The clinical diagnosis of these infections is hampered by the absence of a clear clinical syndrome. Drug resistance means that empirical antibiotic therapy is often ineffective and currently no vaccine is available. The study objective was to identify risk factors for mortality among children presenting to hospital with invasive Salmonella disease in Africa. We conducted a prospective study enrolling consecutive children with microbiologically-confirmed invasive Salmonella disease admitted to Queen Elizabeth Central Hospital, Blantyre, in 2006. Data on clinical presentation, co-morbidities and outcome were used to identify children at risk of inpatient mortality through logistic-regression modeling. Over one calendar year, 263 consecutive children presented with invasive Salmonella disease. Median age was 16 months (range 0-15 years) and 52/256 children (20%; 95%CI 15-25%) died. Nontyphoidal serovars caused 248/263 (94%) of cases. 211/259 (81%) of isolates were multi-drug resistant. 251/263 children presented with bacteremia, 6 with meningitis and 6 with both. Respiratory symptoms were present in 184/240 (77%; 95%CI 71-82%), 123/240 (51%; 95%CI 45-58%) had gastrointestinal symptoms and 101/240 (42%; 95%CI 36-49%) had an overlapping clinical syndrome. Presentation at <7 months (OR 10.0; 95%CI 2.8-35.1), dyspnea (OR 4.2; 95%CI 1.5-12.0) and HIV infection (OR 3.3; 95%CI 1.1-10.2) were independent risk factors for inpatient mortality. Invasive Salmonella disease in Malawi is characterized by high mortality and prevalence of multi-drug resistant isolates, along with non-specific presentation. Young infants, children with dyspnea and HIV-infected children bear a disproportionate burden of the Salmonella-associated mortality in Malawi. Strategies to improve prevention, diagnosis and management of invasive Salmonella disease should be targeted at these children. View Show abstract Elizabethkingia in Children: A Comprehensive Review of Symptomatic Cases Reported from 1944–2017 Article Full-text available Dec 2017 CLIN INFECT DIS Eric J. Dziuban Jessica L Franks Marvin So David D Blaney Elizabethkingia species often exhibit extensive antibiotic resistance and result in high morbidity and mortality, yet no systematic reviews exist that thoroughly characterize and quantify concerns for infected infants and children. We performed a review of literature and identified an initial 902 articles; 96 articles reporting 283 pediatric cases met our inclusion criteria and were subsequently reviewed. Case reports spanned 28 countries and ranged from 1944 to 2017. Neonatal meningitis remains the most common presentation of this organism in children, along with a range of other clinical manifestations. The majority of reported cases occurred as isolated cases, rather than within outbreaks. Mortality was high but has decreased in recent years, although neurologic sequelae among survivors remains concerning. Child outcomes can be improved through effective prevention measures and early identification and treatment of infected patients. View Show abstract Temporal trends and patterns in heart failure incidence: A population-based study of 4 million individuals Article Full-text available Nov 2017 Nathalie Conrad Andrew Judge Jenny Tran Kazem Rahimi Background:
Large-scale and contemporary population-based studies of heart failure incidence are needed to inform resource planning and research prioritisation but current evidence is scarce. We aimed to assess temporal trends in incidence and prevalence of heart failure in a large general population cohort from the UK, between 2002 and 2014.
Methods:
For this population-based study, we used linked primary and secondary electronic health records of 4 million individuals from the Clinical Practice Research Datalink (CPRD), a cohort that is representative of the UK population in terms of age and sex. Eligible patients were aged 16 years and older, had contributed data between Jan 1, 2002, and Dec 31, 2014, had an acceptable record according to CPRD quality control, were approved for CPRD and Hospital Episodes Statistics linkage, and were registered with their general practice for at least 12 months. For patients with incident heart failure, we extracted the most recent measurement of baseline characteristics (within 2 years of diagnosis) from electronic health records, as well as information about comorbidities, socioeconomic status, ethnicity, and region. We calculated standardised rates by applying direct age and sex standardisation to the 2013 European Standard Population, and we inferred crude rates by applying year-specific, age-specific, and sex-specific incidence to UK census mid-year population estimates. We assumed no heart failure for patients aged 15 years or younger and report total incidence and prevalence for all ages (>0 years).
Findings:
From 2002 to 2014, heart failure incidence (standardised by age and sex) decreased, similarly for men and women, by 7% (from 358 to 332 per 100 000 person-years; adjusted incidence ratio 0·93, 95% CI 0·91-0·94). However, the estimated absolute number of individuals with newly diagnosed heart failure in the UK increased by 12% (from 170 727 in 2002 to 190 798 in 2014), largely due to an increase in population size and age. The estimated absolute number of prevalent heart failure cases in the UK increased even more, by 23% (from 750 127 to 920 616). Over the study period, patient age and multi-morbidity at first presentation of heart failure increased (mean age 76·5 years [SD 12·0] to 77·0 years [12·9], adjusted difference 0·79 years, 95% CI 0·37-1·20; mean number of comorbidities 3·4 [SD 1·9] vs 5·4 [2·5]; adjusted difference 2·0, 95% CI 1·9-2·1). Socioeconomically deprived individuals were more likely to develop heart failure than were affluent individuals (incidence rate ratio 1·61, 95% CI 1·58-1·64), and did so earlier in life than those from the most affluent group (adjusted difference -3·51 years, 95% CI -3·77 to -3·25). From 2002 to 2014, the socioeconomic gradient in age at first presentation with heart failure widened. Socioeconomically deprived individuals also had more comorbidities, despite their younger age.
Interpretation:
Despite a moderate decline in standardised incidence of heart failure, the burden of heart failure in the UK is increasing, and is now similar to the four most common causes of cancer combined. The observed socioeconomic disparities in disease incidence and age at onset within the same nation point to a potentially preventable nature of heart failure that still needs to be tackled.
Funding:
British Heart Foundation and National Institute for Health Research. View Show abstract Methicillin-susceptible and Methicillin-resistant Staphylococcus aureus Bacteremia: Nationwide Estimates of 30-Day Readmission, In-hospital Mortality, Length of Stay, and Cost in the United States Article Nov 2019 CLIN INFECT DIS Kengo Inagaki Jose Lucar Chad Blackshear Charlotte V Hobbs Background:
Information on outcomes of methicillin-susceptible and -resistant Staphylococcus aureus (MSSA and MRSA, respectively) bacteremia, particularly readmission, is scarce and requires further research to inform optimal patient care.
Methods:
We performed a retrospective analysis using the 2014 Nationwide Readmissions Database, capturing 49.3% of US hospitalizations. We identified MSSA and MRSA bacteremia using International Classification of Diseases, Ninth Revision, Clinical Modification among patients aged ≥18 years. Thirty-day readmission, mortality, length of stay, and costs were assessed using Cox proportional hazards regression, logistic regression, Poisson regression, and generalized linear model with gamma distribution and log link, respectively.
Results:
Of 92 089 (standard error [SE], 1905) patients with S. aureus bacteremia, 48.5% (SE, 0.4%) had MRSA bacteremia. Thirty-day readmission rate was 22% (SE, 0.3) overall with no difference between MRSA and MSSA, but MRSA bacteremia had more readmission for bacteremia recurrence (hazard ratio, 1.17 [95% confidence interval {CI}, 1.02-1.34]), higher in-hospital mortality (odds ratio, 1.15 [95% CI, 1.07-1.23]), and longer hospitalization (incidence rate ratio, 1.09 [95% CI, 1.06-1.11]). Readmission with bacteremia recurrence was particularly more common among patients with endocarditis, immunocompromising comorbidities, and drug abuse. The cost of readmission was $12 425 (SE, $174) per case overall, and $19 186 (SE, $623) in those with bacteremia recurrence.
Conclusions:
Thirty-day readmission after S. aureus bacteremia is common and costly. MRSA bacteremia is associated with readmission for bacteremia recurrence, increased mortality, and longer hospitalization. Efforts should continue to optimize patient care, particularly for those with risk factors, to decrease readmission and associated morbidity and mortality in patients with S. aureus bacteremia. View Show abstract Bloodstream Infections Caused By Klebsiella Pneumoniae in Onco-Hematological Patients: Incidence and Clinical Impact of Carbapenem Resistance in a Multicentre Prospective Survey Article Dec 2015 Enrico MARIA Trecarichi Mario Tumbarello Roberta Di Blasi Livio Pagano INTRODUCTION. Resistance to carbapenems by Klebsiella pneumoniae (KP) isolates has become a significant problem in recent years in several countries, and has been recently highlighted as one of the major emerging causes of severe and fatal infections in patients suffering from hematological malignancies (HM).
The aim of the present study was to identify risk factors for mortality in HM patients with concurrent bloodstream infections (BSIs) caused by KP. Particular attention was focused on defining the impact of carbapenem resistance by the bacterial isolates on mortality.
METHODS. We conducted a prospective cohort study including all consecutive cases of BSIs caused by KP diagnosed in 13 Italian hematological units participating to HEMABIS registry-SEIFEM group. The outcome measured was death within 30 days of the first positive blood culture. Survivor and non-survivor subgroups were compared, and logistic regression analysis was conducted to identify independent predictors of mortality.
RESULTS. A total of 278 episodes of KP BSI were included in the study between January 2010 and June 2014. One hundred-sixty-one (57.9%) KP isolates were carbapenem resistant (CRKP). The rate of carbapenem resistance among KP isolates significantly increased from 21.4% in 2010 to 75.9% in 2013 (P<0.001), and it was 61.1% during the first six months of 2014. The overall 30-day mortality rate was 36.3% (101/278); however, it was significantly higher for patients with CRKP BSI (84/161, 52.2%) than for those with BSI caused by carbapenem susceptible KP (CSKP) (17/117, 14.5%; P<0.001). Compared to patients with CSKP BSI, those with CRKP BSI more likely were older, had an indwelling peripherally inserted central catheters (PICCs), suffered from acute myeloid leukemia, had previous CRKP culture-positive surveillance swabs, and received antibiotic prophylaxis, in particular with fluoroquinolones. On the other hand, patients who had indwelling centrally inserted (both short- and long-term) venous catheters (CVCs) and those who suffered from non Hodgkin's lymphoma and/or underwent hematopoietic stem cell transplantation, had more likely a BSI episode caused by CSKP.
In multivariate analysis, significant predictors of mortality were septic shock (OR 17.34, 95% CI 6.65-45.23; P<0.001), acute respiratory failure (OR 6.65, 95% CI 2.89-15.31; P<0.001), altered state of consciousness (OR 6.01, 95% CI 1.86-19.45; P=0.003), carbapenem resistance by KP isolate (OR 4.21, 95% CI 1.87-9.47; P=0.001), corticosteroid therapy (OR 2.35, 95% CI 1.09-5.07; P=0.02), and older age (OR 1.02, 95% CI 1.01-1.04; P=0.03).
CONCLUSIONS. Carbapenem resistance has dramatically emerged during the last years as the most frequent and fatal cause of BSI among KP isolates in HM patients in Italy. Although further studies to better define epidemiology and clinical impact of these infections are needed, the efficacy of therapeutic treatment protocols for HM patients could be probably improved through the sound knowledge of the local distribution of KP isolates and their susceptibility patterns and judicious use of antibiotics and control measures to prevent the development and spread of CRKP.
Disclosures
No relevant conflicts of interest to declare. View Show abstract Survival following Staphylococcus aureus bloodstream infection; a prospective multinational cohort study assessing the impact of place of care Article Dec 2018 J INFECTION H Siefert Kate Nambiar Siegbert Rieg Achim J. Kaasch BACKGROUND: Staphylococcus aureus bloodstream infection (SAB) is a common, life-threatening infection with a high mortality. Survival can be improved by implementing quality of care bundles in hospitals. We previously observed marked differences in mortality between hospitals and now assessed whether mortality could serve as a valid and easy to implement quality of care outcome measure. METHODS: We conducted a prospective observational study between January 2013 and April 2015 on consecutive, adult patients with SAB from 11 tertiary care centers in Germany, South Korea, Spain, Taiwan, and the United Kingdom. Factors associated with mortality at 90 days were analyzed by Cox proportional hazards regression and flexible parametric models. RESULTS: 1851 patients with a median age of 66 years (64% male) were analyzed. Crude 90-day mortality differed significantly between hospitals (range 23–39%). Significant variation between centers was observed for methicillin-resistant S. aureus, community-acquisition, infective foci, as well as measures of comorbidities, and severity of disease. In multivariable analysis, factors independently associated with mortality at 90 days were age, nosocomial acquisition, unknown infective focus, pneumonia, Charlson comorbidity index, SOFA score, and study center. The risk of death varied over time differently for each infective focus. Crude mortality differed markedly from adjusted mortality. DISCUSSION: We observed significant differences in adjusted mortality between hospitals, suggesting differences in quality of care. However, mortality is strongly influenced by patient mix and thus, crude mortality is not a suitable quality indicator. View Show abstract Extended-Spectrum β-Lactamase-Producing Enterobacteriaceae: Update on Molecular Epidemiology and Treatment Options Article Aug 2019 DRUGS Gisele Peirano Johann D D Pitout Extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae are a major global public health concern. Presently, Escherichia coli with CTX-Ms are the most common species associated with global ESBLs; CTX-M-15 is the most frequent CTX-M worldwide and is followed by CTX-M-14, which is often found in South-East Asia. Recent surveillance studies showed that CTX-M-27 is emerging in certain parts of the world especially in Japan and Europe. The population structure of ESBL-producing E. coli is dominated globally by an high-risk clone named ST131. Escherichia coli ST131 belongs to three clades (A, B, and C) and three different subclades (C1, C1-M27, and C2). Clade C1-M27 is associated with blaCTX-M-27, and C2 with blaCTX-M-15. Recent whole genome sequencing studies have shown that clade C has evolved from clade B in a stepwise fashion, resulting in one of the most influential global antimicrobial resistance clones that has emerged during the 2000’s. Other important E. coli clones that have been detected among ESBL producers include ST405, ST38, ST648, ST410, and ST1193. The INCREMENT project has shown that ertapenem is as effective as other carbapenems for treating serious infections due to ESBL-producing Enterobacteriaceae. The results of the MERINO open-label randomized controlled study has provided clear evidence that piperacillin-tazobactam should be avoided for targeted therapy of blood-stream infections due to ESBL-producing E. coli and K. pneumoniae, regardless of the patient population, source of infection, bacterial species, and susceptibility result of piperacillin-tazobactam. Research is still warranted to define the optimal therapy of less severe infections due to ESBL-producing Enterobactericeae. View Show abstract Antimicrobial resistance in South Korea: A report from the Korean global antimicrobial resistance surveillance system (Kor-GLASS) for 2017 Article Jul 2019 Changseung Liu Eun-Jeong Yoon Dokyun Kim Seok Hoon Jeong At the end of 2015, a global action plan on antimicrobial resistance (AMR) was proposed by the World Health Organization, and the Global AMR Surveillance System (GLASS) was subsequently initiated. The Centers for Disease Control and Prevention of South Korea established a customized AMR surveillance system for South Korea, called Kor-GLASS, in early 2016. A pilot phase of Kor-GLASS was operated from May to December 2016 with six sentinel hospitals, and phase I of Kor-GLASS started in January 2017 with eight sentinel hospitals. Previous surveillance data for overestimated AMR due to duplicate isolation of drug-resistant pathogens were corrected and error-free AMR data were compared with those from other countries. One-half (53.2%, 377/708) of Staphylococcus aureus blood strains exhibited resistance to cefoxitin, indicating methicillin-resistant S. aureus. Resistance to ampicillin in Enterococcus faecalis blood strains was rare (0.6%, 1/175), while the resistance rate to penicillin was 26.3% (46/175). Resistance to vancomycin (34.0%, 98/288) and teicoplanin (18.8%, 98/288) was frequently observed in Enterococcus faecium strains. The resistance rate of Escherichia coli strains to cefotaxime was 32.4% (574/1772), and that of Klebsiella pneumoniae strains was 26.1% (181/693). The resistance rates of Pseudomonas aeruginosa strains to imipenem and meropenem were 19.5% (29/149) and 18.1% (27/149), respectively. And 92.1% (187/203) of Acinetobacter baumannii strains were resistant to both imipenem and meropenem. The high incidence of bacteremia caused by major AMR pathogens among hospitalized patients especially in intensive care units emphasized the importance of hospital infection control and the need to improve the crowded hospitalization system in South Korea. The isolation rate of the Salmonella spp. is decreasing, reflecting the current socio-economic status of South Korea. The proportions of bacterial species in the blood strains were similar to those in other Asian countries with similar lifestyles. View Show abstract Global Extraintestinal Pathogenic Escherichia coli (ExPEC) Lineages Article Jun 2019 Amee R Manges Hyun Min Geum Alice Guo Johann D D Pitout Extraintestinal pathogenic Escherichia coli (ExPEC) strains are responsible for a majority of human extraintestinal infections globally, resulting in enormous direct medical and social costs. ExPEC strains are comprised of many lineages, but only a subset is responsible for the vast majority of infections. Few systematic surveillance systems exist for ExPEC. To address this gap, we systematically reviewed and meta-analyzed 217 studies (1995 to 2018) that performed multilocus sequence typing or whole-genome sequencing to genotype E. coli recovered from extraintestinal infections or the gut. Twenty major ExPEC sequence types (STs) accounted for 85% of E. coli isolates from the included studies. ST131 was the most common ST from 2000 onwards, covering all geographic regions. Antimicrobial resistance-based isolate study inclusion criteria likely led to an overestimation and underestimation of some lineages. European and North American studies showed similar distributions of ExPEC STs, but Asian and African studies diverged. Epidemiology and population dynamics of ExPEC are complex; summary proportion for some STs varied over time (e.g., ST95), while other STs were constant (e.g., ST10). Persistence, adaptation, and predominance in the intestinal reservoir may drive ExPEC success. Systematic, unbiased tracking of predominant ExPEC lineages will direct research toward better treatment and prevention strategies for extraintestinal infections. View Show abstract Epidemiology of Infectious and Noninfectious Catheter Complications in Patients Receiving Home Parenteral Nutrition: A Systematic Review and Meta‐Analysis Article Jun 2019 Ruth Reitzel Joel Rosenblatt Anne-Marie Chaftari Issam Raad Patients receiving parenteral nutrition (PN) as their primary source of nutrition are at high risk for both infectious and noninfectious catheter complications (catheter‐related infections, catheter occlusion, and venous thrombosis). The aim of this review was to synthesize and evaluate what is known about catheter complications and prevention strategies in the PN population. Three electronic databases (Medline, Embase, and CINAHL) were screened for studies published between January 2012 and February 2019 regarding infectious and noninfectious catheter complications in patients receiving PN. Rates of infectious and noninfectious catheter complications, prevalence of causative pathogens, potential risk factors, and prevention strategies via the use of antimicrobial lock therapy (ALT) were assessed. Fifty‐three catheter complication studies and 12 ALT studies were included. Studies were grouped by definition of complication: catheter‐related bloodstream infections (CRBSI) or central line–associated bloodstream infections (CLABSI). Random effects summary rates per 1000 catheter days were 0.85 CRBSI episodes (95% CI 0.27–2.64) and 1.65 CLABSI episodes (95% CI 1.09–2.48). Use of taurolidine or ethanol ALT was efficacious in reducing infectious catheter complications; however, several studies had concerns for adverse mechanical complications. Potential risk factors for catheter complications were highly varied and often contradictory between studies. The rates of catheter complications were higher among catheterized patients receiving PN compared with nationally reported rates of complications in all catheterized patients. Risk factors for catheter complications need to be better understood for targeted prophylactic use of ALT. Future studies are warranted; however, they should be conducted using more standardized definitions and criteria. View Show abstract Hypervirulent Klebsiella pneumoniae Article May 2019 Thomas A Russo Candace Marr Hypervirulent K. pneumoniae (hvKp) is an evolving pathotype that is more virulent than classical K. pneumoniae (cKp). hvKp usually infects individuals from the community, who are often healthy. Infections are more common in the Asian Pacific Rim but are occurring globally. hvKp infection frequently presents at multiple sites or subsequently metastatically spreads, often requiring source control. hvKp has an increased ability to cause central nervous system infection and endophthalmitis, which require rapid recognition and site-specific treatment. The genetic factors that confer hvKp’s hypervirulent phenotype are present on a large virulence plasmid and perhaps integrative conjugal elements. Increased capsule production and aerobactin production are established hvKp-specific virulence factors. Similar to cKp, hvKp strains are becoming increasingly resistant to antimicrobials via acquisition of mobile elements carrying resistance determinants, and new hvKp strains emerge when extensively drug-resistant cKp strains acquire hvKp-specific virulence determinants, resulting in nosocomial infection. Presently, clinical laboratories are unable to differentiate cKp from hvKp, but recently, several biomarkers and quantitative siderophore production have been shown to accurately predict hvKp strains, which could lead to the development of a diagnostic test for use by clinical laboratories for optimal patient care and for use in epidemiologic surveillance and research studies. View Show abstract Hospital epidemiologists' and infection preventionists' opinions regarding hospital-onset bacteremia and fungemia as a potential healthcare-associated infection metric Article May 2019 INFECT CONT HOSP EP Lilian Abbo Deverick Anderson Raymund B. Dantes Clare Rock Objective:
To ascertain opinions regarding etiology and preventability of hospital-onset bacteremia and fungemia (HOB) and perspectives on HOB as a potential outcome measure reflecting quality of infection prevention and hospital care.
Design:
Cross-sectional survey.
Participants:
Hospital epidemiologists and infection preventionist members of the Society for Healthcare Epidemiology of America (SHEA) Research Network.
Methods:
A web-based, multiple-choice survey was administered via the SHEA Research Network to 133 hospitals.
Results:
A total of 89 surveys were completed (67% response rate). Overall, 60% of respondents defined HOB as a positive blood culture on or after hospital day 3. Central line-associated bloodstream infections and intra-abdominal infections were perceived as the most frequent etiologies. Moreover, 61% thought that most HOB events are preventable, and 54% viewed HOB as a measure reflecting a hospital's quality of care. Also, 29% of respondents' hospitals already collect HOB data for internal purposes. Given a choice to publicly report central-line-associated bloodstream infections (CLABSIs) and/or HOB, 57% favored reporting either HOB alone (22%) or in addition to CLABSI (35%) and 34% favored CLABSI alone.
Conclusions:
Among the majority of SHEA Research Network respondents, HOB is perceived as preventable, reflective of quality of care, and potentially acceptable as a publicly reported quality metric. Further studies on HOB are needed, including validation as a quality measure, assessment of risk adjustment, and formation of evidence-based bundles and toolkits to facilitate measurement and improvement of HOB rates. View Show abstract Effect of carbapenem resistance on outcomes of bloodstream infection caused by Enterobacteriaceae in low-income and middle-income countries (PANORAMA): a multinational prospective cohort study Article Apr 2019 LANCET INFECT DIS Andrew Stewardson Kalisvar Marimuthu Sharmila Sengupta Stephan Harbarth View Staphylococcus capitis and NRCS-A clone: the story of an unrecognized pathogen in neonatal intensive care units Article Mar 2019 Frédéric Laurent Marine Butin Background:
In neonatal intensive care units (NICUs), nosocomial late-onset sepsis (LOS), mostly due to coagulase negative staphylococci, constitute a major cause of death or impairment. Staphylococcus capitis, usually considered as a poorly virulent species, has been reported as a cause of LOS.
Objectives:
To review data regarding S. capitis neonatal LOS and the features of isolates involved.
Sources:
PubMed was searched up to August 2018 to retrieve studies on the topic; the keywords used were 'S. capitis', 'neonate', 'neonatal ICU', 'bloodstream infection' and 'late onset sepsis'.
Content:
Published data highlight the worldwide endemicity of a single S. capitis clone, named NRCS-A, specifically involved in LOS. NRCS-A harbours a multidrug resistance profile (including resistance to the usual first-line antibiotics used in NICUs). It is also able to adapt under vancomycin selective pressure that could confer an advantage for its implantation and dissemination in NICUs where this selective pressure is high. Moreover, a severe morbidity has been observed in NRCS-A-related LOS. The NICU environment, and especially incubators, constitute reservoirs of NRCS-A from which it could diffuse inside the setting. Finally, the virulome and resistome of S. capitis NRCS-A contain many genes potentially implicated in its specific epidemiology and pathophysiology, including the gene nsr that may be involved in its fitness and implantation in neonatal gut flora.
Implications:
S. capitis must be considered as a true pathogen in neonates. The decreased susceptibility to vancomycin may be involved in failure of vancomycin therapy. Further studies are needed to better manage its diffusion inside each NICU but also worldwide. View Show abstract Mortality associated with in-hospital bacteraemia caused by Staphylococcus aureus: a multistate analysis with follow-up beyond hospital discharge Article Jan 2010 Martin Wolkewitz Uwe Frank Gabby Philips on behalf of the BURDEN study group View Trends in Incidence of Methicillin-resistant Staphylococcus aureus Bloodstream Infections Differ by Strain Type and Healthcare Exposure, United States, 2005–2013 Article Feb 2019 CLIN INFECT DIS Isaac See Yi Mu Valerie Albrecht Alexander J Kallen Background:
Previous reports suggested that U.S. methicillin-resistant Staphylococcus aureus (MRSA) strain epidemiology has changed since the rise of USA300 MRSA. We describe invasive MRSA trends by strain type.
Methods:
Data came from five CDC Emerging Infections Program sites conducting population-based surveillance and collecting isolates for invasive MRSA (i.e., from normally sterile body sites), 2005-2013. MRSA bloodstream infection (BSI) incidence/100,000 population was stratified by strain type and epidemiologic classification of healthcare exposures. Invasive USA100 vs USA300 case characteristics from 2013 were compared through logistic regression.
Results:
From 2005-2013, USA100 incidence decreased most notably for hospital-onset (6.1 vs 0.9 / 100,000 persons, P<0.0001) and healthcare-associated, community-onset (10.7 vs 4.9 / 100,000 persons, P<0.0001) BSIs. USA300 incidence for hospital-onset BSIs also decreased (1.5 vs 0.6 / 100,000 persons, P<0.0001). However, USA300 incidence did not significantly change for healthcare-associated, community-onset (3.9 vs 3.3 / 100,000 persons, P=0.05) or community-associated BSIs (2.5 vs 2.4 / 100,000 persons, P=0.19). Invasive MRSA was less likely to be USA300 in patients who were older (adjusted odds ratio [aOR] 0.97 per year, 95% confidence interval [CI] 0.96-0.98), previously hospitalized (aOR 0.36, 95% CI 0.24-0.54), or had central lines (aOR 0.44, 95% CI 0.27-0.74) and associated with USA300 in people who inject drugs (aOR 4.58, 95% CI 1.16-17.95).
Conclusions:
Most of the decline in MRSA BSIs was from decreases in USA100 BSI incidence. Prevention of USA300 MRSA BSIs in the community will be needed to further reduce burden from MRSA BSIs. View Show abstract Preventability of hospital onset bacteremia and fungemia: A pilot study of a potential healthcare-associated infection outcome measure Article Feb 2019 Raymund B. Dantes Clare Rock Aaron M Milstone Surbhi Leekha Hospital-onset bacteremia and fungemia (HOB), a potential measure of healthcare-associated infections, was evaluated in a pilot study among 60 patients across 3 hospitals. Two-thirds of all HOB events and half of nonskin commensal HOB events were judged as potentially preventable. Follow-up studies are needed to further develop this measure. View Show abstract Factors that impact on the burden of Escherichia coli bacteraemia: Multivariable regression analysis of 2011-2015 data from West London Article Nov 2018 J HOSP INFECT Oliver Blandy Kate Honeyford Myriam Gharbi Shiranee Sriskandan Background: The incidence of Escherichia coli bacteraemia in England is increasing amid concern regarding the roles of antimicrobial resistance and nosocomial acquisition on burden of disease. Aim: To determine the relative contributions of hospital-onset E. coli blood stream infection and specific E. coli antimicrobial resistance patterns to the burden and severity of E. coli bacteremia in West London. Methods: Patient and antimicrobial susceptibility data were collected for all cases of E. coli bacteraemia between 2011 and 2015. Multivariable logistic regression was used to determine the association between the category of infection (hospital or community-onset) and length of stay, intensive care unit admission, and 30-day all-cause mortality. Findings: E. coli bacteraemia incidence increased by 76% during the study period, predominantly due to community-onset cases. Resistance to quinolones, third-generation cephalosporins, and aminoglycosides also increased over the study period, occurring in both community- and hospital-onset cases. Hospital-onset and non-susceptibility to either quinolones or third-generation cephalosporins were significant risk factors for prolonged length of stay, as was older age. Rates of mortality were 7% and 12% at 7 and 30 days, respectively. Older age, a higher comorbidity score, and bacteraemia caused by strains resistant to three antibiotic classes were all significant risk factors for mortality at 30 days. Conclusion: Multidrug resistance, increased age, and comorbidities were the main drivers of adverse outcome. The rise in E. coli bacteraemia was predominantly driven by community-onset infections, and initiatives to prevent community-onset cases should be a major focus to reduce the quantitative burden of E. coli infection. View Show abstract Survival following bloodstream infection; a prospective multinational cohort study assessing the impact of place of care Article Sep 2018 J INFECTION Kate Nambiar Harald Seifert Siegbert Rieg Achim J. Kaasch Background:
Staphylococcus aureus bloodstream infection (SAB) is a common, life-threatening infection with a high mortality. Survival can be improved by implementing quality of care bundles in hospitals. We previously observed marked differences in mortality between hospitals and now assessed whether mortality could serve as a valid and easy to implement quality of care outcome measure.
Methods:
We conducted a prospective observational study between January 2013 and April 2015 on consecutive, adult patients with SAB from 11 tertiary care centers in Germany, South Korea, Spain, Taiwan, and the United Kingdom. Factors associated with mortality at 90 days were analyzed by Cox proportional hazards regression and flexible parametric models.
Results:
1,851 patients with a median age of 66 years (64% male) were analyzed. Crude 90-day mortality differed significantly between hospitals (range 23% to 39%). Significant variation between centers was observed for methicillin-resistant S. aureus, community-acquisition, infective foci, as well as measures of comorbidities, and severity of disease. In multivariable analysis, factors independently associated with mortality at 90 days were age, nosocomial acquisition, unknown infective focus, pneumonia, Charlson comorbidity index, SOFA score, and study center. The risk of death varied over time differently for each infective focus. Crude mortality differed markedly from adjusted mortality.
Discussion:
We observed significant differences in adjusted mortality between hospitals, suggesting differences in quality of care. However, mortality is strongly influenced by patient mix and thus, crude mortality is not a suitable quality indicator. View Show abstract A prognostic model of persistent bacteremia and mortality in complicated S. aureus bloodstream infection Article Aug 2018 CLIN INFECT DIS Alessander O Guimaraes Yi Cao Kyu Hong Carrie M. Rosenberger Background:
Staphylococcus aureus is a leading cause of bacteremia, yet there remains a significant knowledge gap in the identification of relevant biomarkers that predict clinical outcomes. Heterogeneity in the host response to invasive S. aureus infection suggests that specific biomarker signatures could be utilized to differentiate patients prone to severe disease, thereby facilitating earlier implementation of more aggressive therapies.
Methods:
To further elucidate the inflammatory correlates of poor clinical outcomes in patients with S. aureus bacteremia, we evaluated the association between a panel of blood proteins at initial presentation of bacteremia and disease severity outcomes using two cohorts of patients with S. aureus bacteremia (n=32 and n=124).
Results:
We identified 13 candidate proteins that were correlated with mortality and persistent bacteremia. Prognostic modeling identified IL-8 and CCL2 as the strongest individual predictors of mortality, with the combination of these biomarkers classifying fatal outcome with 89% sensitivity and 77% specificity (p<0.0001). Baseline IL-17A levels were elevated in patients with persistent bacteremia (p<0.0001), endovascular (p=0.026) and metastatic tissue infections (p=0.012).
Conclusions:
These results demonstrate the potential utility of selected biomarkers to distinguish patients with the highest risk for treatment failure and bacteremia-related complications, providing a valuable tool for clinicians in the management of S. aureus bacteremia. Additionally, these biomarkers could identify patients with the greatest potential to benefit from novel therapies in clinical trials. View Show abstract Clinical and Molecular Correlates of Escherichia coli Bloodstream Infection from Two Geographically Diverse Centers in Rochester, Minnesota, and Singapore Article Aug 2018 Shehara M Mendis Shawn Vasoo Brian Johnston Ritu Banerjee Escherichia coli bacteremia is caused mainly by sequence type complex (STc) 131 and two clades within its fluoroquinolone resistance-associated H 30 subclone, H 30R1 and H 30Rx. We examined clinical and molecular correlates of E. coli bacteremia in two geographically distinct centers. We retrospectively studied 251 unique E. coli bloodstream isolates from 246 patients (48 from the Mayo Clinic, Rochester, Minnesota [MN], 198 from Tan Tock Seng Hospital, Singapore [SG]), from October 2013 through March 2014. Isolates underwent PCR for phylogroup, STc, blaCTX-M type, and virulence gene profiles, and medical records reviewed. Although STc131 accounted for 25-27% of all E. coli bacteremia isolates at each site, its extended-spectrum β-lactamase-associated H 30Rx clade was more prominent in SG than MN (15% versus 4%, P = 0.04). In SG only, patients with STc131 ( versus other E. coli ) were more likely to receive inactive initial antibiotics (odds ratio [OR] 2.8, P = 0.005); this was true specifically for patients with H 30Rx (OR 7.0, P = 0.005). H 30Rx comprised 16% of community-onset bacteremia episodes in SG, but none in MN. In SG, virulence scores were higher for H 30Rx, as compared to H 30R1, non- H 30 STc131, and non-STc131 isolates ( P < 0.02, all comparisons). At neither site did mortality differ by clonal status. The ESBL-associated H 30Rx clade was more prevalent and more often of community-onset in SG, where it predicted inactive empiric treatment. Clonal distribution varies geographically and has potentially important clinical implications. Rapid susceptibility testing and clonal diagnostics for H 30/ H 30Rx might facilitate earlier prescribing of active therapy. View Show abstract Comparison of Predictors and Mortality Between Bloodstream Infections Caused by ESBL-Producing Escherichia coli and ESBL-Producing Klebsiella pneumoniae Article Apr 2018 Oded Scheuerman Vered Schechner Yehuda Carmeli Jesús Rodríguez-Baño OBJECTIVE
To compare the epidemiology, clinical characteristics, and mortality of patients with bloodstream infections (BSI) caused by extended-spectrum β-lactamase (ESBL)-producing Escherichia coli (ESBL-EC) versus ESBL-producing Klebsiella pneumoniae (ESBL-KP) and to examine the differences in clinical characteristics and outcome between BSIs caused by isolates with CTX-M versus other ESBL genotypes
METHODS
As part of the INCREMENT project, 33 tertiary hospitals in 12 countries retrospectively collected data on adult patients diagnosed with ESBL-EC BSI or ESBL-KP BSI between 2004 and 2013. Risk factors for ESBL-EC versus ESBL-KP BSI and for 30-day mortality were examined by bivariate analysis followed by multivariable logistic regression.
RESULTS
The study included 909 patients: 687 with ESBL-EC BSI and 222 with ESBL-KP BSI. ESBL genotype by polymerase chain reaction amplification of 286 isolates was available. ESBL-KP BSI was associated with intensive care unit admission, cardiovascular and neurological comorbidities, length of stay to bacteremia >14 days from admission, and a nonurinary source. Overall, 30-day mortality was significantly higher in patients with ESBL-KP BSI than ESBL-EC BSI (33.7% vs 17.4%; odds ratio, 1.64; P =.016). CTX-M was the most prevalent ESBL subtype identified (218 of 286 polymerase chain reaction-tested isolates, 76%). No differences in clinical characteristics or in mortality between CTX-M and non–CTX-M ESBLs were detected.
CONCLUSIONS
Clinical characteristics and risk of mortality differ significantly between ESBL-EC and ESBL-KP BSI. Therefore, all ESBL-producing Enterobacteriaceae should not be considered a homogeneous group. No differences in outcomes between genotypes were detected.
CLINICAL TRIALS IDENTIFIER
ClinicalTrials.gov. Identifier: NCT01764490.
Infect Control Hosp Epidemiol 2018;1–8 View Show abstract Epidemiology of carbapenem-resistant Enterobacteriaceae infections: report from China CRE Network Article Dec 2017 Yawei Zhang Qi Wang Yuyao Yin Hui Wang Carbapenem-resistant Enterobacteriaceae (CRE) infection is highly endemic in China, but estimates of infection burden are lacking. We established incidence of CRE infection from a multicenter study that covered 25 tertiary hospitals in 14 provinces. CRE cases defined as carbapenem non-susceptible C. freundii , E. coli , E. cloacae , or K. pneumoniae infections during January to December 2015 were collected and reviewed from medical records. Antimicrobial susceptibility testing and carbapenemase genes identification were performed. Among 664 CRE cases, most were caused by K. pneumoniae (73.9%), followed by E. coli (16.6%), and E. cloacae (7.1%). The overall CRE infection incidence per 10,000 discharges was 4.0, and differed significantly by region, with the highest in Jiangsu (14.97), and the lowest in Qinghai (0.34). 83.8% of patients had underlying co-morbidities; the median age was 62 years (range, 45–74) and 450 (67.8%) were male. Lower respiratory tract infections (65.4%) were most common, followed by urinary-tract infection (16.6%), intra-abdominal infection (7.7%), and bacteremia (7.7%). The overall hospital mortality rate was 33.5%. All isolates showed non-susceptibility to carbapenems and cephalosporins. Susceptibility rate of Polymyxin B was >90%. Tigecycline demonstrated higher susceptibility rate against E. coli , compared with K. pneumoniae (90.9% vs. 40.2%). Of 155 clinical isolates analyzed, 89% produced carbapenemases with a majority of isolates producing KPC (50%) and/or NDM (33.5%)-type beta-lactamases among K. pneumoniae and E. coli . Incidence of CRE infection in China was 4.0 per 10,000 discharges. The patient-based disease burden in tertiary hospitals in China is severe, suggesting an urgent need to enhance infection control. View Show abstract Trends in incidence and resistance patterns of Staphylococcus aureus bacteremia Article Nov 2017 Elina Jokinen Janne Laine Reetta Huttunen Jaana Syrjänen Background: Staphylococcus aureus bacteremia (SAB) causes a significant burden on the population. Several infection control measures have been implemented in Pirkanmaa county to combat a local epidemic with methicillin-resistant Staphylococcus aureus (MRSA). We aimed to study the epidemiology of SAB and antibiotic resistance of S. aureus and the possible influence of improved infection control.
Methods: Register data from 2005 to 2015 were retrospectively analysed to study the antimicrobial susceptibility, the incidence and mortality in SAB in a population-based setting.
Results: The incidence of SAB increased during the study period from 21.6 to 35.8/100,000 population. The number of both health care-associated (HA) and community-associated (CA) cases has increased. The incidence of MSSA bacteremia increased from 19.9 to 35.2/100,000 population in Pirkanmaa in parallel to other parts of Finland. The incidence of MRSA bacteremia was 10-fold (4.5/100,000 population) higher in 2011 than in other parts of the country, but sank to the national level (0.59/100,000 population) in 2015. The fatality rate decreased from 22% to 17%. The proportion of penicillin-susceptible Staphylococcus aureus (PSSA) increased from 23.9% in 2008 to 43.1% in 2015.
Conclusion: The incidence of both HA and CA SAB has increased since 2005. Conversely, the proportion of MRSA and PRSA bacteremia has decreased. Promotion of infection control measures may have reduced the incidence of MRSA bacteremia but not the overall incidence of SAB. The rising proportion of PSSA enables the use of targeted, narrow spectrum antimicrobials. View Show abstract Show more
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(PDF) Polarización de la estructura funcional de las capitales de provincia y autonomía en España. 1981‑2011
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Polarización de la estructura funcional de las capitales de provincia y autonomía en España. 1981‑2011
June 2014
Estudios Geográficos 75(276)
DOI: 10.3989/estgeogr.201404
CC BY-NC 4.0
Abstract
Some fundamental trends of the recent reorganization of economic activities in Spain are defined by the growing concentration in certain urban areas of certain economic activities, especially those related to the creation, management and use of innovation and knowledge, and selective decentralization of others.
The main hypothesis of this work assumes that capital of autonomy is a factor that exerts some influence on the structure of economic activities in a city. In this paper we study the scope of this thesis referred to municipalities and provincial capitals of autonomy between 1981 and 2011. The study conducted helps verify the trend towards concentration of capital in certain activities of the knowledge economy. The good connectivity of cities or the proximity to large urban areas are attractive forces; the capital of autonomy has a limited influence on intermediate sized nuclei located in dynamic regional contexts.Parte de la reorganización reciente de las actividades económicas en España se define por la concentración en determinadas áreas urbanas de ciertas actividades económicas, especialmente las relacionadas con la creación, gestión y uso de la innovación y el conocimiento, y por la descentralización selectiva de otras.
La hipótesis principal de este trabajo asume que la capitalidad de autonomía es un factor que ejerce influencia en la estructura de las actividades económicas de una ciudad. En este marco se estudia el alcance de estas tesis referidas a los municipios capitales de provincia y de autonomía entre 1981 y 2011. El estudio permite constatar la tendencia a la concentración en determinadas capitales de las actividades de la «economía del conocimiento» . La buena conectividad de las ciudades o la cercanía a grandes áreas urbanas son fuerzas de atracción de este tipo de actividades; la capitalidad de autonomía tiene una influencia limitada en núcleos de tamaño intermedio ubicados en contextos regionales dinámicos.
[fr] La réorganisation récente des activités économiques en Espagne est définie d’un côté par la concentration de certaines d’entre elles, en particulier celles liées à la création,
gestion et utilisation de l’innovation et de la connaissance dans des zones urbaines concrètes, et de l’autre, par la décentralisation sélective d’autres activités.
L’hypothèse principale de cette recherche accepte que la «capitalité» d’une région autonome a des conséquences sur la structure des activités économiques de cette ville. Nous allons donc vérifier cette thèse référée aux municipalités capitales de province ou de région autonome dans la période 1981-2011. Cette analyse permettra de confirmer la tendance à la concentration des activités de l’économie de la connaissance dans certaines de ces capitales. Une connectivité performante ou la proximité de grands réseaux urbains constituent des pôles d’attraction pour ces activités; la «capitalité» d’une région autonome a une influence limitée dans le cas de villes moyennes situées dans un contexte régional dynamique.
Content uploaded by Severino Escolano Utrilla
Polarización de la estructura funcional de las capitales
de provincia y de autonomía en España: 1981-2011 *
Polarization of the functional structure of capital cities of
provinces and autonomies in Spain: 1981-2011
Severino Escolano Utrilla **
1. I NTRODUCCIÓN
Entre las transformacio nes urbanas más import antes de las últimas décadas
figuran las registrad as en las economí as de las ciudade s que se han plasmado,
tanto en los modos de organiza ción de la producción , la distribución y el con-
sumo, como en la produc tivida d, la composició n de los tipos de actividad eco-
nómica y otros aspectos del «paisaje económico». El estudio de la
re-es tructur ación de las econ omías ur banas c onstitu ye uno de los tema s centra -
les d e la inve stigaci ón c ientífi ca so bre las ciudad es ( Moulaer t y Scott , 19 97, p . 4)
Parte de los c ambios de las a ctivida des e conómi cas u rbanas puede n ser inte r-
preta dos consider ando las ciudades de un espacio determi nado como un sis-
tema d e luga res a lterna tivos, en compe tencia y cooper ación, para loc alizar
activid ades económica s. En este marco, la composic ión del mix de actividades
económi cas de l as ciuda des, qu e varía constan temente , obede ce a la in teracc ión
complej a de múltip les f actor es y , por tanto , sin tetiza bien la p osición de una c iu-
dad en la je rarqu ía urb ana y es un indica dor de l pote ncial económi co-soc ial, d el
grado d e moder nizaci ón y ot ras pr opieda des de las ec onomías urban as.
Estudios Geográficos
V ol. LXXV , 276, pp. 139-175
Enero-junio 2014
ISSN: 0014-1496
eISSN: 1988-8546
doi: 10.3989/estgeogr.201404
* Este texto se enmarca en el proyecto de investigación «Las ciudades españolas en la etapa
autonómica (1978-2008). Dinámicas, procesos y políticas». CSO 2009-11261-(Subpr ograma
GEOG), del Ministerio de Ciencia e Innovación.
** Universidad de Zaragoza.
Estudios Geograficos 276 Final_Estudios Geograficos 275 08/07/14 14:32 Página 139
Por otro lado, desde hace dos décadas la innovación tecnológica y el cono-
cimiento científico se han revelado como fuerzas emergentes y decisivas tanto
para mejorar la competitividad de ciudades y territorios a todas las escalas
como para impulsar la modernización de la sociedad en general.
Alguna de las tendencias fundamentales de la reorganización reciente de
las actividades económicas en España se definen por la creciente concentra-
ción en determinadas áreas urbanas de ciertas actividades económicas, en es-
pecial las relacionadas con la creación, gestión y uso de la innovación, el
conocimiento y la información, y por la descentralización, también selectiva,
de otras.
En este trabajo se estudia el alcance de estas tesis referidas a los municipios
capitales de provincia y de autonomía entre 1981 y 2011. En concreto se pre-
tende responder a las tres preguntas siguientes:
1. ¿Cuál ha sido la variación de los perfiles de actividad económica de las
capitales de provincia y de autonomía entre 1981 y 2011?
2. ¿Se pueden identificar tipos de trayectorias seguidas por las ciudades en
la conformación de sus perfiles de actividad económica?
3. ¿Se aprecian patrones nítidos de cambio y de especialización asociados
a la función de capitalidad autonómica?
Los contenidos de este trabajo están organizados en tres partes, además de
la introducción y las consideraciones finales. En la primera se presentan algu-
nos procesos y factores que configuran la mezcla de actividades económicas
urbanas y se fundamenta la delimitación espacial y temática así como el enfo-
que de estudio adoptado. La siguiente se dedica a describir y justificar la me-
todología utilizada y a caracterizar los datos. En la tercera se exponen y
explican los resultados de los análisis. Finalmente se realizan algunas valora-
ciones acerca del grado y modo de influencia de la capitalidad autonómica en
la especialización funcional de las ciudades.
2. F ACTORES Y TENDENCIAS DE LA ESTRUCTURA FUNCIONAL Y ESP ACIAL DE
LAS ACTIVIDADES ECONÓMICAS DE LAS CIUDADES
La composición de los tipos de actividad económica de las ciudades en un
momento dado es el resultado de un balance instantáneo entre varias catego-
rías relativamente simples: la creación de nuevas empresas, la desaparición de
otras y e l saldo d e traslados hacia y desde otras ciudades, a lo que cabría añadir
los cambios de actividad. Sin embargo, los movimientos de estas variables es-
SEVERINO ESCOLANO UTRILLA
140
Estudios Geográficos, V ol. LXXV , 276, pp. 139-175, enero-junio 2014
ISSN: 0014-1496, eISSN: 1988-8546, doi: 10.3989/estgeogr.201404
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tán sujetos a las complejas interacciones de diversas fuerzas que cristalizan en
modelos espaciales espe cíficos de localización d e las actividades económ icas.
La estructura y variación de los perfiles de actividad económica de las ciu-
dades se explica por la actuación conjunta de factores que, tradicionalmente,
se han considerado que conforman los procesos de localización de las activi-
dades económicas: las ventajas competitivas de las economías de aglomera-
ción y «desaglomeración», la accesibilidad a los mercados de factor es de
producción, las configuraciones de la r edes urbanas a diversas escalas, la posi-
ción y distancia física y funcional entre ciudades, el estado y dotación de in-
fraestructuras y , en fin, las políticas económicas y de ordenación urbana y
territorial, entre otras.
Algunos enfoques de la teoría económica han destacado la importancia de
la estructura económica en el desarrollo socioeconómico de los países, regio-
nes y ciudades, es decir , asocian el potencial socioeconómico de un área o una
ciudad al mayor o menor peso relativo que las diversas actividades tienen en
la composición de la estructura económica de cada entidad.
Diversos factores modifican constantemente la importancia absoluta y rela-
tiva de los principios de localización espacial y , en consecuencia, las ventajas
de localización de las ciudades. Ello hace que los patrones de localización in-
crementen su complejidad debido a la combinación de gradientes de actividad
asociados a la contigüidad con discontinuidades espaciales generadas por la
alta conectividad digital y de los modernos sistemas de transportes y comuni-
caciones.
2.1. La influencia de la integración socioeconómica y del conocimiento
científico
La localización de las actividades económicas en las ciudades está influida
por múltiples procesos interrelacionados, entr e los que sobresalen la creciente
internacionalización de la economía y la sociedad y la emergencia de nuevas
fuerzas económicas y sociales relacionadas con las innovaciones tecnológicas
y el conocimiento científico. Además, otras dimensiones urbanas, de natura-
leza económica, demográfica, paisajística y espacial están afectadas también
por la intervención de estos dos vectores.
La inserción de las economías urbanas en mercados globales promueve la
aparición de nuevas conexiones de todo tipo, de alcance planetario, continen-
tal, nacional, regional y local, establecidas entre una multitud de agentes (paí-
ses, bloques de países, organizaciones, empresas, personas), lo que facilita
POLARIZACIÓN DE LA ESTRUCTURA FUNCIONAL DE LAS CAPITALES DE PROVINCIA 141
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ISSN: 0014-1496, eISSN: 1988-8546, doi: 10.3989/estgeogr.201404
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nuevas divisiones del trabajo y especializaciones económicas que operan en
nuevos escenarios de competitividad y cooperación. La globalización significa
también la aceleración de los procesos económicos, la integración de los siste-
mas financieros, la reor ganización funcional y espacial de los procesos de pro-
ducción facilitadas por las innovaciones tecnológicas y , en fin, la cr eciente
importancia de actividades económicas relacionadas con la creatividad, el co-
nocimiento y la tecnología (Drucker, 1969; Stehr, 1994; Jonhston, Taylor et
al. , 2002; UNESCO, 2005).
La integración de España en la Unión Europea (UE) constituye un hecho
relevante que modifica las condiciones y ventajas de localización de activida-
des económicas en buena parte de las grandes ciudades españolas. La amplia-
ción del espacio económico, político y administrativo facilita la r eorgani -
zación de las redes urbanas y con ello procesos de centralización y descentra-
lización de actividades a escala de la UE.
El proceso de restructuración político administrativa que supone la cons-
trucción del «Estado de las Autonomías», iniciado en 1978, afecta específica-
mente a las ciudades españolas. La transferencia de personas, medios y
funciones desde el Estado central a las instituciones autonómicas para el ejer-
cicio de sus competencias acarrea también un incremento de la actividad eco-
nómica, principalmente en las capitales de autonomía. No obstante, y como se
indicó en otro trabajo (Escolano, 2012) es difícil identificar y cuantificar los
efectos económicos y de otro tipo producidos por la capitalidad autonómica
más allá de la contabilización de los medios materiales y personales asociados
a la misma, pues este hecho crea externalidades de diversa naturaleza y muy
ramificadas por el tejido socioeconómico. En todo caso, se puede aceptar que
la capitalidad de autonomía genera nuevas oportunidades para el desarrollo
de actividades económicas.
La creación y aplicación del conocimiento científico y de innovaciones tec-
nológicas, configuran otro potente conjunto de fuerzas que influyen en la es-
tructura funcional y espacial de las actividades económicas urbanas de
múltiples modos: inciden, de forma indirecta, a través de movimientos de
cambio que impulsan en otras muchas actividades y , de modo dir ecto, me-
diante la formación de nuevos subsectores de actividad muy dinámicos.
En efecto, se ha constatado la influencia significativa de estas actividades
en el crecimiento económico y en la mejora de la competitividad a todas las
escalas (Korres, 2009; V ar ga, 2009; Cooke, Asheim et al. , 2011), su considera-
ble impacto en la or ganización social y del trabajo (Coats, 2005; Coats y
Lekhi, 2008), así como la importancia de la política institucional en el naci-
miento y consolidación de este tipo de actividades. También es destacable la
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desigual incidencia social (brecha digital: digital divide ) y espacial de las acti-
vidades de la economía del conocimiento (Hepworth, 1986; EUROSTA T,
2011; Korres, T sobanoglou et al. , 2011).
Por otra parte, las innovaciones tecnológicas y de organización de los siste-
mas de producción, distribución y consumo han promovido el nacimiento de
nuevas actividades (investigación científica, conocimiento, actividades creati-
vas) o han renovado los modos de pr oducción de otras tradicionales (financie-
ras, seguros), de tal forma que se ha generado un único proceso productivo
bienes-servicios, integrado y continuo (Barcet, Bonamy et al. , 1984; Bailly y
Coffey , 1994). Esta mayor fluidez hace que se difumine la tradicional especia-
lización sectorial, que se desplaza hacia la especialización funcional definida
por agrupamientos espaciales de funciones económicas determinadas (Duran-
ton y Puga, 2002; Halbert, 2005).
La difusión de las aplicaciones del conocimiento y de la innovación tecno-
lógica ha impulsado cambios notables en los patrones de localización de mu-
chas actividades económicas (Mandeville, 1983; Castells, 1995; Yigitcanlar ,
2009). Las ciudades, por su considerable tamaño demográfico y económico,
por su gran diversidad socioeconómica y su buena conectividad, son los lu-
gares más adecuados para la localización de las actividades de la economía
del conocimiento y para el desarrollo pleno del potencial de transformación
social, económico y espacial que éstas llevan incorporado (Mitchell, 1995;
Moss, 1998).
La internacionalización de la economía y los avances tecnológicos conflu-
yen también en la consolidación de otra característica fundamental de las eco-
nomías urbanas como es el creciente peso económico de los servicios y su
omnipresencia en la vida de las ciudades. Su pujanza se debe, entre otras cau-
sas, al incremento de la demanda de servicios por los individuos, las familias y
las empresas, a la externalización de servicios que antes formaban parte de la
actividad industrial y agraria y al crecimiento de los servicios a la colectividad
(educativos, sanitarios, culturales, asistenciales) prestados por las institucio-
nes o por empresas. El grupo de los «servicios a las empresas» ha alcanzado
también un notable desarrollo; por otro lado, los «servicios avanzados a la
producción» (investigación, segur os, auditoría, asesoría jurídica, etc.) y los
servicios financieros han adquirido una gran importancia estratégica, dada su
contribución esencial a la mejora de la competitividad de las empresas.
Las considerables implicaciones de los procesos señalados en las econo-
mías urbanas avalan el empleo de la «intensidad de conocimiento y el tipo de
tecnología» utilizada en la producción de bienes y ser vicios como criterios
principales de la clasificación de actividades, combinados con la desagrega-
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ción de los servicios en varias categorías según su orientación al mercado final
o a las empresas. Este enfoque permite la inclusión en los análisis de gran va-
riedad de actividades económicas que representan la diversidad de la estruc-
tura de las economías urbanas de forma bastante satisfactoria; la magnitud se
ha medido mediante la población ocupada en cada rama de actividad.
2.2. Algunas tendencias de la localización de las actividades económicas en
las ciudades
El d esarr ollo conjunt o de las tend encias apun tadas y o tras han cread o nu evas
lógicas de desc entrali zación y centra lizació n así co mo req uisito s de loca lizaci ón
de las actividades económicas que, articulados con ciertas determinaciones de
políticas nacionales, regionales y locales, han modificado la especialización
económica de las ciudades y regiones.
En general, los perfiles de especialización económica de las ciudades for-
man parte de los patrones complejos de localización de actividades caracteri-
zados, grosso modo , por la concentración espacial de ciertas actividades en
grandes ciudades y por la dispersión selectiva de otras por ciudades medianas
y espacios rurales.
En consecuencia, determinadas actividades tienden a concentrarse en
grandes áreas urbanas que ocupan los puestos de cabeza de las jerarquías ur-
banas nacionales e internacionales, en tanto que otras se dispersan por ciuda-
des más pequeñas, generalmente bien conectadas a las anteriores por
modernos sistemas de transportes y comunicaciones.
Abundantes investigaciones empíricas han mostrado la tendencia a la
concentración en grandes ciudades de diversas actividades creativas y de la
economía del conocimiento (May , 1997, p. 63; Scott, 1997; Acs, 2006; Gla-
zer y Grimes, 2009), pero también han constatado su difusión selectiva por
ciudades medias e incluso por espacios rurales (Méndez, Sánchez et al. ,
2009; Clayton y Morris, 2010; Puissant y Lacour, 2011; Méndez, Michelini
et al. , 2012).
En el mismo sentido, el crecimiento y diferenciación de actividades de ser-
vicios, los avances en las comunicaciones digitales y otros factores han pro-
movido, simultáneamente, la revalorización de los centros urbanos como
asiento de sedes de empresas, centros de decisión, oficinas, etc., y de áreas pe-
riféricas bien comunicadas para la instalación de centros comerciales, oficinas
administrativas, centros logísticos, conglomerados de industrias y servicios de
alta tecnología y otras. Estas tendencias se plasman con desigual intensidad en
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el espacio urbano según el tamaño (demográfico, económico, espacial) de las
ciudades y su posición en las redes urbanas: son muy nítidas en las grandes
entidades urbanas (áreas metropolitanas, ciudades, región…) y se difuminan
en las ciudades medianas y pequeñas.
En resumen: los centros de las ciudades reúnen ventajas de localización
para algunas actividades, como servicios avanzados a la producción, servicios
financieros y actividades creativas y de la economía del conocimiento, mien-
tras que diversos sectores de las periferias urbanas son más competitivos para
la localización de actividades comerciales, de oficinas para desarrollar tareas
administrativas, de diferentes tipos de industria, servicios de alta tecnología y
centros logísticos.
Esta organización espacial de las actividades económicas tiene consecuen-
cias metodológicas en la delimitación de las unidades de análisis. El uso de los
municipios, como en el presente estudio, sólo recoge la dinámica de las áreas
centrales en el caso de las grandes áreas metr opolitanas y no la totalidad de los
procesos espaciales y funcionales.
A otra escala, la configuración de los perfiles de las actividades económicas
de las ciudades está estrechamente asociada a los movimientos que se produ-
cen en la jerarquía urbana. La articulación de la jerarquía urbana de las ciuda-
des españolas está sujeta, por una parte, a la intervención de fuerzas de
integración a escala global, europea, nacional y regional, que afectan con in-
tensidad desigual a cada ciudad. Por otra, diversas actuaciones de variado al-
cance impulsan también otros procesos de integración. Entre las principales
cabe destacar la mejora de las infraestructuras y redes de trasportes y comuni-
caciones, en espacial el desarrollo de la r ed ferroviaria de alta velocidad (A VE)
(Ureña, 2012). La reor ganización territorial de la administración pública y del
poder político (Moreno y Escolano, 1992, pp. 91-141) llevada a cabo con la
creación del estado de las autonomías ha favor ecido la integración regional. La
constitución de redes de ciudades interconectadas, de diversos niveles jerár-
quicos y alcance funcional y espacial variable, ha generado ventajas y externa-
lidades asociadas a la contigüidad y a la conectividad que conforman nuevos y
cambiantes patrones espaciales de oportunidades para la localización de acti-
vidades económicas.
Para aprehender esta cualidad dinámica de las estructuras de las activida-
des económicas de las ciudades, el presente trabajo se centra en el estudio de
las trayectorias temporales e indaga, en la medida que los datos lo permiten,
en los cambios recientes de la composición de las actividades económicas de
las capitales de provincia y de autonomía y sus itinerarios de diferenciación
que han dado lugar a la configuración actual de los perfiles de actividad.
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Los tipos de actividad se consideran como un datum , resultado de decisio-
nes de localización. La investigación, de carácter eminentemente exploratorio
y empírico, está guiada por tres hipótesis fundamentales que caracterizan las
tendencias espaciales de los recientes procesos de restructuración y globaliza-
ción socioeconómicos. La primera se refiere a la creciente concentración eco-
nómica, política y cultural en las ciudades (metropolitanización) (V eltz, 1997,
p. 82; Krätke, 2007), en especial de las actividades relacionadas con el conoci-
miento, la cr eatividad, la investigación y la innovación tecnológica. La se-
gunda, conectada con la anterior, denota las trayectorias diferenciadas que
han seguido las capitales provinciales y autonómicas en la conformación de
sus perfiles de especialización funcional: la capitalidad de autonomía figura
entre los factores que inter vienen en la especialización económica. La tercera
concierne a la escala de los procesos: la conformación de los per files de activi-
dad de algunas ciudades no puede explicarse completamente si sólo se enmar-
can a escala nacional o subnacional; ciertas actividades encuentran ventajas
de localización en ciudades que forman parte de redes urbanas de alcance eu-
ropeo o mundial.
3. M ETODOLOGÍA Y DA TOS
Un estudio de carácter empírico con datos geográficos como el presente re-
quiere que se justifiquen la delimitación de las unidades espaciales, los indica-
dores del objeto de estudio y los procedimientos analíticos utilizados.
La unidad de análisis empleada en este trabajo es el municipio. Su elec-
ción se basa en la existencia de series de datos diacrónicos y sincrónicos con-
sistentes. También es un individuo adecuado para reflejar el alcance de las
políticas locales. Por otra parte, son bastantes los estudios de localización de
actividades económicas que utilizan el municipio como unidad de análisis,
pues permite comparar resultados producidos por diferentes enfoques (Mén-
dez, Sánchez et al., 2009). Sin embargo, es necesario indicar que esta delimi-
tación administrativa puede cercenar algunas conexiones en aquellas áreas
urbanas compuestas por varios municipios que funcionan de forma unitaria,
y por tanto el municipio solo refleja una imagen parcial del fenómeno estu-
diado.
La elección de los municipios capitales de provincia y de autonomía y las
dos ciudades autónomas es congruente con los objetivos del trabajo, que bus-
can identificar y delimitar la posible influencia de la capitalidad autonómica
en la estructura de sus perfiles de actividad económica. Esta muestra de ciuda-
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des, que tienen en común su función administrativa, constituye un conjunto
adecuado para la investigación.
El tipo y magnitud de actividad económica se han medido por la población
ocupada en ramas de actividad desglosadas a dos dígitos de la Clasificación
Nacional de Actividades Económicas (CNAE-93, rev . 1) (INE, s/f). Se ha con-
siderado que este nivel de detalle es suficiente para alcanzar los objetivos pro-
puestos. Los datos de 2011 corresponden a los afiliados a todos los regímenes
de la Seguridad Social.
Para formar los perfiles funcionales de las capitales provinciales y autonó-
economy”. Journal of The Economic Geography , 4, pp. 351-370.
UNESCO (2005): T owar ds Knowledge Societies . Paris, UNESCO.
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Ureña, J. M. D. (ed.) (2012): Teritorial Implications of High Speed Rail. A Spanish Per-
spective . Farnham (UK), Ashgate.
Ureña, J. M. D.; Coronado, J. M.; Garmendia, M. ; et al. (2012): “T errotorial Implica-
tions at national and Regional Scales of High-sèed Rail”, en Ureña, J. M. D. (ed.):
T err otorial Implications of High Speed Rail. A Spanish perspective . Farnham (UK),
Asghate, pp. 129-162.
V arga, A. (ed.) (2009): Universities, Knowledge T ransfer and Regional Development. Ge-
ography , Entrepr eneurship and Policy . Cheltenham, Inglaterra, Edward Elgar Publi-
sing .
V eltz, P . (1997): “The dinamics of production systems, territories and cities”, en
Moulaert, F . y Scott, A. J. (eds.): Cities, enterprises and society on the eve of 21st cen-
tury . London, Pinter , pp. 78-96.
Yigitcanlar , T. (2009): “Spatial reestructuring of cities in the age of knowledge econ-
omy: insights from Australian cities”, en 2nd Knowledge Cities Summit. Shenzhen,
China, QUT Digital Repository .
R ESUMEN
Parte de la reorganización reciente de las actividades económicas en España se define
por la concentración en determinadas áreas urbanas de ciertas actividades económi-
cas, especialmente las relacionadas con la creación, gestión y uso de la innovación y el
conocimiento, y por la descentralización selectiva de otras.
La hipótesis principal de este trabajo asume que la capitalidad de autonomía es un
factor que ejerce influencia en la estructura de las actividades económicas de una ciu-
dad. En este marco se estudia el alcance de estas tesis referidas a los municipios capi-
tales de provincia y de autonomía entre 1981 y 2011. El estudio permite constatar la
tendencia a la concentración en determinadas capitales de las actividades de la «eco-
nomía del conocimiento » . La buena conectividad de las ciudades o la cercanía a gran-
des áreas urbanas son fuerzas de atracción de este tipo de actividades; la capitalidad
de autonomía tiene una influencia limitada en núcleos de tamaño intermedio ubica-
dos en contextos regionales dinámicos.
P ALABRAS CLA VE : especialización; concentración; innovación; capitales; España.
A BSTRACT
Some fundamental trends of the recent reorganization of economic activities in Spain
are defined by the growing concentration in certain urban areas of certain economic
activities, especially those related to the creation, management and use of innovation
and knowledge, and selective decentralization of others.
The main hypothesis of this work assumes that capital of autonomy is a factor that
exerts some influence on the structure of economic activities in a city . In this paper
we study the scope of this thesis referred to municipalities and provincial capitals of
autonomy between 1981 and 2011. The study conducted helps verify the trend to-
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wards concentration of capital in certain activities of the knowledge economy . The
good connectivity of cities or the proximity to large urban areas are attractive forces;
the capital of autonomy has a limited influence on intermediate sized nuclei located
in dynamic regional contexts.
K EY WORDS : specialization; concentration; innovation; capital; Spain.
R ÉSUMÉ
La réorganisation récente des activités économiques en Espagne est définie d’un côté
par la concentration de certaines d’entre elles, en particulier celles liées à la création,
gestion et utilisation de l’innovation et de la connaissance dans des zones urbaines
concrètes, et de l’autre, par la décentralisation sélective d’autres activités.
L ’hypothèse principale de cette recherche accepte que la «capitalité» d’une région au-
tonome a des conséquences sur la structure des activités économiques de cette ville.
Nous allons donc vérifier cette thèse référée aux municipalités capitales de province
ou de région autonome dans la période 1981-2011. Cette analyse permettra de confir-
mer la tendance à la concentration des activités de l’économie de la connaissance dans
certaines de ces capitales. Une connectivité performante ou la pr oximité de grands ré-
seaux urbains constituent des pôles d’attraction pour ces activités; la «capitalité»
d’une région autonome a une influence limitée dans le cas de villes moyennes situées
dans un contexte régional dynamique.
M OTS - CLÈS : spécialisation; concentration; capital; innovation; l’Espagne.
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... As a result of the recent demographic growth of the city, it accounts for 57.5% of the total population of the province and 12.5% of the autonomous community. Valladolid ranks thirteenth among the most populated cities in Spain according to the Spanish National Statistics Institute (INE, for its acronym in Spanish), although it is classified among Spanish 'mediumsized cities' [34][35]
[36]
, which is why its study is interesting as an example for the urban planning of this type of city. Valladolid, as with other Spanish cities, has benefitted from the process of administrative decentralisation, which has mobilised a considerable amount of resources and personnel over the past 30 years [37]. ...
... The exploratory analysis conducted revealed that the census section provides sufficient detail for assessing the city model proposed by the AUE, due to the average dimensions of these spatial units. Census sections are commonly used in the research of different urban issues in Spain
[36]
as they allow analysis at city and district scales when aggregated and visualised as a whole, while also recognising the neighbourhood or urban sector scales. However, progress must be made towards achieving greater detail with scales that allow very specific decisions to be made for those areas where the planned action will have greater impact. ...
Using Maps to Boost the Urban Proximity: Analysis of the Location of Public Facilities According to the Criteria of the Spanish Urban Agenda
Developing analysis models that promote the sustainability, compactness and social balance of cities is particularly important in addressing post-pandemic urban planning. In this context, the population's proximity to public facilities is essential for achieving these objectives. Based on this framework, this paper analyses the city of Valladolid (Spain) under the criteria of distance between the population and public facilities proposed by the Spanish Urban Agenda. Specifically, the focus is on calculating the coverage of population with access to the facilities within the recommended distance thresholds using GIS techniques. The methods used relate the facilities with the distance to the population in the census sections, a highly detailed statistical unit. The results have been mapped as a decision making support tool for the city, and show how general coverage of access to facilities for the urban area as a whole is adequate, especially in terms of public transport services, and meets the recommendations of the Spanish Urban Agenda. Maps also reveal how some areas of the city are not covered by most public facilities.
| https://www.researchgate.net/publication/268629622_Polarizacion_de_la_estructura_funcional_de_las_capitales_de_provincia_y_autonomia_en_Espana_1981-2011 |
Categories of Step-Up DC-DC Converters | Encyclopedia MDPI
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Categories of Step-Up DC-DC Converters
:
Comparison
Please note this is a comparison between versions V1 by Marcelo Cavalcanti and V2 by Camila Xu.
MICs can have either single-stage or two-stages conversion systems: single-stage MICs perform voltage boosting, MPPT and grid current control in a single DC-AC power conversion; two-stages MICs have a DC-DC stage to boost the PV module DC voltage (between 20 V–45 V) to a higher value (above 380 V, for instance) while tracking the PV module maximum power point, followed by a DC-AC stage, responsible to DC-link voltage regulation and the grid-tied functions.
categories of DC-DC converters
high step-up DC-DC converters
microinverter
1. Introduction
In recent years, the deployment of grid-connected photovoltaic (PV) system in large urban centers has increased significantly thanks to cost reductions and technological advances in PV module integrated converters (MICs), intended to perform maximum power point tracking (MPPT) per PV module
[
1
]
. Such feature, known as distributed MPPT, mitigates the power losses caused by PV module mismatch (e.g., manufacturing tolerance)
[
2
]
and enables the installation of PV panel on rooftop with different tilts and orientations, susceptible to partial shading caused by neighbouring buildings
[
3
]
.
MICs can have either single-stage or two-stages conversion systems: single-stage MICs perform voltage boosting, MPPT and grid current control in a single DC-AC power conversion; two-stages MICs have a DC-DC stage to boost the PV module DC voltage (between 20 V–45 V) to a higher value (above 380 V, for instance) while tracking the PV module maximum power point, followed by a DC-AC stage, responsible to DC-link voltage regulation and the grid-tied functions
[
4
]
. The main drawback of single-stage MICs is that the double-line-frequency voltage ripples must be filtered by a bulky input electrolytic capacitors at the input side
[
5
]
, which affects the stable implementation of MPPT algorithms and reducing the life span of the entire system whereas two-stages MICs employ proper control strategies alongside small electrolytic capacitors in both conversion stages to eliminate it
[
6
]
.
Compared to architectures with central inverter, MICs are inherently safer because the DC energy is converted to AC right at the site of the PV module
[
7
]
. Hence, they operate at the same low-voltage AC power as the grid utility, which means there is no long-distance high voltage DC cables
[
4
]
. Besides, since MICs are mounted in a single PV module and operate independently, system with MICs keeps delivering energy to the grid if one or more MICs fail while if a system with a central inverter fails, the energy production stops completely. Moreover, MICs allow simultaneously usage of different solar panels technology and faster and easier system expansion, possibly at any time, thanks to their plug-and-play technology
[
5
]
.
Due to above-mentioned advantages provided for MICs, several high step-up DC-DC converters have been proposed in the literature for being employed as DC-DC power conversion stage in MICs. However, some of them do not meet the other necessary requirements such as high-efficiency, common ground, low input current ripple and reduced weight and volume. Thus, to assist researchers in developing module-level power electronics, this paper categorizes the DC-DC converters based on their constructive and operational characteristics. Then, the principles of elementary voltage-boosting techniques such as switched-capacitor, switched-inductor, magnetic coupling and voltage multiplier cells are approached, with their advantages and disadvantages stated.
2. Categories of Step-Up DC-DC Converters
The DC-DC converters topologies proposed in the literature can be categorized according to their operational characteristics. Doing so, it becomes possible to evaluate which characteristics the step-up DC-DC converters intended for PV applications must feature. For this purpose, DC-DC converters can be essentially classified as (
Figure 1
): isolated or non-isolated; unidirectional or bidirectional; current- or voltage-fed; and hard- or soft-switched.
<here is a image a2342374adb46020-b3ebbe647ca77cf7>
Figure 1.Categories of step-up DC-DC converters.
2.1. Isolated and Non-Isolated DC-DC Converters
Regarding the presence of galvanic isolation, DC-DC converters can be classified into isolated or non-isolated. The isolated converters are characterized for using transformers to obtain the desired voltage gain. However, the leakage inductance of the transformer windings leads to high voltage spikes on the main switch and, consequently, high switching losses.
In applications that do not demand high voltage gain or high efficiency, non-isolated converters without magnetic coupling can be a simple (since the design of the magnetic element is eliminated) and adequate solution.
There are also non-isolated DC-DC converters that use built-in transformer and/or coupled inductor. These solutions are suitable candidates to be employed in applications where high voltage gain with high efficiency and reliability are required, such as microinverters and power optimizers.
In both types of non-isolated DC-DC converters (with or without magnetic coupling), the negative terminal of the output voltage can either be connected to the negative terminal of the input voltage or be floating. However, in grid-connected PV applications where galvanic isolation is not mandatory, the first option can be used to improve system performance. In fact, it helps to reduce the leakage currents between the converter and the point of common coupling, which is grounded.
2.2. Unidirectional and Bidirectional DC-DC Converters
In most DC-DC converters, the power flow is unidirectional (from input to output). This feature is required in applications where the input source should only supply power to the load, e.g., PV modules. On the other hand, in applications that have energy storage systems, DC-DC converters with the ability to transfer energy bidirectionally must be used.
2.3. Voltage- and Current-Fed DC-DC Converters
With respect to the input filter, DC-DC converters can be classified into voltage- or current-fed. The first configuration is characterized for having a capacitive input filter while the second one has an inductive input filter. The use of an inductive input filter makes possible to attenuate the input current ripple, which is a desired feature to step-up DC-DC converters that are used in PV MICs. Furthermore, both configurations can operate with soft switching in applications with variable input voltage. Due to the characteristics described above, the current-fed DC-DC converters are very popular in PV applications, as PV modules behave as current sources.
2.4. Hard- or Soft-Switched DC-DC Converters
The DC-DC converters can operate with hard- or soft-switching. In hard-switched DC-DC converters, the currents and voltages on the semiconductors during the turn-on and turn-off transitions are different from zero, causing switching losses. For this reason, the switching frequency in these converters must be limited, which commits the goals of minimizing the size of the energy storage elements. Besides, these converters are affected by electromagnetic interference problems due to the high current and voltage variation rates.
In soft-switched DC-DC converters, the voltage on the switches falls to zero and, immediately after a short time interval—called dead time—the switches are turned on, mechanism known as “zero voltage switching” (ZVS). Furthermore, small capacitors can be added in series with the leakage inductance of the magnetic element to form resonant operation stages. In these stages, the current flowing through the diodes decreases naturally to zero before the diode becomes reverse-biased, mechanism known as “zero current switching” (ZCS).
2.5. Usual Requirements of DC-DC Converters for Microinverters
From the evaluation of the operational characteristics presented in this section, the main requirements that DC-DC converters intended for PV microinverters should meet are:
(i) Common ground, i.e., the DC-DC converter must be non-isolated;
Common ground, i.e., the DC-DC converter must be non-isolated;
(ii) High voltage gain capability, i.e., the DC-DC converter must be a step-up converter; and
High voltage gain capability, i.e., the DC-DC converter must be a step-up converter; and
(iii) unidirectional.
unidirectional.
It is important to point out that soft switching and resonant mechanisms can lead to reduced switching loss, which is desirable in PV microinverters.
As indicated in the requirements described above, step-up DC-DC converters are the most commonly used solution for DC-DC power conversion stage in MICs. The most common converter that belongs to this category is the conventional boost converter. However, it has several drawbacks already observed in the literature, such as its non-capability to provide high voltage gain. Thus, before presenting some step-up DC-DC converters proposed in the literature for PV applications, it is extremely important to understand how basic voltage-boosting techniques work.
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Country / Region Afghanistan / Central Highlands (Bamyan Daikundi) Afghanistan / South East (Ghazni Paktya Paktika Khost) Benin / Atacora (incl Donga) Benin / Mono (incl Couffo) Burkina Faso / Boucle de Mouhoun Burkina Faso / Cascades Burkina Faso / Centre-Est Burkina Faso / Centre-Nord Burkina Faso / Centre-Ouest Burkina Faso / Centre-Sud Burkina Faso / Est Burkina Faso / Nord Burkina Faso / Plateau Central Burkina Faso / Sahel Burkina Faso / Sud-Ouest Burundi / East (Cankuzo, Rutana, Ruyigi ) Burundi / Middle (Gitega, Karuzi, Muramvya, Mwaro) Burundi / North (Kayanza, Kirundo, Muyinga, Ngozi) Burundi / South (Bururi, Makamba) Cambodia / Kampong Chhnang Cambodia / Kampong Spueu Cambodia / Pousat Cambodia / Svay Rieng Central African Republic CAR / RS I (Ombella Mpoko, Lobaye, Kemo, Nana Grebizi, Ouaka) Central African Republic CAR / RS II (Mambera Kadei, Nana Mambere, Sangha Mbaere) Central African Republic CAR / RS III (Ouham Pende, Ouham) Central African Republic CAR / RS IV (Haute-Kotto, Baminigui Bangoran, Vakaga) Central African Republic CAR / RS V (Basse Kotto, Mbornou, Houte Mbormou) Chad / Zone 2 (Borkou, Ennedi, Tibesti, Kanem, Barh El Gazal, Lac) Chad / Zone 3 (Guera, Batha, Salamat) Chad / Zone 4 (Ouaddai, Assongha, Sila, Biltine - Wadi Fira) Chad / Zone 5 (Chari-Baguimi, Dababa, Baguirmi, Hadjer Lamis) Chad / Zone 6 (Mayo-Kebbi Est and Ouest) Chad / Zone 7 (Logone Occidental & Oriental, Monts de Lam, Tandjile Est & Ouest) Chad / Zone 8 (Mandoul, Moyen-Chari, Bahr Koh, Lac Iro) Congo Democratic Republic / Bandundu Congo Democratic Republic / Equateur Congo Democratic Republic / Kasai Occidental Congo Democratic Republic / Kasai Oriental Congo Democratic Republic / Maniema Congo Democratic Republic / Orientale Congo Democratic Republic / Sud-Kivu Eritrea / Anseba Eritrea / Debub Eritrea / Gash-Barka Ethiopia / Amhara
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Second decile
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Country / Region Liberia / Bomi Liberia / Grand Gedeh Liberia / Grand Kru Liberia / Margibi Liberia / Maryland Liberia / Nimba Liberia / River Cess Liberia / Sinoe Madagascar / Boeny Madagascar / Ihorombe Madagascar / Sava Malawi / Kasungu Malawi / Mangochi Malawi / Mulanje Malawi / Other northern (Chitipa, Karonga, Rumphi, Nkhata Bay) Malawi / Other southern (Balaka, Mwanza, Phalombe, Chiradzulu, Chikwawa, Nsanje, neno) Malawi / Salima Malawi / Zomba Mali / Gao and Kidal Mali / Kayes Mali / Mopti Mali / Segou Mali / Sikasso Mali / Tombouctou Mauritania / Gorgol Mauritania / Guidimagha Mauritania / Hodh Charghi Mauritania / Hodh Gharbi Mozambique / Cabo delgado Mozambique / Nampula Mozambique / Niassa Mozambique / Tete Mozambique / Zambezia Myanmar / Ayeyarwaddy Myanmar / Rakhine Myanmar / Taninthayi Namibia / Northeast Namibia / Northwest Nepal / Karnali Province Niger / Diffa Nigeria / Bauchi Nigeria / Jigawa Nigeria / Kebbi Nigeria / Sokoto Papua New Guinea / Autonomous Region of Bougainville Papua New Guinea / Enga
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Third decile
Country / Region Afghanistan / North East (Baghlan Takhar Badakhshan Kunduz) Angola / Cunene Angola / Huambo Angola / Kuando Kubango Angola / Kuanza Sul Angola / Moxico Angola / Uige Bangladesh / Dinajpur, Nilphamari, Panchagarh, Thakurgaon Bangladesh / Khagrachhari, Rangamati (Chattagram) Bangladesh / Kurigram, Lalmonirhat, Rangpur Benin / Atlantique (incl Littoral (Cotonou)) Bhutan / Dagana Bhutan / Lhuntse Bhutan / Pemagatshel Bhutan / Trashigang Bhutan / Trashiyangtse Bhutan / Trongsa Bhutan / Tsirang Bolivia / Potosi Cambodia / Banteay Mean Chey Cambodia / Bat Dambang-Krong Pailin Cambodia / Kampot-Krong Kaeb-Krong Preah Sihanouk Cambodia / Mondol Kiri-Rotanak Kiri Cambodia / Siem Reab-Otdar Mean Chey Cameroon / Adamaoua Cameroon / Est Cameroon / Nord Ouest China / Xinjiang Congo Brazzaville / Bouenza Congo Brazzaville / Cuvette Ouest Congo Brazzaville / Plateaux Congo Democratic Republic / Bas-Congo Cote d'Ivoire / Centre Cote d'Ivoire / Centre Est Cote d'Ivoire / Nord Cote d'Ivoire / Nord Ouest Ethiopia / Affar Ethiopia / Gambela Gambia / Janjabureh Gambia / Kuntaur Guinea / Boke Guinea / Kankan Guinea / Kindia Guinea Bissau / Biombo Haiti / Centre Haiti / North
Country / Region Haiti / North-East Haiti / South Haiti / South-East Honduras / Gracias a Dios India / Assam India / Bihar India / Jharkhand India / Meghalaya Kenya / Central Kenya / Coast Lesotho / Butha-Buthe Lesotho / Mokhotlong Lesotho / Quthing Liberia / Monrovia Madagascar / Antananarivo Madagascar / Antsiranana Madagascar / Fianarantsoa Madagascar / Mahajanga Madagascar / Toamasina Madagascar / Toliary Madagascar / Analamanga Madagascar / Atsinanana Madagascar / Diana Malawi / Lilongwe Malawi / Mzimba Mali / Koulikoro Mauritania / Assaba Mauritania / Brakna Mauritania / Tagant Mozambique / Inhambane Mozambique / Manica Mozambique / Sofala Myanmar / Bago Myanmar / Kachin Myanmar / Kayah Myanmar / Magway Myanmar / Sagaing Myanmar / Shan Namibia / Ohangwena Namibia / Omusati Nepal / Central Nepal / Sudoorpaschim Province Niger / Agadez Niger / Tillabery (incl Niamey) Nigeria / Adamawa Nigeria / Benue
Fourth decile
Country / Region Afghanistan / South (Uruzgan Helmand Zabul Nimroz Kandahar) Afghanistan / West (Ghor Herat Badghis Farah) Angola / Bengo Angola / Benguela Angola / Huila Angola / Kuanza Norte Angola / Lunda Norte Angola / Lunda Sul Angola / Malange Angola / Zaire Bangladesh / Bagerhat, Khulna, Satkhira Bangladesh / Bandarban, Cox s Bazar Bangladesh / Barguna, Bhola, Patuakhali Bangladesh / Bogra, Gaibandha, Jaypurhat Bangladesh / Chuadanga, Jhenaidah, Kushtia, Meherpur Bangladesh / Habiganj, Sunamganj Bangladesh / Jessore, Magura, Narail Bangladesh / Kishoreganj, Mymensingh, Netrakona Bangladesh / Naogaon, Nawabganj, Rajshahi Bangladesh / Natore, Pabna, Sirajganj Bhutan / Bumthang Bhutan / Haa Bhutan / Mongar Bhutan / Samdrup jongkhar Bhutan / Zhemgang Bolivia / Chuquisaca Bolivia / La Paz Bolivia / Oruro Burkina Faso / Centre (incl Ouagadougou) Cambodia / Kaoh Kong Cameroon / Ouest Central African Republic CAR / Bangui Chad / Zone 1 (N'Djamena) Comoros / Anjouan (Ndzouani) Comoros / Moheli Congo Brazzaville / Cuvette Congo Brazzaville / Niari Congo Brazzaville / Sangha Cote d'Ivoire / Centre Nord Cote d'Ivoire / Sud, Abidjan Djibouti / Other Districts Eritrea / Maekel Ethiopia / Dire Dawa Ethiopia / Harari Gambia / Kerewan Gambia / Mansakonko
Country / Region Ghana / Brong Ahafo Ghana / Northern Ghana / Upper East Ghana / Upper West Ghana / Volta Guatemala / North Guatemala / North-Occidental Guyana / Barima-Waini Guyana / Potaro-Siparuni Guyana / Upper Takutu-Upper Essequibo Haiti / West (incl Metropolitain area) India / Arunachal Pradesh India / Chhattisgarh India / Madhya Pradesh India / Nagaland India / Orissa India / Tripura India / Uttar Pradesh India / West Bengal Indonesia / East Nusa Tenggara Kenya / Nairobi Kiribati / Line and Phoenix Group Lao / Huaphanh Lesotho / Leribe Lesotho / Mafeteng Lesotho / Mohale s Hoek Lesotho / Qasha s Nek Liberia / Montserrado Malawi / Blantyre Mauritania / Adrar Mozambique / Gaza Myanmar / Kayin Myanmar / Mandalay, NayPyitaw Myanmar / Mon Namibia / Central Namibia / Caprivi Namibia / Kavango Namibia / Oshikoto Nepal / Eastern Nepal / Far-western Nepal / Mid-western Nicaragua / Atlantico (Rio San Juan, Atlantico Norte (Raan), Atlantico Sur (Raas)) Nigeria / Akwa Ibom Nigeria / Bayelsa Nigeria / Borno Nigeria / Cross River
Country / Region Nigeria / Ekiti Nigeria / Enugu Nigeria / Kaduna Nigeria / Kogi Nigeria / Kwara Nigeria / Nassarawa Nigeria / Niger Nigeria / Ondo Nigeria / Osun Nigeria / Oyo Pakistan / FATA Pakistan / Gilgit Baltistan Panama / Embera Wounaan Papua New Guinea / Central Papua New Guinea / Chimbu, Simbu Papua New Guinea / Morobe Peru / Central (Huancavelica, Huanuco, Junin, Pasco) Philippines / IVB-MIMAROPA Philippines / V-Bicol Philippines / XI-Davao Senegal / Diourbel Senegal / Fatick Senegal / Kaolack Senegal / Louga Senegal / Saint Louis Senegal / Tambacounda Senegal / Ziguinchor Sierra Leone / Western Rural Sudan / Kassala Sudan / Red Sea Sudan / Sinnar Sudan / White Nile Timor Leste / Baucau Timor Leste / Liquica Timor Leste / Manufahi Togo / Lome Uganda / Central 1 (Central South) Yemen / Beida (Al Bayda), Dhamar, Raimah Yemen / Hodeida (Al Hudaydah), Mahweit (Al Mahwit) Zambia / Central Zambia / North-Western Zimbabwe / Manicaland Zimbabwe / Mashonaland East Zimbabwe / Mashonaland West Zimbabwe / Matebeleland South Zimbabwe / Midlands
Fifth decile
Country / Region Afghanistan / Central (Kabul Wardak Kapisa Logar Parwan Panjsher) Afghanistan / North (Samangan Sar-e-Pul Balkh Jawzjan Faryab) Angola / Namibe Bangladesh / Barisal, Jhalokati, Pirojpur Bangladesh / Chittagong Bangladesh / Faridpur, Manikganj, Rajbari Bangladesh / Feni, Lakshmipur, Noakhali Bangladesh / Gopalganj, Madaripur, Munshiganj, Shariatpur Bangladesh / Jamalpur, Sherpur, Tangail Bangladesh / Maulvibazar, Sylhet Belize / Cayo Bhutan / Chukha Bhutan / Punakha Bhutan / Samtse Bhutan / Sarpang Bhutan / Wangdi Bolivia / Beni Bolivia / Cochabamba Bolivia / Pando Bolivia / Tarija Botswana / Central Botswana / Ghanzi Botswana / Kgalagadi Botswana / Kgatleng Botswana / Kweneng Botswana / North-West, Ngamiland Botswana / Southern Cambodia / Phnom Penh Cameroon / Centre (incl Yaounde) Cameroon / Littoral (incl Douala) Cameroon / Sud Cameroon / Sud Ouest Colombia / Guainja Colombia / Vaupis Comoros / Grande Comore (Ngazidja) Congo Brazzaville / Pointe Noire Congo Democratic Republic / Kinshasa Djibouti / Djibouti Eritrea / Debubawi Keih Bahri Eswatini / Lubombo Eswatini / Shiselweni Ethiopia / Addis Fiji / Cakaudrove, Bua Fiji / Kadavu, Lau, Lomaiviti, Rotuma Gabon / Ngounie Gabon / Nyanga
Country / Region Gabon / Ogooue Ivindo Gabon / Woleu Ntem Gambia / Basse Gambia / Brikama Ghana / Ashanti Ghana / Central Ghana / Eastern Ghana / Western Guatemala / Central Guatemala / North-Oriental Guatemala / Peten Guatemala / South-Occidental Guatemala / South-Oriental Guinea Bissau / Bissau Honduras / El Paraiso Honduras / Intibuca Honduras / La Paz Honduras / Lempira India / Andhra Pradesh India / Dadra and Nagar Haveli India / Karnataka India / Maharashtra India / Manipur India / Rajasthan India / Sikkim India / Telangana Indonesia / Central Java Indonesia / Central Sulawesi Indonesia / Irian Jaya (Papua and Papua Barat) Indonesia / Maluku Indonesia / West Kalimantan Indonesia / West Nusa Tenggara Kiribati / Souyth Tarawa Lao / Luangnamtha Lao / Luangprabang Lao / Oudomxay Lao / Phongsaly Lao / Saravane Lao / Sekong Lesotho / Berea Lesotho / Maseru Malaysia / Sabah Mali / Bamako Mauritania / Inchiri Mauritania / Trarza incl Nouakchott Morocco / South
Country / Region Morocco / Tensift Mozambique / Maputo Provincia Myanmar / Yangon Namibia / Kunene Namibia / Omaheke Namibia / Oshana Nepal / Western Nicaragua / Central-Norte (Boaco, Chontales, Jinotega, Matagalpa, Esteli, Madriz, Nueva Segovia) Nigeria / Abia Nigeria / Abuja FCT Nigeria / Anambra Nigeria / Delta Nigeria / Edo Nigeria / Imo Nigeria / Lagos Nigeria / Ogun Nigeria / Rivers Pakistan / Balochistan Pakistan / Sindh Panama / Bocas del Toro Peru / North (Tumbes, Piura, Lambayeque, Cajamarca, La Libertad) Peru / North East (Amazonas, Loreto, San Martin, Ucayali) Peru / South (Tacna, Moquegua, Arequipa, Ica, Ayacucho) Philippines / Cordillera Admin Region Philippines / I-Ilocos Philippines / II-Cagayan Valley Philippines / III-Central Luzon Philippines / IX-Zamboanga Peninsula Philippines / VI-Western Visayas Philippines / VII-Central Visayas Philippines / VIII-Eastern Visayas Philippines / X-Northern Mindanao Philippines / XII-SOCCSKSARGEN Philippines / XIII-Caraga Senegal / Thies Sierra Leone / Western Urban Sudan / Al Gezira Tanzania / Dar Es Salam Tonga / Ongo Niua Uganda / Kampala Uzbekistan / Central (Navoi, Bukhara, Samarkand) Uzbekistan / East (Namangan, Fergana, Andizhan) Uzbekistan / South (Kashkadarya, Surkhandarya) Yemen / Ibb Yemen / Taiz Zambia / Copperbelt
Sixth decile
Country / Region Angola / Cabinda Azerbaijan / Aran Azerbaijan / Dakhlik Shirvan Azerbaijan / Ganja Gazakh Azerbaijan / Lankaran Azerbaijan / Shaki Zaqatala Bangladesh / Brahmanbaria, Chandpur, Comilla Bangladesh / Dhaka Bangladesh / Gazipur, Narayanganj, Narsingdi Belize / Corozal, Orange Walk Bhutan / Paro Bhutan / Thimphu Bolivia / Santa Cruz Botswana / Chobe Botswana / North-East Botswana / South-East Chili / Arbucania China / Hainan China / Yunnan Colombia / Amazonas Colombia / Cauca Colombia / Choco Colombia / Guajira Colombia / Narino Colombia / Putumayo Congo Brazzaville / Brazzaville El Salvador / Central II El Salvador / Occidental El Salvador / Oriental Eswatini / Hhohho Eswatini / Manzini Fiji / Nadroga or Navosa Fiji / Ra Gabon / Estuaire Gabon / Haut Ogooue Gabon / Moyen Ogooue Gabon / Ogooue Lolo Gabon / Ogooue Maritime Gambia / Banjul Gambia / Kanifing Ghana / Greater Accra Guatemala / Metropolitan Guinea / Conakry Guyana / Cuyuni-Mazaruni Guyana / Pomeroon-Supenaam Honduras / Choluteca
Country / Region Honduras / Colon Honduras / Comayagua Honduras / Copan Honduras / Ocotepeque Honduras / Olancho Honduras / Santa Barbara Honduras / Valle Honduras / Yoro India / Andaman and Nicobar Islands India / Daman and Diu India / Gujarat India / Himachal Pradesh India / Jammu and Kashmir India / Tamil Nadu India / Uttaranchal Indonesia / Bali Indonesia / Bengkulu Indonesia / Central Kalimantan Indonesia / DI Aceh Indonesia / DI Yogyakarta Indonesia / East Java Indonesia / Gorontalo Indonesia / Jambi Indonesia / Lampung Indonesia / North Sulawesi Indonesia / North Sumatra Indonesia / Riau (incl. Riau islands) Indonesia / South Kalimantan Indonesia / South Sulawesi (incl Sulawesi Barat) Indonesia / South Sumatra Indonesia / Southeast Sulawesi Indonesia / West Java Indonesia / West Sumatra Lao / Attapeu Lao / Bokeo Lao / Savannakhet Lao / Xiengkhuang Malaysia / Kelantan Malaysia / Sarawak Mauritania / Nouadhibou Mexico / Chiapas Mexico / Oaxaca Mexico / Puebla Mongolia / Khangai (Arkhangai, Bayankhongor, Bulgan, Uvurkhangai, Khuvsgul, Orkhon) Mongolia / Western (Bayan-Ulgii, Govi-Altai, Zavkhan, Uvs, Khovd) Morocco / Centre
Country / Region Morocco / Centre north Morocco / Centre south Morocco / Eastern Morocco / North west Mozambique / Maputo Cidade Namibia / South Namibia / Erongo Namibia / Hardap Namibia / Karas Namibia / Khomas Namibia / Otjozondjupa Nicaragua / Pacifico (Chinandega, Leon, Managua, Masaya, Granada, Carazo, Rivas) Pakistan / AJK Pakistan / Khyber Pakhtunkhwa (NWFrontier) Pakistan / Punjab Panama / Cocle Panama / Darien Panama / Veraguas Peru / West (Ancash, Lima, Callao) Philippines / IVA-CALABARZON Philippines / National Capital Region Samoa / Savaii Sao Tome & Principe / Regiao Centro Sao Tome & Principe / Regiao Norte Sao Tome & Principe / Regiao Sul Senegal / Dakar South Africa / Eastern Cape Sudan / Khartoum Sudan / Nahr El Nil Suriname / Brokopondo and Sipaliwini Tajikistan / DRS Tajikistan / GBAO Tajikistan / Khatlon Tanzania / Zanzibar West Timor Leste / Dili Tonga / Ha-apai Uzbekistan / Central-East (Dzhizak, Syrdarya) Uzbekistan / West (Karakalpakstan, Khorezm) Venezuela / Apure Venezuela / Portuguesa Vietnam / Central Highlands Yemen / Abyan, Aden (town and countryside), Lahej, Ad Dali (Al Dhalih) Yemen / Sana a (capital; Al Amana), Sana a (governorate) Zambia / Lusaka Zimbabwe / Bulawayo Zimbabwe / Harare
Seventh decile
Country / Region Angola / Luanda Azerbaijan / Yukhari Karabakh Belize / Belize Belize / Stann Creek, Toledo Brazil / Amazonas Brazil / Para Chili / Aisen Chili / Atacama Chili / Bio Bio Chili / Coquimbo Chili / Los Lagos (incl Los Rios) Chili / Maule Chili / OHiggins Chili / Tarapaca (incl Arica and Parinacota) China / Chongqing, Sichuan, Guizhou, Yunnan, Tibet China / Gansu, Qinghai, Ningxia, Xinjiang China / Gansu China / Guangdong China / Guangxi Zhuang China / Guizhou China / Henan China / Jiangxi China / Ningxia China / Qinghai China / Shanxi China / Sichuan Colombia / Bolivar (Sur and Norte) Colombia / Boyaca Colombia / Caqueta Colombia / Cesar Colombia / Cordoba Colombia / Guaviare Colombia / Magdalena Colombia / Sucre Colombia / Tolima Colombia / Vichada Cuba / Camaguey Cuba / Granma Cuba / Guantanamo Cuba / Holguin Cuba / Las Tunas Cuba / Santiago de Cuba Dominican Republic / Region I (Peravia, San Cristobal, San Jose de Ocoa, Azua) Dominican Republic / Region II (Espaillat, Puerto Plata, Santiago) Dominican Republic / Region III (Duarte, Maria Trinidad Sanchez, Salcedo, Samana) Dominican Republic / Region IV (Independencia, Bahoruco, Barahona, Pedernales)
Country / Region Dominican Republic / Region V (El Seibo, La Altagracia, La Romana, San Pedro de Macoris, Hato Mayor) Dominican Republic / Region VI (San Juan, Elias Pina) Dominican Republic / Region VII (Dajabon, Monte Cristi, Santiago Rodriguez, Valverde) Dominican Republic / Region VIII (La Vega, Monsenor Nouel, Sanchez Ramirez) Ecuador / Oriente El Salvador / Central I Fiji / Ba Fiji / Macuata Fiji / Rewa Fiji / Serua, Namosi Fiji / Tailevu Gabon / Libreville-Port Gentil Guyana / East Berbice-Corentyne Guyana / Mahaica-Berbice Honduras / Atlantida Honduras / Francisco Morazan Honduras / Islas de la Bahia India / Haryana India / Kerala India / Lakshadweep India / Mizoram India / New Delhi India / Puducherry Indonesia / Bangka Belitung Indonesia / Banten Indonesia / DKI Jakarta Indonesia / East Kalimantan Jamaica / Manchester, Clarendon Jamaica / St James, Hanover, Westmoreland Jamaica / St Thomas, Portland, St Mary Jamaica / Trelawny, St Elizabeth Lao / Champasack Lao / Khammuane Lao / Sayabury Lao / Vientiane Province Malaysia / Johor Malaysia / Kedah Malaysia / Kuala Lumpur Federal Territory Malaysia / Labuan Federal Territory Malaysia / Pahang Malaysia / Perak Malaysia / Perlis Malaysia / Terengganu Mauritania / Tiris-Zemmour Mexico / Centro (Guerrero, Morelos, Puebla, Tlaxcala, Hidalgo, Michoacan y Colima) Mexico / Sur (Campeche, Chiapas, Oaxaca, Quintana Roo, Tabasco, Veracruz y Yucatan)
Country / Region Mexico / Campeche Mexico / Guerrero Mexico / Hidalgo Mexico / San Luis Potosi Mexico / Tlaxcala Mexico / Veracruz Mexico / Yucatan Moldova / Center Moldova / North Moldova / South Mongolia / Central (Dornogovi, Dundgovi, Umnugovi, Selenge, Tuv, Darkhan-Uul, Govisumber) Mongolia / Eastern (Dornod, Sukhbaatar, Khentii) Panama / Area Central Panama / Area Occidental Panama / Chiriqui Panama / Herrera Papua New Guinea / National Capital District Paraguay / North-West (Boqueron, Alto Paraguay, Presidente Hayes, Conception, Amambay, San pedro, Cordillera) Samoa / North West Upolu Samoa / Rest of Upolu Sao Tome & Principe / Regiao do Principe South Africa / Free State South Africa / Gauteng South Africa / KwaZulu Natal South Africa / Mpumalanga South Africa / North West South Africa / Northern Cape South Africa / Northern Province Sudan / Northern Tajikistan / Sughd (formerly Leninabad) Tonga / Vava-u Tuvalu / Nanumea, Nanumaga, Niutao Tuvalu / Vaitupu, Nui, Nukufetau Venezuela / Amacuros Delta Federal Territory Venezuela / Barinas Venezuela / Cojedes Venezuela / Falcon Venezuela / Guarico Venezuela / Lara Venezuela / Merida Venezuela / Monagas Venezuela / Sucre Venezuela / Trujillo Venezuela / Yaracuy Vietnam / North East, North West Yemen / Jawf, Hadramet, Shabda (Shabwah), Marib, Mohra (Al Mahrah)
Eight decile
Country / Region Albania / Diber Albania / Elbasan Albania / Kukes Azerbaijan / Absheron Azerbaijan / Guba Khachmaz Brazil / Acre Brazil / Alagoas Brazil / Amapa Brazil / Bahia Brazil / Ceara Brazil / Maranhao Brazil / Paraiba Brazil / Pernambuco Brazil / Piaui Brazil / Roraima Brazil / Sergipe Brazil / Tocantins Chili / Norte I - IV Chili / Sur VIII - XII Chili / Antofagasta Chili / Magallanes and La Antartica Chilena Chili / Region Metropolitana Chili / Valparaiso (former Aconcagua) China / Beijing, Tianjin, Hebei, Shandong China / Fujian, Guangdong, Hainan China / Henan, Shanxi, Shaanxi, Inner Mongolia China / Hubei, Jiangxi, Hunan, Guangxi China / Liaoning, Jilin, Heilongjiang China / Anhui China / Chongqing China / Fujian China / Hebei China / Heilongjiang China / Hubei China / Hunan China / Inner Mongolia China / Jilin China / Liaoning China / Shaanxi China / Shandong China / Zhejiang Colombia / Antioquia (incl Medellin) Colombia / Arauca Colombia / Atlantico (incl Barranquilla) Colombia / Bogota D.C. Colombia / Caldas
Country / Region Colombia / Casanare Colombia / Cundinamarca Colombia / Huila Colombia / Meta Colombia / Norte de Santander Colombia / Quindio Colombia / Risaralda Colombia / Santander Cuba / Ciego de Avila Cuba / Cienfuegos Cuba / S.Spiritus Cuba / Villa Clara Dominican Republic / Region 0 (Distrito Nacional, Santo Domingo, Monte Plata) Ecuador / Coste Ecuador / Sierra Egypt / Assuit Egypt / Menya Fiji / Naitasiri Georgia / Guria Georgia / Kakheti Georgia / Mtskheta-Mtianeti Georgia / Samegrelo-Zemo Svateni Georgia / Samtskhe-Javakheti Georgia / Shida Kartli Guyana / Demerara-Mahaica Guyana / Essequibo Islands-West Demerara Guyana / Upper Demerara-Berbice Honduras / Cortes India / Chandigarth India / Goa India / Punjab Iraq / Anbar Jamaica / Kingston, St Andrew Jamaica / St Ann, St Catherine Kyrgyzstan / Jalal-Abad Kyrgyzstan / Naryn Kyrgyzstan / Talas Lao / Borikhamxay Malaysia / East Malaysia (Saba, Sarawak) Malaysia / Melaka Malaysia / Negeri Sembilan Malaysia / Pulau Pinang Malaysia / Selangor Mexico / CDMX-Edo Mexico Ciudad de Mexico (Estado de Mexico) Mexico / Noreste (Aguascalientes, Coahuila, Guanajuato, Nuevo Leon, Queretaro, San Luis Potosi, Tamaulipas, Mexico / Baja California Sur
Country / Region Mexico / Colima Mexico / Durango Mexico / Guanajuato Mexico / Mexico Mexico / Michoacan de Ocampo Mexico / Morelos Mexico / Nayarit Mexico / Queretaro Mexico / Quintana Roo Mexico / Tabasco Mexico / Zacatecas Pakistan / Islamabad (ICT) Panama / Area Oriental Panama / Colon Panama / Los Santos Panama / Panama Paraguay / Central (Asuncion, Central) Paraguay / North-East (Caaguazu, Alto Parana, Canideyu) Paraguay / South-East (Guaira, Misiones, Paraguari, Neembucu) Paraguay / South-West (Caazapa, Itapua) Saint Lucia / St Lucia rural Saint Lucia / St Lucia urban Samoa / Apia Urban Area South Africa / Western Cape Suriname / Commewijne and Marowijne Syria / Al Raka-Raqqa Thailand / Bangkok Tonga / Eua Tonga / Tongatapu Trinidad & Tobago / East Tuvalu / Funafuti Uruguay / Norte (Artigas, Rivera, Cerro Largo and Trienta y Tres) Venezuela / Amazonas Federal Territory Venezuela / Anzoategui Venezuela / Aragua Venezuela / Bolivar Venezuela / Carabobo Venezuela / Miranda Venezuela / Tachira Venezuela / Vargas Venezuela / Zulia Vietnam / Mekong River Delta Vietnam / North Central Coast and South Central Coast Vietnam / Red River Delta Vietnam / South East
Ninth decile
Country / Region Albania / Fier Albania / Korce Albania / Lezhe Albania / Shkoder Algeria / Hauts Plateaux Centre (Djelfa, Laghouat, MSila) Algeria / Hauts Plateaux Ouest (Tiaret, Saida, Tissemsilt, Naama, El Bayadh) Argentina urban / Gran Buenos Aires Argentina urban / NEA Argentina urban / NOA Armenia / Ararat Armenia / Armavir Armenia / Gegharkunik Armenia / Lori Armenia / Shirak Armenia / Syunik Armenia / Tavush Armenia / Vayots Dzor Azerbaijan / Baku Barbados / St Michael Brazil / Goias Brazil / Mato Grosso Brazil / Mato Grosso do Sul Brazil / Minas Gerais Brazil / Parana Brazil / Rio Grande do Norte Brazil / Rondonia Chili / Centro V - VII China / Shanghai, Jiangsu, Zhejiang, Anhui China / Beijing China / Jiangsu China / Tianjin Colombia / San Andres Colombia / Valle (incl Cali) Costa Rica / Alajuela Costa Rica / Guanacaste Costa Rica / Heredia Costa Rica / Limon Costa Rica / Puntarenas Cuba / C. Habana Cuba / Isla Cuba / Matanzas Cuba / Pinar del Rio Cuba / Prov. Habana Egypt / Behera Egypt / Dakahlia Egypt / Fayoum
| https://globaldatalab.org/areadata/rankings/fridge/?highlight=GINr102 |
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14/338-12:27:42.813 CLOSED OPEN OPEN OPEN OPEN OPEN CLOSED OPEN OPEN OPEN CLOSED OPEN OPEN OPEN OPEN CLOSED | https://lasp.colorado.edu/maven/sdc/public/data/sites/site-20190820T173843/anc/eng/usm4/sci_anc_usm414_336_342.drf |
Molar Mass of Unknown Gas Seth Hatfield - Copy.docx
View Molar Mass of Unknown Gas Seth Hatfield - Copy.docx from CHM 151 at Richmond Community College. Determination of the Molar Mass of an Unknown LiquidBackgroundIn this lab, a volatile organic liqui
Molar Mass of Unknown Gas Seth Hatfield - Copy.docx
Determination of the Molar Mass of an Unknown Liquid Background In this lab, a volatile organic liquid is vaporized, and its molar mass determined using the Dumas method. The ideal-gas equation is used to calculate the molar mass of the vapor at room pressure and the boiling point of the water bath. Its identity will be determined from a given list of organic compounds and their molar masses. Once identified, a percentage of error will be calculated for the experimental molar mass. The Dumas method depends on vaporizing a small amount of a volatile organic substance in a known volume at a known temperature. This is typically done using a flask of known volume, adding a small amount of organic substance, and then placing the flask into boiling water until all the organic substance vaporizes. If done correctly, all the air and other gases in the flask are expelled and the flask contains only the organic substance as a gas at atmospheric pressure. The flask is cooled and the gas condenses back into a liquid; it is then weighed. Molar mass is defined as the mass in grams of 1 mole of a substance. If you determine the mass and moles you can determine the molar mass. You will determine the mass of gas on an analytical balance and use the ideal gas equation to determine the number of moles. We will use a version of the ideal gas equation to determine the molar mass of the gas. MM = mRT PV MM is the molar mass. m is the mass of liquid left after the experiment. R is the ideal gas constant (0.08206 L.atm/(mol.K)) T is the temperature in Kelvins P is the pressure (we will use 1.0 atm) V is the volume of the flask (you will have to measure this, not use the volume listed on the flask). Time Requirements ~60 – 75 minutes Materials
Unknown liquid – Provided Laboratory balance – Provided 125-mL Erlenmeyer Flask – Provided Thermometer – Provided 50-mL Graduated cylinder – Provided 10-mL Graduated cylinder – Provided Ruler – Student Provided Pan – Student Provided Oven mitt, pot holder and/or Tongs - Student Provided 12 x 15” Aluminum foil – Student Provided Rubber band – Student Provided Safety Precautions Wear safety glasses at all times while performing this experiment. The unknown liquid and its vapors are flammable. Be sure to keep away from open flames. Keep the unknown liquid away from children and pets. It should be stored in a cool, dark place away from heat and ignition sources. Use a hot pad or oven mitg to remove the flask from the boiling water. Do not eat, drink, or chew gum while performing this experiment. Wash your hands with soap and water before and after performing this experiment. Clean the area with soap and water after performing and completing this experiment. Keep pets and children away from lab materials and equipment. Procedure 1. Record the unknown number in Data Table 1. 2. Cut tw0 7 x 7 cm squares of aluminum foil. 3. Weigh the empty 125-mL Erlenmeyer flask using the laboratory balance and record this in Data table 1. 4. Measure approximately 5 mL of the unknown liquid with a 10-mL graduated cylinder and pour the liquid into the Erlenmeyer flask. 5. Place the center of a 7-cm square of aluminum foil over the mouth of the flask and crimp the edges down over the rim. The foil should be tuat (pretty flat) across the mouth. 6. Secure the foil just below the rim with a rubber band. 7. Make a tiny hole in the center of the aluminum foil with a straight pin. 8. Place the flask in the middle of a saucepan. Hold the flask down with one hand (or some tongs) and add water to the saucepan until it rises to the 100-mL mar on the outside of the flask. 9. Remove the flask and set the pan of water on the burner of a stove. 10. Turn on the stove and heat the water in the pan to boiling. 11. Holding the flask with an oven mitt or pot holder, please the flask into the pan with the boiling water. You can hold the flask down with some tongs if you want or just let it tip to the side making sure it doesn’t tip over.
12. Heat the flask until you don’t see any more liquid in the bottom of the flask. If you can’t see if there is liquid or not, heat for a total of approximately 10 minutes. 13. Record the temperature of the boiling water. 14. Turn off the burner. 15. Using an oven mitt, pot holder or tongs remove the flask and place it on another pot holder or heat resistant surface to cool for a few minutes. 16. Hold the flask by the neck at a 45 o angle and place it under a stream of cool/cold water to continue cooling it to room temperature. Do not allow the running water to touch the aluminum foil cover. 17. Wipe the outside of the flask dry with a paper towel. 18. Remove the rubber band and aluminum foil. Dry any moisture from the outside of the flask neck with a paper towel. 19. Measure the mass of the flask and condensed vapor and record this value in Data Table 1 for Trial 1. 20. Rinse out the flask with tap water and thoroughly dry with paper towels. 21. Repeat this for 1 additional trial. Calculations 1. Determine the volume of the Erlenmeyer flask by filling it up with water. Pour the water from the flask into your 50-mL graduated cylinder as many times as necessary to determine the total volume of the flask. Record this volume in Data Table 1. Conversely, you can use the 50-mL graduated cylinder to add water to the Erlenmeyer flask until it is full making sure you keep a running total of all the water added. 2. You will use 1.00 atm as your atmospheric pressure. In NC, it is very rarely much different that that. Record this in Data Table 1. Possible Unknowns Unknown Molar mass (g/mol) Ethanol 46.07 Isopropyl alcohol 60.01 Hexane 86.18 Toluene 92.14
Data Table 1. Compound used ___#133__________ Trial 1 Trial 2 Mass empty flask (g) 84.82g 85.16g Mass of flask and condensed vapors after cooling (g) 84.92g 85.25 Mass of condensed vapor (g) 0.30g 0.32g Boiling water temperature ( o C) 100 Degrees C 100 Degrees C Boiling water temperature (K) 375.15 Degrees K 375.15 Degrees K Barometric Pressure (atm) 1 atm 1 atm Volume of Flask (mL) 155 mL 155 mL Volume of Flask (L) 0.155L 0.155L Molar mass of unknown MM = mRT PV 59.61 g/Mol 63.58 g/Mol Average Molar Mass 61.60 g/Mol % Error .902% Error 1. Show a calculation of molar mass using your data. ATTACHED ON NEXT PAGE, I HAD PRINTER ISSUES TODAY! 2. What is the chemical formula of your compound? 3. Calculate the molar mass (molecular weight) for your compound using the periodic table and based on the chemical formula.
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JMIR Research Protocols - An Integrated Approach to Control Soil-Transmitted Helminthiasis, Schistosomiasis, Intestinal Protozoa Infection, and Diarrhea: Protocol for a Cluster Randomized Trial
Background: The global strategy to control helminthiases (schistosomiasis and soil-transmitted helminthiasis) emphasizes preventive chemotherapy. However, in the absence of access to clean water, improved sanitation, and adequate hygiene, reinfection after treatment can occur rapidly. Integrated approaches might be necessary to sustain the benefits of preventive chemotherapy and make progress toward interruption of helminthiases transmission. Objective: The aim of this study was to assess and quantify the effect of an integrated control package that consists of preventive chemotherapy, community-led total sanitation, and health education on soil-transmitted helminthiasis, schistosomiasis, intestinal protozoa infection, and diarrhea in rural Côte d’Ivoire. Methods: In a first step, a community health education program was developed that includes an animated cartoon to promote improved hygiene and health targeting school-aged children, coupled with a health education theater for the entire community. In a second step, a cluster randomized trial was implemented in 56 communities of south-central Côte d’Ivoire with 4 intervention arms: (1) preventive chemotherapy; (2) preventive chemotherapy plus community-led total sanitation; (3) preventive chemotherapy plus health education; and (4) all 3 interventions combined. Before implementation of the aforementioned interventions, a baseline parasitologic, anthropometric, and hygiene-related knowledge, attitudes, practices, and beliefs survey was conducted. These surveys were repeated 18 and 39 months after the baseline cross-sectional survey to determine the effect of different interventions on helminth and intestinal protozoa infection, nutritional indicators, and knowledge, attitudes, practices, and beliefs. Monitoring of diarrhea was done over a 24-month period at 2-week intervals, starting right after the baseline survey. Results: Key results from this cluster randomized trial will shed light on the effect of integrated approaches consisting of preventive chemotherapy, community-led total sanitation, and health education against infections with soil-transmitted helminths, schistosomes, an intestinal protozoa and prevention of diarrhea in a rural part of Côte d’Ivoire. Conclusions: The research provided new insights into the acceptability, strengths, and limitations of an integrated community-based control package targeting helminthiases, intestinal protozoa infections, and diarrhea in rural communities of Côte d’Ivoire. In the longer term, the study will allow determining the effect of the integrated control approach on infection patterns with parasitic worms and intestinal protozoa, diarrheal incidence, anthropometric measures, and hygiene-related knowledge, attitudes, practices, and beliefs. Trial Registration: International Standard Randomized Controlled Trial Number (ISRCTN): 53102033; http://www.isrctn.com/ISRCTN53102033 (Archived by WebCite at http://www.webcitation.org/6wpnXEiHo) Registered Report Identifier: RR1-10.2196/9166
This paper is in the following e-collection/theme issue:
RCTs - Protocols/Proposals (non-eHealth) (230)
An Integrated Approach to Control Soil-Transmitted Helminthiasis, Schistosomiasis, Intestinal Protozoa Infection, and Diarrhea: Protocol for a Cluster Randomized Trial
An Integrated Approach to Control Soil-Transmitted Helminthiasis, Schistosomiasis, Intestinal Protozoa Infection, and Diarrhea: Protocol for a Cluster Randomized Trial
Authors of this article:
Giovanna
Raso 1, 2 ;
Clémence
Essé 3, 4 ;
Kouassi
Dongo 3, 4 ;
Mamadou
Ouattara 3, 4 ;
Fabien
Zouzou 3, 5 ;
Eveline
Hürlimann 1, 2 ;
Veronique A
Koffi 3, 4 ;
Gaoussou
Coulibaly 3, 4 ;
Virginie
Mahan 3, 4, 6 ;
Richard B
Yapi 3, 4 ;
Siaka
Koné 3 ;
Jean Tenena
Coulibaly 3, 4 ;
Aboulaye
Meïté 7 ;
Marie-Claire
Guéhi-Kabran 8 ;
Bassirou
Bonfoh 1, 2, 3 ;
Eliézer Kouakou
N'Goran 3, 4 ;
Jürg
Utzinger 1, 2
Marie-Claire Guéhi-Kabran 10 , MBA ;
Bassirou Bonfoh 1, 2, 3 , PhD ;
Eliézer Kouakou N'Goran 3, 6 , PhD ;
Jürg Utzinger 1, 2 , PhD
1Swiss Tropical and Public Health Institute, Basel, Switzerland
2University of Basel, Basel, Switzerland
3Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire
4Unité de Formation et de Recherche Sciences de l'Homme et de la Société, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire
5Unité de Formation et de Recherche Sciences de Terre et des Ressources Minières, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire
6Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire
7FAIRMED, Bern, Switzerland
8UNICEF Côte d'Ivoire, Abidjan, Côte d'Ivoire
9Programme National de Lutte contre les Maladies Tropicales Négligées à Chimiothérapie Préventive, Ministère de la Santé et de l'Hygiène Publique, Abidjan, Côte d'Ivoire
10Direction de l'Assainissement et du Drainage, Ministère de l'Urbanisme, Abidjan, Côte d'Ivoire
Corresponding Author:
Giovanna Raso, PhD
Swiss Tropical and Public Health Institute
Socinstrasse 57
Basel, CH-4002
Switzerland
Phone: 41 61 2848307
Abstract
Background:The global strategy to control helminthiases (schistosomiasis and soil-transmitted helminthiasis) emphasizes preventive chemotherapy. However, in the absence of access to clean water, improved sanitation, and adequate hygiene, reinfection after treatment can occur rapidly. Integrated approaches might be necessary to sustain the benefits of preventive chemotherapy and make progress toward interruption of helminthiases transmission.
Objective:The aim of this study was to assess and quantify the effect of an integrated control package that consists of preventive chemotherapy, community-led total sanitation, and health education on soil-transmitted helminthiasis, schistosomiasis, intestinal protozoa infection, and diarrhea in rural Côte d’Ivoire.
Methods:In a first step, a community health education program was developed that includes an animated cartoon to promote improved hygiene and health targeting school-aged children, coupled with a health education theater for the entire community. In a second step, a cluster randomized trial was implemented in 56 communities of south-central Côte d’Ivoire with 4 intervention arms: (1) preventive chemotherapy; (2) preventive chemotherapy plus community-led total sanitation; (3) preventive chemotherapy plus health education; and (4) all 3 interventions combined. Before implementation of the aforementioned interventions, a baseline parasitologic, anthropometric, and hygiene-related knowledge, attitudes, practices, and beliefs survey was conducted. These surveys were repeated 18 and 39 months after the baseline cross-sectional survey to determine the effect of different interventions on helminth and intestinal protozoa infection, nutritional indicators, and knowledge, attitudes, practices, and beliefs. Monitoring of diarrhea was done over a 24-month period at 2-week intervals, starting right after the baseline survey.
Results:Key results from this cluster randomized trial will shed light on the effect of integrated approaches consisting of preventive chemotherapy, community-led total sanitation, and health education against infections with soil-transmitted helminths, schistosomes, an intestinal protozoa and prevention of diarrhea in a rural part of Côte d’Ivoire.
Conclusions:The research provided new insights into the acceptability, strengths, and limitations of an integrated community-based control package targeting helminthiases, intestinal protozoa infections, and diarrhea in rural communities of Côte d’Ivoire. In the longer term, the study will allow determining the effect of the integrated control approach on infection patterns with parasitic worms and intestinal protozoa, diarrheal incidence, anthropometric measures, and hygiene-related knowledge, attitudes, practices, and beliefs.
Trial Registration:International Standard Randomized Controlled Trial Number (ISRCTN): 53102033; http://www.isrctn.com/ISRCTN53102033 (Archived by WebCite at http://www.webcitation.org/6wpnXEiHo)
Registered Report Identifier:RR1-10.2196/9166
JMIR Res Protoc 2018;7(6):e145
doi:10.2196/resprot.9166
Keywords
community-led total sanitation ; Côte d’Ivoire ; diarrhea ; health education ; integrated control ; intestinal protozoa ; preventive chemotherapy ; schistosomiasis ; soil-transmitted helminthiasis
Introduction
The global strategy to control helminthiases (eg, schistosomiasis and soil-transmitted helminthiasis) emphasizes preventive chemotherapy, that is, the periodic administration of anthelmintic drugs to at-risk populations, most importantly school-aged children [ 1]. However, preventive chemotherapy does not prevent people from rapid reinfection with parasitic worms [ 2, 3]. In view of the current discussion and efforts to shift from morbidity control to interruption of transmission of helminthiases and other neglected tropical diseases, ongoing efforts need to be intensified, along with concurrent implementation of complementary interventions [ 4- 7]. Indeed, integrated approaches, combining preventive chemotherapy with water, sanitation, and hygiene and information, education, and communication, are necessary to sustain the gains made in the control of helminthiases and eventually break transmission [ 8- 11].
In 2015, an estimated 2.4 billion people globally lacked access to improved sanitation, and the absolute number of people practicing open defecation in Africa had increased since 1990 [ 12]. There is evidence that a considerable part of the global burden of disease is attributable to unsafe sanitation, poor water quality, and inadequate hygiene behavior [ 13, 14] and that improved sanitation and water supply are key factors for prevention, control, and elimination of helminthiases and diarrhea [ 11, 15- 18]. Yet, current control efforts do not take these aspects sufficiently into account. Combined interventions have shown around 35% reduction in the incidence of diarrheal diseases and helminthiases [ 15, 19, 20] with improved sanitation being particularly important [ 21]. Studies pertaining to the effect of improved sanitation combined with preventive chemotherapy suggest reductions of 75% and up to 90% for each of the 3 common soil-transmitted helminth species ( Ascaris lumbricoides, hookworm, and Trichuris trichiura) [ 22, 23]. Hence, sanitation and specific health education protect people from rapid reinfection, consolidate the gains of preventive chemotherapy, and are crucial for the sustainability of control programs [ 24- 26].
In 2013, a project was launched in south-central Côte d’Ivoire with the aim to assess and quantify the effect of preventive chemotherapy, combined with either community-led total sanitation (CLTS), or health education, or both measures combined, on reinfection with soil-transmitted helminths, schistosomes, intestinal protozoa, and the incidence of diarrhea, using a cluster randomized design. CLTS was initially designed to reduce diarrhea incidence; through a participatory grassroots approach, it aims to achieve and sustain an open defecation-free status of the target community [ 27].
In a first step, we developed a community health education program (CHEP), including an animated cartoon entitled Koko et les lunettes magiquesfor school-aged children [ 28] and a health education theater targeting the entire community. The emphasis of these health education tools is placed on improving people’s hygiene behavior to prevent the transmission of neglected tropical diseases and diarrhea. In a second step, a cluster randomized trial was implemented in 56 communities of the Taabo, Djékanou, and Toumodi departments in south-central Côte d’Ivoire. Here, we present the study protocol with particular consideration to the cluster randomized trial, whose aim was to assess the effect of preventive chemotherapy combined with either CLTS or CHEP, or both on infections with soil-transmitted helminths, schistosomes, and intestinal protozoa.
Methods
Ethics Approval and Consent to Participate
Ethical clearance for the study was obtained from the Ethics Committee of Basel (EKBB; reference no. 300/13, date of approval: November 11, 2013) and from the ethics committee of the Ministry of Health and Public Hygiene in Côte d’Ivoire (reference no. 76-MSLS-CNER-dkn, date of approval: November 28, 2013). The trial is registered (ISRCTN53102033, date of approval: March 26, 2014). Written informed consent was obtained from each participant, with parents/guardians consenting on behalf of children younger than 18 years.
Study Area and Participants
Between July 2011 and December 2012, an 18-month pilot project, entailing a baseline parasitologic and knowledge, attitudes, practices, and beliefs (KAPB) cross-sectional survey, followed by a cross-sectional follow-up survey, was carried out to study the effect of an integrated disease control package, consisting of preventive chemotherapy, CLTS, and health education against helminthiases and intestinal protozoa infections in 9 communities of the Taabo health and demographic surveillance system in south-central Côte d’Ivoire [ 29- 32]. The results of this pilot project provided an indication that an integrated control package reduced the prevalence of helminth and intestinal protozoa infections and improved people’s hygiene knowledge and practice. In addition, the study results suggested that health education is an important complement, as it enhanced CLTS acceptance in the community [ 33].
Following this pilot project, a larger study was launched in 2013 to assess the effect of an integrated control package in a community cluster randomized trial with 4 intervention arms (preventive chemotherapy alone, or combined with either CLTS or CHEP, or both interventions simultaneously). This trial was implemented in 56 rural communities in 3 departments of south-central Côte d’Ivoire; namely, Taabo, Djékanou, and Toumodi. In this part of Côte d’Ivoire, people are mainly engaged in subsistence agriculture, whereas rubber, cocoa, and coffee are farmed as cash crops.
Development and Validation of Health Education Tools
Before starting the cluster randomized trial in the 3 departments, 2 types of health education tools were developed, refined, and tested—an animated cartoon entitled Koko et les lunettes magiques[ 28] and a community-based health theater. For the development of the animated cartoon, a formative research was conducted with school-aged children to identify key messages to improve hygiene behavior and to prevent transmission of neglected tropical diseases that were subsequently included in the video. The research was done with school-enrolled and nonenrolled children in 8 localities in south-central and western Côte d’Ivoire, in the same regions where further studies would take place [ 28]. Hence, the 8 localities were excluded from further research. The animated cartoon was produced by an Abidjan-based cartoon company, in collaboration with the research team, and was tested for comprehension and acceptance with school children. Subsequently, the cartoon was validated, and its effect on helminth infections and KAPB was determined in an intervention study comprising 25 schools of western Côte d’Ivoire from 2014 to 2015. This intervention study confirmed that knowledge of school children was improved after screening the cartoon, and hence, the cartoon was deemed a useful tool for health education. However, no significant effects on helminth infections were observed in the short term.
As for the development of the animated cartoon, the health education theater was coupled to a KAPB survey in the community. Questionnaires and focus group discussions (FGDs) were administered to groups of women, men, young adults, and the elderly in 2 communities of the nearby Tiassalé department. In addition, direct observations were made with an emphasis on hygiene behavior and transmission of neglected tropical diseases. Community members constituted a theater group that was assisted by the research team who provided a health education session, according to KAPB survey results. The community theater members designed the sketches on their own and conveyed hygiene and health messages during their performance in front of the community. The health education theater was tested with 2 communities and then evaluated for its acceptance in the community in 2014. For this purpose, the team discussed with the community their opinion about the intervention, whether they liked it, if they thought it was helpful to improve their health knowledge, and whether they would welcome such kind of interventions. Figure 1summarizes the 3-step methodological approach for the development of health education tools, comprising identification of key messages, development, and refinement of the tool.
Cluster Randomized Trial Design
Once the health education tools had been developed and validated, a 4-armed cluster randomized trial was launched. The primary outcome of the trial was hookworm infection, as determined by the Kato-Katz method [ 34]. Secondary outcomes were other parasitic infections (ie, other soil-transmitted helminths, Schistosomaspp., and intestinal protozoa) and intensity of helminth infection, KAPB with regard to hygiene and intestinal parasitic infections, diarrhea incidence, and anthropometry of infants. Hookworm infection was chosen as primary outcome because of its endemicity across Côte d’Ivoire and the moderate to high prevalence in the study area [ 33, 35].
Details of the specific outcomes are provided in the following sections. In a first step, a baseline parasitologic, KAPB, and anthropometric survey was implemented in 56 communities (14 communities per arm). Sample size calculation was done using the Web-based sample calculator for cluster randomized trials presented elsewhere [ 36], assuming a baseline hookworm prevalence of 30% according to previous studies in the region [ 33, 37], a prevalence reduction of 50% after implementation of interventions [ 33], an intracluster correlation of .4 as we expected high correlation within the community because of the nature of community-based bottom-up interventions and mass drug administration within a community, and a dropout rate of 30% at each follow-up according to previous experience of the team, resulting in 152 individuals per cluster. In Côte d’Ivoire, the average number of people in a household is 7 (our assumption was 2 adults and 5 children). For a sample size of 152 children per community, we thus needed 30 households per community.
The communities were selected based on their population size. We intended to include communities with at least 30 households and a population size not exceeding 600 individuals because this is the optimal recommended size for implementation of the CLTS intervention [ 27]. Given the demographic characteristics of the study area, somewhat smaller communities (slightly less than 30 households) and villages exceeding 600 individuals were also included. The selection of up to 30 households per community was done at random, according to the World Health Organization’s (WHO) Expanded Program on Immunization method [ 38].
Figure 1. Proposed 3-step process for the development and testing of health education tools for the control of neglected tropical diseases. KAPB: knowledge, attitudes, practices, and beliefs.
Our main target group was children aged 5 to 15 years, on whom sample size calculation was based. In addition, whenever possible, 1 infant (aged 12-24 months) and 1 adolescent or adult (aged >15 years) from each household were also selected. Although all the 3 groups underwent parasitologic examinations, only infants were subjected to anthropometric measurements. Household heads (or their spouses/partners) were administered a questionnaire for KAPB, whereas direct observations occurred in each household to check for the presence, use, and maintenance of latrines as well as potential open defecation and waste disposal sites in close proximity. The questionnaire included a section reserved for these observations that were made by the interviewer during the interview. FGDs were conducted with selected groups (adult women, adult men, school-aged children, and the elderly), and in-depth interviews were conducted with head of communities and community health workers in 24 communities. The topics discussed during the FGDs were the same as for the questionnaires so that qualitative and quantitative results complemented each other. We monitored diarrhea over a 24-month period, determining the length and frequency of each episode, using a rapid assessment questionnaire carried out once every 2 weeks. The trial communities were assigned by restricted randomization to 1 of the 4 intervention arms with 14 communities per intervention arm based on baseline soil-transmitted helminth prevalence and population size [ 39]. The 4 intervention arms are as follows: (1) intervention arm 1: preventive chemotherapy only; (2) intervention arm 2: preventive chemotherapy plus CLTS; (3) intervention arm 3: preventive chemotherapy plus health education; and (4) intervention arm 4: all interventions combined.
Figure 2shows the study area with the 56 selected rural communities, stratified by intervention arm. Interventions started right after randomization of the communities. A first follow-up parasitologic and KAPB survey was carried out 18 months after the baseline cross-sectional survey. A second follow-up survey was scheduled another 21 months later. At the end of the CLTS intervention, the communities were visited and inspected using standardized forms. Transects were done to assess whether open defecation and waste disposal spots were visible, and all households were inspected for the availability of latrines. A summary of the study design is presented in Figure 3.
Figure 2. Map displaying communities included in the cluster randomized trial in 3 departments of south-central Côte d’Ivoire randomly assigned to one of 4 intervention arms. PC: preventive chemotherapy; CLTS: community-led total sanitation; CHEP: community health education program.
Figure 3. Experimental design of the cluster randomized trial. The periodic cross-sectional surveys are highlighted in purple color, diarrhea monitoring is marked in blue, and interventions are highlighted in orange. CLTS: community-led total sanitation; CHEP: community health education program; KAPB: knowledge, attitudes, practices, and beliefs.
Enrollment and Written Informed Consent
For the whole study, including the parasitologic survey, preventive chemotherapy, the KAPB survey, and the interventions (CLTS and CHEP), village authorities were contacted once ethical approval had been granted. The objectives, procedures, and potential risks and benefits were explained. Subsequently, the community was informed about the aims and procedures. A patient information sheet was administered to all participants, explaining objectives, procedures, and potential risks and benefits of the study. Names and contact address of the main investigators were readily provided on this information sheet so that investigators could be contacted anytime if need be. For illiterate participants, the information sheet was read aloud, and, if necessary, an oral translation of the information into a local language was provided in the presence of a team member and a witness from the community. Written informed consent was obtained from each participant, with parents/guardians consenting on behalf of children (aged <18 years). It was emphasized that participation is voluntary, and hence, participants could withdraw from the study at any time without further obligation. Moreover, it was mentioned that preventive chemotherapy was provided to all people in the study area, not just those who decide to participate, free of charge through the national control program.
Inclusion and Exclusion Criteria
All household heads or their representatives of the selected households of the 56 communities were invited to participate in the questionnaire survey, and all children aged 5 to 15 years, 1 infant (aged 12-24 months), and 1 adolescent or adult (aged >15 years) from these households were invited for parasitologic examination, unless they met any of the following exclusion criteria: (1) no written informed consent or no parental/guardian’s permission to participate; and (2) too sick to participate in the study, as determined by qualified medical personnel. All members of the intervention communities were invited to participate in the implementation of CLTS and the CHEP sessions.
Cross-Sectional Surveys
Four teams were formed, each consisting of 1 driver, 2 laboratory technicians, 2 laboratory assistants, 3 field enumerators, 1 parasitologist/epidemiologist (team supervisor), and 1 social scientist. Each team was responsible for carrying out the cross-sectional parasitologic, anthropometric, and KAPB survey in their designated communities. The teams were based in 2 central laboratories of the study area, which are in close proximity to the survey locations. Moreover, 1 to 2 weeks before a cross-sectional survey, the study team visited the communities to announce the upcoming activities and to provide village authorities and inhabitants with exact dates and procedures of the survey.
Parasitologic Surveys
A day before the first sampling, the study team conducting the survey visited the selected households and distributed empty plastic containers for stool and urine collection. The team revisited the households to collect the samples early in the morning of the next day [ 40]. Stool and urine samples were transferred to laboratories at the general hospitals of Taabo and Djékanou, the community health center at Kpouèbo, or a mobile field laboratory set up at the dispensary of Léléblé.
Participants’ infection status with helminths ( A. lumbricoides, hookworm, Schistosoma mansoni, and T. trichiura), pathogenic intestinal protozoa ( Giardia intestinalis, Entamoeba histolytica/E. dispar), as determined in stool samples, and S. haematobium,determined in urine samples, were recorded. From each stool sample, duplicate Kato-Katz thick smears were prepared, using a standard template holding 41.7 mg of feces [ 34]. The slides were allowed to clear for 30 to 45 min before examining under a microscope by experienced laboratory technicians. Helminth eggs were counted and recorded for each species separately. For quality control, approximately 10% of the slides, selected at random, were reexamined by a senior laboratory technician [ 41]. Urine samples were examined for microhematuria using reagent strips (Hemastix; Siemens Healthcare Diagnostics GmbH, Eschborn, Germany). A subsample of 10% of urine specimens was subjected to a filtration method for evaluation of the reagent strip results. Ten milliliters of vigorously shaken urine were pressed through a membrane (diameter: 13 mm; pore size: 30 µm; Sefar AG, Heiden, Switzerland) and the membrane placed on a microscope slide. A drop of Lugol’s iodine was added on the slide, and the number of S. haematobiumeggs was counted under a microscope by experienced laboratory technicians [ 42].
In addition, 1 to 2 g of stool from each specimen was transferred into small tubes, filled with 10 mL of sodium acetate-acetic acid-formalin (SAF) for subsequent diagnosis of intestinal protozoa. In short, the SAF-fixed stool samples were forwarded to a laboratory at the Université Félix Houphouët-Boigny in Abidjan and subjected to an ether-concentration method and examined under a microscope by experienced laboratory technicians. We adhered to a standard protocol [ 43].
Anthropometric Measurements
In intervention arms 1 and 4, infants aged 12 to 24 months were assessed for standard anthropometric measures, including weight (to the nearest 0.1 kg; mothers holding their infant were weighed with a portable scale, and then the weight of the mother was subtracted to obtain the weight of the infant) and height (measured to the nearest cm using a portable centimeter scale). Nutritional status of children at baseline and follow-up was evaluated using the following indicators: underweight (weight for age), stunting (height for age), and wasting (weight for height).
Knowledge, Attitudes, Practices, and Beliefs Surveys
People’s KAPB were assessed, using a combination of direct observations and interviews (questionnaire surveys, in-depth interviews, and FGDs). All the components of the KAPB study were conducted in parallel to the baseline and follow-up parasitologic and anthropometric surveys.
The main topics that were investigated in the KAPB survey pertained to perceived needs of sanitation facilities, common defecation practices, availability and use of latrines, associations of defecation and hygiene behavior (eg, washing hands), general knowledge of health risks associated with (open) defecation, signs and symptoms of parasite infections, and how such infections can be prevented and treated [ 24]. Direct observations and questionnaires were addressed to household heads or their representatives at the unit of the household in the 56 communities. Questionnaires were designed in a semistructured manner with mainly closed but also a few open-ended questions to gather quantitative and qualitative data for the analyses. All interviews were conducted by trained field enumerators in French or local languages. Before the start of the survey, the questionnaire and the direct observation checklist were pretested in neighboring communities that were not part of the study, as done in previous research [ 44, 45].
FGDs were conducted with different groups; namely (1) adult women; (2) adult men; (3) school-aged children; and (4) the elderly. FGDs were conducted in 8 villages; 2 villages per intervention arm. In each FGD, 8 to 10 individuals were invited to participate [ 46]. FGDs were tape-recorded for subsequent transcription and analysis. In-depth interviews were conducted with community health workers and traditional healers in the same 8 villages.
Diarrhea Monitoring
We monitored the incidence of diarrhea (duration and severity) over a 24-month period. Every second week, a short questionnaire was administered by community health workers to all members of the 30 selected households per community, starting right after the baseline cross-sectional survey. For the youngest children who were not able to answer the questionnaire, their mothers/caregivers were interviewed.
Implementation of Interventions
The interventions were implemented after the baseline cross-sectional survey. The CLTS intervention was started in the communities of intervention arms 2 and 4. Only after these communities had commenced building latrines, the CHEP was launched in the communities of intervention arms 3 and 4 to avoid interference with the methodological approach of the CLTS intervention (see section Community-Led Total Sanitation) in arm 4. Preventive chemotherapy was done according to ongoing activities of the national helminthiasis control program of the Ministry of Health in Côte d’Ivoire. These activities consist of community-based yearly mass administration of ivermectin and albendazole (against lymphatic filariasis) and yearly administration of praziquantel and albendazole (against schistosomiasis and soil-transmitted helminthiasis) to at-risk groups, adhering to WHO guidelines [ 47].
Preventive Chemotherapy
After the baseline cross-sectional survey, in October 2014, all participants found positive for S. mansoni,or S. haematobium, or both, received a single 40 mg/kg oral dose of praziquantel using a dose pole for individuals aged 4 years and older, whereas albendazole (single 400 mg dose for participants aged >2 years and 200 mg for 1- to 2-years-old children) was administered against soil-transmitted helminths [ 48]. Thereafter, annual preventive chemotherapy was administered in the frame of the on-going helminthiasis control activities by the Ministry of Health in Côte d’Ivoire. Annual preventive chemotherapy against lymphatic filariasis was done between May and June and against schistosomiasis between October and November. Participants with persistent diarrhea identified during the diarrhea monitoring received oral rehydration solutions and, if needed, were referred to nearby health facilities.
Community-Led Total Sanitation
The CLTS approach is based on participatory rural appraisal that emphasizes that the learning effect is considerably higher if knowledge is acquired through self-experience and self-reflexion. It facilitates critical analysis by the community of their own sanitation profile, their practices of defecation, and the consequences, leading to collective action to become open defecation-free [ 49, 50]. The approach thus focuses on the whole community and their cooperation and interactions because the community only profits when every single community member cooperates and takes action [ 51]. CLTS is a grassroots, community-based, and community-led strategy that triggers community empowerment via feelings of shame and disgust induced through observation of the defecation situation in a specific setting and its environment, which is often missed by health education [ 52, 53].
Before the intervention, CLTS facilitators were trained and instructed during a 1-week workshop by certified national CLTS facilitators from the Ministry of Sanitation, UNICEF, and a Swiss-based nongovernmental organization (FAIRMED). Communities were contacted, and a first community meeting was organized. During this meeting, the ignition process of CLTS was started, which could include the following components according to Kar and Chambers [ 27]: (1) transect walk (“walk of shame”) through the open defecation areas and water points; (2) defecation map, mapping of defecation areas and defecation mobility; (3) identifying the dirtiest neighborhoods; (4) calculation of feces amount and medical expenses; and (5) triggering disgust pathways of fecal contamination (glass of water, feces to food exercise, flow diagrams of fecal-oral routes, etc). These components were used to initiate the ignition moment (we are eating each other’s feces!). When talking about feces, the term “caca” was employed, as “caca” had been identified as the most suited and culturally accepted term by CLTS facilitators in Côte d’Ivoire. Subsequently, 2 more steps were pursued that include the identification of natural leaders and the monitoring and sustaining of open defecation-free status or the process toward an open defecation-free community. Although CLTS encourages the communities to build basic sanitary facilities (ie, latrines), to change one’s hygiene behavior, and to alter people’s waste disposal practices, it does not impose standard designs and does not provide subsidies. Hence, for toilet construction, most communities used readily available local material, so that toilets were more affordable and accessible for rural communities. When a given community decided to go toward open defecation-free status, an implementation plan of community-based basic sanitation and hygiene services was elaborated. This community was frequently visited by the community development agents to ensure that the implementation of the different actions was done according to protocol.
Community Health Education Program
Once communities were well advanced or staggered with the construction of latrines, they were visited by the research team, and a first health education session was offered for the entire community, based on results from the preceding FGDs that facilitated the social science team to identify knowledge gaps and related key health messages. In each community, interested community members (up to 10) were identified (mostly by the village chief and other village authorities) and invited to form a community health theater group. In a further visit, the community theater group received an additional health education session by the team and was coached to develop its own sketch to deliver hygiene and health messages in front of the community. In a final visit, the theater group presented the sketch to the community, and during this visit, the animated cartoon was screen played to children, although adults were also invited to watch. After the theater and screening of the cartoon, people were grouped into adult women, adult men, school-aged children, and the elderly, and discussions about health and hygiene topics were pursued to determine their understanding.
Statistical Analysis
Data collected from the parasitologic and anthropometric surveys and the monitoring of diarrheal episodes were double entered and cross-checked in EpiInfo version 3.5.3 (Centers for Disease Control and Prevention; Atlanta, GA, USA). Household questionnaire data and direct observations were entered on tablets, using open data kit, and uploaded on a server hosted at the Swiss Tropical and Public Health Institute (Swiss TPH; Basel, Switzerland). Statistical analyses were done on STATA, version 14 (Stata Corp; College Station, TX, USA).
To receive a standard infection intensity measure of eggs per 1 g (EPG) of stool, helminth species–specific egg counts from the individual Kato-Katz thick smears were multiplied by a factor of 24. For each individual, the arithmetic mean egg count was estimated. The geometric mean of the helminth infection at the population level was calculated from the arithmetic means of the individual infection intensities. To assess the effect of the interventions, helminth egg count reductions were determined as 1 − (geometric mean EPG after 1 year at follow-up/geometric mean EPG at baseline) multiplied by a factor 100and compared between intervention groups.
The nutritional status for children aged <5 years was determined using available macros for STATA version 10.1 with child growth standards and references published by WHO [ 54] and means between intervention groups, compared between baseline and follow-up. The same approach was used for diarrheal episodes, whereas the prevalence is being defined as the percentage of days with diarrhea, calculated as the number of days with diarrhea divided by the total number of days of observation. Incidence is defined as the number of new episodes divided by the number of days at-risk, which is defined as the number of days of observation minus the number of days with diarrhea self-diagnosis, allowing for 2 illness-free days between episodes [ 55].
Random effect logistic regression models were used to assess the effect of interventions on infection, anthropometric, diarrhea, and KAPB outcomes, using a factorial design. Qualitative data gathered from the FGDs were transcribed and processed in MaxQDA 10/Atlas version 1 (VERBI Software Consult; Berlin, Germany). The coded data were analyzed for the frequency at which coded information and content categories occur. The most frequently occurring topics concerning the study population’s KAPB were analyzed for change after the implementation of CLTS and/or CHEP.
Dissemination of Key Findings
Progress and key results of this cluster randomized trial were communicated at annual workshops with key decision makers and other stakeholders, including community members.
Results
The project was funded in May 2013 and enrollment was completed in September 2014. Baseline, follow-up I, and follow-up II surveys were completed in September 2014, February 2016, and November 2017, respectively. Data analysis is currently under way, and the first results are expected to be submitted for publication in 2018. The findings will be published in peer-reviewed literature and presented at national and international conferences.
Discussion
Neglected tropical diseases, including soil-transmitted helminthiasis, schistosomiasis, giardiasis, and amoebiasis, are important public health issues in Côte d’Ivoire and elsewhere in low- and middle-income countries [ 14, 56- 58]. Indeed, a recent national school-based survey in 94 schools across Côte d’Ivoire revealed that 26% of children aged 5 to 15 years had a helminth infection [ 59]. Giardiasis and amoebiasis were reported from community- and school-based surveys in different parts of Côte d’Ivoire [ 30, 60, 61]. The aim of this project was to assess the effect of an integrated control package, consisting of preventive chemotherapy with either CLTS or CHEP, or all measures combined in 56 small rural communities of south-central Côte d’Ivoire, using a cluster randomized trial. The goal was to generate new evidence to determine whether an integrated control package, including community-based approaches, is useful for the control of helminth and intestinal protozoa infections and thus to assist decision making in translating global policy into local practice.
A previous pilot study in Côte d’Ivoire revealed that CLTS coupled with health education and preventive chemotherapy has the potential to decrease the incidence of helminth and intestinal protozoa infection, although heterogeneity from one community to another rendered interpretation of the results somewhat difficult [ 33]. Notwithstanding, a recent cluster randomized study in Mali found no effect of CLTS on diarrhea 18 months after implementation of the intervention, but a significant beneficial effect on children’s anthropometric measures, as children from the intervention group were significantly less stunted [ 62]. Of note, the authors used a cross-sectional design for assessing diarrheal incidence at 2 time points (baseline and end line). In this protocol, diarrhea was monitored longitudinally over a 24-month period with 2-week intervals, which should capture subtle fluctuations. Two recent cluster randomized trials from India showed no effect on diarrhea, soil-transmitted helminths, and child malnutrition and highlighted the difficulty to achieve high coverage of latrine use at a large scale to demonstrate expected health outcomes [ 63, 64].
There is considerable interest in the scientific community and among disease control program managers to bring integrated approaches into action, although the challenges of scaling up such integrated, intersectoral, multidisease control approaches are recognized [ 65, 66]. CLTS holds promise to decrease diarrhea, helminthiases, and intestinal protozoa infections, yet, limitations with regard to achieving open defecation-free status and sustainability exist. Our previous work in Côte d’Ivoire has provided evidence that health education interventions can improve adherence of communities to CLTS and thus increase the success rate of such an intervention [ 33]. A further limitation of our study is that the distance between communities was sometimes relatively small, and contamination cannot be completely excluded. Although, it has to be emphasized that in this particular study area, the difficult physical accessibility to communities can limit contamination even if communities are relatively close. Furthermore, although during the CLTS and CHEP interventions, it was emphasized that a hand washing facility needs to be provided next to the latrines (eg, bucket with water and soap) and before eating, hands need to be washed with soap, no specific water access intervention was included in the study, which might have an impact on infection outcomes. Finally, sample size was limited by the size of the communities because of the methodological approach of CLTS. Indeed, communities up to a maximum size of 500 to 600 members are more likely to adhere to CLTS compared with larger communities.
This study and experiences gained elsewhere [ 67] will shed new light on the effect of integrated approaches on different outcomes, including parasitic infections (soil-transmitted helminths, schistosomes, and intestinal protozoa), incidence of diarrhea, anthropometric measures, and KAPB of populations. Furthermore, this line of scientific inquiry will enhance our knowledge of community acceptance regarding integrated control approaches, including strengths and limitations, and provide important information for existing sanitation and health programs in Côte d’Ivoire and elsewhere.
Acknowledgments
The authors thank Dr Jan Hattendorf for carrying out the randomization and for inputs on the manuscript. The authors acknowledge financial support from UBS Optimus Foundation (Zurich, Switzerland) and the Rudolf Geigy Foundation (Basel, Switzerland).
Authors' Contributions
GR wrote the manuscript. GR and JU revised the manuscript. EH produced the map. GR, BB, EKN, and JU designed the study. All authors read and approved the manuscript.
Conflicts of Interest
None declared.
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Abbreviations
Edited by G Eysenbach; submitted 12.10.17; peer-reviewed by S Nery, R Bergquist, I Suresh; comments to author 25.01.18; revised version received 05.03.18; accepted 10.03.18; published 12.06.18
Raso G , Essé C , Dongo K , Ouattara M , Zouzou F , Hürlimann E , Koffi VA , Coulibaly G , Mahan V , Yapi RB , Koné S , Coulibaly JT , Meïté A , Guéhi-Kabran M , Bonfoh B , N'Goran EK , Utzinger J An Integrated Approach to Control Soil-Transmitted Helminthiasis, Schistosomiasis, Intestinal Protozoa Infection, and Diarrhea: Protocol for a Cluster Randomized Trial JMIR Res Protoc 2018;7(6):e145 doi: 10.2196/resprot.9166 PMID: 29895511 PMCID: 6019843
| https://www.researchprotocols.org/2018/6/e145 |
Motion-Secondary: Brett A. Phillips v. The Town Of Floyd, Patrick J Aughe, Joanne C Aughe, Lloyd A Miller | Trellis.Law
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Motion-Secondary: Brett A. Phillips v. The Town Of Floyd, Patrick J Aughe, Joanne C Aughe, Lloyd A Miller
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. .
FILED: ONEIDA COUNTY CLERK 06/05/2018 08:55 AM INDEX NO. EFCA2017-001763
NYSCEF DOC. NO. 25 RECEIVED NYSCEF: 06/05/2018
STATE OF NEW YORK
SUPREME COURT COUNTY OF ONEIDA
*********************************************
BRETT A. PHILLIPS,
RESPONSE TO DEMAND FOR
Plaintiff, STATEMENTS, WITNESSES,
-vs- ACCIDENT
PHOTOGRAPHS,
REPORTS, AND INSURANCE
PATRICK J. AUGHE, JOANNE C. AUGHE, INFORMATION
LLOYD A. MILLER, individually and acting on
behalf of the Town of Floyd, TOWN OF FLOYD, Index No.: EFCA2017-001763
jointly and severally,
Defendants
**********************************************
Plaintiff, Brett A. Phillips, as and for a Response to Defendants', Patrick J. Aughe and
Joanne C. Aughe, Demand for Statements, Witnesses, Photographs, Accident Reports, and
Insurance, the Plaintiff, sets forth as follows:
1. There are no statements from the Defendants relating to the accident out of which
this action arises. However, should any statements become available same will be
Defendants'
forwarded to the Attorney promptly.
2. The names and addresses of the following witnesses:
a. Eyewitnesses to the incident alleged in the Complaint:
The Plaintiff is unaware of any eyewitnesses to the incident. Should any
witnesses become available same will be forwarded promptly to the
Defendants'
Attorney.
b. Witnesses to any alleged defective conditions:
The Plaintiff is unaware of any eyewitnesses to the incident. Should any
witnesses become available same will be forwarded promptly to the
Defendants'
Attorney.
1 of 20
FILED: ONEIDA COUNTY CLERK 06/05/2018 08:55 AM INDEX NO. EFCA2017-001763
NYSCEF DOC. NO. 25 RECEIVED NYSCEF: 06/05/2018
c. To any notice to Defendants:
The Plaintiff is unaware of any witnesses to any notice given to the
Defendants. Should any witnesses become available same will be forwarded
Defendants'
promptly to the Attorney.
d. To any admission by Defendants:
The Plaintiff isunaware of any witnesses to any admission by the Defendants.
Should any witnesses become available same will be forwarded promptly to
Defendants'
the Attorney.
e. To any other element reflecting on liability:
The Plaintiff is unaware of any witnesses to any other element reflecting on
liability. Should any witnesses become available same will be forwarded
Defendants'
promptly to the Attorney.
f. Pursuant to the Rule set forth in Troup vs Midland-Ross Corporation, 94
(4th
A.D.2d 949, 464 N.Y.S.2d 74 Dept., 1983) and CPLR 3101, copies of
statements, written or otherwise, of each and every other party to the instant
litigation, their agents, servants and/or employees:
The Plaintiff is unaware of any statements, written or otherwise. Should any
statements, written or otherwise become available same will be forwarded
Defendants'
promptly to the Attorney.
g. Witnesses in connection with any issues concerning damages:
The Plaintiff is unaware of any witnesses in connection with any issues
concerning damages. Should any witnesses become available same will be
Defendants'
forwarded promptly to the Attorney.
2 of 20
FILED: ONEIDA COUNTY CLERK 06/05/2018 08:55 AM INDEX NO. EFCA2017-001763
NYSCEF DOC. NO. 25 RECEIVED NYSCEF: 06/05/2018
"A"
3. Attached hereto and made a part hereof as Exhibit is a photograph of where the
Defendant's, Lloyd A. Miller, truck was sitting in the road prior to the accident.
Should any further photographs become available same will be provided promptly
Defendants'
to Attorney.
"B"
4. Attached hereto and made a part hereof as Exhibit is a copy of the Police
Accident Report and Accident Information Exchange Form. Should any further
Defendants'
reports become available same will be provided promptly to the
Attorney.
5. The Plaintiff is not in possession of any data from any vehicle involved in the
accident. Should any data become available same will be provided promptly to the
Defendants'
Attorney.
"C"
6. Attached hereto and made a part hereof as Exhibit is a copy of the Estimate of
Record for the repairs of Plaintiff's vehicle. Should any further documents become
Defendants'
available same will be forwarded promptly to the Attorney.
Dated:
gy y
WILLIAM M. ESQ.
BORRILL,
Attorney for Plaintiff
23 Oxford Road
New Hartford, New York 13413
(315) 223-3084
TO: BURGIO, CURVIN & BANKER
JAMES P. BURGIO, ESQ.
Attorney for the Defendants
496 Main Street
Buffalo, New York 14202
(716) 854-1744
3 of 20
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NYSCEF DOC. NO. 25 RECEIVED NYSCEF: 06/05/2018
VERIFICATION
STATE OF NEW YORK)
COUNTY OF ONEIDA ) ss.:
BRETT A. PHILLIPS, being duly sworn, depose and say that deponent is the Plaintiff in
the within action and have read the foregoing Response to Demand for Statements, Witnesses,
Photographs, Accident Reports, and Insurance; that the contents of said Response to Demand for
Statements, Witnesses, Photographs, Accident Reports, and Insurance are true to the knowledge of
Plaintiff, except as to the matters therein stated to be alleged upon information and belief, and as to
those matters deponent believes itto be true.
/z~ /'~
BRETT A. PHILLIPS
Subscribed and sworn to before me
this day of
f~ , 2018
Public-
-Notary
PAMELA RETTlG
State of New York
Notary Pubhcin the
Oualifled in Oneida County 01RE60482
Sept,25, 20
My CommisatonExptrea
4 of 20
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NYSCEF DOC. NO. 25 RECEIVED NYSCEF: 06/05/2018
CLIENT CERTIFICATION
I, BRETT A. PHILLIPS, HEREBY CERTIFY, under penalty of perjury, that I have
carefully read and reviewed the annexed Response to Demand for Statements, Witnesses,
Photographs, Accident Reports, and Insurance and that all information contained in this document
is true and accurate in all respects to the best of my knowledge and understanding.
I FURTHER CERTIFY, under penalty of perjury, that neither my attorney, nor anyone
action on my attorney's behalf, was the source of any of the information contained in the annexed
document, that I provided all of the information contained in the annexed document to my attorney,
and that I understand that my attorney, in executing the Attorney Certification required by 22
NYCRR 202 16(e), is relying entirely upon the information provided by me and upon my
certification that allsuch information is true and accurate.
I FURTHER CERTIFY, that the annexed document includes all information which
provided to my attorney which is relevant to such document and that my attorney has not deleted,
omitted or excluded any such information.
I FURTHER CERTIFY, that my attorney has advised me that he isrequired to provide his
own certification regarding the information contained in the annexed document. My attorney has
advised me thathe is relying on the truth and accuracy of all information that I have given to him
in executing that certification.
Dated: '')
/'
BRETT A. PHILLIPS
5 of 20
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NYSCEF DOC. NO. 25 RECEIVED NYSCEF: 06/05/2018
ATTORNEY CERTIFICATION
I hereby certify to the best of my knowledge, information and belief, formed after an inquiry
reasonable under the circumstances, the presentation of the Response to Demand for Statements,
Witnesses, Photographs, Accident Reports, and Insurance or the contentions therein are not frivolous
as defined in Part 130-1.1( c ) of the Rules of the Chief Administrator.
Dated: g. Jg.
@At
WILLIAM M. BORRILL
CERTIFICATION PURSUANT TO 22 N.Y.C.R.R. SECTION 130-1.1-a
To the best of the undersigned's knowledge, information and belief, formed after an inquiry,
reasonable after the circumstances, the presentation of the attached papers or the contentions therein
are not frivolous, as that term is defined in 22 N.Y.C.R.R part 130.
Date±
~ .gg
WILLIAM M. BORRILL, ESQ.
6 of 20
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NYSCEF DOC. NO. 25 RECEIVED NYSCEF: 06/05/2018
Page 1 of 3 Pages New York StateDepartment of Motor Vehicles
Local Codes ~
~ POLICE ACCIDENT REPORT
17-02969
MV-104A (6/04)~x 13
J8P4576MHQ2P lAMEMD RE:
I
2
AccidentDate
Month
2
VEHlCLE
Day
13
1- Dnver
Year
2017
VEHICLE
KS~MWW~W~I
am~mwm~mm~m
Day of Week
Monday
1 1
Military Time
12:35
No of
Vehicles
2
No Injured
1
No Killed
jVr) VEHICLE
0
2 2(
VEHICLE 2- Driver
State of Lic
Not Investigatedat Scene
- - -
- - - - - - - -
- --
Accident Reconstructed
BICYCLIST I ) PEDESTRIAN
Left Scene
i
Police Photos
YesE No
OTHER PEDESTRIAN
-
State of Lic
L
66
License ID Number ~
245763652~~ ~ NY License ID Number 906685731 NY NY 21
Driver Name - exactly Driver Name - exactly
as printed on license
AUGHE, PATRICK J as printed on license
PHILLIPS, BRETT A A m~
Address (include Number and Street) Apt.No Address (include Number and Street) Apt No
W
POBOX 173 2120 HIGHLAND AVE
- 3
City or Town
REMSEN
State
NY
Zip Code City or Town
UTICA
State
NY
Zip Code
22
13438 135020000
1 Dateof Birth Sex Unhcensed No of Occupants
Public Dateof Birth Sex unncensed No. of Occupants PI
Public
Month Uay Year -- Month Day Year --
Properly Property
M __j 01 01 Damaged M [ 01 01 Damaged
Name- pnnted
exactly onregistration
on Sex DateofBirth Name- exactlyasprintedonregistrallon Sex Dateof Birth
Mo Day Year Month Da YearYear
AUGHE, JOANNE C C F PHILLIPS, BRETT A M
1 Address(IncludeNumberandStreet) Apt No Haz | ReleasedAddress(IndudeNumberandStrcot) Haz Rele s
Apt No
----12301230FRANCIS ST ST ~ i l 2120 HIGHLAND AVE ~ 24
Cityor Town State ZipCode ~~ CRyorTownTav/n StateSlala ~~
ZipCodeCade
5 UTICA NY 13502 I UTICA x NY NY 13502 5
1 PlateNumber Stateof Reg~ VehicleYear& MakeMake ~
van cie ype
Ins Code PlateNumber Stateof Reg~ VehicleYear& MakeMakeVehicleType ype Ins.Code
~~
CZF5848 8Iflr)II~ NY NY 2002 PONT ~ 4 DSD DSD 356 GJF4754 NY NY 1996 DODG ~ ~ PICK 639 ~ ~
Ticket/Arrest Ticket/Arrest
Number(s) Number(s)
6 ~
~alion
Violation ~ ~
Violation 13
Section(s)an(s) Section(s)
Check d Involved vehicle rs ' ~ vehicle is
check if~lnvalved
~
~ ICircle the diagram below that describes the accident, or draw your own own
~
~
more than than
95 inches w de, more than than 95 v
wide; wide, diagram in space ¹9 the vehicles. cles
' long; ong,
more than than ~ ~ more than than ~ ~
long; long,
E .. E RearEnd LeftTum RightAngleRightTorn HeadOn
7
C
H ~
operated
operated
overweight permit;H
overdimension permit.
C
t
~
operated
operated
overweight permit;
RWIH
overdimension permit.
4-
Sideewf LeftTum RR~m
RightTum
---w
Sidmip6
+ 26
20
VEHICLE 1 DAMAGE CODES VEHICLE 2 DAMAGE CODES (same irection) (oppoonesection)
L Box 1 - Point of Impact
3
1 2 L Box 1 - Point of Impact 1 2 t,g.,__ +
E Box 2 - Most Damage E Box 2 - Most Damage ~ ---
Enter up to three 3 4 5 Enter up to three 3 4 5 ACCIDENT DIAGRAM 27
1 -'---
more damagecodes 3 1 2 2 ''
more damage ---
codes 12 1 2
2
Vehicle By: NIMEY'S
Towed To: ~NIMEY'S
Vehicle By:
Towed To: ~
See the last page of the MV-104A for the -m
accident diagram.
VEHICLEDAMAGECODING:
1-13SEEDIAGRAMONRIGHT.
14.UNDERCARRIAGE17.DEMOLISHED 2 is 8 ._
15.TRAILER 18.NODAMAGE . - -
to any one vehicle will
Cost of repairs be morethan $1000
16,OVERTURNED~ 19.OTHER
Unknown/Unableto determine Yes No
Reference MarkerCoordinates (if available)
Place Where Accident
Occurred:
Latitude/Northing i County ONEIDA ~
' 1 City . -
Village Town of ~
3 6 5 FLOY D
. Road on which accident occurred
STATE ROUTE 3 65
I (RouteNumberorStreetName)
Longitude/Easting ~ at 1) intersecting street
. (RouteNumberorStreetName)
or 2) -25 - ÏN S RITCHIE ROAD ~
3 O 6 8
feet mtles E W Nearestintersecting
(Milepost, RouteNumberorStreetName)
Accident Description/Officer's notes 30 I
Vehicle 1 was traveling west on State Route 365 when the operator observed a red pick-up truck
operated by Lloyd A. Miller stopped in traffic. Vehicle ] attempted to pass the red pick-up on
the right to avoid oncoming traffic. While overtaking the red pick-up, the snow caused the
operator to lose control vehicle 1 and impact vehicle 2 causing damage to both vehicles. Operator
of vehicle 2 was transported to Rome Memorial Hospital for a report ed
8 9 10 11 12 13 14 15 16 17 BY TO 18 Names of all involved Date of Death Only
A 1 1 4 1 30 M - - AUGHE, PATRICK J J
_
...
- B 2 1 4 1 58 OD M 06 12 6 9999 3204 PHILLIPS, iBRETT A A
---
)m~~M~QMIR~~~
Imm
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mal
~R~~MNS~
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O,'ficer's Rank Badge/ID No. ~NCIC No. ~ Precint/Post ~ Station/Beat
Reviewing Officer Date/Time Reviewed~
DE PUTY
and Signature Troop/Zone Sector
STOCKHAUSER, 2/Ii]/2017
CRAIG 09:r)6
09: 46
10 of 20
.
FILED: ONEIDA COUNTY CLERK 06/05/2018 08:55 AM INDEX NO. EFCA2017-001763
NYSCEF DOC. NO. 25 RECEIVED NYSCEF: 06/05/2018
Page 2 of 3 Pages New York StateDepartment of MolOr Vehicles
Local Codes
POLICE ACCIDENT REPORT
17 - 0 2 9 6 9
t,r.~ Ocr
(S/04j
J8P457 GNHQ2 P [-~} AMECED REPORT
1 -
ccident ale Day of Week Military TimeNo. of No. Injured Not Investigated at Scene
No. Killed ) ) Left Scene
Police Photos
Month av ear Vehicles -
- - - - - - - - - - - - -
2 13 2017 Monday 12:35 2 1 0 Accident Reconstructed LI YesQ)vrNo
VEHICLE VEHICLE ( BICYCLIST i,)
,'.BICYCLIST PEDESTRIAN OTHER PEDESTRIAN
!+
2
21
22
3
23
4
24
5
G
Circle the diagram below that describes the accident, or draw your own
V diagram in space #9. Number the vehicles
E F RearEnd 1.eftTum ghtAngleRightTirn HeedOn
7 H H
5. 7.
+ +
I
LeftTum Right
C C
L L
E E
ACCIDENT DIAGRAM 27
VEHICLEDAMAGECODING: 4 ~ e
0 1
1-13SEEDIAGRAMONRIGHT.
9.
14.UNDERCARRIAGE17.DEMOLISHED a ta
15.TRAILER 18.NODAMAGE Cost of repairs to any one vehicle will be more than $1000
16.OVERTURNED 19.OTHER
I a ,: Unknown/Unableto determine Yes No
ls II IO
Reference Marker Coordinates (if available)
Place Where Accident Occurred:
'
Latitude/Northing County ONE 1 DA City Village I Town of
[-)
) I
Poad on which accident occurred
I \ I (HouteNumberor
tree( smc)
\ ~
Longitude/Easting at 1) intersecting street
.., (RouteNumberor StreetName)
• I or 2) N i S
) I i of
feet miles( ,E E ';.W Nearestintersecting
(Mdepost, RouteNumberor SheetName)
Accident Description/Officer's notes 30
hack injury. Vehicle 1 was towed from scene.
.".cene. WITNESS ill LLOYD A MILLER 8757 STATE RTE 365
STITTVl¯LLE, ) NY 3 34
) )un
G9 (315) & G5-5957
) .).'DI
N
8 9 , 10 11 12 13 14 15 16 17 BY TO 18 Names of all involved Date of Death Only
A
L
L
I
N
V -
0
L
V
JfficerRank -- 3adge/1 ) No. NCIC No. Precint/Postitation/Beat Reviewing Officer )ate/Time Reviewed
E
ind Signature Troop/Zone >ector
D . 3TOCKHAUSER, 2/14/2017
11 of 20
.
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NYSCEF DOC. NO. 25 RECEIVED NYSCEF: 06/05/2018
F-age 3 of 3 Pages New York StateDepartment of Motor Vehicles
Local Codes
P RACCIDENT REPORT
17-02969
MV-104A (6/04)
J8 P4576MHQ2P I I AMENDED REPORT
cc eatoate Day omeek he No of
Monlh Year May
Ue°hices
No InjuredNo. Killed
Not Investigated at Scene( Left Scene
Police Photos
Day
2 13 2017 Monday 12:35 2 1 0 Accident ReconstructedI I Yes ]v'j
No
[Q [
8767 State Route 365
V
V1
~+vtrl
State Route 365
12 of 20
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NYSCEF DOC. NO. 25 RECEIVED NYSCEF: 06/05/2018
ACCIDENT INFORMATION EXCHANGE FORM
NY State Law that any accident
requires in a fatality
resulting . . damage to property
of anyperson (including damage to your vehicle)
or entity
over
be reported
by YOU to the Departmentof Motor
Ven .'-: i with o days after
an accident Failure to report an accident
or failure
to give correct
infor mation
is a misdemeanorand may result
in the suspend -. ation of yur driver's
license(or oper ating priviledge
in NYS) and all vehicle
certifications
or registrations.
Veir-
Report your Accident toDMV on DMV form MV-104 (Report ofMotor Vei,"le Accident).PoliceAccident Reports (DMV form MV-104A) DO NOT
YOUR
satisfy civilian
reportingrequirement.
Accident Report # LocalCodes Date Time # of Veh. Town, City,Road Nam
J8P4576MHQ2P 17-02969 02/13/2017 12:35 PM 2 FLOYD. TOWN OF - 3358 STATE ROUTE 365
PoliceAgency Name/Badge
Officer's ID#
ONElDA CO. SHERIFF - 03200 BAXTER NICHOLAt J.I 28650
VEHICLE # 001
Operator'sName Date of Birth ~. ss
AUGHE PATRICK J
Case Info
Judge
David A Murad Track Judge’s New Case
Case No.
Document Filed Date
June 05, 2018
Case Filing Date
August 31, 2017
County
Category
Torts - Motor Vehicle
Status
BORRILL, WILLIAM MARKAttorney for the Plaintiff
MULLIN, PAUL VINCENTAttorney for the Defendants
BURGIO, JAMES PHILIPAttorney for the Defendants
BURGIO, JAMES PHILIPAttorney for the Defendants
KLUCSIK, JENNA WHITEAttorney for the Defendants
MULLIN, PAUL VINCENTAttorney for the Defendants
Brett A. PhillipsPlaintiff
Lloyd A MillerDefendant
Joanne C AugheDefendant
Patrick J AugheDefendant
The Town of FloydDefendant
| https://trellis.law/doc/12964837/response-to-demand-exhibits-attached |
(PDF) Hair follicle regional specificity in different parts of bay Mongolian horse by histology and transcriptional profiling
PDF | Background: Different morphological structures of hairs having properties like defense and camouflage help animals survive in the wild... | Find, read and cite all the research you need on ResearchGate
Hair follicle regional specificity in different parts of bay Mongolian horse by histology and transcriptional profiling
DOI: 10.1186/s12864-020-07064-1
CC BY
Authors:
Wu Yihan
Yiping Zhao
Bei Li
Bei Li
Abstract and Figures
Background:
Different morphological structures of hairs having properties like defense and camouflage help animals survive in the wild environment. Horse is one of the rare kinds of animals with complex hair phenotypes in one individual; however, knowledge of horse hair follicle is limited in literature and their molecular basis remains unclear. Therefore, the investigation of horse hair follicle morphogenesis and pigmentogenesis attracts considerable interest.
Result:
Histological studies revealed the morphology and pigment synthesis of hair follicles are different in between four different parts (mane, dorsal part, tail, and fetlock) of the bay Mongolian horse. Hair follicle size, density, and cycle are strongly associated with the activity of alkaline phosphatase (ALP). We observed a great difference in gene expression between the mane, tail, and fetlock, which had a greater different gene expression pattern compared with the dorsal part through transcriptomics. The development of the hair follicle in all four parts was related to angiogenesis, stem cells, Wnt, and IGF signaling pathways. Pigmentogenesis-related pathways were involved in their hair follicle pigment synthesis.
Conclusions:
Hair follicle morphology and the activity of ALP differ among four body parts in bay Mongolian horse. Hair follicles of the different body parts of the are not synchronized in their cycle stages. GO terms show a regional specificity pattern between different skin parts of the bay Mongolian horse. These results provide an insight into the understanding of the biological mechanism of the hair follicle in other mammals.
Hair length in different parts of horse showing differences among breeds. a is an Arabian horse (https://en.wikipedia.org/wiki/Arabian_horse). b is a Mongolian horse; the picture was taken in Inner Mongolia, China. The white arrows point four parts as following: mane, dorsal, tail, and fetlock. c is a Trait du Nord, a breed of heavy draft horse (https://en.wikipedia.org/wiki/Trait_du_Nord). a and c are from Wikimedia Commons under CC-BY-SA copyright, which can be used and adapted …
Morphology of Mongolian bay horse hair follicle. From horizontal axis, mane (a1–5), body (b1–5), tail (c1–5), fetlock (d1–5); from longitudinal axis, (a1-d1) and (a4-d4) are anatomical lens images under 2X amplification. (a2-d2), (a3-d3) and (a5-d5) are microscope images of transparency stain or HE stain. Scale bars are, respectively, 100 μm, 200 μm, and 500 μm, as shown in pictures. e is the comparison of hair follicle dermal papilla diameter; f is the comparison of hair follicle density …
ALP staining results. a, b, c and d represent four different parts, respectively, mane, dorsal part, tail and fetlock. Figures a1 ~ d1 are negative control (NC). Figures of a2 ~ d2 are ALP staining. Figures of a3 ~ d5 are the amplifications of ALP staining. a1, a2, × 18; b1, b2, × 40; c1, c2, × 20; d1, d2, × 25; scale bars,100 μm …
Analysis of differential expression genes. a is a Venn diagram of differential expression analysis, different color indicates a different group. Green indicates mane, blue indicates dorsal part, pink indicates tail, and yellow indicates fetlock. b indicates the differentially expressed gene numbers between each group, red bars indicate gene numbers which up-regulated, while blue bars indicate down-regulated …
GO enrichment annotated in the Hair Follicle Morphogenesis and Pigmentogenesis related signaling pathway between every two parts. Different color represents different kinds of pathways shown in the bottom left corner; dark blue refers pathways related to hair follicle morphogenesis to some extent but cannot be classified into one accurate function …
Figures - available from: BMC Genomics
Hair follicle regional specificity in different
parts of bay Mongolian horse by histology
and transcriptional profiling
Ruoyang Zhao
1
, Wu Yihan
2
, Yiping Zhao
1
, Bei Li
1
, Haige Han
1
, Togtokh Mongke
1
, Tugeqin Bao
1
, Wenxing Wang
3
,
Manglai Dugarjaviin
1 †
and Dongyi Bai
1* †
Abstract
Background: Different mor phological str uctures of hair s having properti es like defense and ca mouflage help anim als
survive in the wi ld environment . Horse is one of th e rare kinds of anim als with complex ha ir phenotype s in one
individual ; however, know ledge of hors e hair follicle is limited in literature and their mole cular basis re mains unclear.
Therefore, th e investigati on of horse hair follic le morphogene sis and pigmentog enesis attrac ts considerable in terest.
Result: Histological stud ies revealed the morp hology and pigmen t synthesis of hair fo llicles are differ ent in between
four differ ent parts (mane , dorsal part , tail, and fetl ock) of the bay Mo ngolian hors e. Hair follic le size, densit y, and cycle
are strongl y associated wi th the activit y of alkaline ph osphatase (AL P). We observ ed a great differ ence in gene
expression between the ma ne, tail, and fe tlock, which ha d a greater diff erent gene expr ession patter n compared wi th
the dorsal pa rt through trans criptomic s. The developm ent of the hair fo llicle in all fo ur parts was rela ted to
angiogene sis, stem cells, Wnt , and IGF signaling path ways. Pigmento genesis-rel ated pathways were in volved in their
hair follicle pi gment synthesi s.
Conclusion s: Hair follicle mo rphology and the act ivity of ALP differ amon g four body parts in bay Mongol ian horse.
Hair follicle s of the different body pa rts of the are not synchron ized in their cycle sta ges. GO terms show a region al
specificity pa ttern between di fferent skin part s of the bay Mongolian ho rse. These result s provide an insight in to the
understand ing of the biological me chanism of the hair fo llicle in other mamma ls.
Keywords: Mongolian horse, Skin , Hair follicle, Hist ology, Transcr iptome
© The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License,
which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give
appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if
changes were made. The images or other third party material in this article are included in the article's Creative Commons
licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons
licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain
permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ .
The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/ ) applies to the
data made available in this article, unless otherwise stated in a credit line to the data.
* Correspondence: [email protected]
†
Manglai Dugarjaviin and Dongyi Bai contributed equally to this work.
1
lnner Mongolia Key Laboratory of Equine Genetics, Breeding and
Reproduction; Scientific Observing and Experimental Station of Equine
Genetics, Breeding and Reproduction, Ministry of Agriculture and Rural
Affairs; Equine Research Center, College of animal science, Inner Mongolia
Agricultural University, Zhao Wu Da Road, Hohhot 306 010018, Inner
Mongolia, China
Full list of author information is available at the end of the article
Zhao et al. BMC Genomics (2020) 21:651
https://doi.org/10.1186/s12864-020-07064-1
Content courtesy of Springer Nature, terms of use apply. Rights reserved.
Background
Since about 5500 thousand years ago, horse ( Equus
caballus ) has been domesticated as a crucial role in the
agricultural industry, transportation, and military activ-
ities [ 1 ]. Horse hair, with high regional specificity, can be
mainly characterized at the mane, dorsal part, tail, and
fetlock. Few mammals have such complex hair pheno-
types on one individual body; therefore, the horse is a
good model for studying hair follicle morphology and
development due to the morphological differences exist-
ing among breeds and even in the different body parts of
the same animal (Fig. 1 ).
Science and technology have led to the evolution of
horse domestication and the production of diversified
coat colors [ 2 ]. Horse coat color might be changing
during the early ages to the adult stage, and also be
influenced by environment and nutrition. Compared
with young horses, adult horse coat color keeps rela-
tively unchanged. Horse coat color is described as base
colors, dilutions, and white spotting and depigmentation
patterns [ 3 ]. The base color of a horse is ge nerally classi -
fied into the black , chestnut, bay, or se al brown and is de-
termined by two inte racting loci (exten sion and agouti)
that affect melano cyte function [ 4 , 5 ]. These two loci de-
termine if eumel anin or phaeomelan in will be produced in
their correspo nding melanoso me. The extension loc us (E)
encodes the melan ocortin-1 rece ptor (MC1R) and the
agouti locus (A) enco des agouti signali ng protein (ASIP)
which suppress es MC1R. Signal ing through MC1R with
the agonist resul ts in the production of eume lanin, while
antagonist bi nding (ASIP) resul ts in phaeomelanin pro-
duction [ 6 ]. Ba y horse, the mos t common base co lor in
horses, is the pr oduct of the domi nant wild type alle les at
both loci (A, E). Bay hors es have a red body with blac k
mane, tail, ear tips , and lower legs. Over the las t 70 years,
human and mice hair fo llicles are extensi vely studied, and
other animal mo dels include pi g, cattle, and sh eep were
also used to study hair fol licle biology [ 7 ]. Al though there
are some stud ies on the horse sk in [ 8 , 9 ], littl e is on horse
hair follicle [ 10 , 11 ]. Understan ding the hair growth, cy cle,
and melanogenes is in different part s of horse skin pro-
vides insights an d valuable informat ion for studying the
regional speci ficity of hair follic les in other mammals.
Hair follicle undergoes lifelong cyclical transitions of
anagen, catagen, telogen, and exogen (a stage which does
not occur at every cycle), which is known as the hair
cycle [ 12 ]. Through self-renewal and differentiation,
stem cells are essential for hair follicle development and
cycling, which involve many signaling pathways such as
Wnt, Sonic Hedgehog, Notch, and bone morphogenetic
protein (BMP). Some growth factors are also involv ed in
the transition from telogen to anagen [ 13 , 14 ]. Wnt
signals are considered to be the most important factor s
during hair follicle morphogenesis. Wnt signaling path-
way facilitates stem cell maintenance and proliferation.
Wnt signaling activates the regeneration of hair follicles
[ 15 , 16 ]. Dysregulation of this pathway often results in
epithelial cancers [ 17 ]. Notch signaling also plays an im-
portant role in hair follicle development by maintaining
the follicular structure [ 18 , 19 ]. Notch participates in
hair follicle development to control stem cell fate deter-
mination [ 20 , 21 ]. Notch regulates cell differentiation
and promotes boundary formation by altering the adhe-
sive properties of keratinocytes [ 22 ]. The dermal Wnt
pathway upregulates the epithelial Notch expression.
Hair foll icle has two mes enchymal c omponen ts, in-
cluding dermal papilla (DP) and dermal sheath. The
DP is enveloped by keratinocytes at the anagen phase.
DP releases insulin-like growth factors that are essen-
tial for keratinocyte proliferation and differentiation
[ 23 ]. Alkaline phosphatase (ALP) is detected in many
tissues and organs [ 24 ]. ALP activity is also detected
in the hair follicle during and after hair development,
and this makes ALP a useful marker to indicate the
location, shape, and size of the DP in skin specimens
[ 25 ]. Over the years, scientists have continuously
studied the expression pattern of ALP in the special-
ized struc tures of hai r follicles i n various ma mmals
and the detection of ALP expression is often used in
developmental studies and clinical trials [ 26 ].
Fig. 1 Hair length in different parts of horse showing differences among breeds. a is an Arabian horse ( https://en.wikipedia.org/wiki/Arabian_
horse ). b is a Mongolian horse; the picture was taken in Inner Mongolia, China. The white arrows point four parts as following: mane, dorsal, tail,
and fetlock. c is a Trait du Nord, a breed of heavy draft horse ( https://en.wikipedia.org/wiki/Trait_du_Nord ). a and c are from Wikimedia
Commons under CC-BY-SA copyright, which can be used and adapted
Zhao et al. BMC Genomics (2020) 21:651 Page 2 of 10
Content courtesy of Springer Nature, terms of use apply. Rights reserved.
Our study aimed to reveal the morphological differ -
ences and ALP expression patterns in hair follicles
among four different body parts of the Mongoli an bay
horse. We used transcriptome analysis to show the
pathways relevant to hair follicle morphogenesis and
pigmentogenesis.
Results
Morphological characteristics differ in hair follicles at four
body parts
The morphology differed in different parts of hair folli-
cles (Fig. 2 a2, b2, c2, d2). Measurement of hair bulb
(HB) diameter of four kinds of hair follicles showed that
the tail and mane hair follicles had the biggest HB in
diameter (Fig. 2 e). The hair density was visibly higher at
the dorsal and fetlock regions than that of mane and tail
regions (Fig. 2 a6, b6, c6, d6); Statistical analysis showed
that hair follicles had the highest density at the fetlock
part compared to that of the other body parts (Fig. 2 f).
The tail hair follicles were highly keratinized compared
to the hair follicles at the other body parts (Fig. 2 a3, a4,
c3, c4). A cavity was observed in the hair matrix of the
tail hair follicle (Fig. 2 c3).
Based on the morphology of human and mouse hair
follicles [ 12 , 27 ], either oval-shaped or onion-shaped DP
suggests that the hair follicles in mane, tail, and fetlo ck
regions were at late anagen. In dorsal hair follicles,
together with a complete cessation of hair follicle pig-
mentation and matrix volume loss in the HB, DP was
condensed and almond-shaped (Fig. 2 b3), suggesting
that most dorsal hair follicles were in early catag en,
meanwhile, some follicles remain at late anagen (Fig. 2
b4, amplified in red rectangle). Smaller mid-anagen hair
follicles were observed in between the large hair follicles
in the fetlock region (Fig. 2 d2 with red arrows, ampli-
fied in d4).
Hairs in mane, tail, and fetlock of bay Inner Mongolian
horse were observed to be all black, but hairs at the dor-
sal part include both black and brownish-yellow so that
the entire body of the horse showed a brown color (Fig. 2
a1 ~ d1). Paraffin sections with or without H&E stain-
ing showed two kinds of pigment granules existed in the
dorsal hair follicles (Fig. 2 b4, b6). These included the
pheomelanin (amplified in a yellow rectangle), and the
eumelanin (amplified in a red rectangle). There was only
eumelanin deposition in the hair follicles of the other
three parts.
ALP expression patterns differed in hair follicles among
four body parts
ALP signals were detected in the vessel-like structures
around the hair follicle (Fig. 3 a3, b3, c5, d5) among four
body parts. ALP signals were also shown in the DP of
mane, tail and fetlock follicles (Fig. 3 a4, a5, c3, c4, d5,
red arrowheads), but not found in the dorsal hair folli-
cles (Fig. 3 b4, b5). Different from the others, strong
ALP signals were detected in papillary dermis in fetlock
skin (Fig. 3 d3, red arrowhead). Meanwhile, ALP signals
were also detected in the outer root sheath (O RS) of
fetlock hair follicles (Fig. 3 d4, d5, red arrowhead).
GO terms relevant to hair follicle morphogenesis and
pigmentogenesis
A total of 199.28G raw data and 196.49G valid data were
obtained by transcriptome sequencing from twelve
samples harvested from four different parts of the Inner
Mongolian bay horse. Both G20 and G30 met the re-
quirement of the following analysis (Additional file 1 ).
All raw data fastq sequences were deposited at the Na-
tional Center for Biotechnology Information ( http://
www.ncbi.nlm.nih.gov/ ) under BioProject PRJNA477743
with an SRA accession SRP151228. Dorsal skin had the
most significant differential gene expression compared
to that of skins from the other three parts ( p < 0.05,
Fig. 4 a and b, Additional file 2 in detail).
We selected all GO terms related to hair follicle
morphogenesis and pigmentogenesis and found some
Intriguingly patterns between every two parts (Fig. 5 and
Additional file 3 ). Wnt, stem cell, and angiogenesis-
related signaling pathways were enriched in GO terms
with the comparison between the dorsal and tail skin.
GO terms were mostly associated with melanogenesis
and stem cells between mane and dorsal parts. The ma-
jority of GO terms were classified in insulin-like growth
factor-related signaling pathways and some stem cell
signaling pathways between the dorsal part (or mane)
and fetlock. Every two parts of mane, tail, and fetlock
were all related to the angiogenesis pathway. An alkaline
phosphatase pathway was selected between mane and
tail. qRT-PCR was used to validate eight randomly se-
lected genes that showed consistent expression tendency
with the RNAseq data (Fig. 6 ).
Discussion
Histology of hair follicles in different parts of bay
Mongolian horse was revealed for the first time. The
results showed that mane and tail hair follicles have a
similar morphology. Hair follicles in the dorsal part are
very different in pigment, cycle stage, density, and size
compared with the other three parts. It is obviously seen
that two different kinds of hair follicles exiting in the
fetlock skin, which might be considered as primary and
secondary hair follicles. The density of hair follicles is
very high in the fetlock skin suggesting that the horse
needs more hairs to protect their knees. Mammalian hair
growth is a dynamic process that depends on prolifera-
tion, differentiation, and migration of the matrix cells
within the bulb of the follicle, and the hair shape is
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Fig. 2 (See legend on next page.)
Zhao et al. BMC Genomics (2020) 21:651 Page 4 of 10
Content courtesy of Springer Nature, terms of use apply. Rights reserved.
programmed from the HB [ 28 ]. The size of HB deter-
mines matrix volume, which may lead to the different
hair follicle morphologies in different body parts. In the
present study, we proposed that the HB diameter differ-
ences may cause complex hair phenotypes in one indi-
vidual horse.
Hair follicle is a mini-organ that undergoes cyclic
growth [ 12 ]. Different parts of mammals have different
hair follicle cycling duration; hair follicle morphology
changes during cyclic growth [ 27 ]. ALP activity is widely
expressed in actively proliferating or remodeling tissues,
as well as in cells with a high metabolic rate [ 29 ]. The
expression pattern of ALP is slightly different at different
hair cycle stages in different animals [ 26 , 30 , 31 ]. It has
been reported that the ALP activity can last through the
whole hair follicle cycle in mouse dorsal skin. But DP
and ORS are only ALP-positive during late anagen and
early catagen in rat hair follicles [ 32 ]. ALP activity
changes dynamically in DP and dermal sheath in mou se
vibrissa follicles, it reaches the highest level in the early
anagen in DP, decreases by nearly half after the middle
anagen, and even less in catagen [ 31 ]. ALP activities
could also be detected at the proximal DS adjacent to
DP, with the highest level at the early anagen [ 33 ]. In all,
understanding of ALP patterns in horse skin and hair
follicle helps to determine the hair cycle. Both H&E
staining and ALP expression results showed that mane
and tail hair follicles are at late anagen. Normally, horses
shed twice a year in spring and fall. Our samples were
taken in late fall, a season in the north of China when
the hair coat of most mammals becomes thicker. Hair
cycle of the animal body might be more closely related
to season, the reason why hair follicles in the dorsal skin
tend to enter catagen after shedding. Meanwhile, most
fetlock follicles remain staying in anagen to produce
more hairs to defense the strong northwest wind.
Histology shows that the hair follicles of different
parts of the horse body are not synchronized in their
cycle stages, and the duration of the hair cycle in
each of the body parts need further investigation. Due
to the limited samples, the existing histological results
cannot tell if all the hair follicles in the different four
parts going through the same cycle stage simultan-
eously (such as the first hair cycle in mouse), or they
(See figure on previous page.)
Fig. 2 Morphology of Mongolian bay horse hair follicle. From horizontal axis, mane ( a 1 – 5), body ( b 1 – 5), tail ( c 1 – 5), fetlock ( d 1 – 5); from
longitudinal axis, ( a 1- d 1) and ( a 4- d 4) are anatomical lens images under 2X amplification. ( a 2- d 2), ( a 3- d 3) and ( a 5- d 5) are microscope images of
transparency stain or HE stain. Scale bars are, respectively, 100 μ m, 200 μ m, and 500 μ m, as shown in pictures. e is the comparison of hair follicle
dermal papilla diameter; f is the comparison of hair follicle density
Fig. 3 ALP staining results. a , b , c and d represent four different parts, respectively, mane, dorsal part, tail and fetlock. Figures a1 ~ d1 are negative
control (NC). Figures of a2 ~ d2 are ALP staining. Figures of a3 ~ d5 are the amplifications of ALP staining. a1, a2, × 18; b1, b2, × 40; c1, c2, × 20;
d1, d2, × 25; scale bars,100 μ m
Zhao et al. BMC Genomics (2020) 21:651 Page 5 of 10
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are not synchronized like the hairs on a human scalp.
This needs to be addressed in further studies on
horse embryo skin in different gestational ages.
The phenotypic differences among the four parts of
bay Mongolian horse are significant, also with significant
differential gene expression. The enrichment of differen-
tial mRNAs and GO items is carried out by comparison
between every two parts. In this way, within a certain
range of p -values, the enriched pathway pattern is pre-
liminarily revealed and summarized. Stem cell rele vant
pathways are enriched in every two groups suggesting
that stem cell signals are needed in the whole process of
skin and hair follicle morphogenesis and pigment
synthesis. The biggest difference between the dorsal part
Fig. 4 Analysis of differential expression genes. a is a Venn diagram of differential expression analysis, different color indicates a different group.
Green indicates mane, blue indicates dorsal part, pink indicates tail, and yellow indicates fetlock. b indicates the differentially expressed gene
numbers between each group, red bars indicate gene numbers which up-regulated, while blue bars indicate down-regulated
Fig. 5 GO enrichment annotated in the Hair Follicle Morphogenesis and Pigmentogenesis related signaling pathway between every two parts.
Different color represents different kinds of pathways shown in the bottom left corner; dark blue refers pathways related to hair follicle
morphogenesis to some extent but cannot be classified into one accurate function
Zhao et al. BMC Genomics (2020) 21:651 Page 6 of 10
Content courtesy of Springer Nature, terms of use apply. Rights reserved.
and tail is the shape of hair follicles, Wnt signals are
considered to be mostly involved in its formation. GO
terms enriched in melanogenesis is somewhat expected
because it is obvious that the hair pigment is the most
different phenotype between mane and dorsal part. In
our study, an ALP pathway is enriched between the
mane and tail, suggesting it can not only be used to
determine the cycle stages in different parts of horse hair
follicles. In association with the hair cycle, highly regen -
erative hair follicles are known to express ALP. Regener-
ation of hair follicles is governed by the reciprocal
epithelial-mesenchymal interactions [ 34 ]. DP cells are
critical to hair growth and regeneration of the HB has
regressed in catagen by exhaustion and apoptosis of the
bulbar epithelial cells. It has been described that hair
inductivity of DP appears to be closely related to ALP
activity [ 33 ]. Hair follicle is like other organs in need of
rich nutrients supplement [ 35 ], especially, thick and
strong hair follicles like mane and tail. Enough supply of
nutrition must be accomplished by abundant capillaries
and periodic angiogenesis around hair follicles to satisfy
the demands of hair follicle cyclic growth. Therefore,
ALP activity could have some other functions in hair fol-
licles more than hair inductivity. Although the arteries
and veins are located deep in the dermis, the dendritic
capillaries are widely distributed above the bulge area,
which provides nutrients, hormones, and immune cells
to the skin and also plays an important role in heat
transfer. These vascular tissues may affect the process of
hair follicle regeneration. This is the reason why alkaline
phosphatase, angiogenesis, and stem cell-related path-
ways are enriched in the relatively thick hair follicles.
Fig. 6 Validation of RNAseq data using qRT-PCR. The red line indicates qPCR results; while blue indicates FPKM values
Zhao et al. BMC Genomics (2020) 21:651 Page 7 of 10
Content courtesy of Springer Nature, terms of use apply. Rights reserved.
ALP activity shown in vessel-like structures around hair
follicles in different parts might be directly related to
angiogenesis and artery morph ogenesis. When angiogenesis
is inhibited, the initiation of anagen will be delayed [ 35 ],
which indicates that angiogenesis factors can regulate the
activity of hair follicle stem cells and in turn to affect the
expression of ALP. The relatio nship between ALP activity
and cyclic hair regeneration and the exact roles of ALP in
the horse hair follicles should be addressed by further inves-
tigations. In DP cells, a variety of growth factors control the
hair follicle cycle, including insulin-like growth factors [ 36 ].
GO terms are mostly enriched in IGF pathways between
the fetlock and the other three parts. We could propose
that IGF relevant pathways are closely related to horse hair
cycle and hair density in accordance with histological
results. These findings will provide some novel insights in
horse hair follicle morphogenesis and melanogenesis.
Conclusion
Our study unveiled that hair follicles are in different
morphology at different body parts of the Mongolian bay
horse skin, with significant transcriptome level differences
identified by RNA-seq analysis. The hair follicle size,
density, and cycle among different types of hair follicles are
suggested to be related to ALP activity, angiogenesis, stem
cells, WNT, and IGF signaling pathways. These factors and
pathways may regulate the regional specificity by control-
ling the hair follicle morphogenesis and pigmentogenesis.
Further studies are required to reveal the hair cycle stages
and the molecular mechanism controlling the regional
specificity at the different body parts of the Mongolian bay
horse.
Methods
Sample collection
Three male bay Mo ngolian hors es (10 years old) we re
used in our experime nt (Fig. 1 b was one of the ho rses we
used in this study) . Four kinds of skin sample s from mane,
dorsal part, tail, and fetloc k were excised fr om each horse,
and a total of twelve samp les were taken in Decembe r of
2017by trained ve terinary techni cians. The horses we re
bought from compan y (CHINA HORSE INDUST RY
GROUP CO., LIMITE D) and raised in the same en viron-
ment (Hohhot, In ner Mongolia, Ch ina). All surger y was
performed unde r combination anes thesia and all effort s
were made to mini mize horses suff ering. Detomi dine
(0.01 – 0.02 mg /kg, IV) combine d with butorpha nol (0.02 –
0.04 mg/kg, IV) was used for analgesia following standing
surgery steps. Al l horses were still rear ed carefully after
surgery. Sample s were collected follo wing the instituti onal,
national, an d international gu idelines and ap proved by the
Animal Ethica l Committee of Inner Mon golia Agricult ural
University. Ha lf of the samples were pu t into liquid
nitrogen immed iately then store d at − 80 °C. The other
adjacent half were fixed in paraformaldehy de for 20 h,
then were dehydrat ed with gradient etha nol (70, 80, 80,
100%) and cryo preserved in − 20 °C.
Histological analysis
Samples immersed in 100% ethanol were embedded into
paraffin blocks and cut into sections (Leica RM 2245) of
5-7 μ m thickness, after being deparaffinized and rehy-
drated, then stained with hematoxylin and eosin(H&E),
or without any stain (transparency stain), for there were
no other colors to disrupt observation of original pig-
ment color) (Fig. 2 b4, a6, b6, c6, d6). We measured the
HB diameter of 20 hair follicles under the same magnifi-
cation from 5 locations from serial longitudinal slides
each part and repeated in four parts of skin slides. We
chose HBs which were cut right in the middle of hair
follicles for measurements. The chosen HBs must be in-
tegral and clear structured and the planes we measured
the HB diameter are shown in figures (Red dashed lines
in Fig. 2 a4, b3, c3 ~ 4, d3). Hair follicle density was mea-
sured in 5 different fields using cross-sections and the
planes we cut the cross-sections were shown in figures
(Red dashed lines in Fig. 2 a1, b1, c1, d1). The method
above was applied to a total of 12 samples. Data were
made graphics using GraphPad (San Diego, CA, USA).
Histochemistry
Steps of alkali ne phosphatas e activity dete ction were as
follows: the NB T/BCIP (Maixing , Fuzhou, China) wa s
added on the tissue s after gradient al cohol rehydrat ion in
the dark for 15 min until a dark blue sign al appeared an d
was stopped by washing with PBS (pH 7.2 ~ 7.4). This was
applied to the 12 sa mples. Signal s were detected an d mea-
sured throug h digital photog raphs using the mi croscope
imaging system (A xio Observer D1, ZEI SS).
Library construction and sequencing
Total RNA were extracted from twelve samples (three
replicates from each of four parts) stored in − 80 °C in
accordance with standard procedure of Trizol reagent
(Invitrogen, CA, USA) and Animal Tissue RNA Purifica-
tion Kit (LC Science, Houston, TX). The quantity and
purity of RNA (RIN number > 7.0) were analyzed
according to the previous research [ 37 ]. After, a certain
amount of RNA was purified [ 37 ]. Following, the RNA
fractions were fragmented by cations under suitable
temperature. Finally, cDNA library was constructed
using the stranded procedures of mRNA-seq Library
Prep Kit (Illumina, San Diego, USA). An Illumina Hiseq
4000 platform was then performed the sequencing [ 37 ].
Transcripts assembly
Cutadapt [ 38 ] was used to remove the low-quality frag-
ments. There were two steps we used to wipe out low-
Zhao et al. BMC Genomics (2020) 21:651 Page 8 of 10
Content courtesy of Springer Nature, terms of use apply. Rights reserved.
quality reads to obtain clean reads. Firstly, we wiped out
low reads with adapters and poly-N (N indicates that the
base cannot be confirmed) over the rate of 10% using
Cutadapt. Secondly, we wiped out paired reads with
low-quality through single-ended sequencing (With low-
quality bases over the rate of 50% of the whole reads
were considered to be the low-quality paired reads).
Then, Q20 and Q30 were calculated using q30.py
( https://github.com/d-ayedepps/q30 ). FastQC [ 37 ] was
used to verify the sequence quality. High-quality clean
data obtained were used to do mapping of Equus cabal-
lus genome ( http://asia.ensembl.org/Equus_caballus/Info
/Index) by Bowtie2 [ 39 ] and TopHat [ 40 ]. Reads mapped
to the genome were assembled using StringTie [ 41 ] and
generated a GTF file for each sample. Cuffmerge merges
the GTF files into more comprehensive transcripts
annotation results. Then, we used Cuffdiff to do gene
expression difference analysis [ 42 ].
Expression analysis of mRNAs and GO enrichments
StringTie [ 41 ] was used to perform expression level
analysis for mRNAs by calculating FPKM [ 43 ]. The
fragments per kilobase of transcript per million (FPKM)
mapped reads was calculated for each gene based on
the length of the gene and reads counts mapped to this
gene. FPKM simultaneously considers the effect of
sequencing depth and gene length for the reads count.
The differentially expressed mRNAs were selected with
|log
2 (fold change)
| < 1 and with statistical significance ( p -
value < 0.05) by R package Ballgown [ 44 ]. The Benjamin-
Hochberg method wa s used to correct the P -val ue. GOseq
R package was used to selected Gene Ontology (GO)
enrichment of differentially expressed genes [ 45 ]w i t h
a P -value of < 0.05.
Quantitative real-time PCR (qRT-PCR) validation
RNA was used to perform a reverse tr anscriptio n PCR
using HiScri pt® II qRT Super Mix for qPCR (Vaz yme).
Subsequentl y, qPCR was performe d using the primers
(Additiona l file 4 ) from Invitro gen with SYBR®Pre mix Ex
Taq ™ II (TaKaRa) . A total of 8 genes ( DKK1 , DK K2 , IGF1 ,
IGF1R , WNT5A , WNT5B , CD34 ,a n d SOX2 )w e r er a n -
domly selecte d for qRT-PCR va lidation. Each sample has
3 replicates. GAP DH as the housekeeping ge ne was used
to assess the leve l of RNA expressi on. Data collec tion and
analysis were performed resp ectively by CF X96 Real-Time
PCR Detection Syst em (Bio-Rad) and Mi crosoft Excel.
Supplementary information
Supplementary information accompanies this paper at https://doi.org/10.
1186/s12864-020-07064-1 .
Additional file 1. The quality control of RNAseq data.
Additional file 2. Gene differential expression results. Significant gene
differential expression results between every two different parts.
Additional file 3. GO enrichments. Significant GO enrichments between
every two different parts.
Additional file 4. Primers for qRT-PCR validation.
Abbreviations
DEGs: Differentially expressed genes; FDR: False discovery rate;
FPKM: Fragments per kilobase of transcript per million fragments mapped;
GO: Gene ontology; HE: Haematoxylin-eosin; PCA: Principal component
analysis; q-PCR: Quantitative real-time PCR; RNA-Seq: RNA sequencing
Acknowledgments
Authors would like to thank prof. Mingxing Lei (Chongqing University,
Chong Qing, China) for the excellent ideas of our work and support in the
language improvement. We would like to thank Nei Mongol Bionew
Technology Co. Ltd. for assistance of data analyzing.
Authors ’ contributions
RZ performed the most experiments, analyzed the data and wrote the
manuscript. DB and MD were together conceived, revised and submitted the
manuscript. WY and YZ helped with histological experiment and assisted
with experimental design. BL interpreted morphological data. HH and WW
helped with revising the manuscript. TM applied the Transcriptional Profiling.
TB helped with analyzing Transcriptome data. All authors have read and
approved the final version of the manuscript.
Funding
This work was supported by the National Natural Science Foundation of
China (No.31960657,31961143025),National Basic Research Program of China
(No.2017YFE0108700),Natural Science Foundation Special Project of Inner
Mongolia (No.2017ZD06), Science and Technology major project of Inner
Mongolia (No.ZD20190039),National Natural Science Foundation of Inner
Mongolia (No.2019MS03064),and Youth Fund Project of Collage of Animal
Science of Inner Mongolia Agricultural University (No.QN202006, QN201909).
Availability of data and materials
All raw data fastq sequences are deposited at the National Center for
Biotechnology Information ( http://www.ncbi.nlm.nih.gov/ ) under BioProject
PRJNA477743 with SRA accession SRP151228. All raw sequences are
deposited as BioSamples SAMN09478216, SAMN09478217, SAMN09478218,
SAMN09478219, SAMN09478220, SAMN09478221, SAMN09478222,
SAMN09478223, SAMN09478224, SAMN09478225, SAMN09478226 and
SAMN09478227 ( https://www.ncbi.nlm.nih.gov/sra/ PRJNA477743). Equus
caballus genome ( http://asia.ensembl.org/Equus_caballus/Info /Index) was
used to do mapping.
Ethics approval and consent to participate
The present study was carried out in strict accordance with relevant
guidelines and regulations by the Ministry of Agriculture of the People ’ s
Republic of China. Specimens were collected following the institutional,
national, or international guidelines and approved by the Animal Ethical
Committee of Inner Mongolia Agricultural University.
Consent for publication
Not applicable.
Competing interests
The authors declare that they have no competing interests.
Author details
1
lnner Mongolia Key Laboratory of Equine Genetics, Breeding and
Reproduction; Scientific Observing and Experimental Station of Equine
Genetics, Breeding and Reproduction, Ministry of Agriculture and Rural
Affairs; Equine Research Center, College of animal science, Inner Mongolia
Agricultural University, Zhao Wu Da Road, Hohhot 306 010018, Inner
Mongolia, China.
2
Inner Mongolia Center for Disease Comprehensive Control
and Prevention, Hohhot 010030, China.
3
Inner Mongolia Zhong Yun Horse
Industry Group, Xilinhot 026000, China.
Zhao et al. BMC Genomics (2020) 21:651 Page 9 of 10
Content courtesy of Springer Nature, terms of use apply. Rights reserved.
Received: 10 December 2019 Accepted: 10 September 2020
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| https://www.researchgate.net/publication/344366375_Hair_follicle_regional_specificity_in_different_parts_of_bay_Mongolian_horse_by_histology_and_transcriptional_profiling |
CUDC-907 in relapsed/refractory diffuse large B-cell lymphoma, including patients with MYC-alterations: results from an expanded phase I trial
Oki Y, Kelly KR, Flinn I, Patel MR, Gharavi R, Ma A, Parker J, Hafeez A, Tuck D, Younes A. CUDC-907 in relapsed/refractory diffuse large B-cell lymphoma, including patients with MYC-alterations: results from an expanded phase I trial. Haematologica. 2017 Nov;102(11):1923-1930. doi: 10.3324/haematol.2017.172882. Epub 2017 Aug 31.
Yasuhiro Oki, Kevin R Kelly, Ian Flinn, Manish R Patel, Robert Gharavi, Anna Ma, Jefferson Parker, Amir Hafeez, David Tuck, Anas Younes, Yasuhiro Oki, Kevin R Kelly, Ian Flinn, Manish R Patel, Robert Gharavi, Anna Ma, Jefferson Parker, Amir Hafeez, David Tuck, Anas Younes
Abstract
CUDC-907 is a first-in-class, oral small molecule inhibitor of both HDAC (class I and II) and PI3K (class Iα, β, and δ) enzymes, with demonstrated anti-tumor activity in multiple pre-clinical models, including MYC-driven ones. In this report, we present the safety and preliminary activity results of CUDC-907, with and without rituximab, in patients with relapsed/refractory diffuse large B-cell lymphoma (DLBCL), with a particular focus on those with MYC-altered disease. Thirty-seven DLBCL patients were enrolled, 14 with confirmed MYC-altered disease. Twenty-five patients received monotherapy treatment, and 12 received the combination of CUDC-907 with rituximab. CUDC-907 monotherapy and combination demonstrated similar safety profiles consisting primarily of Grade 1/2 hematologic and gastrointestinal events. The most frequently reported Grade ≥3 treatment-related events were thrombocytopenia, neutropenia, diarrhea, fatigue, and anemia. Eleven responses (5 complete responses and 6 partial responses) were reported, for a response rate of 37% (11 out of 30) in evaluable patients [30% (11 out of 37) including all patients]. The objective response rate in evaluable MYC-altered DLBCL patients was 64% (7 out of 11; 4 complete responses and 3 partial responses), while it was 29% (2 out of 7) in MYC unaltered, and 17% (2 out of 12) in those with unknown MYC status. Median duration of response was 11.2 months overall; 13.6 months in MYC-altered patients, 6.0 months in MYC unaltered, and 7.8 months in those with MYC status unknown. The tolerable safety profile and encouraging evidence of durable anti-tumor activity, particularly in MYC-altered patients, support the continued development of CUDC-907 in these populations of high unmet need. ( clinicaltrials.gov identifier: 01742988).
Trial registration:ClinicalTrials.govNCT01742988.
Copyright© Ferrata Storti Foundation.
Figures
Figure 1.
Extended progression-free survival (PFS) in MYC-altered patients. Kaplan-Meier PFS curve for all patients (n=37) on the trial (solid black line) along with subsets based on MYC status. MYC-altered patients (n=14, blue dotted line), MYC negative patients (n=8, red dashed line) and MYC unknown (n=15, green dash-dotted line). Median PFS was 2.9 months for all diffuse large B-cell lymphoma (DLBCL) patients and 21.8 months for the MYC-altered patients, respectively. x-axis in months; y-axis is the proportion of patients.
Figure 2.
Extended duration of response in MYC-altered patients. Kaplan-Meier duration of response curve for all responding patients (n=11) on the trial (solid black line) along with subsets based on MYC status. MYC-altered patients (n=7, blue dotted line), MYC negative patients (n=2, red dashed line) and MYC unknown (n= 2, green dash-dotted line). x-axis in months; y-axis is the proportion of patients.
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| https://ichgcp.net/clinical-trials-registry/publications/138903-cudc-907-in-relapsed-refractory-diffuse-large-b-cell-lymphoma-including-patients-with-myc |
Multi-Scale Mass Transfer Processes Controlling Natural Attenuation and Engineered Remediation: An IFRC Focused on Hanford’s 300 Area Uranium Plume (Technical Report) | OSTI.GOV
The U.S. Department of Energy's Office of Scientific and Technical Information
Title: Multi-Scale Mass Transfer Processes Controlling Natural Attenuation and Engineered Remediation: An IFRC Focused on Hanford’s 300 Area Uranium Plume
The Integrated Field-Scale Subsurface Research Challenge (IFRC) at the Hanford Site 300 Area uranium (U) plume addresses multi-scale mass transfer processes in a complex hydrogeologic setting where groundwater and riverwater interact. A series of forefront science questions on mass transfer are posed for research which relate to the effect of spatial heterogeneities; the importance of scale; coupled interactions between biogeochemical, hydrologic, and mass transfer processes; and measurements and approaches needed to characterize and model a mass-transfer dominated system. The project was initiated in February 2007, with CY 2007 and CY 2008 progress summarized in preceding reports. The site has 35 instrumented wells, and an extensive monitoring system. It includes a deep borehole for microbiologic and biogeochemical research that sampled the entire thickness of the unconfined 300 A aquifer. Significant, impactful progress has been made in CY 2009 with completion of extensive laboratory measurements on field sediments, field hydrologic and geophysical characterization, four field experiments, and modeling. The laboratory characterization results are being subjected to geostatistical analyses to develop spatial heterogeneity models of U concentration and chemical, physical, and hydrologic properties needed for reactive transport modeling. The field experiments focused on: (1) physical characterization of the groundwater flow field during amore » period of stable hydrologic conditions in early spring, (2) comprehensive groundwater monitoring during spring to characterize the release of U(VI) from the lower vadose zone to the aquifer during water table rise and fall, (3) dynamic geophysical monitoring of salt-plume migration during summer, and (4) a U reactive tracer experiment (desorption) during the fall. Geophysical characterization of the well field was completed using the down-well Electrical Resistance Tomography (ERT) array, with results subjected to robust, geostatistically constrained inversion analyses. These measurements along with hydrologic characterization have yielded 3D distributions of hydraulic properties that have been incorporated into an updated and increasingly robust hydrologic model. Based on significant findings from the microbiologic characterization of deep borehole sediments in CY 2008, down-hole biogeochemistry studies were initiated where colonization substrates and spatially discrete water and gas samplers were deployed to select wells. The increasingly comprehensive field experimental results, along with the field and laboratory characterization, are leading to a new conceptual model of U(VI) flow and transport in the IFRC footprint and the 300 Area in general, and insights on the microbiological community and associated biogeochemical processes. A significant issue related to vertical flow in the IFRC wells was identified and evaluated during the spring and fall field experimental campaigns. Both upward and downward flows were observed in response to dynamic Columbia River stage. The vertical flows are caused by the interaction of pressure gradients with our heterogeneous hydraulic conductivity field. These impacts are being evaluated with additional modeling and field activities to facilitate interpretation and mitigation. The project moves into CY 2010 with ambitious plans for a drilling additional wells for the IFRC well field, additional experiments, and modeling. This research is part of the ERSP Hanford IFRC at Pacific Northwest National Laboratory.« less
Authors:
Zachara, John M ; Bjornstad, Bruce N ; Christensen, John N ; Conrad, Mark E ; Fredrickson, Jim K ; Freshley, Mark D ; Haggerty, Roy ; Hammon, Glenn ; Kent, Douglas B ; Konopka, Allan ; Lichtner, Peter C ; Liu, Chongxuan ; McKinley, James P ; Murray, Christopher J ; Rockhold, Mark L ; Rubin, Yoram ; Vermeul, Vincent R ; Versteeg, Roelof J ; Ward, Anderson L ; Zheng, Chunmiao
Publication Date:
2010-02-01
Research Org.:
Pacific Northwest National Lab. (PNNL), Richland, WA (United States). Environmental Molecular Sciences Lab. (EMSL)
Sponsoring Org.:
USDOE
OSTI Identifier:
1033090
Report Number(s):
PNNL-19209 34494; KP1702030; TRN: US1200280
DOE Contract Number:
AC05-76RL01830
Resource Type:
Technical Report
Country of Publication:
United States
Language:
English
Subject:
| https://www.osti.gov/biblio/1033090 |
Debate: Waste and Environmental Protection (Amendment) (Northern Ireland) (EU Exit) Regulations 2019 - 23rd Oct 2019 - Baroness Chisholm of Owlpen extracts
Wed 23rd Oct 2019 - Lords - Waste and Environmental Protection (Amendment) (Northern Ireland) (EU Exit) Regulations 2019 debate Baroness Chisholm of Owlpen contributions to the 23rd October 2019 Waste and Environmental Protection (Amendment) (Northern Ireland) (EU Exit) Regulations 2019 debate
Waste and Environmental Protection (Amendment) (Northern Ireland) (EU Exit) Regulations 2019 Debate
Waste and Environmental Protection (Amendment) (Northern Ireland) (EU Exit) Regulations 2019
Baroness Chisholm of Owlpen Excerpts
Lords Chamber
My Lords, the regulations make corrections to three other Northern Ireland EU exit instruments and amend one piece of Northern Ireland primary legislation to address failures of retained EU law to operate effectively with regard to Northern Ireland waste legislation, arising from the withdrawal of the United Kingdom from the European Union. Part 2 of the instrument amends the Waste and Contaminated Land (Northern Ireland) Order 1997. Part 3 amends three Northern Ireland EU exit SIs to correct some earlier operability changes made to primary and secondary waste legislation in Northern Ireland. This is considered necessary to ensure that a consistent approach is taken to address operability issues identified across the relevant Northern Ireland waste legislation.
All the amendments are to provisions which relate to the interpretation and application of article 16 of the waste framework directive, once the UK exits the European Union. The amendments ensure that the requirement on the United Kingdom to move towards the aim of becoming self-sufficient in waste disposal and in the recovery of waste is adequately and accurately reflected in domestic legislation. The amendments also ensure that the relevant legislation in Northern Ireland is updated to ensure there are no inoperable references to “best available techniques”. The amendments are therefore primarily corrections which are technical in nature. Importantly, there are no policy changes and there is no reduction in the environmental standards or obligations to which Northern Ireland is currently subject.
The regulations are made under Section 8 of, and paragraph 21 of Schedule 7 to, the European Union (Withdrawal) Act 2018. The Act retains EU-derived legislation in UK law. Section 8 of the Act enables regulations, such as those we are considering, to be made to address deficiencies in EU-derived legislation that arise from the UK leaving the European Union.
The regulations extend and apply solely to Northern Ireland. They concern matters which would normally be dealt with by the Northern Ireland devolved Administration. The Government’s preference is that these Northern Ireland regulations be made and scrutinised by the devolved institutions in Belfast. However, there is no sitting Assembly in Northern Ireland and it would not be possible to make the regulations. The Government are committed to the restoration of devolved government in Northern Ireland but, given existing circumstances, we have decided to process these and other Northern Ireland regulations made under the withdrawal Act through Parliament in order to maintain the integrity of the Northern Ireland statute book. In pursuing this course, we have worked closely with the Northern Ireland Department of Agriculture, Environment and Rural Affairs.
As with other regulations made under the withdrawal Act, these regulations have been drafted on the basis of leaving the EU without an agreement. It is, of course, the Government’s preference that there will be an agreed basis for leaving the EU. The Secondary Legislation Scrutiny Committee highlighted this SI as an instrument of interest. The committee published comments by Green Alliance which highlight the group’s concerns about the removal of references to “bestavailable techniques” in Northern Ireland legislation. They fear that this could lower environmental standards. I categorically reassure noble Lords that there is absolutely no risk of any lowering of standards. Notwithstanding the Government’s repeated commitments to protect environmental standards, the Government are already bound by other legislation to take best available techniques into account. This SI does not change that. The Waste Management Licensing Regulations (Northern Ireland) 2003 set out these requirements in the context of establishing an adequate network of installations for waste disposal and for the recovery of mixed municipal waste from households in Northern Ireland.
The corrections and amendments in this instrument remove the requirement to take best available techniques into account in the context of article 16.1 of the waste framework directive. We are doing so to ensure that the United Kingdom can set its own best available technique requirements and emission limits going forward, rather than having to comply with those which may be produced by the European Commission after the UK exits the European Union. In respect of the amendment to the Waste and Contaminated Land (Northern Ireland) Order 1997, the reference to best available techniques in Schedule 3, which was directly copied from article 16 of the waste framework directive, has been omitted because the term is not defined or used elsewhere in the order. This would render the term inoperable.
The Government have committed to putting a process in place for determining future UK best available technique conclusions for industrial emissions post the UK’s exit from the European Union. This is being developed with the devolved Administrations and competent authorities across the UK. Legislative changes may be required to reflect the agreed process in due course. If so, your Lordships and, where appropriate, the devolved Parliaments and Assemblies, will be able to scrutinise these at the appropriate time. No comments were raised by the JCSI in respect of the regulations. As the purpose of the regulations is to make corrections and minor technical amendments, no consultation was undertaken in respect of the provisions. The regulations will not have any significant impact on business, charities, voluntary bodies or the public sector, but will help ensure legal certainty for regulators, stakeholders and the Government and prevent any ambiguity around environmental obligations.
Similar legislative updates to those contained in this instrument have already been extended to England and Wales through the Environment and Rural Affairs (Amendment) (EU Exit) Regulations 2019, which amended the Waste (Miscellaneous Amendments) (EU Exit) Regulations 2019 and the Waste (Miscellaneous Amendments) (EU Exit) (No. 2) Regulations 2019. These regulations maintain the integrity of the Northern Ireland statute book, ensure legal certainty as we approach our exit from the EU and ensure that we maintain environmental standards and protections across the UK. I beg to move.
My Lords, I thank the Minister for her extensive introduction. I am grateful to her and her officials for their time in providing a briefing.
I am reassured that this SI makes no changes to the regulations covering waste and ensures that the law around waste disposal, installations and the recovery of mixed municipal waste collected from private households after Brexit will now be exactly the same over the whole of the UK. More importantly, perhaps, for Northern Ireland, it will be the same across the whole island of Ireland, as the UK and the EU statutes will be identical, so there will be no issues should a border ever be reintroduced.
This SI covers contaminated land and the supply and storage of prescribed substances and potentially hazardous substances. This could include asbestos. Can the Minister say whether this might also include, as a hazardous substance, nuclear waste, and, if so, whether that might now or in the future be nuclear waste created in England, Wales or Scotland and shipped to Northern Ireland for safe disposal?
As this SI transfers current EU law directly into UK and Northern Ireland law, I am confident that there will be no additional costs on local authorities as they already carry out duties under waste disposal, noise and environmental liabilities.
In the Explanatory Memorandum, paragraph 2.6 refers to the Environment (Miscellaneous Amendments) (Northern Ireland) (EU Exit) Regulations 2019, which have already been debated. Since SIs which have been debated are then allocated an official number, it would be helpful for this number to be used. For those of us grappling with numerous SIs, many with what appear to be the same long titles with only one word different, if where they have a number it is quoted each time they are referred to, this would make life far less confusing. That is a very minor point, but it would certainly assist the process if it were to happen. Apart from that, I am happy to support this SI.
| https://www.parallelparliament.co.uk/lord/baroness-chisholm-of-owlpen/debate/2019-10-23/lords/lords-chamber/waste-and-environmental-protection-amendment-northern-ireland-eu-exit-regulations-2019 |
U.S. v. SHAFFER EQUIPMENT CO., (S.D.W.Va. 1994) | Civ. A. No. 5:90-1195. | S.D.W. Va. | Judgment | Law | CaseMine
Get free access to the complete judgment in U.S. v. SHAFFER EQUIPMENT CO., (S.D.W.Va. 1994) on CaseMine.
U.S. v. SHAFFER EQUIPMENT CO., (S.D.W.Va. 1994)
United States District Court, S.D. West Virginia, Beckley Division
Sep 27, 1994
Judgment
Subsequent
References
Case Information
CITATION CODES
DOCKET NO.
Civ. A. No. 5:90-1195.
ATTORNEY(S)
Richard B. Stewart, Asst. Atty. Gen., Michael D. Goodstein, Sr. Atty., Robert H. Oakley, Sr. Counsel, Environmental Enforcement Section, Environment and Natural Resources Div., U.S. Dept. of Justice, Washington, DC, Carol A. Casto, Asst. U.S. Atty., Charleston, WV, for the U.S.
Johnnie E. Brown, Cynthia M. Salmons, McQueen Law Offices, L.C.,
Anthony P. Tokarz, Bowles, Rice, McDavid, Graff and Love, Charleston, WV, for Shaffer Equip. Co. Anna Shaffer.
John H. Tinney, Spilman, Thomas, Battle Klostermeyer, Charleston, WV, for Berwind Corp.
Robert A. Lockhart, Robert G. McLusky, Barbara D. Little, Jackson
Kelly, Charleston, WV, for Johns Hopkins University.
JUDGES
Elizabeth Virginia Hallanan
ACTS
The Public Health And Welfare — Comprehensive Environmental Response, Compensation, And Liability — Hazardous Substances Releases, Liability, Compensation — Settlements
The Public Health And Welfare — Comprehensive Environmental Response, Compensation, And Liability — Hazardous Substances Releases, Liability, Compensation — Definitions
The Public Health And Welfare — Comprehensive Environmental Response, Compensation, And Liability — Hazardous Substances Releases, Liability, Compensation — Liability
Crimes And Criminal Procedure — Perjury — Crimes — False Declarations Before Grand Jury Or Court
MEMORANDUM OPINION AND ORDER
HALLANAN, District Judge.
I. BACKGROUND
This matter is before the Court via the United States of America's Motion to Enter Proposed Consent Decrees.
On July 8, 1994 consent decrees between the United States of America (United States) and Defendants Anna Shaffer and Shaffer Equipment Company (Shaffer), the United States and Defendant Berwind Land Company (Berwind), and the United States and Defendant Johns Hopkins University (Johns Hopkins) were lodged with this Court. Public notice of their lodging was published in the Federal Register on July 21, 1994 and a thirty day comment period began on that date (See
59 Fed.Reg. 37265
), pursuant to the policy of the United States Department of Justice and consistent with
28 C.F.R. § 50.7
and
42 U.S.C. § 9622(d)(2)
. The comment period closed on August 22, 1994 and no comments were received on the proposed consent decrees. Therefore, the Court is now prepared to rule on the instant Motion.
The approval of a CERCLA (Comprehensive Environmental Response, Compensation, and Liability Act of 1980,
42 U.S.C. § 9601
, et seq., as amended) consent decree is committed to the informed discretion of the District Court. United States v. Akzo Coatings of America, Inc.,
949 F.2d 1409, 1423-24
(6th Cir. 1991); United States v. Cannons Engineering Corp.,
899 F.2d 79, 84
(1st Cir. 1990); United States v. Hooker Chemical Plastics Corp.,
776 F.2d 410, 411
(2d Cir. 1985). "Before approving a CERCLA settlement the Court must be convinced that it is fair, adequate, and reasonable, and consistent with the Constitution and the mandate of Congress." City of New York v. Exxon Corp.,
697 F. Supp. 677, 692
(S.D.N.Y. 1988), citing United States v. Conservation Chemical Co.,
628 F. Supp. 391, 400
(W.D.Mo. 1985).
The District Court, however, must accord deference to the EPA's expertise and its determination that the settlement is appropriate. United States v. Cannons Engineering Corp.,
720 F. Supp. 1027, 1036
(D.Mass. 1989), aff'd,
899 F.2d at 84
. The Court, therefore, "does not have the power to modify a consent decree; it may only approve or reject it." Id. citing United States v. Jones Laughlin Steel Corp.,
804 F.2d 348
(6th Cir. 1986); Walsh v. Great Atlantic Pacific Tea Co.,
726 F.2d 956, 965
(3rd Cir. 1983); Officers for Justice v. Civil Service Commission,
688 F.2d 615, 630
(9th Cir. 1982).
A. THE MINDEN SITE CLEANUP
At the outset, the Court will comment that it fully recognizes that this whole matter began with the release and threatened release of polychlorinated biphenyls (PCBs) at the Shaffer Equipment Site in Minden, West Virginia, for which these Defendants are by all accounts responsible. Unfortunately, this matter does not end, as it should have, with the named Defendants in this case.
The Environmental Protection Agency (EPA) and the Department of Justice (DOJ) have incurred at least six million four hundred seventy-five thousand dollar's ($6,475,000) in response costs for attempting to eliminate the release or threatened release of hazardous substances from the Shaffer Equipment Site in Minden, Fayette County, West Virginia (the Site). Under CERCLA, the United States sought reimbursement for the full amount of these response costs from Defendants Shaffer, Berwind, and Johns Hopkins.
At the outset of this action, the United States appeared to have a good case for reimbursement of their removal, remedial and other costs as the Defendants are arguably persons liable under CERCLA. In its complaint the United States alleged, among other allegations, that Shaffer, the current owner of the Site, and Berwind are liable persons "who at the time of disposal of any hazardous substance owned or operated a facility in which hazardous substances were disposed of."
42 U.S.C. § 9607(a)(2)
. The United States also alleged that Johns Hopkins is a "person who by contract, agreement, or otherwise arranged for disposal or treatment . . . of hazardous substances owned or possessed by such a person."
42 U.S.C. § 9607(a)(3)
.
The consent decrees that the United States moves the Court to enter reflect a total monetary settlement value of seven hundred twenty-five thousand dollars ($725,000). This amount is substantially less than the costs incurred by the United States in cleaning up the Site.
II. REASONS TO ACCEPT SETTLEMENT
Although the Court is prepared to enter the proposed consent decrees, it feels compelled to comment on the vast discrepancy between costs incurred and those recovered. It is the Court's opinion that in the case of each Defendant, the United States' mismanagement of this entire matter sabotaged its potential recovery of response costs from responsible persons, leaving the bulk of these costs to be born by the Superfund as established by CERCLA. See Superfund Amendments and Reauthorization Act of 1986, Pub.L. 99-499, Oct. 17, 1986, 100 Stat. 1613 (codified as amended in scattered sections of
10 U.S.C. § 26
U.S.C. § 29 U.S.C. and 42 U.S.C.), as amended. The Court has observed a tendency on the part of the EPA to treat this appropriation as though it is manna from heaven to be thrown around at will. The Court would like to remind all who are involved in this case that the Superfund is nothing more than an environmental tax on certain corporations which ultimately lands squarely on the rest of us. See Superfund Revenue Act of 1986, Pub.L. 99-499, Title V, Oct. 17, 1986, 100 Stat. 1760 (codified as amended in scattered sections of 26 U.S.C. and 42 U.S.C.), as amended.
A. THE "CARON PROBLEM"
Not the slightest in a series of blunders by the EPA is the fact that the EPA's first chosen method for removal of hazardous substances from the Site, solvent extraction, proved unsuccessful, after an expenditure of one million two hundred thirty five thousand dollars ($1,235,000). The solvent extraction method, a new and relatively unestablished
technology, was chosen by Robert E. Caron, the EPA's "On Scene Coordinator." Mr. Caron is a man who has misrepresented his academic credentials and achievements throughout his career and subsequent to this case was convicted of perjury, specifically making material false declarations in violation of
18 U.S.C. § 1623
. At the time of Mr. Caron's decision to use solvent extraction, solvent extraction had only been pilot tested. At that time the EPA was directed to utilize "established technology when feasible and cost-effective."
40 C.F.R. § 300.61(c)(4)
(1982).
Another decision made by Mr. Caron was raised as a challenge by Defendants when this case first came before this Court. This was the decision to exceed the one million dollar ($1,000,000) ceiling in place at the time for removal actions. See
40 C.F.R. § 300.66
(1985). This could best be described as the first step in a series of many missteps by an inept and deceitful "On Scene Coordinator" who seems to have been let loose in Minden, West Virginia with a virtually unbounded authority to spend federal money. Defendants have also challenged eight hundred eighty thousand dollars ($880,000) in initial costs as excessive. These expenditures were all approved by Mr. Caress. Defendants also question Mr. Caron's decision to ship contaminated soil off-Site at a cost of approximately one million nine hundred thousand dollars ($1,900,000). Defendants argue that once the soil had been consolidated and covered, the risk posed by the Site was minimal and the expense unnecessary.
Because of Mr. Caron's misconduct in this case, Defendants can seek de nova review of Mr. Caron's decisions, among them the decisions to use solvent extraction and to exceed the $1,000,000 limit, as hereinbefore noted, if the Court rejects the Proposed Consent Decrees. In that event, the United States will not be able to rely on Mr. Caron's testimony regarding these expenses. These combined factors pose substantial risks to the United States' ability to prevail in this litigation and are compelling conditions which force this Court to accept the Proposed Consent Decrees.
B. ANNA SHAFFER AND SHAFFER EQUIPMENT COMPANY
In addition to the arguments raised above Shaffer and Berwind have asserted counterclaims against the United States Department of the Interior (DOI) as a current owner of a portion of the site. The portion allegedly owned by the DOI is a railroad right-of-way conveyed to the DOI by deed dated September 27, 1985 by West Virginia's Public Land Corporation to be part of the New River Gorge National River Park, a Park administered by the DOI's Park Service. Shaffer and Berwind assert that the DOI is liable for a portion of the response costs under CERCLA,
42 U.S.C. § 9607(a)
.
The United States moved for summary judgment on this counterclaim, claiming that the DOI does not own any portion of the Site. In an alternative argument, the United States maintains it is not liable for any response costs because cleanup was completed before the property was conveyed to the DOI. This motion is still pending before this Court.
Shaffer also asserts no liability for contamination cleaned up in 1990, costing an additional three hundred eighty thousand dollars ($380,000), claiming this was new contamination caused by vandals.
Additionally, Shaffer Equipment Company is no longer an operating company, with no real assets besides its insurance policies which contain pollution exclusion clauses. Anna Shaffer, sole shareholder of Shaffer Equipment Company, does not have sufficient assets to contribute in any significant way to the EPA's response costs either. Given Shaffer's limited ability to pay, their arguments concerning the EPA's response action, and the fact that the United States cannot use Mr. Caron's testimony to defend their response costs, Shaffer's offer of six hundred thousand dollars ($600,000) in settlement of past claims appears reasonable to the Court.
C. BERWIND LAND COMPANY
Although Berwind has owned a portion of the Site since at least 1971 when it acquired its interest from its parent corporation,
Berwind Corporation, Berwind argues it is an innocent landowner under CERCLA,
42 U.S.C. § 9607(b)(3)
. Berwind claims it has a third party defense to liability. While the United States believes it can prove Berwind had actual knowledge of how its property was being used, if successful, this defense would relieve Berwind of all liability.
Berwind also raises a defense to joint and several liability, relying on a letter from EPA Assistant Regional Counsel dated February 15, 1992 in which Berwind was invited to clean up its portion of the Site. The letter states that Berwind should expect to pay between one hundred fifty and two hundred thousand dollars ($150,000-$200,000) when the EPA cleans up Berwind's portion. Berwind maintains that this letter implies that the EPA believed the environmental harm to be divisible and that Berwind was only liable for its portion of the Site. This contention is also supported by the testimony of Berwind employees and can apparently only be rebutted by Mr. Caron.
Additionally, Berwind Corporation, Berwind Land Company's parent, has filed a motion under Rule 11 of the Federal Rules of Civil Procedure against the United States for naming Berwind Corporation as a defendant without sufficient evidence.
In light of Berwind's claims and defenses, resolved under its Proposed Consent Decree, and other provisions of the Proposed Consent Decrees including a reopener for future release of hazardous substances caused by Berwind, the Court believes Berwind's settlement offer of seventy five thousand dollars ($75,000) for reimbursement of past response costs is reasonable.
D. JOHNS HOPKINS UNIVERSITY
The basis for Johns Hopkins' liability are three large used transformers, admittedly filled with PCBs, which Johns Hopkins contends it sent to the Site for re-use by Shaffer Equipment Company. Johns Hopkins has a number of defenses to liability, many of which relate to actions taken by the EPA in cleanup efforts.
At either Mr. Carons or the EPA counsel's direction, the EPA removed the Johns Hopkins transformers from the Site and destroyed them before contacting Johns Hopkins. The EPA was required to notify Johns Hopkins, having identified Johns Hopkins as a "potentially responsible person" under CERCLA. The transformers, relevant evidence, were also destroyed without ascertaining in any verifiable manner that they were leaking at the time they were removed from the Site. Regarding these actions taken by the EPA, Johns Hopkins has asserted a claim of governmental misconduct as part of its motion for Summary Judgment. If granted in relation to this part of the motion, this claim would entitle Johns Hopkins to an evidentiary presumption fatal to much of the United States' case. McGuire v. Sigma Coatings, Inc., No. 91-2076, 1993 U.S.Dist. LEXIS 19174 (E.D.La. Nov. 1, 1993).
Johns Hopkins contends that if it had received notice that its transformers were at the Site at the time of cleanup, it would have removed them at a fraction of the cost incurred by the EPA. Johns Hopkins argues that it has thereby also been deprived of an opportunity to show that its transformers did not leak. If the transformers did not leak, Johns Hopkins would only be responsible for disposal of the transformer. Therefore, destruction of the transformers also deprived Johns Hopkins of the opportunity to argue that harm was divisible.
Johns Hopkins further maintains it sent the transformers to Shaffer for re-use and not disposal, and was not an "arranger for disposal" under CERCLA, Section 107(a)(3). See United States v. Gordon Stafford, Inc.,
810 F. Supp. 182
(N.D.W. Va.1993); Chesapeake and Potomac Telephone Company of Virginia v. Peck Iron Metal Co.,
814 F. Supp. 1269, 1275
(E.D.Va. 1992) (conveyance of usable equipment to be used for its originally intended purpose not "arrangement for disposal.") If it were to prevail in this argument, Johns Hopkins would have no liability.
Johns Hopkins also has a third party defense under CERCLA Section 107(b)(3) for Shaffer's handling of the transformers which if successful would also relieve Johns Hopkins of all liability.
Johns Hopkins can demonstrate that the maximum cost to the United States for removing the transformers in question and their contents was fifty seven thousand four hundred seventy-five dollars ($57,475), including a proportionate share of overhead costs. Given the EPA's mishandling of the transformers, Johns Hopkins' limited involvement and its arguments against all liability, particularly against joint and several liability, the Court believes Johns Hopkins' settlement offer of fifty thousand dollars ($50,000) to be more than reasonable.
E. THE "CARON PROBLEM:" SNYDER AND HUTCHINS
As the United States admits in its Additional Information Regarding Proposed Settlements, no small part of its mismanagement of this matter was the so-called "Caron Problem," in which it was discovered that Mr. Caron had been substantially misrepresenting his credentials and had given perjured testimony in other matters. Compounding this problem was the fact that the United States' attorneys, J. Jared Snyder and William A. Hutchins, violated their duty of candor to this Court with respect to the "Caron Problem" by repeatedly obstructing Defendants' attempts to uncover Mr. Caron's perjury and failing to reveal what they knew of Mr. Caron's misrepresentation once they learned of it. See United States v. Shaffer Equipment Co.,
11 F.3d 450, 461
(4th Cir. 1993). See also Rules of Professional Conduct, Rule 3.3(a)(2) (W.Va. 1989) ("A lawyer shall not knowingly fail to disclose a material fact to the tribunal when disclosure is necessary to avoid assisting in a criminal or fraudulent act by the client").
In all appearances, actions and proceedings in and within the jurisdiction of this Court, attorneys shall conduct themselves in accordance with the ethical considerations and disciplinary rules of the Model Federal Rules of Disciplinary Enforcement and the said Codes of Professional Responsibility, being subject at all times to the statutes, rules and orders applicable to and controlling the procedures and practice of law in this Court. Attorneys should remember that said codes and rules and orders are minimal standards. The Court encourages counsel to strive to reach the highest standards of ethical conduct. Local Rules of the United States District Court for the Southern District of West Virginia, Rule 1.03(h) (effective through September 1, 1994).
This violation, in fact, compromised the United States to the extent that this Court dismissed the case and awarded attorney fees and costs to Defendants. Indeed, the Court felt compelled to take this severe action, because, as it said, "there is no price tag that comes with the duty of candor charged by the courts and the applicable "rules of professional responsibility" United States v. Shaffer Equipment Co.,
796 F. Supp. 938, 953
(S.D.W. Va. 1992) (emphasis in original), aff'd in part, rend in part, remanded,
11 F.3d 450
(4th Cir. 1993).
Upon appeal the United States Court of Appeals for the Fourth Circuit (Fourth Circuit) found that the sanction of dismissal was too severe and remanded the case on that issue. However, the Fourth Circuit agreed with this Court that Mr. Hutchins and Mr. Snyder had violated their duty of candor to the Court, "exposing themselves and their employer to sanctions." U.S. v. Shaffer at 461 (emphasis added). Neither Mr. Hutchins nor Mr. Snyder can claim ignorance of an attorney's duty of candor to the Court. Both attended law-school and are members of the bar where the Court must assume they have learned something about legal ethics or have been at least exposed to the subject.
In an example of how much damage the "Caron Problem," including the roles played by Mr. Snyder and Mr. Hutchins, may have contributed to the outcome of this litigation, the Fourth Circuit suggested that an appropriate sanction might be the denial of the government's "right to claim any expertise which may have been tainted by Caron's misconduct." U.S. v. Shaffer,
11 F.3d at 463
. By the United States' own admission, the total amount of these expenses, incurred while Mr. Caron was overseeing the Site cleanup, is approximately five million two hundred thirty thousand dollars ($5,230,000), which is approximately eighty percent (80%) of the total cleanup cost of $6,475,000, leaving
the United States with a remaining claim against Defendants for only one million two hundred forty-five thousand dollars ($1,245,000). This remaining claim is the maximum the United States would be able to recover under this scenario. However, as hereinbefore noted, each Defendant in this case has significant defenses to their respective liability.
III. AUTHORITY TO SANCTION
A. ABUSE OF DISCOVERY
The Court must point out that when Mr. Hutchins and Mr. Snyder breached their duty of candor to the Court they also flagrantly abused the discovery process. In failing to supplement Defendants' discovery requests regarding Mr. Caron's credentials with information that Mr. Snyder admitted was relevant, Mr. Snyder and his immediate supervisor, Mr. Hutchins, violated Rule 26(e) of the Federal Rules of Civil Procedure.
Mr. Snyder and Mr. Hutchins violated Rule 26(e)(1) and Rule 26 (a)(2)(C) by failing to supplement information on an expert witness. Rule 26(e)(2) was ignored when Mr. Snyder failed to amend his prior objection to an interrogatory regarding Mr. Caron after he learned that the matter was indeed relevant and his previous objection to the questions was incorrect.
This Court's discretion to impose sanctions for abuse of discovery is quite broad under its inherent power and under Federal Rule of Civil Procedure 26(e) which itself furnishes fair warning of the Court's power to impose sanctions. Thibeault v. Square D Co.,
960 F.2d 239, 245
(1st Cir. 1992). The Rules permit the imposition of a sanction in the form of a fine, paid to the court and not to the opposing party. A finding of contempt is not a prerequisite to the imposition of such a sanction. Pereira v. Narragansett Fishing Corp.,
135 F.R.D. 24
(D.C.Mass. 1991). Monetary sanctions in the form of attorney fees for litigation abuse in this case would not be barred by sovereign immunity because a sufficiently explicit rule authorizing such an award exists, namely Federal Rule of Civil Procedure 26(e). See United States v. Horn,
29 F.3d 754
(1st Cir. 1994).
B. DUTY OF CANDOR
The Court has the inherent authority to discipline all attorneys who appear before it and "the inherent power extends to the full range of litigation abuses." U.S. v. Shaffer,
11 F.3d at 457
. See Chambers v. NASCO,
501 U.S. 32,
111 S.Ct. 2123,
115 L.Ed.2d 27
(1991) citing Anderson v. Dunn, 6 Wheat 204,
5 L.Ed. 242
(1821). Therefore, this Court possesses the inherent authority to fashion a sanction for attorneys violating the duty of candor in a manner it finds appropriate. See Chambers,
501 U.S. at 44-45,
111 S.Ct. at 2132-33
.
The duty of candor to the tribunal is a widely recognized one within the legal profession, United States v. Associated Convalescent Enterprises, Inc.,
766 F.2d 1342, 1346
(9th Cir. 1985), and government attorneys, like all attorneys, have a duty to conform to the ethical guidelines of their profession. In so failing to conform, Mr. Hutchins and Mr. Snyder were not acting within the directives of their employment and therefore cannot claim any exemption from sanction for their actions by way of sovereign immunity. Sovereign immunity is not a bar to personal sanctions on government attorneys for their ethical violations because these sanctions do not come from the public coffers. See U.S. v. Horn, 29 F.3d at 754.
IV. SANCTIONS ORDERED
Despite the Fourth Circuit's opinion, the U.S. Department of Justice, Office of Professional Responsibility, has refused to find misconduct" by Mr. Snyder and Mr. Hutchins, instead characterizing their behavior as "repeated exercises of poor judgment." Letter from Michael E. Shaheen Jr. to Mr. John Tinney, Attorney and Mr. Richard Rivers, Vice President and General Counsel of Berwind Corporation.
To demonstrate the cursory attitude of this in-house investigation, the full letter, dated July 19, 1994 is herein quoted:
Dear Messrs. Tinney and Rivers:
This is in final response to your letter of complaint dated February 10, 1992, concerning Justice Department Attorney Jared Snyder and his handling of United States v. Shaffer Equipment, et al., Civil Action No. 5:90-1195 (S.D.W.Va). Subsequently, the U.S. District Court for the Southern District of West Virginia dismissed Shaffer on the basis of its findings that Jared Snyder and his supervisor, ENRD senior trial attorney had engaged in intentional misconduct. On appeal, the Fourth Circuit affirmed the district court's findings of misconduct, but reversed and remanded for a sanction short of dismissal. It is our understanding that the matter is presently pending before the district court.
We have carefully reviewed your allegations of misconduct against Mr. Snyder and the court's findings of misconduct against Mr. Snyder and Mr. Hutchins. We find that Mr. Snyder and Mr. Hutchins engaged in repeated exercises of poor judgment in their handling of aspects of Shaffer. We do not, however, find they engaged in intentional misconduct [emphasis added]. We have advised the Acting Assistant Attorney General of the Environment and Natural Resources Division of our findings. We are now closing our file in this matter.
If you have any questions, please contact me or Assistant Counsel Rob Lyon on 202-514-3365.
Sincerely,
Michael E. Shaheen Jr. Counsel
"And thereby hangs a tale."
With such perfunctory treatment, two complete sentences, given to matters of ethics found to be worthy of at least a dozen paragraphs by the Fourth Circuit, it is no small wonder, but no excuse, that these attorneys behaved as they did. Quite frankly, it shocked this Court to learn of the Department of Justice's superficial investigation and evaluation of the conduct of these attorneys. We are dealing here with a hodgepodge of bureaucratic bungling and cover up of abysmal proportions.
William Shakespeare, As You Like It, Act II, scene vii.
Be that as it may, as directed by the Fourth Circuit, this case is again before this Court to resolve its merits, which it will do by entering the consent decrees, and to sanction the United States, short of outright dismissal, in such a way as to deter future violations of the duty of candor by government attorneys. U.S. v. Shaffer,
11 F.3d at 462-63
.
Therefore, IT IS ORDERED that Mr. J. Jared Snyder shall pay from his personal funds the amount of two thousand dollars ($2,000) and Mr. William A. Hutchins shall pay from his personal funds the amount of two thousand five hundred dollars ($2,500) to reimburse the Superfund (to be deposited into Department of Justice lockbox bank, referencing CERCLA number 03D8, DOJ Case Number 90-11-2-649 and US Attorney Office file number 90V0304) as sanctions for their respective breaches of ethical conduct, namely for violation of the duty of candor to the Court. In determining the amount of sanction the Court deemed appropriate, the Court considered, inter alia, the salary levels of these attorneys.
Further, IT IS ORDERED that neither Mr. Hutchins or Mr. Snyder shall seek reimbursement for these sanctions from their employer. See Chilcutt v. United States,
4 F.3d 1313, 1362
(5th Cir. 1993) (Assistant United States Attorney (AUSA) ordered to personally reimburse plaintiffs for attorney fees which arose from AUSA's discovery abuses). See also J.M. Cleminshaw Co. v. City of Norwich,
93 F.R.D. 338
(D.C.Conn. 1981) (discovery sanction assessed against attorney to be paid to the clerk of the court out of attorney's personal funds). Payment of personal assessments directly into the Superfund is an appropriate way for these attorneys to make some restitution toward this pyramid of errors which ultimately collapsed upon itself, resulting in serious and costly consequences to all those involved in the Minden cleanup debacle.
V. VALUE OF THE CONSENT DECREES
Without the substantial cost to the United States of attorney fees previously awarded,
totalling one hundred ninety three-thousand nine hundred thirty-six dollars and fifteen cents ($193,936.15), and with provisions in the consent decrees governing maintenance of the response actions and access to the Site, and provisions allowing the United States to reopen this matter against Shaffer for future response costs and against Berwind for future releases of hazardous substances, the consent decrees actually have a greater value than $725,000. This value could range from as low as nine hundred eighteen thousand nine hundred thirty-six dollars and fifteen cents ($918,936.15) (the total of the $725,000 settlement and $193,936.15 in previously awarded attorney fees) to millions of dollars if there are future releases and response costs.
In addition to the sanctions ordered above and consistent with the consent decrees, IT IS ORDERED that those portions of this Court's July 31, 1992 and October 29, 1992 Orders awarding Defendants attorney fees totalling one hundred thirty-three thousand five hundred four dollars and fifty-two cents ($133,504.52) to Berwind's counsel, twenty-four thousand seven hundred seventy-one dollars and fifty-six cents ($24,771.56) to Shaffer's counsel and thirty-five thousand six hundred sixty dollars and seven cents ($35,660.07) to Johns Hopkins' counsel are VACATED.
VI. MOTION TO ENTER CONSENT DECREES GRANTED
Due in part to the fact that the consent decrees are more significant than their face monetary value would indicate and due primarily to the mismanagement of this matter which severely weakened the United States' chances for recovery of any substantial portion of its response costs and the conceivably enormous expenses for all parties involved in proceeding with this litigation, the United States' Motion to Enter Proposed Consent Decrees is GRANTED. The Court will enter the decrees by executing them in the space provided at the end of each decree.
The Clerk is directed to send a copy of this Order and the executed consent decrees between the United States and Anna Shaffer and Shaffer Equipment Company, the United States and Berwind Land Company, and the United States and Johns Hopkins University to all counsel of record.
IT IS SO ORDERED.
| https://www.casemine.com/judgement/us/5914bdcaadd7b049347a46d3/amp |
The substrate-binding pocket. aAtNIT4 structure showing two dimers... | Download Scientific Diagram
Download scientific diagram | The substrate-binding pocket. aAtNIT4 structure showing two dimers interacting across the C-interface, the position of the catalytic site is indicated by a square. b The active-site pocket, the catalytic residues (E76, K163, E170, and C197) are shown (**), residues conserved in all plant NITs (*). A loop (tan) arising from the adjacent monomer (between α2 and α3) extends over the entrance to the active-site pocket. c As expected, the amino acid residues surrounding the binding pocket correlate with substrate specificity. Three amino acid positions in particular are responsible for the majority of the variation between known plant NITs: 169, 224, and 95 (numbered according to AtNIT4). d A lid (tan), formed by the loop, limits the length of the binding pocket (#). R95 is in the lid loop; S224 is on the outer border of the binding pocket and L169 points toward the light green subunit across the C-interface from publication: Cryo-EM and directed evolution reveal how Arabidopsis nitrilase specificity is influenced by its quaternary structure | Nitrilases are helical enzymes that convert nitriles to acids and/or amides. All plants have a nitrilase 4 homolog specific for ß-cyanoalanine, while in some plants neofunctionalization has produced nitrilases with altered specificity. Plant nitrilase substrate size and... | Directed Evolution, Arabidopsis and Secondary Metabolism | ResearchGate, the professional network for scientists.
The substrate-binding pocket. aAtNIT4 structure showing two dimers interacting across the C-interface, the position of the catalytic site is indicated by a square. b The active-site pocket, the catalytic residues (E76, K163, E170, and C197) are shown (**), residues conserved in all plant NITs (*). A loop (tan) arising from the adjacent monomer (between α2 and α3) extends over the entrance to the active-site pocket. c As expected, the amino acid residues surrounding the binding pocket correlate with substrate specificity. Three amino acid positions in particular are responsible for the majority of the variation between known plant NITs: 169, 224, and 95 (numbered according to AtNIT4). d A lid (tan), formed by the loop, limits the length of the binding pocket (#). R95 is in the lid loop; S224 is on the outer border of the binding pocket and L169 points toward the light green subunit across the C-interface
Nitrilases are helical enzymes that convert nitriles to acids and/or amides. All plants have a nitrilase 4 homolog specific for ß-cyanoalanine, while in some plants neofunctionalization has produced nitrilases with altered specificity. Plant nitrilase substrate size and specificity correlate with helical twist, but molecular details of this relatio...
Citations
... The contact interfaces between the monomers in a helical oligomer are designated A, C, D, and E, whereas in nitrilase Nit4 from Arabidopsis thaliana, the F interface has also been found, which depends on oligomer termination
[54]
. The positions of A, C, and D surfaces for Cyn pum are shown in Figure 5a (the E interface is formed by the rotation of the terminal dimers in the helix). ...
... The C-termini, which are part of the A interface, also maintain interactions required for the formation of the quaternary structure in nitrilases. They span at least two adjacent dimers in Nit4 from Arabidopsis thaliana (pdb 6i00)
[54]
and the nitrilase from Pseudomonas fluorescens EBC191 (pdb 6zby). The orientation of the C-terminus in the dimer of the recently reported structure of CynD pum is shown in Figure 5b. ...
... The C-terminus in CynH homologs has a conserved motif (DXXGHY) similar to that of CynDs ( Figure 5c). C, D, and E, whereas in nitrilase Nit4 from Arabidopsis thaliana, the F interface has also been found, which depends on oligomer termination
[54]
. The positions of A, C, and D surfaces for Cynpum are shown in Figure 5a (the E interface is formed by the rotation of the terminal dimers in the helix). ...
Nitrilases have a high potential for application in organic chemistry, environmental technology, and analytics. However, their industrial uses require that they are produced in highly active and robust forms at a reasonable cost. Some organic syntheses catalyzed by nitrilases have already reached a high level of technological readiness. This has been enabled by the large-scale production of recombinant catalysts. Despite some promising small-scale methods being proposed, the production of cyanide-converting nitrilases (cyanide hydratase and cyanide dihydratase) is lagging in this regard. This review focuses on the prospects of cyanide(di)hydratase-based catalysts. The current knowledge of these enzymes is summarized and discussed in terms of the origin and distribution of their sequences, gene expression, structure, assays, purification, immobilization, and uses. Progresses in the production of other nitrilase catalysts are also tackled, as it may inspire the development of the preparation processes of cyanide(di)hydratases.
... In CynD C1 and CynD from P. stutzeri, mutations in the C-terminal region decrease oligomerization (14,36,37). The C-terminal region of nitrilases stabilizes the spiral structure through criss-crossed beta sheets in the center of the oligomer (8,
40)
. Also, Acidic pH has been shown to promote higher-order oligomerization states of CynDs (12,36); however, the effects of pHs greater than 9 have not been reported. ...
(Mulelu et al. 2019)
. The structure was repaired by FoldX. ...
... On the other hand, in the B subunit of H90M, three new hydrogen bonds in the C-terminal tail that are relevant in the spiral oligomer to form the C-surface were formed. The C-surface is the major region that contributes to the formation of the larger spiral structure of nitrilases
(Mulelu et al. 2019)
... Central to the discussion of the reaction mechanism is the correct identification of the reaction catalyzed by any particular member of the superfamily as this will enable an understanding of the subtle effects of the differences in active site conformation. In particular, there are only two published intermediate-resolution structures of verified nitrilases
(Mulelu et al., 2019;
Zhang et al., 2014) that have not yet led to a satisfactory explanation of the differences between the active sites of amidases and nitrilases. ...
... Several attempts to co-crystallize the C146A variant of the P. horikoshii amidase with all the nitriles that we tested failed in our hands. Although the mode of binding suggested by Raczynska et al. (2011) seems plausible, further discussion of nitrile binding should await experimental visualization of the bound substrate, perhaps in the active site of an enzyme that has been shown to have nitrilase activity of which two structures are now published
(Mulelu et al., 2019;
The nitrilase superfamily enzymes from Pyrococcus abyssi and Pyrococcus horikoshii hydrolyze several different amides. No nitriles that we tested were hydrolyzed by either enzyme. Propionamide and acetamide were the most rapidly hydrolyzed of all the substrates tested. Amide substrate docking studies on the wild-type and C146A variant P. horikoshii enzymes suggest a sequence in which the incoming amide substrate initially hydrogen bonds to the amino group of Lys-113 and the backbone carbonyl of Asn-171. When steric hindrance is relieved by replacing the cysteine with alanine, the amide then docks such that the amino group of Lys-113 and the backbone amide of Phe-147 are hydrogen-bonded to the substrate carbonyl oxygen, while the backbone carbonyl oxygen of Asn-171 and the carboxyl oxygen of Glu-42 are hydrogen-bonded to the amino group of the substrate. Here, we confirm the location of the acetamide and glutaramide ligands experimentally in well-resolved crystal structures of the C146A mutant of the enzyme from P. horikoshii. This ligand location suggests that there is no direct interaction between the substrate amide and the other active site glutamate, Glu-120, and supports an active-site geometry leading to the formation of the thioester intermediate via an attack on the si-face of the amide by the sulfhydryl of the active site cysteine.
[84]
revel substrate specificity, binding pocket and binding mode of Arabidopsis nitrilase. ...
Nitrilase enzyme catalyze conversion of nitrile compounds to its corresponding carboxylic acid and ammonia. With the rise of digital era, the use of computational analysis to revel hidden characteristics of enzymes is continuously growing because of its cost effectiveness and faster output. Highly developed sequencing technology provides an opportunity to conduct virtual studies and explore unique properties and applications of various enzymes. Physico-chemical properties of aliphatic nitrilase evaluated results show quite similar properties of all 13 studied aliphatic nitrilase. The 3D structures of aliphatic nitrilase were generated by using Swiss-Model server and validated using different tools describes that quality of 3D structure of all 13 protein is good. Docking of 13 nitriles with all 13 aliphatic nitrilase was done by using Autodock v4.2.6 software, reveals that cis-cis Mucononitrile has highest binding affinity with most of studied protein, while Glycolonitrile and Propionitrile has less binding affinity toward major studied nitrilase.
... Details related to the helical twisted nature of these enzyme has received considerable attention of late because of its demonstrated importance in determining substrate specificity [12]. In the absence of available crystal structures the recent application of cryoEM has proven itself useful for these studies
[13]
... Recent studies have shown that a significant factor contributing to the substrate specificity of Branch1 nitrilases is their quaternary structure consisting of oligomeric left-handed helical spirals or twisted filaments comprised of interacting dimers [11][12]
[13]
. Nit6803, for example, has been described as a spiral with a small twist (relaxed) (Δ Ψ ~ − 60 • ) which has been equated with broad specificity for relatively larger substrates [12]. In contrast, other nitrilases such as the Arabidopsis thaliana Nit4 (AtNit4) enzyme, exhibits a large twist (tight) (Δ Ψ ~ − 73 • ), has a narrow substrate specificity, and acts mainly on smaller substrates. ...
... In contrast, other nitrilases such as the Arabidopsis thaliana Nit4 (AtNit4) enzyme, exhibits a large twist (tight) (Δ Ψ ~ − 73 • ), has a narrow substrate specificity, and acts mainly on smaller substrates. AtNit4, for example, is specific for relatively small compounds such as β-cyanoalanine which is thought to be the physiological substrate
[13]
. We may predict that Nit11764 would also assume a small helical twist in its quaternary state because of its close homology to Nit6803. ...
Characterization of the Nit6803 nitrilase homolog from the cyanotroph Pseudomonas fluorescens NCIMB 11764
We report the purification and characterization of a nitrilase (E.C. 3.5.5.1) (Nit11764) essential for the assimilation of cyanide as the sole nitrogen source by the cyanotroph, Pseudomonas fluorescens NCIMB 11764. Nit11764, is a member of a family of homologous proteins (nitrile_sll0784) for which the genes typically reside in a conserved seven-gene cluster known as Nit1C. The physical properties and substrate specificity of Nit11764 resemble those of Nit6803, the current reference protein for the family, and the only true nitrilase that has been crystallized. The substrate binding pocket of the two enzymes places the substrate in direct proximity to the active site nucleophile (C160) and conserved catalytic triad (Glu44, Lys126). The two enzymes exhibit a similar substrate profile, however, for Nit11764, cinnamonitrile, was found to be an even better substrate than fumaronitrile the best substrate previously identified for Nit6803. A higher affinity for cinnamonitrile (Km 1.27 mM) compared to fumaronitrile (Km 8.57 mM) is consistent with docking studies predicting a more favorable interaction with hydrophobic residues lining the binding pocket. By comparison, 3,4-dimethoxycinnamonitrile was a poorer substrate the substituted methoxyl groups apparently hindering entry into the binding pocket. in situ ¹H NMR studies revealed that only one of the two nitrile substituents in the dinitrile, fumaronitrile, was attacked yielding trans-3-cyanoacrylate (plus ammonia) as a product. The essentiality of Nit11764 for cyanotrophy remains uncertain given that cyanide itself is a poor substrate and the catalytic efficiencies for even the best of nitrile substrates (~5 × 10³ M⁻¹ s⁻¹) is less than stellar.
... (Figure 1). All nitrilases showed complete conservation of the catalytic tetrad Cys-Glu-Glu-Lys (CEEK)
[20]
. In addition, 79 residues in NitAF were conserved in the sequences of the aligned nitrilases. ...
... Nitrilases, as thiol enzymes, form covalent thioimidate complexes by attacking the carbon of nitriles (R-CN). The catalytic tetrad of nitrilase consists of CEEK; the cysteine carries out a nucleophilic attack on the cyanocarbon, the glutamate functions by mediating the transfer of a proton as a general base, and the lysine plays an essential role in the stabilization of a tetrahedral intermediate
[20,
21,24]. Although previous investigations have aimed to elucidate the role of an amino acid residue in the substrate specificity of nitrilases using mutational and computational approaches, its role in the catalytic efficiency has not been reported; thus, a comprehensive understanding of the factors contributing to the catalytic efficiency of nitrilases remains elusive. ...
... The homology model of NitTv1 was constructed previously [18]. Since then, a new template NIT4 in A. thaliana (pdb code 6i00)
[21]
emerged. In this study, this template was used for multiple sequence alignment ( Figure S3) along with the previously used template [18], i.e., the NLase from Synechocystis sp. ...
... However, as this information on the active form of NitAb or NitTv1 has not been available yet, we used both the monomer and an oligomer (tetramer) for the docking studies ( Figures S7 and S8 in Supplementary Materials). The recently reported structure of NIT4
[21]
allowed a precise modeling of loop HL1 and hence improved prediction and characterization of ligand binding in the NLase oligomers. ...
... The model of NitTv1 was previously constructed [18] and the model of NitAb was made analogously. The templates for homology modeling of NitAb were the recently released cryo-EM structure of NIT4 from A. thaliana (pdb code 6i00
[21]
) and crystal structure of the NLase from Synechocystis sp. (pdb code 3wuy [22]). ...
| https://www.researchgate.net/figure/The-substrate-binding-pocket-aAtNIT4-structure-showing-two-dimers-interacting-across-the_fig3_334519175 |
Dentistry Journal | Free Full-Text | A Longitudinal Study on the Relationship of Oral Health at 4 Years of Age with That in Adulthood
This longitudinal study aimed to clarify the relationship of oral health in infancy with that in adulthood among participants who were the subjects of the oral health promotion project (OHPP) conducted in Miyako Island, Okinawa Prefecture, Japan, since 1984. Twenty-seven subjects, around 35 years of age, were examined for dental caries, periodontal diseases (community periodontal index), dental plaque, occlusion, and bite-force and compared with those at 4 and 13–15 years of age. The dental caries status and maximum bite force in adulthood was significantly reflected for those at 4 and 13–15 years of age (p 0.05). Most of the normal occlusion at 4 years of age became normal permanent occlusion in adulthood (88.9%). Most of the cases involving the discrepancy factor retained the same condition in both the deciduous and permanent dentitions (83.3%) (p < 0.001). Those who participated in the OHPP soon after birth showed significantly fewer DMFT (p < 0.05) compared with those who did not. This study revealed that oral health at 4 years of age was related to that in adulthood, suggesting that fostering good oral health soon after birth is of great importance.
Open Access Article
A Longitudinal Study on the Relationship of Oral Health at 4 Years of Age with That in Adulthood
by
Sho Yamada 1 ,
Reiko Sakashita 2,* ,
Mikinori Ogura 3 ,
Eiko Nakanishi 2 and
Takuichi Sato 4
1
2
College of Nursing Art and Science, University of Hyogo, Akashi 673-8588, Japan
3
Maxillofacial Unit, Oita Oka Hospital, Oita 870-0192, Japan
4
Division of Clinical Chemistry, Niigata University Graduate School of Health Sciences, Niigata 951-8518, Japan
*
Author to whom correspondence should be addressed.
Dent. J. 2021 , 9 (2), 17; https://doi.org/10.3390/dj9020017
Received: 28 December 2020 / Revised: 18 January 2021 / Accepted: 23 January 2021 / Published: 1 February 2021
(This article belongs to the Section Oral Hygiene, Periodontology and Peri-implant Diseases )
Abstract
:
This longitudinal study aimed to clarify the relationship of oral health in infancy with that in adulthood among participants who were the subjects of the oral health promotion project (OHPP) conducted in Miyako Island, Okinawa Prefecture, Japan, since 1984. Twenty-seven subjects, around 35 years of age, were examined for dental caries, periodontal diseases (community periodontal index), dental plaque, occlusion, and bite-force and compared with those at 4 and 13–15 years of age. The dental caries status and maximum bite force in adulthood was significantly reflected for those at 4 and 13–15 years of age (
p
< 0.05). CPI in adulthood was related to the dental caries status at 4 and 13–15 years of age but not to the gingival score at 4 years of age, and it was weakly related to the gingival score at 13–15 years (r = 0.264,
p
> 0.05). Most of the normal occlusion at 4 years of age became normal permanent occlusion in adulthood (88.9%). Most of the cases involving the discrepancy factor retained the same condition in both the deciduous and permanent dentitions (83.3%) (
p
p
< 0.05) compared with those who did not. This study revealed that oral health at 4 years of age was related to that in adulthood, suggesting that fostering good oral health soon after birth is of great importance.
Keywords:
oral health
;
dental caries
;
periodontal disease
;
occlusion
;
bite-force
;
infant
;
longitudinal study
1. Introduction
It has been suggested that the underdevelopment of the masticatory system will increase among young Japanese population [ 1 , 2 ]. For example, 63.1% of young Japanese people (n = 495) have crowding of teeth [ 3 ], and Japanese children currently show a narrowing of the dental arch width as compared with those in 1964 [ 4 ], and 34.6% of children aged 3 to 5 years (n = 107) have problem in eating such as slow eating and less function [ 5 ]. The present diet, with its soft and nutritious food, bottle feeding, and long-lasting pureed baby food, has been suspected to be the cause of these problems [ 6 ]. Experiments have shown that breast-fed mice have a better developed masticatory system than bottle-fed ones. A diet of liquidized or pureed food reduces the height of the mandible, the length of the body of the mandible, and the condylar width, and widens the gonial angle [ 7 ]. It also reduces the size of the masseter and temporal muscles as well as of the salivary glands [ 8 ]. Experiments with rats have also shown that the feeding of a liquid diet after being weaned may alter the motor output of jaw and tongue muscles and obstruct the functional transition from suckling to mastication, and jaw elevators that develop without motor learning of mastication are inefficiency when performing functionally [ 9 ].
Hence, if diet can be the main cause of not only dental diseases but also insufficient development of the masticatory system, healthy oral conditions can possibly be brought about by a change in the dietary regime from a young age. Hoping to reduce the insufficient development of the masticatory system and to prevent dental problems through health education focusing on diet, we set up the Oral Health Promotion Project (OHPP) and a longitudinal study in selected districts on Miyako Island, Okinawa Prefecture, Japan, in 1984 [
10
]. The OHPP lasted eight years, with another nine years of follow-up, and completed in the year 2000. Positive effects of this project were reported on dental occlusion, masticatory function, and dental caries in the participants at 4 and 13–15 years of age [
11
,
12
].
After graduating from junior high school, many participants left this remote island for study or work, but some of them were expected to return for the reunion to celebrate the 20th anniversary of graduating from junior high school in Karimata on Miyako Island, when they were about 35 years old. On this and on other occasions, such as New Year’s and Homecoming, this study aimed to clarify the relationship between the oral conditions at 4 years of age (completed deciduous dentition [Hellman’s dental age, IIA]), 13–15 years old (permanent dentition [IVA]), and in adulthood.
2. Methods
2.1. Study Design
This prospective, longitudinal study was based on three examinations conducted in Ikema and Karimata district, remote Island Miyako, Okinawa, Japan.
2.2. The Oral Health Promotion Project (OHPP)
The Project began in April 1984. During the first eight years, the OHPP intervention focused mainly on health education, with special emphasis on diet and thrice-yearly dental examinations and treatments such as cavity restoration [ 10 ]. Participants were followed up, including an assessment of their oral health, once a year until the year 2000. Children born in the district between 1979 and 1992 were enrolled in the OHPP.
Based on previous studies [ 6 , 10 , 13 ], the guidelines for oral health promotion were developed [ 1 ]. At the first stage of the lactation period, ‘breast feeding’ was recommended; at the second step of the transition from milk to solid food, ‘natural weaning’, i.e., the introduction of food at the proper time was advised. In the third step, after approximately three years of age, when the deciduous dentition was complete, establishment of a good dietary style was suggested.
Two small communities, Ikema and Karimata, Miyako Island, Okinawa, where no regular dentist served and public health nurses requested for help in improving the poor oral condition of the population in 1984, were selected as model venues for the OHPP.
2.3. Subjects
The subjects who participated in the OHPP had records at two periods, namely at 4 years of age (completed deciduous dentition [IIA]) and at 13–15 years (permanent dentition [IVA]). The main targets were 39 participants born between 1982 and 1985 in Karimata, who would possibly return for the 20th anniversary reunion around 35 years of age. In addition, invitation cards were sent to the 70 expected participants to inform them of dental surveys and to request their participation. However, 46 cards (65.7%) were returned as the addresses were unknown.
2.4. Examinations
2.4.1. Oral Health Examinations
Dentists examined each participant to determine the oral condition, including dental caries, periodontal diseases [ 14 ], dental plaque [ 15 ], and occlusion [ 11 ], according to the criteria shown in Table 1 . This was done using a mouth mirror and an explorer, with careful consideration of the lighting conditions. Dentists assessed the dental caries status as intact, decayed, missing, or filled teeth, and DMF (number of decayed, missing, or filled permanent teeth) was used as an index.
The previous data at 4 years and 13–15 years of age contained the Gingival Score (GS), in which the areas of greatest gingivitis progression were scored following Dunning’s criteria [ 16 ]. For the deciduous dentition, pseudo-normal occlusion, which is a deciduous normal occlusion with closed dental arches, was used to determine occlusion [ 11 ].
2.4.2. Bite-Force Measurements
The bite-force was measured using a bite-force transducer (Occluser, Nagano Seiki Co., Tokyo, Japan). The block portion of the transducer was inserted into the subject’s mouth. The bite block was positioned parallel to the occlusal plane and was centered on the mandibular second molar. Maximum bites on both sides were measured, and the maximum value was used as the maximum bite force.
2.5. Data Analysis Methods
The data of this study were compared with that at 4 and 13–15 years of age. The relationship of the oral condition in adulthood with that at 4 and 13–15 years of age was examined [ 11 , 12 ].
Spearman’s correlation coefficient among quantitative variables was performed to examine the relationship among variables.
Chi-squared tests were performed to examine the relationship among age-related occlusion.
In previous studies [ 11 , 12 ], a major improvement of oral health has been observed in children born after the OHPP started (1984). Thus, the oral conditions were compared between those born before 1984 and in or after 1984 using t-tests for quantitative variables and the Chi-squared test for nominal scale.
Differences in the bite force by age and sex were tested using repeated measures ANOVA with post hoc multiple comparison by Bonferroni.
Statistical analysis software (SPSS PASW Statistics 24, Tokyo, Japan) was used for testing.
2.6. Ethical Approval
This study was conducted in accordance with the Declaration of Helsinki, and the protocol was approved by the Research Ethics Committee of the College of Nursing Art and Science, University of Hyogo (KYOUIN20) on 13 December 2017. Written informed consent was obtained from the participants.
3. Results
3.1. Subjects’ Characteristics
The demographic data of the subjects are shown in Table 2 . A total of 27 subjects (mean age, 34.5 ± 1.5 years; 66.7% male) participated in this study. As there were no significant sex differences except for the bite-force, males and females were analyzed together, except for the analysis of bite-force.
3.2. Longitudinal Change in Oral Conditions
The high values of the DMF (number of decayed, missing, or filled deciduous teeth) at 4 years (11.6 ± 5.3) dropped to 5.7 ± 3.1 at 13–15 years of age, with the replacement to permanent teeth; however, it went up to 12.2 ± 5.7 around 35 years of age ( Table 3 ). Participants born in and after 1984 had significantly lower DMF levels compared to those born before 1984 ( p < 0.05). The CPI scores were also lower among those born in/after 1984, although the difference was not significant ( Table 3 ).
The percentage of normal occlusion increased from 33.3% at 4 years to 44.4% around 35 years of age. Less crowding was found in those born in/after 1984 (11.1%) compared to those born before 1984 (44.4%), although the difference was not significant. More significant functional factors were found in those born in 1984 (33.3%) compared to those born before 1984 (0.0%) ( p < 0.05) as causative factors ( Table 3 ).
3.3. Longitudinal Change in the Maximum Bite Force
Significant differences were observed among all age groups and sexes ( p < 0.001). The maximum bite force increased significantly with age and the sex gap, and it was the largest around 35 years of age ( Table 4 ).
3.4. Correlation among Variables
The dental caries status and the maximum bite force in adulthood significantly reflected those at 4 and 13–15 years of age ( Table 5 ). The CPI in adulthood was related to the DMF and number of untreated teeth at 4 years and the DMF at 13–15 years, whereas it was not related to the GS at 4 years of age and only weakly related to the GS at 13–15 years ( Table 5 ). The number of untreated teeth at 4 years of age was strongly related to the DMF and the CPI in adulthood ( p < 0.001–0.01). Dental caries, periodontal status, and dental plaque scores were significantly related to each other in adulthood ( Table 5 ).
3.5. Distribution of Occlusion at 4 Years of Age and in Adulthood
Most of the subjects with normal occlusion at 4 years of age (88.9%) had normal permanent occlusion in adulthood, whereas only 16.7% of the subjects with pseudo-normal deciduous occlusion had normal permanent occlusion ( Table 6 ).
Most of the cases involving the discrepancy factor (83.3%) retained the same conditions in both the deciduous and permanent dentitions ( p < 0.001) ( Table 7 ). Two deciduous open-bite malocclusions, which were caused by thumb-sucking, disappeared in the permanent dentition, since the habit stopped with the eruption of the permanent teeth. One permanent posterior cross-bite malocclusion seemed to be caused by a tongue habit ( Table 7 ).
4. Discussion
Dental caries and periodontal diseases are the two most important causes for extraction in Japan [ 18 ]. Dental caries develops in both the crowns and roots of teeth, and it can arise in early childhood as aggressive tooth decay affecting the deciduous teeth of infants [ 19 ]. In the present study, as in a previous study [ 12 ], differences in dental caries prevalence were found in those born before the onset of the OHPP compared to those born after the onset of the OHPP, and these conditions continued through adolescence (age 13–15 years) into adulthood (age 35 years) ( Table 3 ).
The causes associated with early childhood caries are multifactorial, including infant feeding habits, dietary habits, consumption of sugary foods, oral hygiene procedures, use of fluoride, and psycho-social factors [ 20 ]. Among them, Sheiham and James [ 21 ] indicated that the consumption of sugars was a major etiological factor for dental caries. In the present study, those born after 1984 had good eating habits, such as less snack intake and greater intake of fiber-rich food [ 12 ], and this may have reflected in the low caries rate in adults born after 1984.
Several recent studies have provided evidence suggesting that periodontitis may increase the risk of systemic disorders such as cardiovascular diseases and premature low birth weight infants [
22
]. As oral conditions affect systemic conditions, such as atherosclerotic vascular, pulmonary disease, diabetes, pregnancy, low birth weight, osteoporosis, and kidney diseases either coincidentally or causally [
23
], it is very important to maintain good oral health throughout life. In this study, the gingivitis status at 4 years of age and at middle school correlated strongly with dental caries from the age of 4 to adulthood and seemed to reflect the oral hygiene status, but was not related to the CPI status of adults (
Table 5
). Conversely, the caries status at 4 years of age showed a strong correlation with the periodontal disease status in adults. Although the disease states of gingivitis and periodontal disease in young people are suggested to be different [
24
], maintaining a caries-free oral condition soon after birth may reduce the risk of periodontal disease in the future.
This study revealed that oral conditions in childhood were strongly related with those in adulthood ( Table 3 and Table 5 ). Many studies indicate that the caries status in the deciduous dentition is related to that in the permanent dentition, although the subjects’ age was under 20 years in most of the studies [ 25 , 26 , 27 ]. There are a few longitudinal studies from childhood to adulthood, although epidemiological studies suggest that gingivitis is common in children, and the untreated cases may progress to severe breakdown of the periodontium and loss of teeth in adults [ 28 ]. Prevention should start when deciduous teeth change into permanent teeth. However, this study confirms that the condition of the deciduous teeth is passed on to the permanent teeth ( Table 5 ). This is because the oral condition is greatly influenced by diet. Previous studies comparing the secular changes in the rates of carious teeth and the prevalence of malocclusion of discrepancy type showed that both would be expected to grow in severity as the economy progressed, with a resultant influence on dietary regimes [ 3 , 10 , 29 , 30 ]. Fiber-rich food has been seen to be most effective in dealing with this problem, as it produces a greater load on the jaws during mastication and promotes a self-cleansing system, reducing oral pollution [ 30 , 31 ]. The two main points of the OHPP dietary instructions after transition to solid food were: 1) stop drinking large amounts of high-calorie drinks like juice, especially before meals; and 2) eat fiber-rich food such as vegetables at all meals. The consumption of high-calorie drinks reduce appetite and result in not eating enough fibrous vegetables. [ 12 ]. As a result of inadequate meals, infants soon become hungry again and more juice and snacks are given. To break this vicious circle, mothers must regulate their infants’ and children’s intake so that they have empty stomachs at mealtimes. This promotes the development of the chewing system, chewing ability, and salivary secretion. Both brushing of teeth and the application of fluoride reduce dental caries [ 32 , 33 ]. However, it is not expected to have significant effects on the development of oral morphology and function. Therefore, we focused on dietary instructions and did not introduce fluoride mouth rinses.
Previous studies showed a decrease in crowding with the type of discrepancy, and dental caries could be seen among those born after the establishment of the OHPP [ 11 , 12 ]. There was less improvement in children born in 1979–1980, whose deciduous dentitions were already fully developed at the beginning of the project. Considering that the DMF improved significantly, according to the findings of this study ( Table 3 ), the developmental “direction” and risk of dental diseases would be difficult to change with increasing age. Children’s dietary intake has been shown to be strongly associated with their mother’s dietary intake [ 34 ], and the children’s own dietary habits develop early in life [ 35 , 36 ]. Thus, the suckling and weaning stages seem to be the key periods.
Experiments on mice have shown that the masticatory muscles and jaw bone in breast-fed mice developed better than those in mice fed maternal milk through artificial teats [ 37 ]. In human babies, the activity of the masticatory muscles was reduced in bottle-fed babies compared to that in breast-fed babies [ 6 , 38 ]. Rats or mice fed on soft or liquid food showed a lower percentage of oxidative fibers in the ascending rami, and it has been demonstrated that altered muscular function can influence craniofacial morphology [ 8 , 39 , 40 ]. A constant liquid diet reduces the size of the masseter and temporal muscles, and even of the salivary glands. It also affects the chewing pattern [ 8 , 9 ]. Several experiments on rats have shown that insufficient mechanical stress in the growth process results in the underdevelopment of the masticatory system, the weight of the masseter muscles, and the size of the jaw bone and condylar head [ 41 , 42 , 43 ].
Based on the above findings, we recommend breast feeding and natural weaning processes, such as baby-led weaning [ 44 ], through the OHPP. The main dietary instructions in the OHPP, as described above, are important not only for the masticatory system but also for the life-long health of the whole body. Experiences in early life influence later dietary regimes [ 45 ] and could help decrease metabolic risk factors leading to obesity and obesity-related diseases [ 46 , 47 , 48 ]. In this study, we tried to confirm the relationship between feeding and weaning processes, but in vain, due to the lack of records.
One of the limitations of the present study was the small sample size, which was a consequence of the relatively small number of participants in the OHPP, as most of the young people moved out of the region in search of education and jobs, and it was difficult to track them. There was also sex bias, as female candidates tended to be less likely to participate in this research because they were too shy to let their mouth be examined. Although there have been significant advances in treatment methods over the past 30 years, the diagnostic criteria for health screening have not changed. Thus the same criteria were used in this study.
5. Conclusions
The dental caries status and maximum bite force in adulthood was significantly reflected for those at 4 and 13–15 years of age. Periodontal diseases in adulthood was related to the dental caries status at 4 and 13–15 years of age but not to the gingival score at 4 years of age, and it was weakly related to the gingival score at 13–15 years. Most of the normal occlusion at 4 years of age became normal permanent occlusion in adulthood. Most of the cases involving the discrepancy factor retained the same condition in both the deciduous and permanent dentitions. Those who participated in the OHPP soon after birth showed significantly fewer DMF compared with those who did not. Thus, this study revealed that oral health at 4 years of age was related to that in adulthood, suggesting that fostering good oral health and dietary habits soon after birth is of substantial importance.
The authors would like to express their sincere appreciation to participants in the study.
Conflicts of Interest
The authors declare no conflict of interest.
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Table 1. Assessment scores for oral conditions.
Table 1. Assessment scores for oral conditions.
Community Periodontal Index (CPI) [ 14 ] A special probe was used to determine the probing depth, bleeding response, and presence of calculus. Six areas were measured (upper and lower central incisors, and the upper and lower, left and right first molars) and the highest applicable number was used. 0: Healthy periodontal tissues 1: Bleeding after gentle probing 2: Supragingival or subgingival calculus or defective margin of filling or crown 3: 4 mm or 5 mm periodontal pocket 4: 6 mm or deeper pathologic periodontal pocket Dental plaque index (DPI) The teeth with the most plaque were scored according to Greene & Vermillion’s criteria [ 15 ]. 0: No plaque present 1: Plaque covering not more than one-third of the exposed tooth surface 2: Plaque covering more than one third, but not more than-two thirds of the exposed tooth surface 3: Plaque covering more than two-thirds of the exposed tooth surface Categories of occlusion [ 17 ] Each occlusion was examined and classified into one of the following categories: (1) Normal occlusion: The upper and lower molars were in a relationship whereby the mesiobuccal cusp of the upper molar occluded in the buccal grove of the lower molar and the teeth were arranged in a smoothly curving line of occlusion. (2) Crowding: Crowded arrangement of the teeth. (3) Maxillary protrusion: Protruding anterior maxillary teeth. (4) Anterior cross-bite: Reversed occlusion of the anterior teeth, i.e., one or more mandibular teeth biting in front of the maxillary teeth. (5) Open bite: A partial gap of 2 mm or more between the anterior maxillary and mandibular teeth when in occlusion. (6) Others: Occlusion that does not meet the above criteria Causative factors Four main causative factors were seen in the cases of malocclusion, and these were used in combination to describe each case (e.g., anterior cross-bite with skeletal discrepancy factors): (1) Skeletal factor: Skeletal imbalance in size and/or shape between the maxilla and mandible. (2) Functional factor: Functional interference in occlusion, e.g., abnormal movement of the mandible. (3) Discrepancy factor: Tooth-to-denture base discrepancy. (4) Habitual factor: Thumb sucking or other habit.
Table 2. Subjects’ characteristics.
Table 2. Subjects’ characteristics.
Variable Age in years (Mean (SD)) 34.5 (1.5) Sex (n, %) Male 18 (66.7%) Female 9 (33.3%) Employment (n, %) Full-time 23 (85.1%) Part-time 2 (7.4%) Missing 2 (7.4%)
Table 3. Longitudinal change in oral conditions.
Table 3. Longitudinal change in oral conditions.
Variables 4 Years’ Old n = 27 13–15 Years’ Old n = 27 Adulthood n = 27 Adulthood, Born before 1984, n = 18 Adulthood, Born in/after 1984, n = 9 dmf, DMF Mean (SD) 11.6 (5.3) 5.7 (3.1) 12.2 (5.7) 14.2 (5.3) * 8.3 (4.7) * Number of untreated teeth, Mean (SD) 5.0 (4.7) 0.9 (1.7) 1.6 (2.7) 1.6 (1.9) 1.6 (4.1) GS < 15 years, CPI at 35 years, Mean (SD) 1.1 (0.5) 1.2 (0.6) 1.9 (1.2) 2.1 (1.2) 1.3 (1.3) DPI Mean (SD) 0.6 (0.6) 0.9 (0.5) 0.9 (0.7) 0.9 (0.6) 0.9 (0.8) Occlusion (1) (1) Normal 9 (33.3%) 10 (37.0%) 12 (44.4%) 8 (44.4%) 4 (44.4%) Pseudo normal 13 (48.1%) - - - - Crowding 0 (0.0%) 10 (37.0%) 9 (33.3%) 8 (44.4%) 1 (11.1%) Maxillary protrusion 0 (0.0%) 2 (7.4%) 2 (7.4%) 0 (0.0%) 1 (11.1%) Anterior cross-bite 3 (11.1%) 5 (18.5%) 1 (3.7%) 0 (0.0%) 2 (22.2%) Others 2 (7.4%) 0 (0.0%) 1 (3.7%) 0 (0.0%) 1 (11.1%) Causative factors Skeletal 1 (3.7%) 2 (7.4%) 0 (0.0%) 0 (0.0%) 0 (0.0%) Functional 2 (7.4%) 5 (18.5%) 3 (12.0%) 0 (0.0%) 3 (33.3) * Discrepancy 14 (51.9%) 14 (51.9%) 12 (40.7%) 8 (44.4%) 3 (33.3) Habitual 2 (7.4%) 1 (3.7%) 1 (8.0%) 0 (0.0%) 1 (11.1%)
* A significant difference p < 0.05 was observed between the two groups: born before and in/after 1984. (1) Two cases were excluded in which normal occlusion was achieved after orthodontic treatment.
Table 4. Longitudinal change in maximum bite force.
Table 4. Longitudinal change in maximum bite force.
Max Bite Force (kg) 4 Years Old 13–15 Years Old Adulthood Adulthood, Born before 1984 Adulthood, Born in/after 1984 n Mean (SD) n Mean (SD) n Mean (SD) n Mean (SD) n Mean (SD) Male 18 15.9 (7.3) 18 44.3 (15.9) 18 78.5 (22.5) 10 78.6 (23.8) 8 78.4 (22.3) Female 9 9.6 (5.4) 9 38.6 (5.8) 9 38.2 (12.6) 7 35.7 (11.4) 1 55.3 (-)
Repeated measures ANOVA p < 0.001, sex factor p < 0.001.
Table 5. Correlation among variables.
Table 5. Correlation among variables.
Adulthood DMF Untreated Carious Teeth CPI DPI Maximum Bite Force Age 4 years DMF 0.504 ** 0.414 * 0.392 * 0.220 −0.104 Untreated carious teeth 0.610 ** 0.256 0.675 *** 0.064 −0.133 GS 0.579 ** 0.163 0.073 0.143 −0.297 DPI 0.068 0.167 0.078 0.020 −0.083 Max bite force −0.230 −0.014 −0.317 −0.031 0.443 * Age 13–15 years DMF 0.651 ** 0.378 0.447 * 0.248 −0.289 Untreated carious teeth 0.501 ** 0.492 ** 0.298 0.592 ** 0.057 GS 0.537 ** 0.393 * 0.264 0.504 ** −0.156 DPI 0.447 * 0.305 0.264 0.510 ** 0.078 Max bite force −0.297 −0.172 −0.319 0.044 0.451 * Adulthood DMF 0.504 ** 0.580 ** 0.413 * −0.094 Untreated carious teeth 0.536 ** 0.551 ** −0.173 CPI 0.534 ** −0.200 DPI 0.110
CPI: Community Periodontal Index, DPI: Dental plaque index, GS: Gingival Score. * p < 0.05, ** p < 0.01. *** p < 0.001.
Table 6. Distribution of occlusion at 4 years of age and in adulthood.
Table 6. Distribution of occlusion at 4 years of age and in adulthood.
Adulthood Age 4 Years Normal Crowding Maxillary Protrusion Anterior Cross-Bite Others Total Normal n 8 1 0 0 0 9 % 88.9% 11.1% 0.0% 0.0% 0.0% 100.0% Pseudo normal n 2 8 1 0 1 12 % 16.7% 66.7% 8.3% 0.0% 8.3% 100.0% Maxillary protrusion n 0 0 0 2 0 2 % 0.0% 0.0% 0.0% 100.0% 0.0% 100.0% Open bite n 2 0 0 0 0 2 % 100.0% 0.0% 0.0% 0.0% 0.0% 100.0%
χ2 test, p < 0.001.
Table 7. Distribution of causative factors at 4 years of age and in adulthood (around 35 years).
Table 7. Distribution of causative factors at 4 years of age and in adulthood (around 35 years).
Adulthood Skeletal Functional Discrepancy *** Habitual Age 4 Years − + − + − + − + Skeletal − 24 0 % 100.0% 0.0% + 1 0 % 100.0% 0.0% Functional − 22 0 % 100.0% 0.0% + 2 1 % 66.7% 33.1% Discrepancy − 12 1 % 93.3% 7.7% + 1 10 % 16.7% 83.3% Habitual − 22 1 % 95.1% 4.3% + 2 0 % 100.0% 0.0%
*** A significant relationship was observed between the discrepancy type at 4 years old and that in adulthood ( p < 0.001). n = 26; Two were excluded because of orthodontic treatment.
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Remote Sensing | Free Full-Text | Fusion of China ZY-1 02D Hyperspectral Data and Multispectral Data: Which Methods Should Be Used?
ZY-1 02D is China’s first civil hyperspectral (HS) operational satellite, developed independently and successfully launched in 2019. It can collect HS data with a spatial resolution of 30 m, 166 spectral bands, a spectral range of 400~2500 nm, and a swath width of 60 km. Its competitive advantages over other on-orbit or planned satellites are its high spectral resolution and large swath width. Unfortunately, the relatively low spatial resolution may limit its applications. As a result, fusing ZY-1 02D HS data with high-spatial-resolution multispectral (MS) data is required to improve spatial resolution while maintaining spectral fidelity. This paper conducted a comprehensive evaluation study on the fusion of ZY-1 02D HS data with ZY-1 02D MS data (10-m spatial resolution), based on visual interpretation and quantitative metrics. Datasets from Hebei, China, were used in this experiment, and the performances of six common data fusion methods, namely Gram-Schmidt (GS), High Pass Filter (HPF), Nearest-Neighbor Diffusion (NND), Modified Intensity-Hue-Saturation (IHS), Wavelet Transform (Wavelet), and Color Normalized Sharping (Brovey), were compared. The experimental results show that: (1) HPF and GS methods are better suited for the fusion of ZY-1 02D HS Data and MS Data, (2) IHS and Brovey methods can well improve the spatial resolution of ZY-1 02D HS data but introduce spectral distortion, and (3) Wavelet and NND results have high spectral fidelity but poor spatial detail representation. The findings of this study could serve as a good reference for the practical application of ZY-1 02D HS data fusion.
Fusion of China ZY-1 02D Hyperspectral Data and Multispectral Data: Which Methods Should Be Used?
by Han Lu 1,2,3,† , Danyu Qiao 1,2,3,† , Yongxin Li 4 , Shuang Wu 1,2,3 and Lei Deng 1,2,3,*
Author to whom correspondence should be addressed.
†
Co-first author.
Remote Sens. 2021 , 13 (12), 2354; https://doi.org/10.3390/rs13122354
Received: 12 May 2021 / Revised: 14 June 2021 / Accepted: 14 June 2021 / Published: 16 June 2021
(This article belongs to the Special Issue Remote Sensing Data Fusion as a Strategy to Add Value to Earth Observation Data )
Abstract
ZY-1 02D is China’s first civil hyperspectral (HS) operational satellite, developed independently and successfully launched in 2019. It can collect HS data with a spatial resolution of 30 m, 166 spectral bands, a spectral range of 400~2500 nm, and a swath width of 60 km. Its competitive advantages over other on-orbit or planned satellites are its high spectral resolution and large swath width. Unfortunately, the relatively low spatial resolution may limit its applications. As a result, fusing ZY-1 02D HS data with high-spatial-resolution multispectral (MS) data is required to improve spatial resolution while maintaining spectral fidelity. This paper conducted a comprehensive evaluation study on the fusion of ZY-1 02D HS data with ZY-1 02D MS data (10-m spatial resolution), based on visual interpretation and quantitative metrics. Datasets from Hebei, China, were used in this experiment, and the performances of six common data fusion methods, namely Gram-Schmidt (GS), High Pass Filter (HPF), Nearest-Neighbor Diffusion (NND), Modified Intensity-Hue-Saturation (IHS), Wavelet Transform (Wavelet), and Color Normalized Sharping (Brovey), were compared. The experimental results show that: (1) HPF and GS methods are better suited for the fusion of ZY-1 02D HS Data and MS Data, (2) IHS and Brovey methods can well improve the spatial resolution of ZY-1 02D HS data but introduce spectral distortion, and (3) Wavelet and NND results have high spectral fidelity but poor spatial detail representation. The findings of this study could serve as a good reference for the practical application of ZY-1 02D HS data fusion.
Keywords:
ZY-1 02D
;
hyperspectral remote sensing
;
multispectral remote sensing
;
data fusion
Graphical Abstract
1. Introduction
The ZY-1 02D Satellite, also known as a 5-m optical satellite, is the first operational civil hyperspectral (HS) satellite, independently developed and successfully operated by China as the China–Brazil Earth Resources Satellite. It was launched on 12 September 2019, and one of the three main payloads is an advanced HS imager developed by the Shanghai Institute of Technical Physics (SITP), Chinese Academy of Sciences. The ZY-1 02D HS imager has 166 spectral bands ranging from 400 nm to 2500 nm, a spatial resolution of 30 m, and a swath width of 60 km, allowing it to provide detailed spectral information about ground features. Compared with other on-orbit or planned satellites (e.g., Environmental Mapping and Analysis Program, Precursore Iperspettrale della Missione Applicativa, and DLR Earth Sensing Imaging Spectrometer), the spectral resolution and the swath width of the ZY-1 02D are more advantageous. Unfortunately, due to the unavoidable trade-offs between spectral resolution, spatial resolution and signal-to-noise ratio [ 1 , 2 ], the ZY-1 02D HS data cannot directly make full use of its advantages in some specific applications [ 3 , 4 , 5 , 6 , 7 ]. In this case, a simple and feasible solution that improves spatial resolution while preserving spectral fidelity is required. Nowadays, data fusion has become an important data processing method for achieving the aforementioned goal, as it can fuse HS data with MS data to combine the benefits of both [ 8 ]. Given the availability of ZY-1 02D MS data and the benefits of imaging under the same conditions as HS data, this paper focuses on fusing ZY-1 02D HS data with ZY-1 02D MS data to fully excavate and effectively use its internal information [ 9 , 10 ].
In recent years, with the development of high-precision quantitative remote sensing applications, a large amount of remote sensing data with both high spatial resolution and high spectral resolution has become urgently needed [ 11 , 12 , 13 , 14 ]. To address this issue, domestic and international researchers have conducted a lot of research in the hopes of improving spatial resolution and enriching information while preserving the spectral fidelity of the original image [ 15 ]. Data fusion technology can synthesize the effective information of various image data, eliminate the redundancy and contradictions between multiple sources of information, and produce a composite image with improved interpretability [ 16 , 17 ]. So far, several mature image fusion methods have been developed, including the Gram-Schmidt (GS) transform [ 18 ], Intensity-Hue-Saturation (IHS) [ 19 ], High-Pass Filter (HPF) [ 20 ], Nearest-Neighbor Diffusion (NND) [ 21 ], Wavelet Transform (Wavelet) [ 22 ], Principal Component Analysis (PCA) [ 23 ], Color Normalized Spectral Sharpening (CNSS) [ 24 ] and Color Normalized Sharping (Brovey) [ 25 ], etc. To evaluate the quality of the fused result, statistical indicators (mean, standard deviation, and mean gradient, etc.) or ground object classification accuracy, and target extraction accuracy are typically used [ 26 , 27 , 28 , 29 ]. Among the numerous studies, Huang et al. [ 30 ] compared the performance of HPF, IHS and super-resolution Bayesian (Pansharp) in the image fusion application of Mapping Satellite-1 (TH-1) and found that HPF is the best. Sun et al. [ 31 ] made a performance comparison of five different fusion methods to find a suitable method for GaoFen-2 (GF-2), and the results show that the fused images transformed by HCS and GS have good performance in both visual interpretation analysis and ground object classification. Du et al. [ 32 ] used four methods including Pansharp, GS and Wavelet to carry out data fusion on GaoFen-1 (GF-1), finding that the GS method could effectively improve the spatial resolution and enrich the texture information. Huang et al. [ 33 ] fused the ZiYuan-3 (ZY-3) satellite data with a variety of commonly used image fusion methods and evaluated the fusion results from both qualitative and quantitative aspects. Obviously, it can be seen that these fusion methods have good performance in high-spatial-resolution satellite data fusion. In addition, there have also been some studies considering the use of multi-source data fusion to explore the best fusion method for different data, such as Ren et al. [ 34 ], who conducted a comprehensive evaluation study on the fusion results of GF-5 HS data with three MS data (namely GF-1, GF-2 and Sentinel-2A), and the results showed that LANARAS, Adaptive Gram-Schmidt (GSA), and modulation transfer function (MTF)-generalized Laplacian pyramid (GLP) methods were more suitable for fusing GF-5 with GF-1 data, while MTF-GLP and GSA methods were recommended for fusing GF-5 with GF-2 data, and GSA and smoothing filtered-based intensity modulation (SFIM) could be used to fuse GF-5 with S2A data. Ghimire et al. [ 35 ] also created an optimal image fusion and quality evaluation strategy for various satellite image data (GF-1, GF-2, GF-4, Landsat-8 OLI, and MODIS).
The preceding studies point us in the right direction for data fusion. It can be found that different fusion methods have different fusion performance when applied to remote sensing data. This disparity can be attributed to the characteristics of remote sensing data as well as the fusion method. As a result, in practice, it is critical to select the appropriate fusion method according to the image characteristics and application purpose [ 36 ]. Given the short launch time of the ZY-1 02D satellite, there are currently few related research and results regarding image fusion of ZY-1 02D data. Because the fusion methods suitable for existing satellite data are not necessarily suitable for the ZY-1 02D, it is critical to investigate its suitable fusion methods, and this is of great significance for future application and research using ZY-1 02D data. Furthermore, when compared to multi-source remote sensing data, ZY-1 02D provides HS and MS data under the same imaging conditions, reducing the uncertainty caused by input data. The fusion results of ZY-1 02D will have more application value. For these reasons, we will look into image fusion on ZY-1 02D HS and ZY-1 02D MS data. There are numerous fusion methods available for us to use in this research [ 37 , 38 , 39 , 40 , 41 , 42 ], but many of them are not user-friendly in terms of operability, computing resource requirements, and professional requirements. Taking into account the needs of users in practical applications, the focus of this research is to identify suitable methods for ZY-1 02D data among the existing well-known methods.
The objective of this paper is to find appropriate methods for fusing ZY-1 02D HS and ZY-1 02D MS data from among some well-known methods. To meet the main objective, we test six common image fusion methods (i.e., GS, HPF, IHS, Wavelet, NND, and Brovey) and use a comprehensive evaluation framework to evaluate their performance, including aspects of their visual interpretation and quantitative metrics. This study will serve as a reference for the choice of fusion methods for the ZY-1 02D data, thereby further broadening its application in a variety of fields.
2. Materials and Methods
2.1. ZY-1 02D Data
At 11:26 a.m. on 12 September 2019, the ZY-1 02D satellite was launched into the planned orbit by a Long March-4B carrier rocket from the Taiyuan Satellite Launch Center in China’s Shanxi Province. It is currently in a solar synchronous orbit 778 km above the earth, with a five-year expected lifespan. The two sensors on board enable it to effectively acquire 8-band MS data with a width of 115 km and 166-band HS data with a width of 60 km. Specifically, the spatial resolution of the MS data is 10 m, the HS data is 30 m, and the spectral resolution of the HS reaches 10 nm and 20 nm in the visible-near infrared (VIS-NIR) and short-wave infrared (SWI) ranges. The main parameters of the ZY-1 02D HS and MS sensors are shown in
Table 1
.
Figure 1
shows the spectral response function of MS sensor.
Figure 1. Spectral response function of multispectral sensor.
Table 1. Parameters of ZY-1 02D hyperspectral and multispectral sensors.
For the experiment, the ZY-1 02D HS image and MS image covering Anxin County, Baoding City, Hebei Province, China were used ( Figure 2 ). They were collected on 7 October 2020. There are several common surface types in the area, mainly artificial buildings, farmland, vegetation, and water.
Figure 2. Location of study area. ( a ) hyperspectral image; ( b ) multispectral image.
2.2. Data Preprocessing
The preprocessing of the data was divided into two sections: (1) MS data preprocessing, and (2) HS data preprocessing. MS data preprocessing included image mosaicking, image clipping and image registration. First, the two MS images were mosaicked into one image, and then the part that overlapped with the HS image was clipped out (the size of the clipped image was 7670 × 8291 pixels). Then, the automatic registration tool in ENVI (i.e., Image Registration Workflow) was used to register it with the HS image (RMS Error: 0.31), and the processed MS image was used as input data for the fusion experiment. HS data preprocessing included radiometric calibration, atmospheric correction, and band extraction. Radiation calibration was used to covert the gray value (digital number, DN) into top of atmosphere (TOA) reflectance. FLAASH model was used for atmospheric correction. The atmospheric model was set to mid-latitude summer, and the aerosol model parameters were set to city. Since the spectral range of the HS image (396~2501 nm) was wider than that of the MS (452–1047 nm), a subset of the data spanning the range 452~1047 nm was extracted from the HS data, and the bands were grouped to match specific MS bands (
Table 2
), and the processed HS image was used as the input data of the fusion experiment. All of the preceding procedures were carried out using the ENVI 5.3 software.
Table 2. Correspondence between the eight MS bands and seventy-five HS bands.
2.3. Fusion Method
In this experiment, six commonly used fusion methods were compared, namely GS, HPF, NND, IHS, Wavelet, and Brovey. The methodological flowchart is shown in Figure 3 . In the fusion experiment, 8 MS bands and their corresponding 75 HS bands (as shown in Table 2 ) were input into different algorithms, respectively.
Figure 3.
Methodological flowchart of the research. GS: Gram-Schmidt; HPF: High-Pass Filter; NND: Nearest-Neighbor Diffusion; IHS: Intensity-Hue-Saturation; Wavelet: Wavelet Transform; Brovey: Color Normalized Sharping.
2.3.1. Gram-Schmidt (GS)
GS transform can remove redundant information by converting an HS image to orthogonal space. The transformed components are orthogonal in the orthogonal space, and the degree of information retention varies little between them. Compared with PCA transform, this method avoids the problem of information over-concentration [ 43 , 44 ]. Its advantage is that the process is simple, there are no restrictions on the number of input bands, and the spectral information of the original low-spatial-resolution image can be well preserved. During the experiment, the HS data was input as a low-resolution image, and the MS data were input as a high-resolution image (the following methods also used the same setting). The resampling method was set to nearest neighbor. This method was implemented in ENVI 5.3.
2.3.2. High-Pass Filter (HPF)
The HPF fusion method extracts structural detail information from the high-spatial-resolution image using a high-pass filter operator and then superimposes the detail information on the low-spatial-resolution image to achieve a combination of the two [ 45 ]. The advantages of this method include a simple algorithm, a small amount of calculation, and no limit on the number of input bands. The keral size and weighting factor were set to 5 × 5 and the minimum value, respectively, while the other parameters remained unchanged. This method was implemented in ERDAS IMAGINE 2014.
2.3.3. Nearest-Neighbor Diffusion (NND)
NND was proposed by the Rochester Institute of Technology (RIT) in the United States, which uses the Nearest-Neighbor Diffusion pan-sharpening algorithm for fusion [ 21 ]. The principle is to first perform down-sampling processing on the high-spatial-resolution image to make the spatial resolution consistent with the low-spatial-resolution image data; then, the spectral band contribution vector is calculated via linear regression, obtaining the nearest super-pixel difference factor of each pixel in the original high-spatial-resolution image; and finally, the linear mixed model is used to obtain the fused image. It is characterized by fast operation speed and high spectral fidelity. This method was implemented in ENVI 5.3.
2.3.4. Modified Intensity-Hue-Saturation (IHS)
IHS is a color representation system that employs intensity, hue, and saturation. When using this method for image fusion, it is primarily divided into the following three steps: (1) Resampling the low-spatial-resolution image to match the spatial resolution of the high-spatial-resolution image, then converting it from RGB space to IHS space; (2) histogram matching the high-resolution image and the I component of the low-resolution image, then replacing the I component of the low-resolution image with the new luminance component; (3) inverse transformation of the above result and its restoration to RGB space. This method has been widely used because of its high spatial detail enhancement capabilities. Compared with the traditional IHS, modified IHS overcomes the limitation of three input bands by fusing multi-band data via multiple iterations. In the B03 band, for an example, a combination of 13-14-15 and 16-17-18 is used for two iterations of fusion to produce a fused result of 13-18. The resampling method was set to nearest neighbor, and the ratio celling was set to 2.0. Because there is no ZY-1 02D in the sensor options, the band information (including center wavelength, wavelength, etc.) was customized according to the provided data file. This method was implemented in ERDAS IMAGINE 2014.
2.3.5. Wavelet Transform (Wavelet)
Wavelet transform is a spatial signal decomposition and reconstruction fusion technology. Its basic principle is to perform wavelet forward transformation on a low-spatial-resolution image and a high-resolution image to obtain high-frequency information from the high-resolution image and low-frequency information from the low-resolution image, respectively, and then generate a fused image using inverse wavelet transformation [ 46 ]. The spectral transform and resampling method were set to single band and nearest neighbor, respectively. This method was implemented in ERDAS IMAGINE 2014.
2.3.6. Color Normalized Sharping (Brovey)
The Brovey fusion method first normalizes the high-spectral-resolution data, before multiplying it by the high-spatial-resolution image to obtain the fusion result. Each band in the RGB image is multiplied by the ratio of the high-resolution data to the RGB data, and the RGB image is then resampled to the high-resolution pixel size. The resampling method was set to nearest neighbor. This method was implemented in ERDAS IMAGINE 2014.
2.4. Quality Evaluation Methods
We evaluate the quality of fusion results using two criteria: qualitative evaluation (i.e., visual interpretation) and quantitative evaluation (i.e., statistical metrics).
2.4.1. Qualitative Evaluation
Visual interpretation is the method used in qualitative evaluation, and it refers to the observer’s subjective evaluation of the fusion result with respect to both the overall effect and the local effect via visual perception. Qualitative evaluation has become an indispensable part of the quality evaluation of remote sensing fusion images due to its quick and simple advantages.
2.4.2. Quantitative Evaluation
The use of various remote sensing image statistical metrics to evaluate the quality of the fusion results is referred to as quantitative evaluation. The advantages and disadvantages of various fusion methods can be discovered through statistics and analysis of the aforementioned metrics. In this experiment, five statistical metrics (i.e., mean, standard deviation, entropy, mean gradient, and correlation coefficient) were selected to quantitatively evaluate the fused results from the four aspects of brightness, clarity, information content, and spectral fidelity (
Figure 4
). The calculations of the five metrics are performed as follows.
Figure 4. Structure of the fused image quality evaluation system.
The gray mean value is primarily used to describe the average brightness of the image. When the gray mean value of the fused image is close to that of the original multispectral image, it indicates that the fusion effect is good. It is defined as
Mean = 1 M × N ∑ i = 1 M ∑ j = 1 N I ( i , j )
(1)
where
M
and
N
are the total number of rows and columns of the image,
i
and
j
are the pixel positions,
I ( i , j )
indicates the gray value of the pixel located in the
i
-th row and
j
-th column of the image.
The standard deviation is frequently used to describe the uniformity of image grayscale. The larger the standard deviation, the more dispersed the grayscale distribution of the image and the higher the image contrast. It is defined as
Std = 1 M × N ∑ i = 0 M − 1 ∑ j = 0 N − 1 ( I ( i , j ) − I ) 2
(2)
where
I
represents the gray mean value of the image.
The entropy is an important indicator for measuring the richness of image information because it reflects the average information content in the image. It is defined as
Entropy = − ∑ P ( x i ) log ( 2 , p ( x i ) )
(3)
where
x i
represents the random variable, and
P ( x i )
is the output probability function.
The mean gradient refers to the obvious difference in the gray scale near the border or both sides of the shadow line of the image, indicating that the gray scale change rate is high, and the magnitude of this change rate can be used to express the clarity of the image. It can sensitively reflect the rate at which the image expresses the contrast of small details and characterize the relative clarity and texture of the image. The larger the mean gradient, the clearer the image is. It is defined as
G = 1 ( M − 1 ) ( N − 1 ) ∑ i = 1 M ∑ j = 1 N ( ( ∂ Z ( x i , y j ) ∂ x i ) 2 + ( ∂ Z ( x i , y j ) ∂ y j ) 2 ) 2
(4)
where
∂ Z ( x i , y j ) ∂ x i
represents the gradient in the horizontal direction, and
∂ Z ( x i , y j ) ∂ y j
represents the gradient in the vertical direction.
The correlation coefficient indicates how similar the images were before and after fusion. A high correlation coefficient indicates that the fused image is close to the original image and has good spectral fidelity. It is defined as
C = ∑ i = 1 M ∑ j = 1 N [ R ( i , j ) − F ˉ R ] [ F ( i , j ) − F ˉ ] ∑ i = 1 M ∑ j = 1 N [ R ( i , j ) − F ˉ R ] 2 ∑ i = 1 M ∑ j = 1 N [ F ( i , j ) − F ˉ ] 2
(5)
In addition to the statistical metrics listed above, the spectral curve of typical ground objects can also be used to evaluate the quality of the fusion results [ 47 ]. In this experiment, the spectral curves of typical ground objects (vegetation, water, and artificial building) are extracted, and a comparison is drawn between the original HS image and the fused image, respectively, to quantify the benefits and drawbacks of the fusion methods.
3. Results
3.1. Qualitative Evaluation
Figure 5
shows false-color images of the original HS image, the six fused results (R: 954 nm; G: 765 nm; B: 482 nm), and the original MS image (R: B09; G: B08; B: B02). There are some color differences between different fused images and the original HS image from the perspective of the entire image, but they all retain the main spectral characteristics of the original HS image. The colors of the HPF and Wavelet images are the closest to the original HS image, and the tone of the two is lighter than that of the original HS image, with almost no difference between the HPF and the Wavelet images. When compared to the original HS image, the color of the NND and GS images is more orange, and the contrast between adjacent objects in the two is not as clear, indicating that the NND and GS fusion methods perform worse than the above two methods. The IHS image and the original HS image have a distinct spectral difference, which is reflected in the darker tone of the IHS image as well as the spectral distortion phenomenon. Nevertheless, IHS images possess clarity. The color deviation between the Brovey image and the original HS image is the greatest, indicating that the Brovey image has significant spectral distortion.
Figure 5. Experimental results of ZY-1 02D hyperspectral and multispectral data fusion. ( a ) ZY-1 02D hyperspectral image; ( b ) Brovey image; ( c ) GS image; ( d ) HPF image; ( e ) ZY-1 02D multispectral image; ( f ) IHS image; ( g ) NND image; ( h ) Wavelet image.
To further evaluate the visual interpretation effect of the fused images, especially the enhancement effect of the spatial details, Figure 6 and Figure 7 show the detail of several typical ground objects, namely artificial buildings, farmland, vegetation and water.
Figure 6. The details of farmland and artificial buildings. ( a ) ZY-1 02D original hyperspectral image; ( b ) GS image; ( c ) HPF image; ( d ) IHS image; ( e ) NND image; ( f ) Wavelet image; ( g ) Brovey image.
Figure 7. The details of vegetation and water.( a ) ZY-1 02D original hyperspectral image; ( b ) GS image; ( c ) HPF image; ( d ) IHS image; ( e ) NND image; ( f ) Wavelet image; ( g ) Brovey image.
When the edge and texture differences between the original HS image and fused image are compared, it can be found that, with the exception of the Wavelet image, the clarity of the other five fused images is higher than that of the original HS image, indicating that the above five fusion methods are able to improve the spatial resolution of the original HS image, thereby improving the accuracy and reliability of the visual interpretation. The IHS image has the best clarity and good spatial sharpening effect. The boundaries between building, road, and farmland are the clearest, and the outlines of vegetation and artificial fences in the water are the most visible, indicating that the IHS fusion method improves the spatial details of the original image the most. Unfortunately, the IHS image contains some spectral distortions, resulting in significant color differences between the IHS image and the original HS image. HPF and GS fusion methods are second only to IHS in terms of spatial detail enhancement. Specifically, the contours of aquatic vegetation are more visible in the HPF fused image, and the details of some buildings and farmland features are blurred. The detailed spatial information of the Brovey fused image is slightly lost, which is reflected in the fact that the artificial fence edge in the water is difficult to identify, and its spectral distortion is more pronounced. The spatial resolutions of the NND and Wavelet fused images are low, and the visual interpretation effect is not optimal. Between them, the Wavelet image has the closest color match to the original HS image, but the effect of its spatial detail representation is poor, and there are some obvious distortions and unclear texture features in the buildings.
3.2. Quantitative Evaluation
3.2.1. Statistical Metrics
Considering a large number of HS bands, eight HS bands are quantitatively accounted for this experiment, corresponding to the center wavelength positions of the eight MS bands. Table 3 shows the mean, standard deviation, entropy, mean gradient, and correlation coefficient of the original HS image and six fused images.
Table 3. Quantitative evaluation statistics metrics.
By comparing the statistical metric values of the six fused images in Table 3 with the original HS image, the following five results can be obtained.
(1)
The HPF and GS fused images (gray mean value of the HPF image: 101~160; GS: 96~154) had high brightness similarity with the original HS image (100~155); the NND image (103~147) and Wavelet image (99~166) were second to them; the IHS image (73~131) had some spectral distortion when compared to the original HS image; the mean value of the Brovey image (29~49) was much lower than that of the original HS image, the mean value between the two had the largest deviation, and the spectral distortion of the Brovey image was the most significant.
(2)
The standard deviations of HPF, IHS and GS fused images were relatively large. Among them, the HPF image had the largest standard deviation in the visible light (standard deviation of the HPF fused image: 23~27), and the IHS image had the biggest standard deviations in the near-infrared and red edge bands (IHS image: 22~24), and the standard deviations of the three fused images were higher than the original HS image, greatly improving the information richness of the original HS image; the standard deviations of the NND and Wavelet images were slightly lower than those of the above three fused images. The standard deviation of the Wavelet image (16~21) was slightly higher than that of the NND (12~22); the standard deviation of the Brovey image (6~8) was much lower than that of the original image, indicating that the gray level of the fused image after Brovey transformation was not sufficiently dispersed and the tone tended to be single.
(3)
Except for the Brovey image, the entropy of the other five fused images was improved when compared to the original HS image, and there was no significant difference in the entropy of different fusion images (5–7). Among them, the entropy of the Wavelet image was the highest, followed by the HPF and GS images. The information content of the three was nearly identical, with the exception of the IHS, which was slightly lower; the information content of Brovey fusion images was lower than that of the original HS images.
(4)
The mean gradient of the fused image was higher than that of the original HS image, indicating that the six fusion methods were able to improve the original image’s ability to represent spatial details. The mean gradients of HPF and IHS fused images were larger, and their spatial detail information enhancement effects were the best, as shown in
Table 3
. Between them, the mean gradient of HPF image was more visible in the visible light band (mean gradient of HPF fusion image: 47~61). The IHS fusion image outperformed the other two fusion methods in the red edge and near-infrared bands (55~57); the mean gradient of GS and Brovey fused images were slightly lower than the above two fused images. Between them, the mean gradient of Brovey image (43~57) was slightly higher than GS image (41~58); the mean gradient of NND and Wavelet fused was the lowest, indicating that the spatial resolution of these two fused images was low.
(5)
Similar to the visual interpretation result, the correlation coefficients of Wavelet, HPF and NND were relatively large, indicating that they have excellent spectral fidelity performance. Except for the red band, the correlation coefficients of Wavelet and HPF fused images were all greater than 0.9; the correlation coefficient between the IHS fusion image and the original image was second only to HPF and Wavelet, but it performed poorly in the blue and red bands; and the Brovey fused image had the lowest correlation coefficient, indicating that there was a large spectral difference between it and the original HS image.
To summarize, the HPF image not only preserved the spectral characteristics of the original HS image to a large extent, but also improved the spatial resolution of the HS data, making it the best choice for ZY-1 02D HS data enhancement; although Wavelet and NND fused images had a large amount of information and a high spectral fidelity, the spatial detail representation effect of the two was not satisfactory; the IHS fused image was clear and rich in texture information, but there was obvious spectral distortion; the performance of the GS fusion image was at a medium level; the Brovey transform had a mediocre performance in spectral fidelity and spatial detail representation, and had a serious spectral distortion problem, making it far inferior to the above five methods.
3.2.2. The Spectral Curves of Typical Ground Objects
To more intuitively evaluate the spectral fidelity of the different fused images, this experiment takes typical objects (i.e., vegetation, artificial building, and water) as examples to compare the differences between the six fused results and the original HS image. To ensure that the results are representative, the spectral curves of the three objects are averaged over three homogeneous areas with 5 × 5 pixels. As shown in
Figure 8
, the left column is the three spectral curves of six fused images and HS image. In addition, the spectral differences between the six fused images and the original HS image are also shown (the right column of
Figure 8
), which is convenient for identifying the differences in the spectral fidelity of the different fusion methods.
Figure 8. Spectral curves of typical objects. Top: vegetation spectral curves of six fused images and HS image ( a ), difference between fused images and HS image in vegetation spectral curve ( d ); Middle: artificial building spectral curves of six fused images and HS image ( b ), difference between fused images and HS image in building spectral curve ( e ); Bottom: water spectral curves of six fused images and HS image ( c ), difference between fused images and HS image in water spectral curve ( f ).
By comparing the spectral curves of different fused images and the original HS image, we can obtain similar results to those presented above. Overall, the HPF, Wavelet, NND and GS fused images possessed high spectral fidelity; while the IHS and Brovey fused images exhibited significant spectral distortion. The spectral curves of the fused images have roughly the same trend as the original HS image and fluctuate around the original HS spectral curve with slight variations. In the spectral curves of vegetation, the difference between the Wavelet and HPF fused image and the original HS image was the smallest, indicating that the two fusion methods had the best spectral fidelity. Between them, the Wavelet fused image was more prominent in the visible light band, while the HPF fused image was more prominent in the visible light and near-infrared (NIR) bands; the spectral fidelity of the NND and GS fused images were second, with a lager difference between their spectral curves. In the spectral curves of the building, the Wavelet fused image had a higher degree of overlap and a smaller difference with the original HS image; the spectral curves of HPF and GS fused images basically fitted the original HS image after about 510 nm; and the performance of NND was quite different in the NIR band (approximately 765 nm). The curve in the second half of the spectral curve was very similar to that of the original HS image, whereas the curve in the first half was quite different from the gray value of the original HS image. This result is consistent with the color deviation of the building in the visual interpretation effect. In the spectral curves of water, the NND and the original HS image were highly overlapped; the difference between Wavelet and GS was slightly larger; the change trend of the HPF fused image was the same as the original image, but compared to the above fused methods, there was a larger difference between HPF and the original HS, which is slightly different from the high correlation coefficient obtained for the HPF method in the metric statistical results. This may have been caused by the small amount of water in the entire image. Similar to the visual interpretation results, the IHS and Brovey fused images were significantly different from the original HS image with respect to the spectral curves of the three ground objects. There were obvious spectral distortions in the two fused images, particularly the Brovey image, which had the lowest spectral fidelity.
In conclusion, the HPF, Wavelet, NND, and GS fusion methods performed well, and different fusion methods performed differently when confronted with different ground objects. HPF and Wavelet had the best spectral fidelity in the vegetation and building areas, respectively, while NND had the best spectral fidelity in the water area. It can be found that the HPF, Wavelet, NND and GS fusion methods have good performance, and different fusion methods have different performance when facing different ground objects. Specifically, HPF and Wavelet have the best spectral fidelity in vegetation and building areas, and NND has the best spectral fidelity in the water area.
4. Discussion
4.1. Performance of Fusion Methods
In this paper, six well-known fusion methods were successfully used to enhance the spatial resolution and the information of ZY-1 02D data. Compared to the original HS data, the six fused images were clearer and easier to visually interpret. Furthermore, there were also some noticeable differences among the six fused results. HPF, in particular, demonstrated excellent performance with respect to both spectral fidelity and spatial resolution enhancement. The reason for this could be that the HPF injects the spatial details of the MS data into the HS data via a high-pass filter and has a low-pass filter to maintain the spectral separation of HS data. This result was also discovered in the fusion experiment of Mapping Satellite-1 by Huang et al. [ 30 ]. The difference is that the research object of this study is HS data with high spectral resolution, which are better suited to narrow-band spectroscopy research. Aside from HPF, Wavelet and NND exhibited high robustness in terms of spectral fidelity. Between them, the spatial resolution of the Wavelet fused image was slightly lower, and the boundary between different features was not significant, but it was always clearer than the original HS data. As concluded by Sun et al. [ 31 ] and Du et al. [ 32 ], GS performs well when applied to remote sensing data. On the contrary, the spectral fidelity performances of IHS and Brovey were slightly inferior, and there is still room for improvement in spatial resolution [ 48 , 49 ]. The spectral distortion of IHS is mainly caused by the forced direct replacement of the I component [ 50 ], whereas the spectral distortion of Brovey was affected by the simple multiplication of HS and MS [ 25 ]. It is worth noting that these two methods are simple in terms of theory, simple to implement, and quick to calculate, and so can be used for some low-demand applications.
4.2. Selection of Quantitative Metrics
The quality evaluation of the fused results in remote sensing data fusion research is too complicated to establish a unified standard. Until now, it has been performed using a combination of visual interpretation and quantitative metrics [
51
]. As a result, we used the same method to evaluate the quality of six fused images. The five quantitative metrics selected for this paper adhered to three principles: (1) they were able to evaluate the quality of fused images with respect to different aspects (typically spatial resolution enhancement capability and spectral fidelity); (2) they were able to distinguish the performance differences of the six fusion methods; and (3) they were simple and easy to calculate. The comparison results also demonstrate the applicability of the five metrics. In addition to the common metrics listed above, many researchers have attempted to supplement the quality evaluation system by improving or proposing new metrics [
52
,
53
,
54
]. There is still a long way to go before we establish a unified evaluation standard. In practical applications, appropriate quantitative metrics should be selected based on geographic conditions, application requirements, and data sources.
4.3. Limitations
The study was carried out on a single date in a single study area with four typical surface types; it would be preferable if different study areas with more surface types in different periods were used [ 55 ]. Because the spectral range of the HS image is wider than that of the MS, this study only performed fusion processing on the HS data in the 452~1047 nm range. In subsequent research, we will fully exploit the advantages of the wide spectral range to investigate suitable fusion methods for shortwave of infrared band, as well as extending the practical application of ZY-1 02D data. In reality, the primary purpose of data fusion is to prepare for remote sensing image applications such as image classification [ 56 ], change detection [ 57 ], and so on. As a result, more research into the application of fused images is required in the future to obtain better results and conclusions.
5. Conclusions
Six fusion methods, GS, HPF, IHS, NND, Wavelet, and Brovey, were used in this paper to realize the fusion of ZY-1 02D HS data and MS data. The six fusion results were compared and analyzed using a combination of qualitative and quantitative evaluation methods, and the following conclusions were drawn: (1) Considering the three aspects of visual effect, spectral fidelity, and spatial detail expression, the HPF method was the most suitable for the fusion of ZY-1 02D HS data and MS data. In comparison to the original HS image, the HPF fused image maintained its spectral characteristics while improving its spatial resolution, enriching its information, and providing the best fusion performance. (2) Different fusion methods perform differently for different datasets. In practice, appropriate data fusion methods should be selected according to the data type and specific needs. Six commonly used fusion methods were used in this study for fusion processing of ZY-1 02D satellite HS and MS images, providing a significant reference for future ZY-1 02D data processing and application-related research.
Author Contributions
H.L., D.Q. and L.D. designed and developed the research idea. H.L., D.Q. and S.W. conducted the field data collection. H.L., D.Q., Y.L. and S.W. processed all remaining data. H.L. and D.Q. performed the data analysis and wrote the manuscript. H.L., D.Q., Y.L., S.W. and L.D. contributed to result and data interpretation, discussion, and revision of the manuscript. All authors have read and agreed to the published version of the manuscript.
Funding
This research was funded by the landscape plant maintenance monitoring and intelligent diagnosis model development of Capital Normal University (no. 21220030003).
Acknowledgments
The authors are very thankful for Zou Hanyue, Fan Tianxing and Chen Yong for their valuable support.
Conflicts of Interest
The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.
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Figure 1. Spectral response function of multispectral sensor.
Figure 2. Location of study area. ( a ) hyperspectral image; ( b ) multispectral image.
Figure 3. Methodological flowchart of the research. GS: Gram-Schmidt; HPF: High-Pass Filter; NND: Nearest-Neighbor Diffusion; IHS: Intensity-Hue-Saturation; Wavelet: Wavelet Transform; Brovey: Color Normalized Sharping.
Figure 4. Structure of the fused image quality evaluation system.
Figure 5. Experimental results of ZY-1 02D hyperspectral and multispectral data fusion. ( a ) ZY-1 02D hyperspectral image; ( b ) Brovey image; ( c ) GS image; ( d ) HPF image; ( e ) ZY-1 02D multispectral image; ( f ) IHS image; ( g ) NND image; ( h ) Wavelet image.
Figure 6. The details of farmland and artificial buildings. ( a ) ZY-1 02D original hyperspectral image; ( b ) GS image; ( c ) HPF image; ( d ) IHS image; ( e ) NND image; ( f ) Wavelet image; ( g ) Brovey image.
Figure 7. The details of vegetation and water.( a ) ZY-1 02D original hyperspectral image; ( b ) GS image; ( c ) HPF image; ( d ) IHS image; ( e ) NND image; ( f ) Wavelet image; ( g ) Brovey image.
Figure 8. Spectral curves of typical objects. Top: vegetation spectral curves of six fused images and HS image ( a ), difference between fused images and HS image in vegetation spectral curve ( d ); Middle: artificial building spectral curves of six fused images and HS image ( b ), difference between fused images and HS image in building spectral curve ( e ); Bottom: water spectral curves of six fused images and HS image ( c ), difference between fused images and HS image in water spectral curve ( f ).
Table 1. Parameters of ZY-1 02D hyperspectral and multispectral sensors.
Sensors Bands Spectral Range/nm Spatial Resolution/m Spectral Resolution/nm Swath Width/km MS B02 452~521 10 115 B03 522~607 B04 635~694 B05 776~895 B06 416~452 B07 591~633 B08 708~752 B09 871~1047 HS VIS-NIR 396~1039 30 10 60 SWI 1056~2501 20
Table 2. Correspondence between the eight MS bands and seventy-five HS bands.
Spectral Range/nm Bands of MS (HS) 452~521 B02 (4~12) 522~607 B03 (13~18) 635~694 B04 (22~33) 776~895 B05 (40~55) 416~452 B06 (1~3) 591~633 B07 (19~21) 708~752 B08 (34~39) 871~1047 B09 (56~75)
Table 3. Quantitative evaluation statistics metrics.
Number of Bands (Wavelength) Fusion Method Mean Standard Deviation Entropy Mean Gradient Correlation Coefficient B02 (48 nm) Original HS 100.3648 12.7672 6.0404 26.8851 1.0000 GS 96.9338 19.6723 6.1241 47.8024 0.9027 HPF 103.5575 24.3926 6.0896 54.4626 0.9448 IHS 73.1858 24.1157 5.2708 49.4911 0.8613 NND 103.8201 14.2127 6.0183 29.0472 0.9237 Wavelet 102.7105 18.2765 6.1112 38.4877 0.9711 Brovey 29.6865 6.3760 4.9725 46.1580 0.7841 B03 (56 nm) Original HS 109.7536 14.0712 6.0792 30.4275 1.0000 GS 108.7666 21.017 6.0606 54.8879 0.8979 HPF 113.8481 25.3081 6.1309 58.9571 0.9479 IHS 104.0233 22.5063 6.0326 52.4368 0.8986 NND 111.2329 15.7797 6.0458 32.9132 0.9501 Wavelet 112.7678 19.1729 6.1322 41.9692 0.9682 Brovey 33.6375 6.7881 5.037 51.8042 0.7923 B04 (66 nm) Original HS 105.6488 15.0996 6.1017 32.1022 1.0000 GS 103.7238 22.5502 6.1283 55.0825 0.8966 HPF 108.9427 26.6834 6.1284 60.8555 0.9426 IHS 104.1239 23.5609 6.0404 54.7468 0.8995 NND 108.6382 16.4924 6.0502 33.9025 0.9411 Wavelet 111.4921 20.2655 6.1502 44.3468 0.9664 Brovey 32.2769 7.2767 5.0268 53.6661 0.7904 B05 (83 nm) Original HS 148.1834 10.9544 5.7649 24.2174 1.0000 GS 147.7579 17.8605 5.9226 56.4583 0.9281 HPF 148.4721 19.7851 6.0258 49.2987 0.9095 IHS 129.5685 23.5102 5.8911 56.8161 0.9252 NND 138.3355 14.0712 5.8797 30.2696 0.9403 Wavelet 156.0215 16.0169 5.8548 34.2237 0.9813 Brovey 48.5566 5.9984 4.9162 47.4623 0.8193 B06 (43 nm) Original HS 98.2831 11.9164 6.0626 25.3595 1.0000 GS 104.1284 15.3213 6.1055 41.8993 0.8887 HPF 101.6062 24.5561 6.0715 55.1704 0.9341 IHS 79.5842 22.2562 5.6839 44.5485 0.8834 NND 115.3039 19.2873 6.0474 45.6413 0.8802 Wavelet 99.2973 17.6968 6.0998 37.4642 0.9696 Brovey 33.4879 5.6296 5.0001 43.9359 0.7811 B07 (61 nm) Original HS 107.9341 14.5122 6.0967 31.1587 1.0000 GS 105.9264 22.2558 6.1283 54.5936 0.8972 HPF 110.5961 26.2106 6.1309 60.1416 0.9442 IHS 104.6792 22.3629 6.0433 55.7009 0.8985 NND 109.8163 15.9687 6.0527 33.1166 0.9502 Wavelet 112.5107 20.2215 6.1508 44.2971 0.9688 Brovey 32.2255 7.2689 5.0279 53.6364 0.8894 B08 (76 nm) Original HS 147.6844 11.2318 5.7661 24.9981 1.0000 GS 147.2125 17.7753 5.9252 57.0881 0.9289 HPF 139.327 21.3667 6.0161 53.9328 0.8806 IHS 116.0493 22.1731 6.0229 55.1546 0.6981 NND 127.7334 21.6202 5.9381 56.6921 0.8184 Wavelet 134.6255 20.4686 6.0776 45.9071 0.8207 Brovey 48.9651 6.0844 4.9028 56.1831 0.8106 B09 (95 nm) Original HS 154.8327 9.9505 5.7401 22.1483 1.0000 GS 153.1369 18.2631 5.8793 51.5527 0.9529 HPF 159.3981 18.0164 6.0258 47.0832 0.9775 IHS 130.1481 22.2889 5.8911 55.1831 0.9226 NND 146.2381 12.7801 5.8583 27.7978 0.9461 Wavelet 159.3499 15.8887 5.8548 36.2066 0.9832 Brovey 48.0108 6.1852 4.8995 46.1493 0.8071
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Lu, H.; Qiao, D.; Li, Y.; Wu, S.; Deng, L. Fusion of China ZY-1 02D Hyperspectral Data and Multispectral Data: Which Methods Should Be Used? Remote Sens. 2021, 13, 2354.
https://doi.org/10.3390/rs13122354
Lu H, Qiao D, Li Y, Wu S, Deng L. Fusion of China ZY-1 02D Hyperspectral Data and Multispectral Data: Which Methods Should Be Used? Remote Sensing. 2021; 13(12):2354.
https://doi.org/10.3390/rs13122354
Lu, Han, Danyu Qiao, Yongxin Li, Shuang Wu, and Lei Deng. 2021. "Fusion of China ZY-1 02D Hyperspectral Data and Multispectral Data: Which Methods Should Be Used?" Remote Sensing13, no. 12: 2354.
https://doi.org/10.3390/rs13122354
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Pictures of parabolic dunes (a) and transverse dunes (b) at the Grande... | Download Scientific Diagram
Download scientific diagram | Pictures of parabolic dunes (a) and transverse dunes (b) at the Grande beach, São Francisco do Sul Island. The recognition of large blowouts on parabolic dunes is easily appreciable, as is the difference in vegetation cover between the two dune types. from publication: Morpho-sedimentological and vegetational characterization of Grande beach at São Francisco do Sul Island (Santa Catarina, Brazil) | A multidisciplinary study based on several digital (geology, lithology, shoreline evolution, photo-interpretation of aerial and ortho-photographs) and field (topographic and vegetational surveys, grain-size analysis) datasets prompted new insights to a better definition of... | Beach, Islands and Vegetation | ResearchGate, the professional network for scientists.
Pictures of parabolic dunes (a) and transverse dunes (b) at the Grande beach, São Francisco do Sul Island. The recognition of large blowouts on parabolic dunes is easily appreciable, as is the difference in vegetation cover between the two dune types.
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Morpho-sedimentological and vegetational characterization of Grande beach at São Francisco do Sul Island (Santa Catarina, Brazil)
A multidisciplinary study based on several digital (geology, lithology, shoreline evolution, photo-interpretation of aerial and ortho-photographs) and field (topographic and vegetational surveys, grain-size analysis) datasets prompted new insights to a better definition of the processes in action at the Grande beach at São Francisco do Sul Island (...
Contexts in source publication
Context 1
... width of the Grande beach, which averages about 20 m, is quite constant throughout the entire length of the beach. The beach is subjected to erosion processes that at times produced the destruction of the frontal dune and the generation of a steep scarp at the transition between the backshore and the dunes. The erosion is uniform throughout the length of the beach; no particular accumulation or retreat areas are detectable. The littoral drift is northwards trending (Zular, 2011). Parabolic dunes up to 15 m high characterize the northern sector of the Grande beach (Zone A). They are well developed, but wide blowouts interrupt their regularity (
Figure 2
(a)). In addition, human interference is significant in this por- tion of the beach. In the central sector of the beach (Zone B), the dunes are transverse. They are character- ized by lower height (hardly over 7 m) and less human impact, likely due to their major distance from the vil- lages (
Figure 2
(b)). Close to Praia do Ervino village, human interference increases ...
Context 2
... width of the Grande beach, which averages about 20 m, is quite constant throughout the entire length of the beach. The beach is subjected to erosion processes that at times produced the destruction of the frontal dune and the generation of a steep scarp at the transition between the backshore and the dunes. The erosion is uniform throughout the length of the beach; no particular accumulation or retreat areas are detectable. The littoral drift is northwards trending (Zular, 2011). Parabolic dunes up to 15 m high characterize the northern sector of the Grande beach (Zone A). They are well developed, but wide blowouts interrupt their regularity (
Figure 2
(a)). In addition, human interference is significant in this por- tion of the beach. In the central sector of the beach (Zone B), the dunes are transverse. They are character- ized by lower height (hardly over 7 m) and less human impact, likely due to their major distance from the vil- lages (
Figure 2
(b)). Close to Praia do Ervino village, human interference increases ...
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(Alquini et al., 2018)
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Poleward mangrove expansion in South America coincides with MCA and CWP: A diatom, pollen, and organic geochemistry study
QUATERNARY SCI REV
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... The complexity of this environment justifies the worldwide concern about the rising sea level in the coming decades, which will intensify the impact of coastal erosion and flooding on coastal communities (Rao et al., 2008;USAID, 2009;Özyurt and Ergin, 2010;IPCC, 2014;Germani et al., 2015;Alsahli and Alhasem, 2016). Brazil is one example of the detrimental effects of the erosion process, and has been struggling to manage the effects all along its coasts (Mazzer, 2007;Mazzer and Dillenburg, 2009;Figueiredo, 2013;Ribeiro et al., 2013;Lima and Amaral, 2015;
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The main environmental features that control the marine processes of this gravel beach appear to be linked to geological and morphological contexts such as the presence of the river mouth, the outcropping of a beach-rock along the coastline, the deposition of gravelly sediment in the beachface and the seagrass cover.
Palaeoenvironmental reconstruction through phytolith analysis in the Casa de Pedra shell mound archaeological site, São Francisco do Sul, Santa Catarina, Brazil
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David Oldack Barcelos Ferreira Machado
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Shell mounds, or middens, are artificial accumulations of food remains such as shells, sediments, artefacts and remains from daily life and funerary rituals, which were deposited in our study area by groups of Sambaquian fisher-hunter-gatherers. These mounds contain remains, which are representative of the fauna and flora at the time they were formed, enabling the recovery of palaeoenvironmental data related to biodiversity of taxa and biogeography, 14C dating and analysis of changes in the patterns of marine biodiversity and ocean circulation. This paper uses the Casa de Pedra shell mound rock shelter, located in São Francisco do Sul, state of Santa Catarina, southeastern Brazil, to study aspects of the palaeoenvironment through analyses of the archaeological material of the site, which contains well-preserved phytoliths and sponge spicules. Among the phytoliths, those from grasses predominate and some trees and palms were present, with no variation in vegetation type during the period of site occupation, between 5,470 and 4,460 years bp. Despite the general stability of the vegetation, a small increase in the density of the tree cover was identified from the base to the top, which may be related to an increase in precipitation, and is in agreement with other palaeoenvironmental studies carried out in southern Brazil.
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(PDF) Pyrolysis temperature during biochar production alters its subsequent utilization by microorganisms in an acid arable soil
PDF | Biochar amendment of agricultural soils can have a significant impact on microbial carbon (C) metabolism by providing C substrates and altering... | Find, read and cite all the research you need on ResearchGate
Pyrolysis temperature during biochar production alters its subsequent utilization by microorganisms in an acid arable soil
December 2017
Land Degradation and Development29(7)
DOI: 10.1002/ldr.2846
Authors:
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Yu Luo
Zhejiang University
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Jennifer Dungait
University of Exeter
<here is a image 1937ee36a50dd27a-fa33d150fae83bfe>
Xiaorong Zhao
China Agricultural University
<here is a image c8477ea08d4ff0f5-abe0a1c0933ac387>
Philip Brookes
Institute of soil and water resourcesand Environmental Sciences
Abstract and Figures
Biochar amendment of agricultural soils can have a significant impact on microbial carbon (C) metabolism by providing C substrates and altering soil properties, including amelioration of soil acidity. It remains unclear whether available C of biochar or its pH effects determines the utilization of biochar by microorganisms. Compound-specific stable 13C isotope analysis of phospholipid fatty acids (13C-phospholipid fatty acid analysis) was used to explore which microbial group utilized biochar distinguished with pHs and C availability. C4 Miscanthus biochar (δ13C = −12.2‰) was prepared at 2 pyrolysis temperatures (350 °C and 700 °C) and applied (50 mg C g−1 soil) to a very acid soil (pH 3.7, δ13C = −27.7‰), which was sampled from the long term Hoosfield Acid Strip experiment at Rothamsted Research, and incubated for 14 months. Biochar700 increased soil pH to 5.1 and biochar350 increased soil pH to 4.3. All microbial groups (Gram-positive bacteria, Gram-negative bacteria, actinobacteria, and fungi) were more abundant in the biochar-treated soils. The 13C values of biomarker phospholipid fatty acid analysis suggested that all groups of microorganisms, and especially Gram-positive bacteria, were using the C from the biochar350, but not the biochar700, as a substrate. We conclude that its utilization of biochar by microorganisms after 14 months was largely determined by the pyrolysis temperature controlling the availability of biochar C, instead of the pH effects, in a very acidic soil.
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Mean contents (μg C g −1 soil; n = 3, ±1 SE) of biomarker phospholipid fatty acid analysis (PLFA; Gram-positive bacteria, Gramnegative bacteria, actinobacteria, and fungi) in low pH soils treated with BC350, BC700 or no biochar (control) after 431 days. Error bars represent standard errors of the means (n = 3). Different letters indicate significant difference at p < .05 between treatments (control, BC350 and BC700) …
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The incorporation (a) of labelled biochar 13 C into biomarker phospholipid fatty acid analysis (Gram-positive bacteria, Gramnegative bacteria, actinobacteria, and fungi) and mean δ 13 C values (b) in low pH soils treated with BC350, BC700 or no biochar (control) after 431 days. Error bars represent standard errors of the means (n = 3). Different letters indicate significant difference at p < .05 between treatments (BC350 and BC700) …
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Microbial colonization and its utilization of biochar350 and biochar700. Colonization images were obtained from Luo et al. (2013) [Colour figure can be viewed at wileyonlinelibrary.com] …
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Figures - uploaded by
Yu Luo
SPECIAL ISSUE ARTICLE
Pyrolysis temperature during biochar production alters its
subsequent utilization by microorganisms in an acid arable soil
substrates, such as sucrose and plant straw (Luo, Lin, Durenkamp,
Dungait, & Brookes, 2017; Luo, Zang, et al., 2017). The preparation
(pyrolysis) temperature of biochar is a major factor for determining
its organic chemistry: biochars produced at higher pyrolysis temper-
atures have significantly increased pH values (Xu, Zhao, Yuan, &
Jiang, 2012) and more condensed polyaromatic structures, compared
to biochars produced at lower temperatures that are more likely to
retain labile fractions available fo r subsequent microbial utilization
after application to soils, but wi th reduced pH effects on the func-
tioning of microorganisms in acidic soils. The question is, which fac-
tor, pH effects or available C determines its microbial utilization of
biochar in a highly acidic soil? The combined effects of C ‐ availability
and pH amelioration have not been explored explicitly in the same
experiment. A shift of the primary effect of biochar on soil microbial
processes from providing C (short term) to pH effects (relatively long
term) might occur when the small fraction of labile biochar ‐ Cis
depleted and becomes barely bioavailable in the late stage of
incubation.
Direct evidence of the microbial utilization of biochar have been
proven using
14
C and
13
C labelled biochar ‐ C to investigate routing of
biochar C into the microbial biomass C (Kuzyakov et al., 2009)
and microbial phospholipid fatty acid analyses (PLFAs; Steinbass
et al., 2009). Relatively short ‐ term incubations and pot experiments
(up to 175 days) have been conducted to examine the fate of
13
C ‐
labelled biochar ‐ C made from contrasting plant ‐ derived feedstocks
using
13
C ‐ PLFA analyses to investigate the functional groups of soil
microorganisms utilising biochar ‐ C as a substrate (Farrell et al., 2013;
Watzinger et al., 2014). Gram ‐ negative bacteria, (Watzinger et al.,
2014), Gram ‐ positive bacteria and fungal PLFAs (Farrell et al., 2013)
were observed to incorporate biochar ‐ C. The difference in the activity
of different microbial groups between studies corresponds to biochar
preparation and incubation time (early or late stage). Biochars pro-
duced at lower temperatures have less condensed structures and are
more likely to retain labile fractions available for microbial utilization
by r ‐ strategists typified by Gram ‐ negative bacteria directly after appli-
cation to soils, whereas biochar produced at high temperatures is more
likely to be utilized by spore ‐ forming, K ‐ strategists. However, these
studies were relatively short term (less than 3 months), and whether
soil microbial groups utilize biochar C in the relatively long term (above
1 year) remains unclear.
Our hypothesis was that the microbial utilization of biochar in a
very acid arable soil was largely de termined by the pyrolysis temper-
ature that controls both the availability of biochar ‐ CanditspH,and
the biochar ‐ C availability will be overwhelmed by its pH effects in
the late stage of above 1 year. Thus, we used the same C4 feedstock
(Miscanthus grass) to produce biochar350 and biochar700at two
temperatures (350 °C and 700 °C), which gave biochars with differ-
ent pH (7.8 and 10.8, respectively). Biochar350 and biochar700
were applied (50 mg C g
− 1
soil) to a very acid C3 soil (pH 3.7) from
the Hoosfield Acid Strip experim ent at Rothamsted Research. The
difference in the
13
C values of the biochar (C4) and SOC (C3)
enabled the use of biochar ‐ C by soil microorganisms to be identified.
We chose a long incubation (14 months) to explore the response of
the soil microbial biomass to the combined effect of pH and biochar
C availability.
2 | MATERIALS AND METHODS
2.1 | Soil sampling
Full details of soil sampling, preparation, and chemical properties are
given in Luo, Durenkamp, De Nobili, Lin, and Brookes (2011). In brief,
soil of pH 3.7 was sampled (0 – 23 cm, plough layer depth) with a Dutch
auger from the Hoosfield acid strip at Rothamsted Research, UK. The
soil samples were hand ‐ picked to remove visible plant debris and roots,
sieved at field moisture (<2 mm) and subsequently adjusted to 40% of
water holding capacity. The soils were then preincubated at 25 °C for
7 days before starting the experiments. The soil contained 0.90% total
C and 0.1% total N, microbial biomass C (Cmic) was 62.9 μ gg
− 1
, and
the bulk δ
13
C value was − 27.7 ‰.
2.2 | Biochar production
Full details of biochar preparation are given by Luo et al. (2011). In
brief, two biochars were prepared from the same source material
( Miscanthus giganteus straw; δ
13
C= − 11.8 ‰ ) at two temperatures
(350 °C and 700 °C) in a Carbolite CWF 1200 furnacewith a sealable
retort (Carbolite, Hope, UK) flushed with argon. Hereafter, the two
biochar treatments are referred to as biochar350 and biochar700,
respectively. The total C of biochar350 and biochar700 were 65.5%
and 83.9%, total N were 3.8% and 0.7%, respectively, and the corre-
sponding δ
13
C values for biochar350 and biochar700 were − 12.0 ‰
and − 12.3 ‰ , and pH values were 7.8 and 10.8, respectively (Luo,
Lin, et al., 2017).
2.3 | Soil incubation
The preincubated soil were mixed with no biochar (control) or 50 mg
Cg
− 1
soil (on a soil dry weight basis) of either biochar350 or bio-
char700 and incubated for 14 months (431 days) at 25 °C in the dark
at 40% water holding capacity. NH
4
NO
3
(170 μ gNg
− 1
soil) was added
to avoid N limitation. After 431 days, the biochar350 ‐ and biochar700 ‐
treated soil both contained 5.29% total C and 0.12% total N and had a
pH values of 4.3 and 5.1, respectively. Further properties are described
in Luo, Lin et al. (2017).
2.4 | Compound ‐ specific stable isotope analysis of
PLFAs
A modified Bligh Dyer extraction procedure was applied for the extrac-
tion of PLFA (Dungait et al., 2013). In brief, Bligh Dyer solvent
(KH
2
PO
4
‐ buffered H
2
O, pH 7.2 MeOH:CHCl
3
in 4:10:5 v:v:v) was
used to liberate a total lipid extract from freeze ‐ dried soils. A normal
pressure chromatography was used to separate the phospholipid frac-
tion from the total lipid extract. The polar lipids were saponified (0.5 M
methanolic NaOH; 1 hr, 80 °C) and acidified (1 M HCl), and the liber-
ated PLFAs were methylated with acidified dry MeOH (1 hr; 80 °C).
The PLFA were analysed as their methyl esters using gas chromatogra-
phy – mass spectrometry (GC – MS; Rothamsted Research North Wyke,
Okehampton, UK) and gas chromatography combustion isotope ratio
mass spectrometry (GC/C/IRMS; James Hutton Institute, Aberdeen,
Scotland). PLFA biomarkers were grouped as Gram ‐ positive bacteria
2 LUO ET AL.
( i 15:0, a15:0, i16:0, i17:0, a 17:0), Gram ‐ negative bacteria (16:1 ω5,
16:1 ω 7, 17:1 ω 8, cy17:0, 18:1 ω 7, cy19:0, 19:1), actinobacteria
(10Me16:0, 10Me17:0, 10Me18:0), and fungi (18:2 ω 6; Zelles, 1999).
2.5 | Calculation of biochar ‐
13
C incorporation into
PLFAs
The fractional abundance expresses the concentration of
13
C as a pro-
portion of the total concentration of C in the PLFA using the equation
described by Nold, Boschker, Pel, and Laanbroek (1999)
F ¼ 13 C = 13 C þ 12 C
(1)
The fractional abundance (F) of
13
C in the control (Fc) and
enriched (Fe) PLFA were used to calculate the concentration of
13
C
incorporated into PLFA from the total PLFA concentration, using the
equation
13 C PLFA ¼ Fe −Fc ðÞ
PLFAs (2)
The percentage of biochar ‐
13
C incorporation into the various
PLFAs groups was calculated according to Gunina, Dippold, Glaser,
and Kuzyakov (2014)
13 C incorporation ¼13 C PLFA =13 C Applied 100 %(3)
2.6 |Statistics
Data meeting assumptions of normality and equality of variances were
analysed by analysis of variance. A 1 ‐ way analysis of variance was
undertaken to determine the significance ( p < .05) of differences
between the treatments of without, with biochar350and biochar700.
Least significant difference was chosen for the comparisons between
different treatments. Data were performed using GenStat software
(13th edition).
3 | RESULTS
Total PLFA content was more than doubled in the biochar ‐amended
soils, but there was no significant difference between biochar350
and biochar700 (Figure 1). All groups of microorganisms identified by
PLFA biomarkers were significantly more abundant in the biochar ‐
amended soils (Figure 1). All soils were dominated by Gram ‐positive
bacteria, but the content of Gram ‐ negative bacteria, actinobacteria,
and fungi biomarkers were increased in the biochar ‐ amended soils,
with the largest increases of both groups in the biochar700 amended
soils. The fungal to bacterial ratio (f:b) was significantly greater in the
biochar ‐ treated soils (control = 0.06; biochar350 = 0.11;
biochar700 = 0.18).
The δ
13
C values of the biomarker PLFAs revealed significant incor-
poration of
13
C from biochar350 into Gram ‐ positive bacteria, followed
by actinobacteria, Gram ‐ negative bacteria, and fungi after 431 days
(Figure 2). However, the total amount of the initial applied
13
Cof
biochar700 incorporated to PLFA was very small (less than 0.01%)
even though a substantial amount of biochar700 ‐ C was added
(50 mg C g
− 1
soil, equivalent roughly to 5 times of SOC).
4 | DISCUSSION
Changes in the activity and community structure of the soil microbial
biomass after biochar addition have been reported, e.g. Kolb,
FIGURE 1 Mean contents ( μ gCg
− 1
soil; n = 3, ±1 SE) of biomarker
phospholipid fatty acid analysis (PLFA; Gram ‐ positive bacteria, Gram ‐
negative bacteria, actinobacteria, and fungi) in low pH soils treated
with BC350, BC700 or no biochar (control) after 431 days. Error bars
represent standard errors of the means ( n = 3). Different letters
indicate significant difference at p < .05 between treatments (control,
BC350 and BC700)
FIGURE 2 The incorporation (a) of labelled biochar
13
C into biomarker
phospholipid fatty acid analysis (Gram ‐ positive bacteria, Gram ‐
negative bacteria, actinobacteria, and fungi) and mean δ
13
C values (b)
in low pH soils treated with BC350, BC700 or no biochar (control)
after 431 days. Error bars represent standard errors of the means
( n = 3). Different letters indicate significant difference at p < .05
between treatments (BC350 and BC700)
LUO ET AL . 3
Fermanich, and Dornbush (2009). Increased CO
2
emissions have been
observed immediately after biochar addition but these diminished in
days to weeks (Luo et al., 2011; Zimmerman, Gao, & Ahn, 2011) and
were largely attributed to a small fraction of available C contained
within the biochar (Smith, Collins, & Bailey, 2010). The soil microbial
communities of the biochar ‐ treated soils, quantified as PLFA, were sig-
nificantly larger than the control soil after 431 days (Figure 1). It has
been suggested that, such as all particulate organic matter, the large
surface area of biochar serves as an adsorption site for water, soluble
carbon, and nutrients that is favourable for microbial colonisation
(Pietikäinen et al., 2000; Saito et al., 2002), which was previously
described as the ‘ Charsphere ’ (Luo et al., 2013). PLFA is used to sepa-
rate out broad groups of soil microorganisms with different morphol-
ogies that tend to have the same functional ecologies (Wixon &
Balser, 2013). In this study, the content of Gram ‐ positive bacteria,
Gram ‐ negative bacteria, actinobacteria, and fungi biomarkers
increased in the biochar ‐ treated soils. The large f:b (Fungi:Bacterial)
of the biochar ‐ treated soils indicates the importance of fungal coloni-
sation of biochar to decompose the polyaromatic structure of biochar
and to make it available to other microbial groups as a substrate,
although its contents of PLFA was still limited. Gram ‐ positive bacteria
were the largest group in the biochar ‐ treated and control soils, and the
greatest relative increase was in the actinobacteria. Gram ‐ positive bac-
teria and actinobacteria (that are a subgroup of Gram ‐ positive bacteria)
are described as K ‐ strategists that are associated with slow and persis-
tent growth on more resistant organic residues (Blagodataskaya et al.,
2008; Dungait et al., 2011, 2013) that are typified by the characteris-
tically condensed structure of biochars.
Although the increase in the abundance of total and biomarker
PLFA was similar in soils treated with biochar350 or biochar700,
13
C ‐ PLFA analysis revealed that all groups of microorganisms were
only using biochar ‐ C as a substrate in the biochar350 treatment after
431 days (Figure 2a), suggesting that C from the biochar700 was less
available for microbial utilization. This does not mean that no bio-
char700 had been utilised, but maybe that it was below detection for
the natural abundance
13
C labelling technique used herein. There
was significant incorporation of biochar350 ‐ C into all PLFAs, especially
within Gram ‐ positive bacteria (Figure 2a), although the most
13
C ‐
enriched values were determined in the Gram ‐ negative bacteria
(Figure 2b). Farrell et al. (2013) also observed significant
13
C ‐ enrich-
ments in Gram ‐ positive bacteria ( K ‐ strategists) after 3 days and fungal
PLFAs in the latter stages of the incubations (up to 74 days) of biochars
from different feedstocks. However, a short term ‐incubation
experiment (up to 35 days) by Watzinger et al. (2014) showed a signif-
icant
13
C ‐ enrichment of Gram ‐ negative bacteria ( r ‐ strategists). The
overall % incorporation of applied
13
C into PLFA was very small, but
similar to that previously observed (< 1% added
13
C as a range of sub-
strates) by Dungait et al. (2011, 2013). Farrell et al. (2013) attributed
the incorporation of biochar into PLFAs biomarker to direct uptake
of biochar ‐ C, or from the turnover of microorganisms as Gram ‐positive
bacteria continuously decompose biochar labile C or even recalcitrant
C. This may suggest routing of biochar ‐ C into the microbial biomass
had occurred, but that its provenance may have been the biochar350
itself, or a secondary metabolite of another organism within the soil
food web that was using biochar350 after 14 months. However, this
needs further research to clarify the microbial succession at different
stages along incubation time.
The effect of biochar pH effects on the incorporation of biochar ‐C
remains unclear. Previous investigations of the soil microbial dynamics
along the pH gradient of the Hoosfield acid strip experiment (the
source of the very acid experimental soil) determined thatthe microbial
community changed in composition because the soil organic carbon
decreased as the pH declined (Rousk, Bååth, et al., 2010a; Rousk,
Brookes, & Bååth, 2010), whereas concentrations of NH
4 + ─
N and
extracted toxic elements (Al, Mn) tended to increase (Aciego Pietri &
Brookes, 2008a, 2008b). Farrell et al. (2013) attributed the significant
and rapid changes in the soil microbial community after biochar appli-
cation to both addition of labile C and increased soil pH. In this lon-
ger ‐ term study, the initial very acid soil pH (3.7) that was increased
to 4.3 and 5.1 more than a year after the addition of biochar. These
pH values are the rangeregularly measured in agricultural soils (e.g.,
http://esdac.jrc.ec.europa.eu/Library/Data/PH/Documents/pH_Pub.
FIGURE 3 Microbial colonization and its utilization of biochar350 and biochar700. Colonization images were obtained from Luo et al. (2013)
[Colour figure can be viewed at wileyonlinelibrary.com]
4 LUO ET AL.
pdf). The incorporation of biochar350 ‐ C into all groups of PLFAs was
greater than for biochar700 ‐ C after 431 days, suggesting that (a) its
incorporation of biochar ‐ C into PLFA was governed by its chemical
structure, thatis, biochars producedathigher temperatures have
more condensed structures which are more recalcitrant,and (b) the
pH effects of biochar was secondary to the available biochar ‐ Ccon-
tent (Figure 3). Although less incorporation of biochar700 ‐ Cinto
PLFAs, we found biochar700 increased total PLFAs with almost the
same extend as biochar350 (Figure 1), which can be mainly attributed
to more alkaline pH within biochar700 compared with biochar350.
Moreover, the alkaline conditions imposed by biochar addition was
suggested to be more favourable forGram ‐ positive bacteria than
for Gram ‐ negative bacteria (Gul et al., 2015). This agreed with our
finding that Gram ‐ positive bacteria dominated biochar ‐ C utilization
(Figure 2), suggesting that biochar exert pH effects on microbial uti-
lization within certain microbialgroups although a comparatively limited
effect compared with its C availability effects.
Overall, when considering the microbial utilization of biochar within
PLFAs, it appeared that the content of available C in biochar after
14 months, which was dictated by the pyrolysis temperature in this
study, was more important than its effects on soil pH (Figure 3). In the
biochar350 amended soil, the microorganisms (Gram ‐ positive,
actinobacteria, Gram ‐ negative bacteria, and Fungi) used labile biochar C
and the activated microorganisms might further utilize SOC due tothe
co ‐ metabolisms, causing soil priming effects (Figure 4). Biochar700
increased the total PLFAs via affecting soilpH (Figure 1), and the
enhanced microorganisms (Gram ‐ positive, actinobacteria, Gram ‐ negative
bacteria, and Fungi) by biochar700might utilize otherC sources, instead
of recalcitrant biochar700 ‐ C, to maintain its growth. This was attributed
to the preferential utilization of relatively labile C sources, also leading to
the soil priming effects, but with relatively smaller scale (Figure 4). How-
ever, the mechanisms (or hypothesis) need further research, adopting Iso-
tope techniques and DNA/PLFA ‐SIP (Stable Isotope Probing), to clarify.
5 | CONCLUSION
In conclusion, (a) the addition of biochars, regardless of produced tem-
peratures, to very acidic soils caused an increase in the content of all
PLFA; (b) biochar produced by pyrolysis at lower temperatures
(biochar350) was more likely to be used as a substrate by all soil micro-
organisms, especially Gram ‐ positive bacteria after 14 months; (c) the
content of available C, rather than altering soil pH, is the mainmecha-
nism determining the microbial utilization of biochar ‐ C in acidic soils;
(d) biochar can be used for soil C sequestration as most of recalcitrant
biochar C is resistant to microbial attack, even biochar induced higher
microbial biomass and activity.
ACKNOWLEDGEMENTS
We thank J. Zhou for chemical analyses and A. Duffey for bulk stable
isotope analyses. This study was supported by the National Science
Foundation of China (41671233, 41520104001) and National Basic
Research Program of China (2014CB441003). This work represents
part of the BBSRC ‐ funded programme “ Soil to Nutrition ”(BB/
P01268X/1) at Rothamsted Research.
ORCID
Yu Luo http://orcid.org/0000-0002-3834-498X
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How to cite this article: Luo Y,DungaitJAJ,ZhaoX,etal.
Pyrolysis temperature during biochar production alters its sub-
sequent utilization by microorganisms in an acid arable soil. Land
Degrad Develop . 2017;1 – 6. https://doi.org/10.1002/ldr.2846
6 LUO ET AL.
... A previous study indicated that the abundances of both fungi and bacteria were increased in soils amended with biochar and that both microbial groups used the C from the added biochar as a substrate
(Luo et al., 2017)
. The results of the current study are consistent with this previous study because the abundances of fungi (F 3,12 = 7.2, P < 0.01) as well as of G + bacteria (F 3,12 = 5.9, P < 0.05) and actinobacteria (F 3,12 = 5.2, P < 0.05) were higher in the biochar treatment than in the noaddition treatment (Fig. 3). ...
... The only exception were G − bacteria, whose abundance was not affected by treatments (F 3,12 = 2.7, P > 0.05) (Fig. 3). Fungi, G + bacteria, and actinobacteria derive greater benefit from biochar than G − bacteria because biochar commonly lacks easily available substrates, which are essential for the growth of G − bacteria (Farrell et al., 2013;Zhang et al., 2018), and because biochar only provides less degradable substances that tend to support the growth of fungi
(Luo et al., 2017)
, G + bacteria (Farrell et al., 2013), and actinobacteria (Watzinger et al., 2014). The rapid depletion of readily available compounds might also explain the generally lower abundances of fungi, G + bacteria, and actinobacteria in the compost treatment than in the biochar treatment and the lack of differences in the abundance of G − bacteria among treatments. ...
Biochar and compost amendments to a coarse-textured temperate agricultural soil lead to nutrient leaching
Article
May 2022
APPL SOIL ECOL
<here is a image e49c7766f5f855df-e498965e9a384584> V. Jílková
<here is a image edf3aa5a9706f46f-bf95f47efb05c6dd> Gerrit Angst
Organic soil amendments benefit agricultural soils depleted in soil organic matter because they improve soil chemical and biological properties. Biochar and compost, used as organic amendments, differ in their contents of total vs. available nutrients and may therefore differ in their effects on soil properties. The effects of these amendments have seldom been assessed in coarse-textured temperate soils and in no-tillage agriculture. In this study, we conducted a 6-month laboratory experiment with a coarse-textured temperate soil with a history of conventional farming to determine the effects of biochar, compost, and their combination, which were spread evenly on the soil surface, on microbial activity and biomass, and nutrient release and leaching. Both biochar and compost increased microbial activity and nutrient release compared to the no-addition treatment, but compost effects were relatively short term (<two months), and biochar effects were relatively long term (>six months). Biochar and compost had additive effects on all properties when added in combination. Biochar addition to soil increased soil pH, microbial biomass, and the abundance of fungi, G⁺ bacteria, and actinobacteria after 6 months of incubation compared to the compost treatment and the no-addition treatment. Although biochar was expected to reduce loss of nutrients through leaching, the short exposure time and disturbance of the soil probably hindered its capacity to adsorb nutrients and to thereby limit leaching; as a consequence, the biochar acted only as a slow-release nutrient fertilizer during the 6-month incubation.
... (Arriagada et al., 2014) and can provide essential support for achieving crop yield and ecosystem services (Knoblauch et al., 2021). Biochar amendments to soil have been previously shown to increase OM and available nutrient contents (Abujabhah et al., 2016;Cooper et al., 2020; Jílková & Angst, 2022) as well as soil microbial activity and biomass (Abujabhah et al., 2016;Jílková & Angst, 2022;
Luo et al., 2018)
. Based on recent meta-analyses, these effects are especially evident in coarsetextured, acidic soils (Liu et al., 2016;Zhang et al., 2018). ...
Biochar‐application rate and method affect nutrient availability and retention in a coarse‐textured, temperate agricultural Cambisol in a microcosm experiment
Article
Feb 2023
<here is a image e49c7766f5f855df-e498965e9a384584> V. Jílková
Agricultural soils often require organic amendments, which improve crop yield and ecosystem services. Biochar has been proven to increase nutrient availability and retention in fine‐textured, tropical soils. Here we determine how coarse‐textured, temperate soils react to different biochar‐application rates in different tillage systems. We conducted a 6‐month laboratory incubation experiment in microcosms filled with a coarse‐textured, temperate agricultural soil to determine the effects of biochar‐application rate (none, low, or high, i.e., 0, 20, or 40 t dw ha−1, respectively) and application method (mixed into the soil or applied to the soil surface) on microbial activity and biomass, and nutrient availability and leaching. Microbial activity and biomass and contents of carbon, nitrogen, and phosphorus in leachates were higher in biochar‐addition treatments (by 134%, 37%, 372%, 28%, and 801%, respectively) than in the no‐addition treatment. The effect was stronger with the low than with the high biochar‐application rate. Biochar applied by both methods acted as a slow‐release fertilizer, but this effect was stronger when biochar was mixed into the soil. Although available nutrient contents in the soil remained high, nutrient leaching decreased with incubation time. This effect was especially evident when biochar was mixed into the soil. Biochar is an effective organic amendment in coarse‐textured soils providing available nutrients. On the other hand, nutrient‐retention mechanisms develop slowly after biochar application and may be greater when biochar is mixed into the soil than applied on the soil surface. Graphical Abstract:
... Thirdly, the organic matrix of biochar acts as promising habitat for plant growth promoting bacteria (PGPB) (Bertola et al. 2019). Again, low-temperature biochars with low aromaticity are good candidates because bacteria can utilize aliphatic moieties much easier than aromatic ones
(Luo et al. 2018;
Zhong et al. 2020). Stimulated microbial activities within the charosphere account for improved soil health within the rhizosphere, thus leading to an elevated plant biomass yield (Dissanayake et al. 2022;Weralupitiya et al. 2022). ...
Role of biochar toward carbon neutrality
Article
Full-text available
Jan 2023
Liuwei Wang
<here is a image c04546fa1991f4a8-8743dd001bd31ba4> Jiayu Deng
Xiaodong Yang
<here is a image 3fb4ba50142c86d5-6a0cc0df6fc96c43> Deyi Hou
Carbon neutrality by the mid-twenty-first century is a grand challenge requiring technological innovations. Biochar, a traditional soil amendment which has been used for fertility improvement and contaminant remediation, has revealed new vitality in this context. In this review we highlight the huge potential of biochar application in different fields to mitigate as high as 2.56 × 10 ⁹ t CO 2 e total greenhouse gas (GHG) emissions per year, accounting for 5.0% of the global GHG emissions. Soil applications of biochar as either a controlled-release fertilizer or an immobilization agent offer improved soil health while simultaneously suppressing the emissions of CH 4 and N 2 O. Non-soil applications of biochar also contribute to carbon neutrality in unique ways. Firstly, biochar application as a ruminant feed decreases CH 4 emissions via physical sorption and enhanced activities of methanotrophs. Secondly, biochar can be used as a green catalyst for biorefinery. Besides, biochar as an additive to Portland cement and low impact development (LID) infrastructure lowers the carbon footprint and builds resilience to climate change. Furthermore, biochar can be used as novel batteries and supercapacitors for energy storage purposes. Finally, the high CO 2 adsorption capacity makes it possible for biochar being used as a sorbent for carbon capture, utilization, and storage (CCUS). We advocate that future research should further explore the effectiveness of biochar systems for climate change mitigation in large scale applications, and assess the economic and social viability of local biochar systems to combat climate change.
Graphical Abstract
... "Increased enzyme activity of dehydrogenase, βglucosidase, and urease in a red soil of China was recorded when amended with an oak wood or bamboo biochar at 0.5, 1.0, and 2.0% after 372 days of incubation" [31]. Luo et al.
[32]
showed that "all microbial groups (Gram positive and Gram-negative bacteria, Actinobacteria and Fungi) were more abundant in the biochar treated soil after 14 months of incubation". Similar findings were reported by Gomez et al. [33] in a study using four soils from the Midwest, USA, and concluded that biochar stimulated microbial activity and growth. ...
Biochar: An Emerging Soil Amendment for Sustaining Soil Health and Black Gold for Indian Agriculture
Full-text available
<here is a image 1937ee36a50dd27a-fa33d150fae83bfe> Vikram N Shiyal
<here is a image 9861eb773076b9d7-22b6a57dbbb769fd> Vinaykumar Patel
<here is a image fa41d0bc505f9a36-5219690e1e8bb4f5> Hiren Patel
<here is a image 8ac39acab7c2774b-04ac4e53e3b5b21a> Piyush H. Patel
At the international level, improving soil with coal is seen as a means to increase soil productivity, fertility and also to mitigate climate change. Biochar, which is used to increase land fertility and store carbon, is currently gaining scientific attention and popularity in the agriculture sector. It is a solid material made by pyrolysis process of any biomass, including weeds, agricultural leftovers and other plant wastes, to carbonise it and use it as a soil amendment and carbon sequestration medium. Biochar is a viable option for enhancing soil chemical properties such as cation exchange capacity (CEC) and soil pH, as well as lowering exchangeable acidity. Biochar was also discovered to boost soil biota by boosting nutrient availability, improving habitat appropriateness, increasing water retention and aeration as well as lowering harmful compounds in the soil. Also, it can help to mitigate climate change by sequestering carbon in the soil and reducing nitrous oxide (N2O) and methane (CH4) gas emissions to the environment by enhancing soil absorption.
... To lessen the PS's microbial toxicity, SBB could boost adsorption and enhance soil quality. The soil microorganisms could receive nutrition and protection directly from biochar (Jia et al. 2018;
Luo et al. 2018)
or a more favorable habitat by altering the soil's physical characteristics. Biochar could release dissolved organic carbon (DOC) into the soil solution after application and directly alter the DOC's properties (Dittmar et al. 2012). ...
Methane emissions and rice yield in a paddy soil: the effect of biochar and polystyrene microplastics interaction
| https://www.researchgate.net/publication/321578113_Pyrolysis_temperature_during_biochar_production_alters_its_subsequent_utilization_by_microorganisms_in_an_acid_arable_soil |
RIDGEWAY v. UNITED STATES | 558 F.2d 357 | 6th Cir. | Judgment | Law | CaseMine
Get free access to the complete judgment in RIDGEWAY v. UNITED STATES on CaseMine.
RIDGEWAY v. UNITED STATES
558 F.2d 357
Case Information
CITATION CODES
558 F.2d 357
DOCKET NO.
No. 76-2145.
ATTORNEY(S)
Ovid C. Lewis, Covington, Ky. (Court-appointed), for defendant-appellant.
Philip M. Van Dam, U.S. Atty., Peter M. Rosen, Detroit, Mich., Dana D. Biehl, Washington, D.C., for plaintiff-appellee.
JUDGES
Harry Phillips
ACTS
Food And Drugs — Drug Abuse Prevention And Control — Import And Export — Attempt And Conspiracy
Food And Drugs — Drug Abuse Prevention And Control — Import And Export — Importation Of Controlled Substances
Food And Drugs — Drug Abuse Prevention And Control — Control And Enforcement — Offenses And Penalties — Attempt And Conspiracy
Food And Drugs — Drug Abuse Prevention And Control — Control And Enforcement — Offenses And Penalties — Prohibited Acts A
Smart Summary
Important Paras
Against this background of the origin and purpose of the Agreement, we turn now to the writ of habeas corpus ad prosequendum and its origins. A federal writ of habeas corpus ad prosequendum is a court order directing the production of a prisoner to stand trial in federal court. A history of the writ in American jurisprudence is presented in Carbo v. United States, 364 U.S. 611, 81 S.Ct. 338, 5 L.Ed.2d 329 (1961). The writ of habeas corpus ad prosequendum is one of the oldest writs available to the judiciary. Blackstone described the writ in his Commentaries on English law. In the United States the writ traces its origins from § 14 of the First Judiciary Act, 1 Stat. 81-82 (1789), and it is now incorporated in 28 U.S.C. § 2241(c)(5) . For almost 200 years the United States has utilized the writ in cases where a State prisoner was facing federal charges. Nowhere have we found any expression of Congressional intent to modify or change the writ. Go to
Since the Congressional history does not answer our question, we look to the origins of the Agreement. A detainer is simply a notice to prison authorities that charges are pending against an inmate elsewhere, requesting the custodian to notify the sender before releasing the inmate. The detainer itself does nothing to affect the prosecution of an inmate. Filing a detainer is an informal process which does not bind the authorities to act. Generally, a penal institution will recognize a detainer lodged by any person who has authority to take an inmate into custody. In most instances, the prosecutor charged with the task of bringing the case to disposition files the detainer, but, if the case has not yet reached the stage of a formal indictment or information, the detainer may be filed by the police. Go to
The Agreement was first promulgated by the Council of State Governments in 1957. It was adopted by Congress in 1970, and 46 states, the District of Columbia and the United States are signatories. The Agreement was designed to facilitate the disposition of charges in one jurisdiction when the accused is incarcerated in another jurisdiction. Some of the reasons for the agreement are set forth in Article I: Go to
See United States v. Ford, supra, 550 F.2d 732 (2d Cir. 1977). Go to
The Agreement is applicable to situations in which one participating jurisdiction has lodged a detainer for a prisoner in another participating jurisdiction where the prisoner is incarcerated. Article III provides that a prisoner can demand to be brought to trial within 180 days on any untried indictment, information or complaint which is the basis for a detainer lodged against him. If the prisoner is not brought to trial within the 180 day limit, the appropriate court of the jurisdiction in which the outstanding charge is pending is required to dismiss the charge with prejudice and the detainer thereupon ceases to have effect. The time limit can be extended for good cause in open court, if either the prisoner or his counsel are present. Thus, Article III provides a prisoner with a procedure for bringing about a prompt disposition of detainers placed against him. Go to
The Agreement also provides a method under Article IV whereby prosecutors can secure prisoners serving sentences in other jurisdictions for a prompt trial. Unless a request is disapproved by the Governor of the State having custody (or in an appropriate case by the Attorney General of the United States) within 30 days, temporary custody of the prisoner is given to the requesting prosecutor. Trial must commence within 120 days of the arrival of the prisoner in the jurisdiction requesting him, unless a continuance is granted for good cause in open court with the prisoner or his counsel present. Article IV(e) mandates that: Go to
First we consider the question of whether a writ of habeas corpus ad prosequendum is a detainer under the Interstate Agreement on Detainers (Agreement). Go to
The party States find that charges outstanding against a prisoner, detainers based on untried indictments, informations, or complaints and difficulties in securing speedy trial of persons already incarcerated in other jurisdictions, produce uncertainties which obstruct programs of prisoner treatment and rehabilitation. Accordingly, it is the policy of the party States and the purpose of this agreement to encourage the expeditious and orderly disposition of such charges and determination of the proper status of any and all detainers based on untried indictments, informations, or complaints. The party States also find that proceedings with reference to such charges and detainers, when emanating from another jurisdiction, cannot properly be had in the absence of cooperative procedures. It is the further purpose of this agreement to provide such cooperative procedures.
If a trial is not had on any indictment, information, or complaint . . . prior to the prisoner's being returned to the original place of imprisonment . . . the court shall enter an order dismissing the [indictment, information or complaint] with prejudice.
Dictum in United States v. Roberts, 548 F.2d 665, 670 (6th Cir. 1977) indicated that this court might find a writ of habeas corpus ad prosequendum to be a detainer under the Agreement. However, in view of this court's ultimate conclusion in Roberts that the Agreement did not apply to a prisoner in Roberts' situation, the dictum is not binding upon this court when we are faced squarely with the issue. Go to
We have reviewed the legislative history of the Agreement and find no conclusive answer to the question before us. The Senate Report defined a detainer as "a notification filed with the institution in which a prisoner is serving a sentence, advising that he is wanted to face pending criminal charges in another jurisdiction" Nowhere in the legislative history do we find any express reference to a writ of habeas corpus ad prosequendum. Go to
The effects of a detainer on an inmate can be profound. Extensive delay in bringing the prisoner to trial is only one of the problems. Many prison authorities regard convicts subject to detainers as potential escape risks, and, therefore, restrict their activities and privileges.
An inmate may be denied institutional privileges resulting in decreased freedom of movement, and he may be precluded from preferred living quarters such as dormitories.
Such an inmate may be denied trusty status,
or he may be considered ineligible to reside on an "honor farm" or to take part in a furlough program. Detainers may be taken into account by parole boards and thus may affect the length of a sentence. A detainer can also have a psychological effect upon an inmate, thus frustrating rehabilitation. As the Senate Report noted:
Detainers, separate and distinct from the writ of habeas corpus ad prosequendum, continue to be used by federal authorities. We refuse to interpret the word "detainer" to include the writ of habeas corpus ad prosequendum. Go to
The abuses of detainers designed to be corrected by the Agreement are not present in the use of the writ. The writ is a federal court order. It can be issued only by the court, unlike a detainer which can be filed by police authorities and prosecutors. The primary emphasis of the proponents of the Agreement was on the anti-rehabilitative effect of longstanding detainers. Note, Effective Guaranty of a Speedy Trial for Convicts in Other Jurisdictions, supra note 5, 77 Yale L.J. at 775. The writ is not subject to this objection because it is executed expeditiously, unlike a detainer which can lay dormant for many years. Go to
The interpretation of the Agreement proposed by appellant would implicitly repeal § 2241(c)(5) and runs counter to fundamental rules of statutory construction. Where Congress has enacted legislation on a particular subject, as it has for a writ of habeas corpus ad prosequendum, subsequent legislation will not be construed to modify, repeal or supplant the legislation, particularly where both statutes serve distinct purposes. Rosencrans v. United States, 165 U.S. 257, 17 S.Ct. 302, 41 L.Ed. 708 (1897). Rather, the courts will reconcile the earlier statute and the later legislation if possible. McCool v. Smith, 66 U.S. (1 Black) 459, 17 L.Ed. 218 (1861). We re-emphasize that the legislative history of the Agreement in Congress does not even mention the writ of habeas corpus ad prosequendum. It would be error to conclude that § 2241(c)(5) incorporating the writ in the current code was modified by the Agreement. Go to
RIDGEWAY v. UNITED STATES
PHILLIPS, Chief Judge.
The principal question raised on this appeal is whether a writ of habeas corpus ad prosequendum is a detainer under the Interstate Agreement on Detainers. We hold that it is not.
Robert Lee Ridgeway was indicted and convicted on one count of conspiracy to import, possess and distribute cocaine. On appeal he raises four grounds for reversal:
(1) That a writ of habeas corpus ad prosequendum is a detainer under the Interstate Agreement on Detainers and that the federal indictment against him should have been dismissed with prejudice when he was not tried within 120 days after his arrival within federal jurisdiction, and when he was returned to his incarceration in a State institution prior to trial on the federal charges;
(2) That an in-court identification was improperly admitted into evidence;
(3) That the evidence was insufficient to support the conviction; and
(4) That he was denied the effective assistance of counsel.
We conclude that all four of these contentions are without merit and affirm the conviction.
I.
On August 8, 1975, Ridgeway was charged under a federal indictment with one count of conspiracy. The count charged appellant and others under the conspiracy provision,21 U.S.C. § 963, with having conspired to smuggle cocaine knowingly and intentionally into the United States in violation of21 U.S.C. § 952(a)and under the conspiracy provision21 U.S.C. § 846, with having conspired to distribute or possess with intent to distribute, cocaine in violation of21 U.S.C. § 841(a)(1). A second count charged appellant with possession of cocaine with the intent to distribute it in violation of21 U.S.C. § 841(a)(1).
When the indictment was filed appellant was serving a sentence in a Michigan prison for an unrelated state charge. He was brought to the United States District Court for the Eastern District of Michigan pursuant to a writ of habeas corpus ad prosequendum for his arraignment and plea of not guilty on August 14, 1975. From the arraignment and throughout the proceedings, appellant and the Government agreed that appellant would be placed on personal bond rather than having a detainer filed against him with the State prison authorities.This arrangement was requested by appellant so that he could maintain his trustee status and be eligible for benefits he might not have had if he had been held in a federal facility or had a detainer filed against him while awaiting trial.
He was returned to the Michigan state prison until November 20, 1975, when he was brought back to the district court for trial pursuant to another writ of habeas corpus ad prosequendum. During the trial, appellant, his attorney and the Government agreed that in return for appellant's waiver of a jury trial the Government would drop the substantive possession charge against him. Appellant's counsel then requested a continuance so that he could obtain certain scientific evidence. Appellant was returned to the Michigan State prison while the trial of his co-defendants continued. He was brought before the court for trial pursuant to yet another writ of habeas corpus ad prosequendum on March 5, 1976.
Appellant was indicted as a member of the Robert Wind cocaine smuggling conspiracy, alleged to have involved shipments of cocaine from South America in large quantities for distribution in the Detroit area for a period of almost two years from mid-1973 to mid-1975. Seventeen persons were named as co-conspirators, fifteen of whom were indicted. The district court sentenced appellant to twelve years imprisonment running consecutively with his State sentence. In addition, the court imposed a special parole term of ten years. This appeal was then filed.
II.
First we consider the question of whether a writ of habeas corpus ad prosequendum is a detainer under the Interstate Agreement on Detainers (Agreement).
The Agreement was first promulgated by the Council of State Governments in 1957.It was adopted by Congress in 1970, and 46 states, the District of Columbia and the United States are signatories. The Agreement was designed to facilitate the disposition of charges in one jurisdiction when the accused is incarcerated in another jurisdiction. Some of the reasons for the agreement are set forth in Article I:
Council of State Governments Suggested Legislation 167 (1959).
The party States find that charges outstanding against a prisoner, detainers based on untried indictments, informations, or complaints and difficulties in securing speedy trial of persons already incarcerated in other jurisdictions, produce uncertainties which obstruct programs of prisoner treatment and rehabilitation. Accordingly, it is the policy of the party States and the purpose of this agreement to encourage the expeditious and orderly disposition of such charges and determination of the proper status of any and all detainers based on untried indictments, informations, or complaints. The party States also find that proceedings with reference to such charges and detainers, when emanating from another jurisdiction, cannot properly be had in the absence of cooperative procedures. It is the further purpose of this agreement to provide such cooperative procedures.
The Agreement is discussed in United States v. Ford,550 F.2d 732(2d Cir. 1977), petition for cert. filed,46 U.S.L.W. 3056(U.S. Aug. 16, 1977, No. 77-52).
The Agreement is applicable to situations in which one participating jurisdiction has lodged a detainer for a prisoner in another participating jurisdiction where the prisoner is incarcerated. Article III provides that a prisoner can demand to be brought to trial within 180 days on any untried indictment, information or complaint which is the basis for a detainer lodged against him. If the prisoner is not brought to trial within the 180 day limit, the appropriate court of the jurisdiction in which the outstanding charge is pending is required to dismiss the charge with prejudice and the detainer thereupon ceases to have effect. The time limit can be extended for good cause in open court, if either the prisoner or his counsel are present. Thus, Article III provides a prisoner with a procedure for bringing about a prompt disposition of detainers placed against him.
The Agreement also provides a method under Article IV whereby prosecutors can secure prisoners serving sentences in other jurisdictions for a prompt trial. Unless a request is disapproved by the Governor of the State having custody (or in an appropriate case by the Attorney General of the United States) within 30 days, temporary custody of the prisoner is given to the requesting prosecutor. Trial must commence within 120 days of the arrival of the prisoner in the jurisdiction requesting him, unless a continuance is granted for good cause in open court with the prisoner or his counsel present. Article IV(e) mandates that:
If a trial is not had on any indictment, information, or complaint . . . prior to the prisoner's being returned to the original place of imprisonment . . . the court shall enter an order dismissing the [indictment, information or complaint] with prejudice.
In addressing the issue of whether a writ of habeas corpus ad prosequendum is a detainer under the Agreement, we note that there is a split of authority among the other Circuits. The Second Circuit in United States v. Mauro,544 F.2d 588(2d Cir. 1976) (Mansfield, J., dissenting) and the Third Circuit in United States ex rel. Esola v. Groomes,520 F.2d 830(3rd Cir. 1975), held that the writ is a detainer under the Agreement, while the Fifth Circuit has recently reached the opposite conclusion in United States v. Scallion,548 F.2d 1168(5th Cir. 1977).
Dictum in United States v. Roberts,548 F.2d 665, 670(6th Cir. 1977) indicated that this court might find a writ of habeas corpus ad prosequendum to be a detainer under the Agreement. However, in view of this court's ultimate conclusion in Robertsthat the Agreement did not apply to a prisoner in Roberts' situation, the dictum is not binding upon this court when we are faced squarely with the issue.
We have reviewed the legislative history of the Agreementand find no conclusive answer to the question before us. The Senate Reportdefined a detainer as "a notification filed with the institution in which a prisoner is serving a sentence, advising that he is wanted to face pending criminal charges in another jurisdiction"Nowhere in the legislative history do we find any express reference to a writ of habeas corpus ad prosequendum.
S.Rep. No. 91-1356, 91st Cong., 2d Sess. (1970), reprinted in [1970] U.S. Code Cong. Ad. News, p. 4864; H.R. Rep. No. 91-1018, 91st Cong., 2d Sess.; 116 Cong. Rec. 13999-14000 (remarks of Rep. Kastenmeier and Rep. Poff), 3884-85 (remarks of Sen. Hruska) (1970).
S.Rep. No. 91-1356, supra,n. 2 at 4865.
See also116 Cong.Rec. 13999 (1970) (remarks of Rep. Kastenmeier).
Since the Congressional history does not answer our question, we look to the origins of the Agreement.A detainer is simply a notice to prison authorities that charges are pending against an inmate elsewhere, requesting the custodian to notify the sender before releasing the inmate. The detainer itself does nothing to affect the prosecution of an inmate. Filing a detainer is an informal process which does not bind the authorities to act.Generally, a penal institution will recognize a detainer lodged by any person who has authority to take an inmate into custody. In most instances,the prosecutor charged with the task of bringing the case to disposition files the detainer, but, if the case has not yet reached the stage of a formal indictment or information, the detainer may be filed by the police.
See generally,Meyer, Effective Utilization of Criminal Detainer Procedures, 61 Ia.L.Rev. 659 (1976); Yackle, Taking Stock of Detainer Statutes, 8 Loy.L.A.L.Rev. 88 (1975); Dauber, Reforming the Detainer System: A Case Study, 7 Crim.L.Bull. 669 (1971); Wexler Hershey, Criminal Detainers in a Nutshell, 7 Crim.L.Bull. 753 (1971); Note, Extending the Smith v. HooeyDuty to the Holding Jurisdiction, 23 Me. L.Rev. 201 (1971); Note, The Interstate Criminal Detainer and the Sixth Amendment, 23 Ark.L.Rev. 634 (1970); Note, Effective Guaranty of a Speedy Trial for Convicts in Other Jurisdictions, 77 Yale L.J. 767 (1968); Schindler, Interjurisdictional Conflicts and the Right to a Speedy Trial, 35 U.Cin.L.Rev. 179 (1966); Note, Detainers and the Correctional Process, 1966 Wn.U.L.Q. 417; Comment, The Detainer System and the Right to a Speedy Trial, 31 U.Chi.L.Rev. 535 (1964); Note, Convicts — The Right to Speedy Trial and the New Detainer Statutes, 18 Rut.L.Rev. 828 (1964).
Note, Detainers and the Correctional Process, supranote 5, 1966 Wn.U.L.Q. at 417.
Yackle, Taking Stock of Detainer Statutes, supranote 5, 8 Loy.L.A.L.Rev. at 90.
Detainers have been filed with little consideration of whether the inmate will be brought to trial. In some cases they may be withdrawn as a matter of prosecutorial discretion. Some detainers apparently have been filed for punitive reasons.They are withdrawn shortly before the inmate's release, having served their purpose by limiting his prison privileges and preventing parole. The dangers in this practice were discussed by Judge Sobeloff in Pitts v. North Carolina,395 F.2d 182, 187(4th Cir. 1968):
Note, Effective Guaranty of a Speedy Trial for Convicts in Other Jurisdictions, supranote 5, 77 Yale L.J. at 773.
Detainers, informal aides in interstate and intrastate criminal administration, often produce serious adverse side-effects. The very informality is one source of the difficulty. Requests to an imprisoning jurisdiction to detain a person upon his release so that another jurisdiction may prosecute or incarcerate him may be filed groundlessly, or even in bad faith, as suspected by the appellant in this case. The accusation in a detainer need not be proved; no judicial officer is involved in issuing a detainer. As often happens, the result of the then unestablished charge upon which the detainer in this case rested was that the detainee was seriously hampered in his quest for a parole or commutation.
The effects of a detainer on an inmate can be profound. Extensive delay in bringing the prisoner to trial is only one of the problems. Many prison authorities regard convicts subject to detainers as potential escape risks, and, therefore, restrict their activities and privileges.An inmate may be denied institutional privileges resulting in decreased freedom of movement, and he may be precluded from preferred living quarters such as dormitories.Such an inmate may be denied trusty status,or he may be considered ineligible to reside on an "honor farm" or to take part in a furlough program. Detainers may be taken into account by parole boards and thus may affect the length of a sentence. A detainer can also have a psychological effect upon an inmate, thus frustrating rehabilitation. As the Senate Report noted:
[W]hen detainers are filed against a prisoner he sometimes loses interest in institutional opportunities because he must serve his sentence without knowing what additional sentences may lie before him, or when, if ever, he will be in a position to employ the education and skills he may be developing. Although a majority of detainers filed by States are withdrawn near the conclusion of the Federal sentence, the damage to the rehabilitation program has been done because the institution staff has not had sufficient time to develop a sound pre-release program.
Note, Detainers and the Correctional Process, supranote 5, 1966 Wn.U.L.Q. at 419.
Yackle, Taking Stock of Detainer Statutes, supranote 5, 8 Loy.L.A.L.Rev. at 91.
Note, Detainers and the Correctional Process, supranote 5, 1966 Wn.U.L.Q. at 419. Sometimes the inmate would be automatically held under maximum security or be declared ineligible for special work programs, athletic programs, release for visits to relatives' death beds, or funerals. United States v. Ford,550 F.2d 732(2d Cir. 1977).
S.Rep. No. 91-1356 supra,n. 2 at 4866.
Against this background of the origin and purpose of the Agreement, we turn now to the writ of habeas corpus ad prosequendum and its origins. A federal writ of habeas corpus ad prosequendum is a court order directing the production of a prisoner to stand trial in federal court. A history of the writ in American jurisprudence is presented in Carbo v. United States,364 U.S. 611,81 S.Ct. 338,5 L.Ed.2d 329(1961). The writ of habeas corpus ad prosequendumis one of the oldest writs available to the judiciary. Blackstone described the writ in his Commentaries on English law.In the United States the writ traces its origins from § 14 of the First Judiciary Act, 1 Stat. 81-82 (1789), and it is now incorporated in28 U.S.C. § 2241(c)(5). For almost 200 years the United States has utilized the writ in cases where a State prisoner was facing federal charges. Nowhere have we found any expression of Congressional intent to modify or change the writ.
3 Blackstone, Commentaries [*] 129.
Detainers, separate and distinct from the writ of habeas corpus ad prosequendum, continue to be used by federal authorities.We refuse to interpret the word "detainer" to include the writ of habeas corpus ad prosequendum.
See United States v. Ford, supra,550 F.2d 732(2d Cir. 1977).
The abuses of detainers designed to be corrected by the Agreement are not present in the use of the writ. The writ is a federal court order. It can be issued only by the court, unlike a detainer which can be filed by police authorities and prosecutors. The primary emphasis of the proponents of the Agreement was on the anti-rehabilitative effect of longstanding detainers. Note, Effective Guaranty of a Speedy Trial for Convicts in Other Jurisdictions, supranote 5, 77 Yale L.J. at 775. The writ is not subject to this objection because it is executed expeditiously, unlike a detainer which can lay dormant for many years.
The interpretation of the Agreement proposed by appellant would implicitly repeal § 2241(c)(5) and runs counter to fundamental rules of statutory construction. Where Congress has enacted legislation on a particular subject, as it has for a writ of habeas corpus ad prosequendum, subsequent legislation will not be construed to modify, repeal or supplant the legislation, particularly where both statutes serve distinct purposes. Rosencrans v. United States,165 U.S. 257,17 S.Ct. 302,41 L.Ed. 708(1897). Rather, the courts will reconcile the earlier statute and the later legislation if possible. McCool v. Smith,66 U.S. (1 Black) 459,17 L.Ed. 218(1861). We re-emphasize that the legislative history of the Agreement in Congress does not even mention the writ of habeas corpus ad prosequendum. It would be error to conclude that § 2241(c)(5) incorporating the writ in the current code was modified by the Agreement.
We agree with the Fifth Circuit that the legislative history shows no intent to make the Agreement the exclusive means by which a state prisoner can be brought to trial in federal court. United States v. Scallion, supra,548 F.2d at 1171.
Further evidence that Congress did not intend to equate federal writs of habeas corpus with detainers is provided by a statement of the Senate Committee on the Judiciary issued to clarify this matter:
Federal prosecution authorities and all Federal defendants have always had and continue to have recourse to a speedy trial in a Federal court pursuant to
28 U.S.C. § 2241(c)(5)
, the Federal writ of
habeas corpus ad prosequendum.
The Committee does not intend, nor does it believe that the Congress in enacting the [Interstate Agreement on Detainers] in 1970 intended, to limit the scope and applicability of that writ. S. 1, 94th Cong., 1st Sess. (1975).
Since we conclude that a writ of habeas corpus ad prosequendum is not a detainer, it follows that the charges against Ridgeway are not required to be dismissed under the terms of the Agreement.
III.
We have considered Ridgeway's other contentions and find them to be without merit. Specifically, we hold that the district court did not err in admitting an incourt identification into evidence; that the evidence is sufficient to support the conviction; and that Ridgeway was not denied effective assistance of counsel.
Affirmed.
| https://www.casemine.com/judgement/us/5914c5c1add7b049347d65d9 |
(!) Cephalic Index vs. Y-haplogroups in Europe [Archive] - Eupedia Forum
Hello everybody, Is anybody familiar with any study on the relationship of the Cephalic Index vs. Y-haplogroups in Europe? Thank you.
(!) Cephalic Index vs. Y-haplogroups in Europe
Hello everybody,
Is anybody familiar with any study on the relationship of the Cephalic Index vs. Y-haplogroups in Europe?
Thank you.
I think it will be a waste of time to study such a relationship unless u focus on a single region of a country where Y haplogroups could be correlated to the migration of a group from another area and so on. Take a look at R1b for instance, its linked to brachycephaly in Anatolia and Balkans, while its farther branches in Scotland and Ireland or Iberia are dolichocephals. I think mtdna is a better candidate for the cephalic index than ydna.
The cephalic index could vary from brachy to dolicho and vice-versa over time. It was studied already in the mid XX-th century and from that point the cephalic index was dropped out from most of the study fields. So, yes, don't waste your time with that.
... I think mtdna is a better candidate for the cephalic index than ydna.
Thank you.Would you be kind to refer to any study you are aware of?
The cephalic index could vary from brachy to dolicho and vice-versa over time. It was studied already in the mid XX-th century and from that point the cephalic index was dropped out from most of the study fields. So, yes, don't waste your time with that.
Thank you.Would you be kind to refer to any such studies?
The cephalic index could vary from brachy to dolicho and vice-versa over time. It was studied already in the mid XX-th century and from that point the cephalic index was dropped out from most of the study fields. So, yes, don't waste your time with that.
very simplistic answer for a genetic trait: don't mistake long term collective variations of diverse origins (often cultural, environmental) and genetic basis of individual CI differences - that said, it's evident Y-HG's don't play a big role in this (as in other genetic traits), here I do the same answer as others forumers, it is not very new -I wait for true Albanians with a mean CI of 72 as among 1930's Pathans, even now in the 2010's spite the dolichocephalicizing trend -
Thank you.Would you be kind to refer to any such studies?
very simplistic answer for a genetic trait: don't mistake long term collective variations of diverse origins (often cultural, environmental) and genetic basis of individual CI differences - that said, it's evident Y-HG's don't play a big role in this (as in other genetic traits), here I do the same answer as others forumers, it is not very new -I wait for true Albanians with a mean CI of 72 as among 1930's Pathans, even now in the 2010's spite the dolichocephalicizing trend -
There were several studies in the past from which I can recall the study of Franz Boas on Jewish emigrants in America that observed how there was a complete reverse in the cephalic index of the generation born on American soil. Also, there's another study on Czech bone material which states that the medieval Czechs were dolichocephalic and gradually unto XIX century they went through brachycephalization that characterize them now. Another or maybe the same study, stated that the so-called Baltic phenotype was a reduced form of a Nordic prototype, (i.e. from dolicho to brachy). Furthermore there's some information about the brachy processes that happen when a population is living in mountainous area for long time. Also, you can see how the PIE Kurgan people were dolichocephalic cro-magnids and now this type and features almost don't exist.So, I am saying that the cephalic index is not a constant and I don't think it correlates well with anything.
MOESAN, what are you implying? I agree the CI does not correlate with Y-dna and it is something connected to many different things.
I found this archived thread:http://www.eupedia.com/forum/archive/index.php/t-27058.html
Is anybody aware of anything new?
I wait for true Albanians with a mean CI of 72 as among 1930's Pathans, even now in the 2010's spite the dolichocephalicizing trend -Well 72 is too extreme but better nutrition and no cradling for babies did reduce the extreme brachycephaly among Tosk Albanians. But you're right that even after 100 years we can probably see a maximum of 3-4 decrease in CI, not a shift from brachy to dolicho.
I'm more interested in facial index. I've noticed that Haplogroup J corresponds to higher facial index in Asia for one thing.
From my observation south,east Europeans tend to have more broad brachy heads and faces than north, west Europeans. I even mentioned this to my mom once, and she said maybe they sleep more on their side.
IMO there is no relation whatsoever between cephalic index and Y-DNA. Any correlation would be fortuitous. The best proof is that Swiss and North Italians have mostly brachycephalic, while Spanish, British and Irish people are more dolicocephalic, despite both having high percentages of R1b. Likewise, most Slavs are brachycephalic, but Norwegians, who also have high levels of R1a, are dolicocephalic.
From my observation south,east Europeans tend to have more broad brachy heads and faces than north, west Europeans. I even mentioned this to my mom once, and she said maybe they sleep more on their side.
I agree with east vs west, but I've seen the opposite in north vs south. I think of long, narrow faces as typical of the Mediterranean more than Northern Europe. Spaniards and Italians seem to typify this. Here in the Balkans in Southeastern Europe South Slavs have this facial type combined with a brachycephalic head ("Dinaric"-type craniofacial profile).
Likewise, most Slavs are brachycephalic, but Norwegians, who also have high levels of R1a, are dolicocephalic.The region in Norway where R1a is highest is brachycephalic, which was observed by early anthropologists.
Cephalic index in France differs from village to village, so we don't know whether North Italians who are R1b lean brachycephalic or dolicocephalic.
IMO there is no relation whatsoever between cephalic index and Y-DNA. Any correlation would be fortuitous. The best proof is that Swiss and North Italians have mostly brachycephalic, while Spanish, British and Irish people are more dolicocephalic, despite both having high percentages of R1b. Likewise, most Slavs are brachycephalic, but Norwegians, who also have high levels of R1a, are dolicocephalic.
Thank you.I know the thread specifically targets at Y-DNA in Europe, but how about this relation occuring in other regions?
in the historical context, males who succeeded in conquering people often took concubines and multiple wives from the conquered or tributary people, resulting overtime, in mixed phenotypes. A perfect example is the Yamna culture which had more than 90% of its males belonging to haplogroup R1b. These then should have been predominantly red-haired but because of the high incidence of foreign mtDNA belonging to NE. Caucasian/Iranian Plateau people as well as European hunter-gatherer lines, the population ended up having dark hair in most cases. I suppose same thing goes for the cephalic index.One thing I a having a hard time with understanding this whole Haplogroup I2 with its variants I2a1 an I2a2 because the names were changed so many times.Apparently, I2a2 is bracycephalic originally and is most likely the old Borreby type Coon talked about. As far as the Balkans and Sardinia however, I am confused as they seem to represent a similar type but the Balkans are brachycephalic while Sardinia I exactly the opposite. Any thoughts?
what about claims of an increase in dolicho and mesocephalic trends in the Balkans and in German Saxony? Are these correct?
I think that skull shape is determined mostly by autosomal genes not haplogroup, nutrition and other external factors could also play a role
I looked up for CI in web yet to my surprise the data was very old and there weren't no new maps, and if regions like Nordica is so mix in ydna then why data shows only doliocephalic and other regions too are titled certain CI as if they are completely homogenous which I don't think they are! and is there link between height and CI?
Oh I just saw maps of CI in Europe and the lowest rates in Europe are above 75(Iberia, UK) so they fall under Mesocephalic then why people term them Doliocephalic?
Hello everybody,
Is anybody familiar with any study on the relationship of the Cephalic Index vs. Y-haplogroups in Europe?
Thank you.
There should be no relations of y-dna to cephalic index. It makes no sense, as that is not how those things work.There might be relation to auDNA haplogroups, though, but that is not what you are looking for... ;)
The y-chromosome carries important genes for brain development and Y-DNA haplogroups are strongly correlated with intelligence.
| https://www.eupedia.com/forum/archive/index.php/t-33965.html?s=ae010b9cba55c93677d36fe6a2c9729e |
Mask Detection Using IoT - A Comparative Study of Various Learning Models | Request PDF
Request PDF | On Jun 17, 2022, Mohamed Amine Meddaoui and others published Mask Detection Using IoT - A Comparative Study of Various Learning Models | Find, read and cite all the research you need on ResearchGate
Mask Detection Using IoT - A Comparative Study of Various Learning Models
University Sultan Moulay Slimane
IMT-Atlantique
Novel Face Mask Detection Technique using Machine Learning to control COVID’19 pandemic
Article
Full-text available
S. V. N. Sreenivasu
Kuldeep Chouhan
Ravindra Manohar Potdar
The COVID-19 pandemic has been scattering speedily around the world since 2019. Due to this pandemic, human life is becoming increasingly involutes and complex. Many people have died because of this virus. The lack of antiviral drugs is one of the reasons for the spreading of COVID-19 virus. This disease is spreading continuously and easily due to some common mistakes by people, like breathing, coughing and sneezing by infected persons. The main symptom is the normal flu. Therefore, in the present condition, the best precaution for this disease is the face mask, which covers both areas of mouth & nose. According to the government and the World Health Organization, everyone should wear a face mask in busy places like hospitals and marketplaces. In today's environment, it's difficult to tell if someone is wearing a mask or not, and physical inspection is impractical since it adds to labour costs. In this research, we present a mask detector that uses a machine learning facial categorization system to determine whether a person is wearing a mask or not, so that it may be connected to a CCTV system to verify that only persons wearing masks are allowed in.
Covid-19 Face Mask Detection Using TensorFlow, Keras and OpenCV
Conference Paper
Full-text available
Dec 2020
Arjya Das
Mohammad Wasif Ansari
Rohini Basak
Thor: A Deep Learning Approach for Face Mask Detection to Prevent the COVID-19 Pandemic
Conference Paper
Mar 2021
Shay E. Snyder
Ghaith Husari
Face Mask Detection Using MobileNetV2 in The Era of COVID-19 Pandemic
Conference Paper
Oct 2020
Samuel Ady Sanjaya
Suryo Adi Rakhmawan
Fighting against COVID-19: A novel deep learning model based on YOLO-v2 with ResNet-50 for medical face mask detection
Nov 2020
Mohamed Loey
Gunasekaran Manogaran
Mohamed Hamed N. Taha
Nour Eldeen Khalifa
Deep learning has shown tremendous potential in many real-life applications in different domains. One of these potentials is object detection. Recent object detection which is based on deep learning models has achieved promising results concerning the finding of an object in images. The objective of this paper is to annotate and localize the medical face mask objects in real-life images. Wearing a medical face mask in public areas, protect people from COVID-19 transmission among them. The proposed model consists of two components. The first component is designed for the feature extraction process based on the ResNet-50 deep transfer learning model. While the second component is designed for the detection of medical face masks based on YOLO v2. Two medical face masks datasets have been combined in one dataset to be investigated through this research. To improve the object detection process, mean IoU has been used to estimate the best number of anchor boxes. The achieved results concluded that the adam optimizer achieved the highest average precision percentage of 81% as a detector. Finally, a comparative result with related work has been presented at the end of the research. The proposed detector achieved higher accuracy and precision than the related work.
A Hybrid Deep Transfer Learning Model with Machine Learning Methods for Face Mask Detection in the Era of the COVID-19 Pandemic
Article
Jan 2021
MEASUREMENT
Mohamed Loey
Gunasekaran Manogaran
Mohamed Hamed N. Taha
Nour Eldeen Khalifa
The coronavirus COVID-19 pandemic is causing a global health crisis. One of the effective protection methods is wearing a face mask in public areas according to the World Health Organization (WHO). In this paper, a hybrid model using deep and classical machine learning for face mask detection will be presented. The proposed model consists of two components. The first component is designed for feature extraction using Resnet50. While the second component is designed for the classification process of face masks using decision trees, Support Vector Machine (SVM), and ensemble algorithm. Three face masked datasets have been selected for investigation. The Three datasets are the Real-World Masked Face Dataset (RMFD), the Simulated Masked Face Dataset (SMFD), and the Labeled Faces in the Wild (LFW). The SVM classifier achieved 99.64 % testing accuracy in RMFD. In SMFD, it achieved 99.49%, while in LFW, it achieved 100% testing accuracy.
MobileNetV2: Inverted Residuals and Linear Bottlenecks
Conference Paper
Jun 2018
Mark Sandler
Andrew Howard
Z Wang
Lin, T.-Y., et al.: Microsoft COCO: common objects in context. In: Fleet, D.,
Pajdla, T., Schiele, B., Tuytelaars, T. (eds.) ECCV 2014. LNCS, vol. 8693, pp.
740-755. Springer, Cham (2014). https://doi.org/10.1007/978-3-319-10602-1 48
Face mask detection using deep learning during COVID-19
Jan 2021
S Taneja
A Nayyar
P Nagrath
Taneja, S., Nayyar, A., Nagrath, P.: Face mask detection using deep learning during COVID-19. In: International Conference on Computing, Communications and
Cyber-Security (2021). https://doi.org/10.1007/978-981-16-0733-2 3
Mohamed Amine Meddaoui
Mohammed Erritali
| https://www.researchgate.net/publication/362536576_Mask_Detection_Using_IoT_-_A_Comparative_Study_of_Various_Learning_Models |
Processes | Free Full-Text | Transient Characteristics of Three-Dimensional Flow in a Centrifugal Impeller Perturbed by Simple Pre-Swirl Inflow
The pre-swirl inflow generated by guide vanes could improve the hydrodynamic performances of centrifugal pumps as long as the inflow matches the patterns of internal flow of the impeller. In this work, we present a numerical investigation on the internal flow in a centrifugal impeller subjected to inflow artificially constructed with simple pre-swirling; unsteady Reynolds-Averaged Navier-Stokes (URANS) simulations are performed at the designed flow rate with five values of rotating velocity of the inflow, i.e., Urot/Uref = & minus;0.5, & minus;0.3, 0.0, 0.3 and 0.5, where Urot and Uref denote the rotating and normal velocity component at the entrance of the inflow tube, respectively. The primary objective of this work is to reveal the three-dimensional characteristics of internal flow of the impeller as influenced by the superimposed pre-swirl inflow, and to identify the propagation of inflow within the impeller. The numerical data are presented and analyzed in terms of the streamline fields, the distributions of various velocity components along the circumferential and axial directions, the pressure distribution and limiting streamlines on the surfaces of a blade. Numerical results reveal that separation occurs around the leading edge of the blades and occasionally at the trailing edge, and the internal flow is more uniform in the central region of the channels. A noticeable fluctuation of both radial and circumferential velocities is observed at the outlet of the impeller as it is subjected to counter-rotating inflow, and the greatest fluctuation is close to the hub instead of the middle channel and shroud as for the co-rotating inflow. The boundary layer flow of suction surface is more sensitive to the inflow; occasional small-scale separation bubble occurs on the suction surface around the leading edge for some blades, and reattachment of separated flow is reduced for the counter-rotating inflow.
Transient Characteristics of Three-Dimensional Flow in a Centrifugal Impeller Perturbed by Simple Pre-Swirl Inflow
by Ze Wang and Wei Zhang *
Key Laboratory of Fluid Transmission Technology of Zhejiang Province, Zhejiang Sci-Tech University, Hangzhou 310018, China
Author to whom correspondence should be addressed.
Processes 2022 , 10 (10), 2007; https://doi.org/10.3390/pr10102007
Received: 6 September 2022 / Revised: 26 September 2022 / Accepted: 27 September 2022 / Published: 5 October 2022
Abstract
:
The pre-swirl inflow generated by guide vanes could improve the hydrodynamic performances of centrifugal pumps as long as the inflow matches the patterns of internal flow of the impeller. In this work, we present a numerical investigation on the internal flow in a centrifugal impeller subjected to inflow artificially constructed with simple pre-swirling; unsteady Reynolds-Averaged Navier-Stokes (URANS) simulations are performed at the designed flow rate with five values of rotating velocity of the inflow, i.e., U
rot
/U
ref
= −0.5, −0.3, 0.0, 0.3 and 0.5, where U
rot
and U
ref
denote the rotating and normal velocity component at the entrance of the inflow tube, respectively. The primary objective of this work is to reveal the three-dimensional characteristics of internal flow of the impeller as influenced by the superimposed pre-swirl inflow, and to identify the propagation of inflow within the impeller. The numerical data are presented and analyzed in terms of the streamline fields, the distributions of various velocity components along the circumferential and axial directions, the pressure distribution and limiting streamlines on the surfaces of a blade. Numerical results reveal that separation occurs around the leading edge of the blades and occasionally at the trailing edge, and the internal flow is more uniform in the central region of the channels. A noticeable fluctuation of both radial and circumferential velocities is observed at the outlet of the impeller as it is subjected to counter-rotating inflow, and the greatest fluctuation is close to the hub instead of the middle channel and shroud as for the co-rotating inflow. The boundary layer flow of suction surface is more sensitive to the inflow; occasional small-scale separation bubble occurs on the suction surface around the leading edge for some blades, and reattachment of separated flow is reduced for the counter-rotating inflow.
Keywords:
centrifugal impeller
;
pre-swirl inflow
;
three-dimensional flow
1. Introduction
Centrifugal pumps are widely used for liquid transportation applications in many fields, such as thermal power plants, metallurgical production, and processing industries. The performances of the centrifugal pumps, i.e., head and efficiency which represent the work and loss during energy transfer, are greatly determined by the centrifugal impeller in terms of the patterns of its internal flow. Since energy transfer between the impeller and fluid is crucial for the implementation of the pumps, the characteristics of internal flow within the impeller and even the whole pump system have been investigated in many works, even for the simplest working conditions as steady and uniform fluid enters the pump. However, in a lot working circumstances, the flow patterns are rather complex as they are affected by certain influential factors, such as unsteady and/or non-uniform inflow, during a start/stop stage where the rotation speed varies, and in a multi-stage pump. The flow in the channels of the impeller may separate from the solid walls and result in separation bubbles which block the channel, and the interactions between the flows in the impeller and inflow tube or diffusers are consequently affected.
To understand the mechanisms of flow in a centrifugal impeller, a large number of numerical and experimental investigations have been carried out with the consideration of various influential factors. Byskov et al. [ 1 , 2 ] performed large-eddy simulation (LES) on the internal flow of a six-blade impeller for a centrifugal pump. The LES approach is capable of accurately predicting the hydrodynamic performances of the impeller and capturing the transient flow field compared with the experimental result. No significant separation is observed at designed flow rate, while notable differences are shown for flows in neighboring channels at a quarter flow rate. A steady non-rotating stall was observed at the entrance of one channel and relative vortices were observed for the rest channels. Zhang et al. [ 3 , 4 ] analyzed the transient evolutions of stalled structures in a low specific speed centrifugal pump based on coherent analysis of pressure signals, and presented and explored the unsteady evolution of flow and pressure pulsation in the stagnant state by using the DDES method. Krause et al. [ 5 ] and Ullum et al. [ 6 ] successfully captured the rotating stall flow using the time-resolved particle image velocimetry (PIV) technique. Zhou et al. [ 7 , 8 ] studied stalled flow in a centrifugal pump using LES approach. As the flow rate decreases, the stalled cell grows in size and occupies the channel. The pressure fluctuation caused by the evolution of stalled cell is analyzed, and the peak value of the pressure fluctuation at quarter designed flow rate is obviously greater than that at half designed flow rate. Pei et al. [ 9 ] carried out numerical simulations on flow in a centrifugal pump with a volute under partial load to analyze the three-dimensional periodic flow in all channels of the impeller. Li et al. [ 10 ] measured the internal flow in the impeller of a low specific speed centrifugal pump using the PIV technique to quantify the energy conversion characteristics as determined by the internal flow patterns. Westra et al. [ 11 ] analyzed the effect of secondary flow in the impeller of a low specific speed centrifugal pump with vane-less diffuser under designed and off-designed conditions.
The patterns of inflow at the entrance of the centrifugal impeller have a substantial impact on the hydrodynamic performance of the impeller, as revealed in some works. Song et al. [ 12 ] studied the influence of different pre-swirl inflows on the aerodynamic performances of the impeller in a centrifugal compressor. Xiao et al. [ 13 ] conducted numerical simulations on the internal flow of a single-stage centrifugal compressor with inflow following pre-swirl patterns; numerical results showed that the inflow pre-swirling directly affects the circumferential distribution of flow parameters in the impeller. Gish et al. [ 14 ] studied the effect of the geometry of inlet stators on the performances of a hydro-turbine under different Reynolds numbers, and found the proper geometry has the potential to improve the performance. Danlos et al. [ 15 ] investigated flow in a compressor impeller and analyzed the influence of pre-swirling on the instability of the compressor system with emphasis on the surge line. Amin and Xiao [ 16 ] conducted numerical simulations on flow through a horizontal-axis tidal turbine with or without the pre-swirl stator. It was found that the velocity field around the turbine can be improved by using the pre-swirl stator, and the turbine efficiency can be increased by about 13% at a certain blade tip velocity ratio. Mohseni et al. [ 17 ] conducted numerical and experimental studies on the effect of guide blade profiles in terms of the setting angle and positive or negative inlet swirling, and found that series profiles showed better aerodynamic performance than S-profile under negative inlet swirls. Zhang et al. [ 18 ] studied the clocking effect in a multi-stage centrifugal pump in terms of the velocity field and hydrodynamic performances of the pump; it was found that at the appropriate clocking position, the guide vanes could effectively reduce the size and intensity of vortices between neighboring stages of the pump. Zhao et al. [ 19 ] applied the inlet guide vane in a centrifugal compressor to improve its performance and studied the flow patterns in the impeller. Xu et al. [ 20 ] studied the influence of chord length and installation angle of guide vanes on the efficiency and internal flow field of an axial-flow pump, and found that the efficiency can be improved under low flow rates by rotating the guide vanes in the counter-clockwise direction. Poujol et al. [ 21 ] studied the effect of staggered inlet guide vanes on the stability of a centrifugal compressor. The increased staggered angle moves the surge line towards the left, and rotating instability occurs at a lower mass flow rate. Zhong et al. [ 22 ] experimentally tested the performance characteristics of an axial-flow pump with and without guide vanes to explore the patterns of flow in the impeller. Liu et al. [ 23 ] conducted numerical calculations using the steady and unsteady Reynolds-averaged Navier-Stokes (RANS and URANS) simulation approaches to investigate the internal flow in a centrifugal fan under the condition of incoming flow from an upstream bended inflow tube of various radii and demonstrated the effects of the non-axisymmetric pre-swirl flow generated due to the curvature of the bended inflow tube. Heidarian et al. [ 24 ] modelled shark’s skin for the first time, and analyzed the effects of riblet on a submerged flat plate. Jiang et al. [ 25 ] presented a review on two phase performances from various centrifugal pumps designs, mainly based on experimental results and detected the significant geometrical parameters. Heidarian et al. [ 26 ] presented calculations on the Clark-Y wing section of the Reynolds-averaged Navier-Stokes (RANS) equations solver and verified the numerical results of lift and drag of the rectangular airfoil at ground effect. Xu et al. [ 27 ] developed a wind turbine rotor blade design and optimization method and introduced a propeller-turbine rotor code coupling aerodynamic and structural properties.
It is revealed in the above reviewed literature that the characteristics of inflow of the centrifugal impeller greatly determine the patterns of flow within the impeller and consequently the performances of the pump system. In most of the existing studies, the centrifugal impeller of the pump or compressor system is equipped with an upstream guide vane or stator system to be compatible to different working conditions, thus the pre-swirl flow is generated and the inflow of the centrifugal impeller rotates in the circumferential direction and is spatially non-uniform. It is already known that the pre-swirl inflow affects the internal flow of the impeller and determines the hydrodynamic performances of the impeller, however, the transient characteristics of the internal flow is not revealed in terms of the three-dimensionality, which represents the temporal unsteadiness and spatial non-uniformity that are crucially related with significant flow phenomena such as boundary layer separation and stall. In this work, we performed a numerical investigation on the transient flow in a centrifugal impeller at the designed flow rate under the influence of pre-swirl inflow. Different from the models in existing works where the pre-swirl flow is generated by the inlet guide vanes or a stator of specific geometry, we artificially constructed the pre-swirl flow in a simple way without the consideration of certain geometries that the inflow rotates in the circumferential direction. The benefit of this model is that the essential influence of the pre-swirl flow on the internal flow of impeller is considered, while the particular effect associated with the specific geometry or installation of guide vanes or stator is omitted, thus the present model reflects the general influence from the pre-swirl flow. The objective of our work is to demonstrate the effect of pre-swirl inflow, in both magnitude and direction, on the transient three-dimensional flow within the impeller. The three-dimensionality of the internal flow are presented and analyzed mainly in terms of the distributions of radial, circumferential and axial velocities within the channels of the impeller. Moreover, we discuss the boundary layer flow on the blade surfaces in terms of the limiting streamlines and pressure field.
The paper is organized as follows. Section 2 introduces the physical models, the formulation of the pre-swirl inflow, the numerical simulation and grid independence verification. Section 3 presents and analyzes the numerical results. Section 4 gives some conclusions.
2. Numerical Setup
2.1. Physical Model
In this work, we investigate the flow in a six-blade centrifugal impeller which is introduced in the work of Byskov et al. [ 1 , 2 ], as shown in Figure 1 a. The geometrical and operational parameters of the impeller are listed Table 1 and Table 2 respectively. Byskov et al. [ 2 ] have carried out a detailed experimental study on the internal flow of this centrifugal impeller at designed and off-designed flow rates using the PIV technique, and the transient flow patterns are revealed and compared with the numerical data obtained by LES approach. Since our objective is to explore the patterns of flow in the impeller subjected to pre-swirl inflow, an extended inflow tube is applied upstream of the impeller to permit the development of swirling flow; its radius is the same as that of the impeller and extends in the streamwise (axial) direction for a length of 2.1 D 1 . An outflow section is placed at the outlet of the impeller to prevent the occurrence of backflow; the inner and outer diameters are D 2 and 1.36 D 2 , respectively, and the width is the same as that of the impeller, i.e., b 2 . The computational domain is shown in Figure 1 b.
The centrifugal impeller is geometrically axisymmetric and the blades are backward-curved, thus the direction of swirling of the inflow determines the patterns of internal flow of the impeller. The fluid at the entrance of the inflow tube has two velocity components. The uniform streamwise velocity is along the axial direction towards the impeller whose magnitude is defined as U
ref
as determined by the volume flow rate. The circumferential velocity defined as U
rot
is applied perpendicular to the streamwise velocity. The direction of inflow could be either clockwise or counterclockwise, i.e., in contrary or aligned with the direction of rotation of the impeller, and is termed as counter-rotating and co-rotating inflow as exemplified in
Figure 2
. The magnitude of circumferential velocity is set as zero, 0.3 U
ref
and 0.5 U
ref
, and is represented as positive or negative depending on the direction.
2.2. Numerical Methods
The time-dependent incompressible flow is governed by the conservation of mass and momentum equations [
28
]:
∂
u
i
∂
x
i
=
0
(1)
∂
u
i
∂
t
+
u
j
∂
u
i
j
=
f
i
−
1
ρ
∂
P
∗
∂
x
i
+
ν
∂
2
u
i
∂
x
x
j
(2)
where
x i
is the components of the Cartesian coordinate system;
u i
is the velocity component;
P
* represents the pressure considering the conversion of turbulent kinetic energy and centrifugal force;
f i
is the component of volume force.
Since the SST
k
-
ω
turbulence model [
29
] has good results in the simulation of boundary layer flows near the wall [
30
], the SST
k
-
ω
turbulence model is chosen to simulate the impeller numerically in this paper. The transport equations of the turbulent kinetic energy
k
and the turbulent dissipation rate
ω
[
31
] are as follows:
∂
k
∂
t
+
∇
⋅
(
u
k
)
=
P
u
ω
=
δ
S
2
−
β
ω
2
+
∇
⋅
ν
+
σ
w
ν
T
∇
ω
1
−
F
σ
ω
2
ω
∇
k
⋅
∇
ω
T
(4)
ν
T
=
a
1
k
max
ω
;
S
F
2
(5)
where
P
k
=
min
ν
T
∇
×
u
⋅
∇
×
u
T
β
∗
k
ω
,
S
is the absolute value of the vorticity. The constants of the SST
k
-
ω
turbulence model in the present study [
32
] are:
σ k
1
= 0.85,
σ k
2
= 1.0,
σ
ω
1
= 0.5,
σ
ω
2
= 0.856,
β
1
= 0.075,
β
2
= 0.0828,
α
1
= 0.31,
δ
1
= 0.5532,
δ
2
= 0.440,
β
* = 0.09.
In this work, the simulations are performed for the centrifugal impeller operated under designed flow rate Q
d
= 3.06 L/s, which is used to compute the magnitude of streamwise velocity imposed at the entrance of the inflow tube (U
ref
). The UDF program is set in the inlet boundary condition to control the rotation direction of the fluid. The circumferential velocity of the inflow is set as U
rot
/U
ref
= −0.5, −0.3, 0.0, 0.3 and 0.5 in which the value of 0.0 denotes zero-swirling inflow. Zero gauge pressure is set at the outlet of the outflow section. No-slip condition is applied for velocity components on all solid walls.
The unsteady Reynolds-averaged Navier-Stokes (URANS) simulations were performed using ANSYS-Fluent. The governing equations are discretized by second-order central difference scheme in space and second-order implicit scheme in time. The SIMPLEC algorithm is used to decouple the solutions of velocity and pressure. The time step size of the unsteady simulation is fixed at 2.3 × 10
−4
s as the impeller rotates for one degree. The maximum number of iterations in one physical step is 20 and the convergence criterion of all equation is 10
−5
. To ensure the fully development of flow within the impeller, we first carried out the simulation for ten revolutions of the impeller, and subsequently the production simulation as the impeller rotates for another revolution that the results are saved for following analysis and discussions.
2.3. Grid Sensitivity Study
The structured grid of the model is generated using ANSYS-ICEM CFD, as shown in Figure 3 a. To resolve the boundary layer flow, the grid is refined in the near-wall region of all solid walls especially around the leading and trailing edges of the blades, as given in Figure 3 b,c. The value of y+ on the surfaces of blade, shroud and hub is generally lower than 10, and is slightly higher as <15 at the outlet of impeller.
We performed grid sensitivity study to evaluate the influence of grid number on the accuracy of simulation results. Four sets of grids are generated and the head of the impeller for the zero-swirling inflow case is calculated and listed in Table 3 . It is seen that the relative difference is less than 5% for grid 3 and the experimental data. To balance the computational cost and numerical accuracy, we chose to use grid 3 for following simulations.
3. Results and Discussion
3.1. Development of Pre-Swirl Inflow
Although swirling is imposed at the entrance of the inflow tube, the circumferential velocity of the inflow, representing the intensity of swirling, is attenuated during its motion into the interior of the finite-length tube along with the formation of boundary layer. It is necessary to quantify the intensity of pre-swirl flow at the exit of the inflow tube (inlet of the impeller).
Figure 4
shows the distribution of axial and circumferential velocities in the radial direction at the exit of the inflow tube. Since the inflow tube is axisymmetric in geometry, the distributions are the same at any circumferential position. It is seen in the figure that the uniform inflow, in both axial and circumferential directions, gradually develops and presents a parabolic distribution after the fluid moves through the inflow tube. The distribution of axial velocity is obviously affected by the value of U
rot
in that the velocity of near-wall flow close to the inner wall (shaft of the impeller) is comparably smaller at certain radial positions for the U
rot
/U
ref
= −0.5 and 0.5 cases. The nearly identical distributions reflect that the rotating flow in the impeller has no influence on the flow in the upstream region. The swirling of the inflow is notably attenuated as the flow develops towards the impeller. The maximum magnitude of circumferential velocity reduces to around 0.24 U
ref
and 0.40 U
ref
for the U
rot
/U
ref
= ±0.3 and ±0.5 cases, in which the difference denotes the attenuation. As the value of U
rot
increases, the maximum magnitude of axial and circumferential velocities appears close to the outer wall of the inflow tube because of centrifugal force. The effective Reynolds number for flow near the inner wall of the tube gets lower, thus a thick boundary layer develops.
3.2. General Flow Patterns
To demonstrate the general patterns of flow in the impeller, we present the instantaneous distribution of streamlines at three axial cross-sections in
Figure 5
. The cross-sections are labeled as Z/b
2
= 0.1, 0.5 and 0.9 as measured from the hub of the impeller, i.e., close to the hub, at the middle and close to the shroud of the impeller. In general, the streamline field is quite similar for the several cases with different pre-swirl inflows. Small-scale vortices appear at the leading edge of the suction side of the blade, and no reversed flow is observed within the channels. On the cross-sections at Z/b
2
= 0.5 and 0.9, tiny vortices may also appear around the trailing edge of some blades. The boundary layer flow is found to detach from the pressure surface in the upstream part of the blade. As the fluid moves towards the outlet of impeller, the significant Coriolis force drives the fluid towards the pressure surface where the magnitude of velocity increases, and the flow at the outlet of impeller is getting uniform. It is observed that for co-rotating inflow (U
rot
< 0), the detachment of boundary layer flow on the pressure surface is relatively weak compared with the counter-rotating inflow (U
rot
> 0) cases, especially for the Z/b
2
= 0.1 cross-section.
3.3. Three-Dimensional Flow: Blade-to-Blade Distribution
The three-dimensionality of internal flow of the impeller is presented and analyzed by the blade-to-blade distribution of velocity components. We define the normalized radial position as r* = (r − r
1
)/(r
2
− r
1
) in which r
1
and r
2
are the radii of inlet and outlet of the channels, respectively. Three radial positions for the cross-sections are chosen for further analysis which locate at the inlet, middle and outlet of the channels, i.e., r* = 0.0, 0.5 and 1.0, as exemplified in
Figure 6
. The distributions of normalized radial velocity V
r
in the circumferential direction across all channels are presented in
Figure 7
. The curves are obtained at the intersection line formed by the axial cross-section at Z/b
2
= 0.5 and the respective constant-r* cross-section, and for six moments during the impeller rotates for 60° which is termed as period T. The distributions are generally similar at the leading edge of blades for cases of inflows of different swirling, and the temporal fluctuation is minor as observed by the overlapping curves. The magnitude of V
r
reduces substantially at the middle and outlet of the channels because of the diverging of the channel, and significant temporal fluctuation is seen for all channels.
The distribution of V
r
around the leading edge of the blades (r* = 0.0) is quite similar for the several channels. The magnitude of V
r
gradually increases from the pressure surface and abruptly decreases close to the suction surface, and could even be negative as a result of the formation of vortices for cases of zero-swirling (U
rot
= 0.0) and counter-rotating (U
rot
> 0) inflows, and the reversed flow is more obvious for the U
rot
= 0.3 and 0.5 cases. For co-rotating inflow cases, the peak magnitude of Vr observed near the suction surface gets smaller compared with other cases.
In the middle of the channels (r* = 0.5), the flow within the same channel is more non-uniform and the temporal fluctuation is strong. There is both abrupt increasing and decreasing close to the pressure and suctions surfaces of the blades, while an additional fluctuation appears at the center of the channel for all cases. It is observed that as U
rot
increases from negative to positive, i.e., from co-rotating to counter-rotating inflow, the position for the peak magnitude of V
r
moves from the suction surface to pressure surface for all channels, and the fluctuating amplitude at any circumferential position greatly increases, reflecting stronger unsteady behaviors of internal flow.
The temporal fluctuation of V
r
at the outlet of the impeller (r* = 1.0) is much stronger than flow in the center of the channels. Except for the drastic variation in velocity magnitude on the surfaces of the blades, the internal flow in the central region of all channels exhibits significant temporal variation. It is seen that the magnitude of V
r
varies a lot especially for inflow with strongly swirling inflow U
rot
/U
ref
= ±0.5, while the position of the peak magnitude also moves in time, although the motion is asynchronous for the various channels. The magnitude of V
r
is greatly different for flow in various channels. In the case of U
rot
/U
ref
= 0.3, abnormal fluctuation of V
r
is found in channel-I and channel-II with mild fluctuation and relatively small peak magnitude, especially in channel-II.
The three-dimensionality of flow from a blade-to-blade view is further presented and analyzed by the distribution of circumferential velocity V
θ
on the intersecting lines between the axial cross-section at Z/b
2
= 0.5 and radial cross-sections at r* = 0.0, 0.5 and 1.0, as shown in
Figure 8
. The flow is quite stable and there is almost no temporal variation in velocity magnitude at the inlet of channels, and the distribution is quite similar for the various channels. A minor fluctuation is observed at the middle of the channels, and the largest magnitude reduces; the distribution is still similar for the various channels. Great fluctuations form at the outlet of the channels especially in the central region.
The circumferential velocity shows almost no temporal fluctuation at the leading edge of the blades especially close to the surfaces, and the distributions in various channels are similar. The maximum magnitude for the negative velocity appears close to the suction surface and the value increases with U
rot
which is the same as that of V
r
. Moreover, a positive value of V
θ
is clearly observed close to the suction surface for zero-swirling (U
rot
= 0.0) and counter-rotating (U
rot
> 0) inflow cases, and it gradually becomes obvious as U
rot
increases. This is generated by the small-scale vortices at the inlet of the channels which restrain the development of flow in the channels and produce the weak circumferential motion of local flow, as is also seen in
Figure 5
. In the middle region of the channels, the maximum magnitude of negative V
θ
reduces compared with flow at the inlet of the channels, and the difference among the various peaks is minor. There is one local peak in the central region of the channel whose magnitude decreases with the value of U
rot
; for high values of U
rot
, the fluctuation tends to occupy the whole channel, as revealed by the fluctuation around the suction surface. The flow at the outlet of the channels is highly fluctuating in time for the majority of the channel, and the fluctuation is especially remarkable for the counter-rotating (U
rot
> 0) inflow cases. For the co-rotating (U
rot
< 0) inflow cases, the temporal fluctuation is notably non-uniform especially for the U
rot
= −0.5 case, i.e., strong in channel-I, channel-II, channel-III and channel-VI but relatively weak in channel-IV and channel-V.
3.4. Three-Dimensional Flow: Hub-to-Shroud Distributions
Since there is a transition of direction for flow from axial to radial in the impeller, the patterns of flow close to the hub and shroud of the impeller differ because of the inertia of flow and possible separation of boundary layer flow on the curved surfaces. The three-dimensionality of internal flow is also reflected by the non-uniformity of velocity across the meridian section of the impeller. In this section, we analyze the three-dimensional flow by its hub-to-shroud distributions of velocity components at two positions as given in
Figure 6
; the two hub-to-shroud lines locate at r* = 0.5 close to the pressure and suction surfaces of the same channel. The non-dimensional quantity b* is used to denote the local coordinate as the distance measured from the hub, and b* = 0.0 and 1.0 denote the hub and shroud, respectively.
Figure 9
shows the distributions of instantaneous radial velocity V
r
on the two hub-to-shroud lines at six equally spaced moments as the impeller rotates for 60°. The curves exhibit temporal variations which are greatly dependent on U
rot
, and the curves representing flow adjacent to the surfaces are drastically different depending on the position (pressure or suction surface). For the near-wall flow of pressure surface, the curves vary gently for the co-rotating inflow cases (U
rot
< 0), although the amplitude of variation is noticeable mainly in the central region across the channel. For the zero-swirling inflow case (U
rot
= 0.0), the fluctuation is the most significant at around b* = 0.3, i.e., close to the hub, while it is much smaller in the region close to the shroud. As U
rot
further increases, the magnitude of instantaneous V
r
generally increases in the near-wall regions of hub and shroud, and presents a great fluctuation in the central region of the channel, resulting in an uneven double-peak pattern. The radial velocity of flow near the hub is higher than that of the shroud; this is attributed to the inertia of fluid during the transition of direction as it moves through the channel. The radial velocity in the central region can be nearly zero at a certain moment; we believe that this is induced by the weakly separated flow in the upstream region. The magnitude of V
r
for flow close to the suction surface is generally higher. The fluctuating amplitude is quite small in the region very adjacent to the hub and shroud surfaces, while it rapidly increases for flow away from the surfaces. The fluctuation is strongest in the central region of the channel for the co-rotating inflow cases (U
rot
< 0) and comparably weak for the zero-swirling inflow case (U
rot
= 0.0). For counter-rotating inflow cases (U
rot
> 0), the radial velocity fluctuates notably near the hub, and reversed local flow with negative value of V
r
appears at certain moments due to the transient evolution of separated vortex.
The distributions of circumferential velocity V
θ
in the hub-to-shroud direction are presented in
Figure 10
. The temporal variations of V
θ
at the two positions differ a lot in terms of the magnitude, fluctuating amplitude and distribution. The magnitude and temporal variation of V
θ
is more uniform for flow near the pressure surface. For flow near the pressure surface, the distribution of V
θ
is generally uniform through the whole channel in the hub-to-shroud direction; the magnitude of velocity increases or decreases as a whole such that the fluctuating amplitude at different positions is not substantially different. As U
rot
increases, the amplitude first decreases until the zero-swirling inflow case and then increases, thus the fluctuation is the most notable for cases of U
rot
/U
ref
= ±0.5. For flow near the suction surface, the distribution of V
θ
is obviously non-uniform and the maximum magnitude of negative V
θ
generally appears close to the hub. It is found that the co-rotating inflow (U
rot
< 0) results in great fluctuation in the central region and close to the shroud of the channel, while counter-rotating inflow (U
rot
> 0) produces strong fluctuation in the central region and close to the hub of the channel. A consistent reduction in both circumferential and radial velocities is observed for the counter-rotating inflow (U
rot
> 0) cases which is induced by a small-scale vortex generated in the upstream part of the channel and restrains the development of flow towards the outlet.
3.5. Pressure Gradient Field on the Blade Surfaces
The patterns of near-wall flow of the blade are affected by the pressure gradient field on the surfaces; positive and negative pressure gradient could accelerate and decelerate the local flow. To analyze how the pre-swirl inflow affect the near-wall flow of the blade,
Figure 11
presents the distributions of instantaneous pressure coefficient on the mid-span cross-section (Z/b
2
= 0.5) from the inlet to outlet of the blade separating channel-I and channel-II at six moments. A local coordinate S is defined on the curved surface of the blade which starts from the leading edge of the blade and ends at the trailing edge, and S
0
is the arc length of the curve, thus S/S
0
= 0.0 and 1.0 represent the leading and trailing edges of the blade, respectively.
It is seen that both the pressure and suction surfaces of the blade are occupied by the adverse pressure gradient (APG) field. On the pressure surface, the pressure coefficient monotonically increases from the leading edge and reaches maximum at around S/S
0
= 0.8–0.9, and then slightly decreases until the trailing edge. However, it is observed in
Figure 5
that there is no separation because of the weak APG field. The fluctuation of pressure coefficient is relatively strong for cases of inflow with higher Urot, especially in the upstream and middle section of the pressure surface S/S
0
= 0.0–0.7, while the pre-swirl inflow has no obvious influence on the pressure coefficient in the remained part of the surface. The pressure coefficient on the suction surface of the blade exhibit entirely different distributions. It decreases right at the leading edge and then recovers until the trailing edge, thus the suction surface is almost entirely occupied by APG which decelerates the boundary layer flow along with the viscous drag. It is seen in
Figure 5
that small-scale vortices are generated on the suction surface of the leading edge, and moves towards the outlet of impeller while the size and intensity do not vary a lot.
3.6. Topology of Limiting Streamlines
The three-dimensionality of boundary layer flow on the surfaces of the blade reflects the patterns of possible separation and reattachment.
Figure 12
shows the distribution of instantaneous limiting streamlines on the pressure and suction surfaces of the blade located between channel-I and channel-II. The sinks and sources of the streamlines represent the separation and reattachment of local boundary layer flow. It is seen that separation and reattachment of flow, although weak as seen in
Figure 5
, occur around the leading edge of the blade, while the boundary layer flow in the middle and downstream sections of the blade is stable. The pre-swirl inflow does not have any noticeable effect on the patterns of separation and reattachment, especially for the pressure surface. However, the patterns of reattachment on the suction surface are also determined by the corner flow between the surface and the hub/shroud of the impeller. It is noticed that for the zero-swirling inflow case (U
rot
= 0.0), reattachment also occurs at the central region of the suction surface. Therefore, it is believed that for the counter-rotating inflow cases (U
rot
> 0), the separation and reattachment on the blade surfaces can be effectively reduced which improves the uniformity of the flow.
4. Conclusions
This work presents a numerical investigation on the transient characteristics of three-dimensionality of internal flow in a centrifugal impeller perturbed by simple pre-swirl inflow. The influences of co-rotating and counter-rotating inflow under the designed flow rate are explored using the URANS approach. The following conclusions are obtained:
(1)
The temporal fluctuation of flow is weak at the inlet of the blade channels (r* = 0.0). Close to the suction surface, the magnitude of radial velocity V
r
for the counter-rotating inflow is 15–25% larger compared to the co-rotating inflow cases. The peak magnitude reaches the maximum about 2.5 m/s near the suction surface. In the middle of the channels (r* = 0.5), the peak magnitude of V
r
moves from suction to pressure surface as the inflow gets from co-rotating to counter-rotating, and the fluctuating amplitude greatly increases, and the magnitude of V
r
varies from 0 to 1.2 m/s. The fluctuation is highest at the outlet of the channels (r* = 1.0) especially for the counter-rotating inflow cases. The magnitude of circumferential velocity V
θ
reaches the minimum in the central channel for the counter-rotating inflow cases, and the minimum value reaches about 2.2 m/s.
(2)
The internal flow of the impeller is highly three-dimensional in the hub-to-shroud direction. The strongest fluctuation of V
r
occurs in the central region of the channel for the co-rotating inflow cases, while the peak is observed close to the hub for the counter-rotating inflow cases which can be negative as a result of the separated vortex. Close to the hub, compared to the zero-swirling inflow, the magnitude of V
r
near the pressure surface is smaller for the co-rotating inflow cases and the degree of reduction increases with the increase in rotating speed, while for the counter-rotating inflow cases the magnitude of V
r
reaches 1.25 m/s, which is 25% larger for the zero-rotating inflow cases. On the contrary, near the suction surface the magnitude of V
r
is smaller for the counter-rotating inflow cases about 50–75%, compared to the co-rotating cases. For the circumferential velocity V
θ
, great fluctuation appears in the central region and close to the shroud for the co-rotating inflow cases, while in the central region and close to the hub for the counter-rotating cases.
(3)
Both pressure and suction surfaces of the blade are mainly occupied by an adverse pressure gradient field. There is no obvious separation on the pressure surfaces because of the weak APG, and small-scale vortices appear on the suction surface around the leading edge.
(4)
Three-dimensional separation and reattachment of flow occur around the leading edge of the blade are observed by the limiting streamlines, while the internal flow is quite stable and uniform in the middle and downstream sections of the channels. Reattachment also occurs at the central region of the suction surface for the zero-swirling inflow, and the counter-rotating inflow could reduce the reattachment which improves the uniformity of the internal flow.
The primary objective of this work was to present and analyze the transient characteristics of three-dimensional internal flow of a centrifugal impeller as perturbed by simply constructed pre-swirl inflow, and to reveal the influence of the pre-swirl inflow. The findings and conclusions may be helpful in the design of a pump system involving a curved inflow tube or guide vanes system for the improved efficiency and operational stability of the impeller. Since the pre-swirl inflow is simple in pattern, the significance of present study is limited, and we would analyze the influence of realistic guide vanes which generate non-uniform and fluctuating wake flow in future works.
Author Contributions
Conceptualization, Z.W. and W.Z.; data curation, Z.W.; formal analysis, Z.W. and W.Z.; funding acquisition, W.Z.; investigation, Z.W. and W.Z.; methodology, Z.W.; project administration, W.Z.; resources, W.Z.; software, Z.W.; supervision, W.Z.; validation, Z.W.; visualization, Z.W.; writing—original draft, Z.W.; writing—review and editing, W.Z. All authors have read and agreed to the published version of the manuscript.
Funding
This work was supported by Natural Science Foundation of China (52176047), Zhejiang Province Science and Technology Plan Project (2020C04011, 2022C01227) and 111 Project (D21011).
Institutional Review Board Statement
Not applicable.
Informed Consent Statement
Not applicable.
Data Availability Statement
Not applicable.
Conflicts of Interest
The authors declare no conflict of interest.
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Figure 1. The geometry of the centrifugal impeller; ( a ) configuration of six-blade impeller; ( b ) computational domain.
Figure 1. The geometry of the centrifugal impeller; ( a ) configuration of six-blade impeller; ( b ) computational domain.
Figure 2. Definition of the direction of pre-swirl inflow. The clockwise and counterclockwise directions are termed as counter−rotating and co−rotating inflows, respectively.
Figure 2. Definition of the direction of pre-swirl inflow. The clockwise and counterclockwise directions are termed as counter−rotating and co−rotating inflows, respectively.
Figure 3. ( a ) Gird of the whole model; ( b ) enlarged view at the leading edge of the blade; ( c ) enlarged view at the trailing edge of the blade.
Figure 3. ( a ) Gird of the whole model; ( b ) enlarged view at the leading edge of the blade; ( c ) enlarged view at the trailing edge of the blade.
Figure 4. Distributions of axial velocity (V z ) and circumferential velocity (V θ ) at the exit of the inflow tube.
Figure 4. Distributions of axial velocity (V z ) and circumferential velocity (V θ ) at the exit of the inflow tube.
Figure 5. ( a – e ) Distribution of instantaneous streamlines for (from top to bottom): U rot /U ref = −0.5, −0.3, 0.0, 0.3 and 0.5. The left, middle and right columns represent the distributions on the cross-sections at Z/b 2 = 0.1. 0.5 and 0.9, respectively.
Figure 5. ( a – e ) Distribution of instantaneous streamlines for (from top to bottom): U rot /U ref = −0.5, −0.3, 0.0, 0.3 and 0.5. The left, middle and right columns represent the distributions on the cross-sections at Z/b 2 = 0.1. 0.5 and 0.9, respectively.
Figure 6. Definitions of radial cross-sections at r* = 0.0, 0.5 and 1.0.
Figure 7. ( a – e ) Distributions of instantaneous normalized radial velocity along the circumferential direction at r* = 0.0 (left), r* = 0.5 (middle) and r* = 1.0 (right) for (from top to bottom) U rot /U ref = −0.5, −0.3, 0.0, 0.3 and 0.5.
Figure 7. ( a – e ) Distributions of instantaneous normalized radial velocity along the circumferential direction at r* = 0.0 (left), r* = 0.5 (middle) and r* = 1.0 (right) for (from top to bottom) U rot /U ref = −0.5, −0.3, 0.0, 0.3 and 0.5.
Figure 8. ( a – e ) Distributions of instantaneous normalized circumferential velocity along the circumferential direction at r* = 0.0 (left), r* = 0.5 (middle) and r* = 1.0 (right) for (from top to bottom) U rot /U ref = −0.5, −0.3, 0.0, 0.3 and 0.5.
Figure 8. ( a – e ) Distributions of instantaneous normalized circumferential velocity along the circumferential direction at r* = 0.0 (left), r* = 0.5 (middle) and r* = 1.0 (right) for (from top to bottom) U rot /U ref = −0.5, −0.3, 0.0, 0.3 and 0.5.
Figure 9. ( a – e ) Distributions of instantaneous normalized radial velocity along the hub-to-shroud direction for flow near the pressure surface (left) and suction surface (right) for (from top to bottom) U rot /U ref = −0.5, −0.3, 0.0, 0.3 and 0.5.
Figure 9. ( a – e ) Distributions of instantaneous normalized radial velocity along the hub-to-shroud direction for flow near the pressure surface (left) and suction surface (right) for (from top to bottom) U rot /U ref = −0.5, −0.3, 0.0, 0.3 and 0.5.
Figure 10. ( a – e ) Distributions of instantaneous normalized circumferential velocity along the hub-to-shroud direction for flow near the pressure surface (left) and suction surface (right) for (from top to bottom) U rot /U ref = −0.5, −0.3, 0.0, 0.3 and 0.5.
Figure 10. ( a – e ) Distributions of instantaneous normalized circumferential velocity along the hub-to-shroud direction for flow near the pressure surface (left) and suction surface (right) for (from top to bottom) U rot /U ref = −0.5, −0.3, 0.0, 0.3 and 0.5.
Figure 11. ( a – e ) Distribution of pressure coefficient at the mid-span (Z/b 2 = 0.5) of pressure surface (left) and suction surface (right) from inlet to outlet of the channel. The curves are plotted (from top to bottom) at U rot /U ref = −0.5, −0.3, 0.0, 0.3 and 0.5.
Figure 11. ( a – e ) Distribution of pressure coefficient at the mid-span (Z/b 2 = 0.5) of pressure surface (left) and suction surface (right) from inlet to outlet of the channel. The curves are plotted (from top to bottom) at U rot /U ref = −0.5, −0.3, 0.0, 0.3 and 0.5.
Figure 12. Instantaneous limiting streamlines on the pressure ( top ) and suction ( bottom ) surfaces of the blade for (from ( a – e )) U rot /U ref = −0.5, 0.5, −0.3, 0.3 and 0.0.
Figure 12. Instantaneous limiting streamlines on the pressure ( top ) and suction ( bottom ) surfaces of the blade for (from ( a – e )) U rot /U ref = −0.5, 0.5, −0.3, 0.3 and 0.0.
Table 1. Geometric specifications of the centrifugal impeller.
Table 1. Geometric specifications of the centrifugal impeller.
Parameter Value Inlet Diameter, D 1 (mm) 71.0 Outlet Diameter, D 2 (mm) 190.0 Inlet height, b 1 (mm) 13.8 Outlet height, b 2 (mm) 5.8 Blade thickness, t (mm) 3.0 Number of blades, Z 6 Inlet angle, β 1 (deg) 19.7 Outlet angle, β 2 (deg) 18.4 Blade curvature radius, Rb (mm) 70.0 Specific speed, N s 26.3
Table 2. Flow specifications of working condition.
Table 2. Flow specifications of working condition.
Parameter Value Q/Q d 1.0 Flow rate, Q 3.06 Head, H 1.75 Rotation speed, n 725 Reynolds number, Re 1.4 × 106
Table 3. Head of the impeller obtained using different number of grid.
Table 3. Head of the impeller obtained using different number of grid.
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Text of H.R. 4364 (116th): Taxpayer Fairness for Resource Development Act of 2019 (Introduced version) - GovTrack.us
Text of H.R. 4364 (116th): Taxpayer Fairness for Resource Development … as of Sep 17, 2019 (Introduced version). H.R. 4364 (116th): Taxpayer Fairness for Resource Development Act of 2019
The text of the bill below is as ofSep 17, 2019(Introduced).
The bill was not enacted into law.
I
116th CONGRESS
1st Session
H. R. 4364
IN THE HOUSE OF REPRESENTATIVES
Mr. McAdams(for himself and Mr. Rooney of Florida) introduced the following bill; which was referred to the Committee on Natural Resources
A BILL
To amend the Mineral Leasing Act to make certain adjustments to the fiscal terms for fossil fuel
development and to make other reforms to improve returns to taxpayers for
the development of Federal energy resources, and for other purposes.
1.
Short title
This Act may be cited as the Taxpayer Fairness for Resource Development Act of 2019.
2.
Table of contents
The table of contents for this Act is the following:
Sec. 1. Short title.
Sec. 2. Table of contents.
Sec. 3. Onshore fossil fuel royalty rates.
Sec. 4. Minimum bid amount.
Sec. 5. Onshore oil and gas rental rates.
Sec. 6. Penalties.
Sec. 7. Royalty relief.
Sec. 9. Royalty in kind.
Sec. 10. Amendments to definitions.
Sec. 11. Compliance reviews.
Sec. 12. Liability for royalty payments.
Sec. 13. Recordkeeping.
Sec. 14. Adjustments and refunds.
Sec. 15. Obligation period.
Sec. 16. Tolling agreements and subpoenas.
Sec. 17. Appeals.
Sec. 18. Assessments.
Sec. 19. Pilot project on automatic data transfer.
Sec. 20. Penalty for late or incorrect reporting of data.
Sec. 21. Required recordkeeping for natural gas plants.
Sec. 22. Shared penalties.
Sec. 23. Applicability to other minerals.
Sec. 24. Entitlements.
Sec. 25. Royalties on all extracted methane.
3.
Onshore fossil fuel royalty rates
The Mineral Leasing Act ( 30 U.S.C. 181et seq.) is amended—
(1)
in section 7—
(A)
by striking 12 1/2and inserting 18.75; and
(B)
by adding at the end the following:
(d)
Periodic evaluation of royalty rates
The Secretary shall establish a periodic process of evaluating increases in royalty rates to achieve a fair market value return for the public. The process should include:
(1)
publishing annually the average, weighted by relative production per State, of the top fossil fuel royalty rates charged by States for fossil fuels production on State-owned public lands;
(2)
evaluating triennially increases in the Federal fossil fuel royalty rates above the minimum rates required under this Act to match the production-weighted average of State royalty rates. The triennial review shall include and benefit from public participation through written comment, public hearings and other meetings open to all interested parties; and
(3)
submitting the triennial evaluation to Congress, including a summary of the views expressed in the public participation processes related to the evaluation.
.
(2)
in section 17, by—
(A)
striking 12.5each place such term appears and inserting 18.75; and
(B)
striking 12 1/2each place such term appears and inserting 18.75; and
(3)
in section 31(e), by striking 16 2/3both places such term appears and inserting 25.
4.
Minimum bid amount
Section 17 of the Mineral Leasing Act ( 30 U.S.C. 226) is amended—
(1)
in subsection (b)(1)(B)—
(A)
by striking $2 per acreand inserting $5 per acre, except as otherwise provided by this paragraph; and
(B)
by striking Federal Onshore Oil and Gas Leasing Reform Act of 1987and inserting Taxpayer Fairness for Resource Development Act of 2019;
(2)
in subsection (b)(2)(C), by striking $2 per acreand inserting $5 per acre; and
(3)
by adding at the end the following:
(q)
Inflation adjustment
The Secretary shall—
(1)
by regulation, at least once every 4 years, adjust each of the dollar amounts that apply under subsections (b)(1)(B), (b)(2)(C), and (d) to reflect the change in the Consumer Price Index for All Urban Consumers published by the Bureau of Labor Statistics; and
(2)
publish each such regulation in the Federal Register.
.
5.
Onshore oil and gas rental rates
The Mineral Leasing Act ( 30 U.S.C. 181et seq.) is amended—
(1)
in section 17(d)—
(A)
by striking $1.50 per acreand inserting $3 per acre; and
(B)
by striking $2 per acreand inserting $5 per acre; and
(2)
in section 31(e), by striking $10and inserting $20.
6.
Penalties
(a)
Mineral Leasing Act
Section 41 of the Mineral Leasing Act ( 30 U.S.C. 195) is amended—
(1)
in subsection (b), by striking $500,000and inserting $1,000,000; and
(2)
in subsection (c), by striking $100,000and inserting $250,000.
(b)
Federal Oil and Gas Royalty Management Act of 1982
The Federal Oil and Gas Royalty Management Act of 1982 ( 30 U.S.C. 1701et seq.) is amended—
(1)
in section 109—
(A)
in subsection (a), by striking $500and inserting $1,500;
(B)
in subsection (b), by striking $5,000and inserting $15,000;
(C)
in subsection (c), by striking $10,000and inserting $25,000; and
(D)
in subsection (d), by striking $25,000and inserting $75,000; and
(2)
in section 110, by striking $50,000and inserting $150,000.
(c)
Outer Continental Shelf Lands Act
(1)
Civil penalty, generally
Section 24(b) of the Outer Continental Shelf Lands Act ( 43 U.S.C. 1350(b)) is amended to read as follows:
(b)
Civil penalties
(1)
In general
Except as provided in paragraph (2), any person who fails to comply with any provision of this Act, or any term of a lease, license, or permit issued pursuant to this Act, or any regulation or order issued under this Act, shall be liable for a civil administrative penalty of not more than $75,000 for each day of the continuance of such failure. The Secretary may assess, collect, and compromise any such penalty.
(2)
Opportunity for a hearing
No penalty shall be assessed until the person charged with a violation has been given an opportunity for a hearing.
(3)
Adjustment for inflation
The Secretary shall, by regulation at least every 3 years, adjust the penalty specified in this paragraph to reflect any increases in the Consumer Price Index (all items, United States city average) as prepared by the Department of Labor.
(4)
Threat of harm
If a failure described in paragraph (1) constitutes or constituted a threat of harm or damage to life, property, any mineral deposit, or the marine, coastal, or human environment, a civil penalty of not more than $150,000 shall be assessed for each day of the continuance of the failure.
.
(2)
Knowing and willful violations
Section 24(c) of the Outer Continental Shelf Lands Act ( 43 U.S.C. 1350(c)) is amended by striking $100,000and inserting $1,000,000.
(3)
Officers and agents of corporations
Section 24(d) of the Outer Continental Shelf Lands Act ( 43 U.S.C. 1350(d)) is amended by striking knowingly and willfully authorized, ordered, or carried outand inserting authorized, ordered, carried out, or through reckless disregard of the law caused.
7.
Royalty relief
(a)
Gulf of Mexico royalty relief
The following provisions of the Energy Policy Act of 2005 ( 42 U.S.C. 15801et seq.) are hereby repealed:
(1)
Section 344 ( 42 U.S.C. 15904) (relating to incentives for natural gas production from deep wells in the shallow waters of the Gulf of Mexico).
(2)
Section 345 ( 42 U.S.C. 15905) (relating to royalty relief for deep water production).
(b)
Alaska royalty relief
(1)
Provisions relating to planning areas offshore Alaska
Section 8(a)(3)(B) of the Outer Continental Shelf Lands Act ( 43 U.S.C. 1337(a)(3)(B)) is amended by striking and in the Planning Areas offshore Alaskaafter West longitude.
(2)
Provisions relating to naval petroleum reserve in Alaska
Section 107 of the Naval Petroleum Reserves Production Act of 1976 ( 42 U.S.C. 6506a) is amended—
(A)
in subsection (i)—
(i)
by striking (1) In general; and
(ii)
by striking paragraphs (2) through (6); and
(B)
by striking subsection (k).
8.
Revision of Royalty Policy Committee charter
Not later than one year after the date of enactment of this Act, or March 29, 2021, whichever is earlier, the Secretary of the Interior shall revise the charter of the Royalty Policy Committee (as signed on March 29, 2017) to—
(1)
require that of the 6 members of such Committee who are representatives of the Governors of States, no more than 4 members may be representatives of Governors of the same political party;
(2)
increase to 6 the number of members who are representatives of academia or the public, of whom—
(A)
2 members shall be representatives of academia;
(B)
2 members shall be representatives of public interest groups; and
(C)
2 members shall be representatives of nonprofit environmental groups; and
(3)
require that for a person to be eligible to serve as a member who is a representative of a person who is a mineral stakeholder or energy stakeholder (or both) in Federal and Indian royalty policy, the employer of that member shall provide to the Secretary, who shall publish—
(A)
for the preceding 10-year period—
(i)
aggregated information on all Federal royalty payments made by the employer, by year and by commodity;
(ii)
conclusions from compliance reviews and audits conducted by Federal or State revenue collection entities; and
(iii)
a description of all enforcement actions taken against the employer regarding payment of Federal or State royalties; and
(B)
records of—
(i)
prices charged by the employer for sales of minerals to captive affiliates of the employer; and
(ii)
prices charged by such affiliates for subsequent resales of such minerals.
9.
Royalty in kind
(a)
Onshore oil and gas lease royalties
Section 36 of the Mineral Leasing Act ( 30 U.S.C. 192) is amended by inserting , except that the Secretary may not demand such payment in oil or gas if the amount of such payment would exceed the amount necessary to fill the strategic petroleum reserveafter in oil or gas.
(b)
Offshore oil and gas lease royalties
Section 27(a)(1) of the Outer Continental Shelf Lands Act ( 43 U.S.C. 1353(a)) is amended by striking the period at the end and inserting , except that the Secretary may not demand such payment in oil or gas if the amount of such payment would exceed the amount necessary to fill the strategic petroleum reserve..
10.
Amendments to definitions
Section 3 of the Federal Oil and Gas Royalty Management Act of 1982 ( 30 U.S.C. 1702) is amended—
(1)
in paragraph (20)(A), by striking : Provided, Thatand all that follows through subject of the judicial proceeding;
(2)
in paragraph (20)(B), by striking (with written notice to the lessee who designated the designee);
(3)
in paragraph (23)(A), by striking (with written notice to the lessee who designated the designee);
(4)
by amending paragraph (24) to read as follows:
(24)
designeemeans a person who pays, offsets, or credits monies, makes adjustments, requests and receives refunds, or submits reports with respect to payments a lessee must make pursuant to section 102(a);
;
(5)
in paragraph (25), in subparagraph (B)—
(A)
by striking (subject to the provisions of section 102(a) of this Act); and
(B)
in clause (ii), by striking subclause (IV) and all that follows through the end of the subparagraph and inserting the following:
(IV)
any assignment,
that arises from or relates to any lease, easement, right-of-way, permit, or other agreement regardless of form administered by the Secretary for, or any mineral leasing law related to, the exploration, production, and development of oil and gas or other energy resource on Federal lands or the Outer Continental Shelf;
;
(6)
in paragraph (29), by inserting or permitafter lease; and
(7)
by striking andafter the semicolon at the end of paragraph (32), by striking the period at the end of paragraph (33) and inserting a semicolon, and by adding at the end the following new paragraphs:
(34)
compliance reviewmeans an examination of a lessee’s lease accounts to compare one or all elements of the royalty equation (volume, value, royalty rate, and allowances) against anticipated elements of the royalty equation to test for variances; and
(35)
marketing affiliatemeans an affiliate of a lessee whose function is to acquire the lessee’s production and to market that production.
.
11.
Compliance reviews
Section 101 of the Federal Oil and Gas Royalty Management Act of 1982 ( 30 U.S.C. 1711) is amended by adding at the end the following new subsection:
(d)
The Secretary may, as an adjunct to audits of accounts for leases, conduct compliance reviews of accounts. Such reviews shall not constitute nor substitute for audits of lease accounts. The Secretary shall immediately refer any disparity uncovered in such a compliance review to a program auditor. The Secretary shall, before completion of a compliance review, provide notice of the review to designees whose obligations are the subject of the review.
.
12.
Liability for royalty payments
Section 102(a) of the Federal Oil and Gas Royalty Management Act of 1982 ( 30 U.S.C. 1712(a)) is amended to read as follows:
(a)
Liability for royalty payments
(1)
Time and manner of payment
In order to increase receipts and achieve effective collections of royalty and other payments, a lessee who is required to make any royalty or other payment under a lease, easement, right-of-way, permit, or other agreement, regardless of form, or under the mineral leasing laws, shall make such payment in the time and manner as may be specified by the Secretary or the applicable delegated State.
(2)
Designee
Any person who pays, offsets, or credits monies, makes adjustments, requests and receives refunds, or submits reports with respect to payments the lessee must make is the lessee’s designee under this Act.
(3)
Liability
Notwithstanding any other provision of this Act, a designee shall be liable for any payment obligation of any lessee on whose behalf the designee pays royalty under the lease. The person owning operating rights in a lease and a person owning legal record title in a lease shall be liable for that person’s pro rata share of payment obligations under the lease.
.
13.
Recordkeeping
Section 103(b) of the Federal Oil and Gas Royalty Management Act of 1982 ( 30 U.S.C. 1713(b)) is amended by striking 6and inserting 7.
14.
Adjustments and refunds
Section 111A of the Federal Oil and Gas Royalty Management Act of 1982 ( 30 U.S.C. 1721a) is amended—
(1)
in subsection (a)—
(A)
by amending paragraph (3) to read as follows:
(3)
(A)
An adjustment or a request for a refund for an obligation may be made after the adjustment period only upon written notice to and approval by the Secretary or the applicable delegated State, as appropriate, during an audit of the period which includes the production month for which the adjustment is being made.
(B)
Except as provided in subparagraph (C), no adjustment may be made with respect to an obligation after the completion of an audit or compliance review of such obligation unless such adjustment is approved by the Secretary or the applicable delegated State, as appropriate.
(C)
If an overpayment is identified during an audit, the Secretary shall allow a credit in the amount of the overpayment.
; and
(B)
in paragraph (4)—
(i)
by striking six-yearand inserting four-year; and
(ii)
by striking period shalland inserting period may; and
(2)
in subsection (b)(1)—
(A)
in subparagraph (C), by striking and;
(B)
in subparagraph (D), by striking the period and inserting ; and; and
(C)
by adding at the end the following:
(E)
is made within the adjustment period for that obligation.
.
15.
Obligation period
Section 115(c) of the Federal Oil and Gas Royalty Management Act of 1982 ( 30 U.S.C. 1724(c)) is amended by adding at the end the following new paragraph:
(3)
Adjustments
In the case of an adjustment under section 111A(a) in which a recoupment by the lessee results in an underpayment of an obligation, the obligation becomes due on the date the lessee or its designee makes the adjustment.
.
16.
Tolling agreements and subpoenas
(a)
Tolling agreements
Section 115(d)(1) of the Federal Oil and Gas Royalty Management Act of 1982 ( 30 U.S.C. 1724(d)(1)) is amended by striking (with notice to the lessee who designated the designee).
(b)
Subpoenas
Section 115(d)(2)(A) of the Federal Oil and Gas Royalty Management Act of 1982 ( 30 U.S.C. 1724(d)(2)(A)) is amended by striking (with notice to the lessee who designated the designee, which notice shall not constitute a subpoena to the lessee).
17.
Appeals
Section 115(h) of the Federal Oil and Gas Royalty Management Act of 1982 ( 30 U.S.C. 1724(h)) is amended—
(1)
in paragraph (1), in the heading, by striking 33-monthand inserting 48-month;
(2)
by striking 33 monthseach place it appears and inserting 48 months; and
(3)
by striking 33-montheach place it appears and inserting 48-month.
18.
Assessments
Section 116 of the Federal Oil and Gas Royalty Management Act of 1982 ( 30 U.S.C. 1724) is repealed.
19.
Pilot project on automatic data transfer
(a)
Pilot project
Not later than 2 years after the date of enactment of this Act, the Secretary of the Interior shall complete a pilot project with willing operators of oil and gas leases on the outer Continental Shelf (as such term is defined in the Outer Continental Shelf Lands Act ( 43 U.S.C. 1331et seq.)) that assesses the costs and benefits of automatic transmission of data regarding the volume and quality of oil and gas produced under Federal leases on the outer Continental Shelf in order to improve the production verification systems used to ensure accurate royalty collection and audit.
(b)
Report
The Secretary shall submit to Congress a report on findings and recommendations based on the pilot project not later than 3 years after the date of enactment of this Act.
20.
Penalty for late or incorrect reporting of data
(a)
In general
The Secretary of the Interior shall issue regulations by not later than 1 year after the date of enactment of this Act that establish a civil penalty for late or incorrect reporting of data under the Federal Oil and Gas Royalty Management Act of 1982 ( 30 U.S.C. 1701et seq.).
(b)
Amount
The amount of the civil penalty shall be—
(1)
an amount (subject to paragraph (2)) that the Secretary determines is sufficient to ensure filing of data in accordance with that Act; and
(2)
not less than $10 for each failure to file correct data in accordance with that Act.
(c)
Content of regulations
Except as provided in subsection (b), the regulations issued under this section shall be substantially similar to section 216.40 of title 30, Code of Federal Regulations, as most recently in effect before the date of enactment of this Act.
21.
Required recordkeeping for natural gas plants
Not later than 1 year after the date of enactment of this Act, the Secretary of the Interior shall publish final regulations with respect to required recordkeeping of natural gas measurement data as set forth in section 250.1203 of title 30, Code of Federal Regulations (as in effect on the date of enactment of this Act), to include operators and other persons involved in the transporting, purchasing, or selling of gas under the requirements of that rule, under the authority provided in section 103 of the Federal Oil and Gas Royalty Management Act of 1982 ( 30 U.S.C. 1713).
22.
Shared penalties
Section 206 of the Federal Oil and Gas Royalty Management Act of 1982 ( 30 U.S.C. 1736) is amended by striking Any payments under this section shall be reduced by an amount equal to any payments provided or due to such State or Indian tribe under the cooperative agreement or delegation, as applicable, during the fiscal year in which the civil penalty is received, up to the total amount provided or due for that fiscal year..
23.
Applicability to other minerals
Section 304 of the Federal Oil and Gas Royalty Management Act of 1982 ( 30 U.S.C. 1753) is amended by adding at the end the following new subsection:
(e)
Applicability to other minerals
(1)
Notwithstanding any other provision of law, sections 107, 109, and 110 of this Act and the regulations duly promulgated with respect thereto shall apply to any lease authorizing the development of coal or any other solid mineral on any Federal lands or Indian lands, to the same extent as if such lease were an oil and gas lease, on the same terms and conditions as those authorized for oil and gas leases.
(2)
Notwithstanding any other provision of law, sections 107, 109, and 110 of this Act and the regulations issued under such sections shall apply with respect to any lease, easement, right-of-way, or other agreement, regardless of form (including any royalty, rent, or other payment due thereunder)—
(A)
under section 8(k) or 8(p) of the Outer Continental Shelf Lands Act ( 43 U.S.C. 1337(k)and 1337(p)); or
(B)
under the Geothermal Steam Act ( 30 U.S.C. 1001et seq.), to the same extent as if such lease, easement, right-of-way, or other agreement were an oil and gas lease on the same terms and conditions as those authorized for oil and gas leases.
(3)
For the purposes of this subsection, the term solid mineralmeans any mineral other than oil, gas, and geo-pressured-geothermal resources, that is authorized by an Act of Congress to be produced from public lands (as that term is defined in section 103 of the Federal Land Policy and Management Act of 1976 ( 43 U.S.C. 1702)).
.
24.
Entitlements
(a)
Directed rulemaking
Not later than 180 days after the date of enactment of this Act, the Secretary of the Interior shall publish final regulations prescribing when a Federal lessee or designee must report and pay royalties on—
(1)
the volume of oil and gas such lessee or designee produces or takes under a Federal lease or Indian lease; or
(2)
the volume of oil and gas that such lessee or designee is entitled to based on its ownership interest under a unitization agreement for Federal leases or Indian leases.
(b)
100 percent entitlement reporting and paying
The Secretary shall give consideration to requiring 100 percent entitlement reporting and paying based on Federal or Indian oil and gas lease ownership.
25.
Royalties on all extracted methane
(a)
Assessment on all production
(1)
In general
Except as provided in paragraph (2), royalties otherwise authorized or required under the mineral leasing laws (as that term is defined in the Federal Oil and Gas Royalty Management Act of 1982 ( 30 U.S.C. 1701et seq.)) to be paid for gas shall be assessed on all gas produced under the mineral leasing laws, including—
(A)
gas used or consumed within the area of the lease tract for the benefit of the lease; and
(B)
all gas that is consumed or lost by venting, flaring, or fugitive releases through any equipment during upstream operations.
(2)
Exception
Paragraph (1) shall not apply with respect to—
(A)
gas vented or flared for not longer than 48 hours in an acute emergency situation that poses a danger to human health; and
(B)
gas injected into the ground on a lease tract in order to enhance production of an oil or gas well or for some other purpose.
(b)
Conforming amendments
(1)
Mineral Leasing Act
The Mineral Leasing Act is amended—
(A)
in section 14 ( 30 U.S.C. 223), by adding at the end the following: Notwithstanding any other provision of this Act (including this section), royalty shall be assessed with respect to oil and gas, other than gas described in section 124(a)(2) of the Sustainable Energy Development Reform Act , without regard to whether oil or gas is removed or sold from the leased land.;
(B)
in section 17 ( 30 U.S.C. 226), by striking removed or soldeach place it appears;
(C)
in section 31 ( 30 U.S.C. 188), by striking removed or soldeach place it appears.
(2)
Outer Continental Shelf Lands Act
The Outer Continental Shelf Lands Act is amended—
(A)
in section 6(a)(8) ( 43 U.S.C. 1335(a)(8)), by striking saved, removed, or soldeach place it appears; and
(B)
in section 8(a) ( 43 U.S.C. 1337(a))—
(i)
in paragraph (1), by striking saved, removed, or soldeach place it appears; and
(ii)
by adding at the end the following:
(9)
Notwithstanding any other provision of this Act (including this section), royalty under this Act shall be assessed with respect to oil and gas, other than gas described in section 124(a)(2) of the Sustainable Energy Development Reform Act, without regard to whether oil or gas is removed or sold from the leased land.
.
(c)
Application
The provisions of this section and the amendments made by this section shall apply only with respect to leases issued on or after the date of the enactment of this Act.
| https://www.govtrack.us/congress/bills/116/hr4364/text |
Publications - Global Disability Innovation Hub
The GDI Hub brings together academic excellence, innovative practice and co-creation; harnessing the power of technology for good.
Type
Conference Paper
Themes
Assistive & Accessible Technology
Culture and Participation
The Social Network: How People with Visual Impairment use Mobile Phones in Kibera, Kenya
Giulia Barbareschi,Catherine Holloway, Katherine Arnold, Grace Magomere, Wycliffe Ambeyi Wetende, Gabriel Ngare, Joyce Olenja
We present the findings of a case study of mobile technology use by People with Visual Impairment (VIPs) in Kibera, an informal settlement in Nairobi. We used contextual interviews, ethnographic observations and a co-design workshop to explore how VIPs use mobile phones in their daily lives, and how this use influences the social infrastructure of VIPs. Our findings suggest that mobile technology supports and shapes the creation of social infrastructure. However, this is only made possible through the existing support networks of the VIPs, which are mediated through four types of interaction: direct, supported, dependent and restricted.
CHI '20: Proceedings of the 2020 CHI Conference; 2020
Abstract
The Social Network: How People with Visual Impairment use Mobile Phones in Kibera, Kenya
Living in an informal settlement with a visual impairment can be very challenging resulting in social exclusion. Mobile phones have been shown to be hugely beneficial to people with sight loss in formal and high-income settings. However, little is known about whether these results hold true for people with visual impairment (VIPs) in informal settlements. We present the findings of a case study of mobile technology use by VIPs in Kibera, an informal settlement in Nairobi. We used contextual interviews, ethnographic observations and a co-design workshop to explore how VIPs use mobile phones in their daily lives, and how this use influences the social infrastructure of VIPs. Our findings suggest that mobile technology supports and shapes the creation of social infrastructure. However, this is only made possible through the existing support networks of the VIPs, which are mediated through four types of interaction: direct, supported, dependent and restricted.
Cite
The Social Network: How People with Visual Impairment use Mobile Phones in Kibera, Kenya
Giulia Barbareschi, Catherine Holloway, Katherine Arnold, Grace Magomere, Wycliffe Ambeyi Wetende, Gabriel Ngare, and Joyce Olenja. 2020. The Social Network: How People with Visual Impairment use Mobile Phones in Kibera, Kenya. In Proceedings of the 2020 CHI Conference on Human Factors in Computing Systems (CHI '20). Association for Computing Machinery, New York, NY, USA, 1–15.https://doi.org/10.1145/331383...
The Social Network: How People with Visual Impairment use Mobile Phones in Kibera, Kenya
Type
Conference Paper
Disability design and innovation in computing research in low resource settings
Dafne Zuleima Morgado-Ramirez,Giulia Barbareschi, Maggie Kate Donovan-Hall, Mohammad Sobuh, Nida' Elayyan, Brenda T Nakandi, Robert Tamale Ssekitoleko, joyce Olenja, Grace Nyachomba Magomere, Sibylle Daymond, Jake Honeywill, Ian Harris, Nancy Mbugua, Laurence Kenney,Catherine Holloway
80% of people with disabilities worldwide live in low resourced settings, rural areas, informal settlements and in multidimensional poverty. ICT4D leverages technological innovations to deliver programs for international development. But very few do so with a focus on and involving people with disabilities in low resource settings. Also, most studies largely focus on publishing the results of the research with a focus on the positive stories and not the learnings and recommendations regarding research processes.
ASSETS '20: Proceedings of the 22nd International ACM SIGACCESS Conference on Computers and Accessibility; 2020
Abstract
Disability design and innovation in computing research in low resource settings
80% of people with disabilities worldwide live in low resourced settings, rural areas, informal settlements and in multidimensional poverty. ICT4D leverages technological innovations to deliver programs for international development. But very few do so with a focus on and involving people with disabilities in low resource settings. Also, most studies largely focus on publishing the results of the research with a focus on the positive stories and not the learnings and recommendations regarding research processes. In short, researchers rarely examine what was challenging in the process of collaboration. We present reflections from the field across four studies. Our contributions are: (1) an overview of past work in computing with a focus on disability in low resource settings and (2) learnings and recommendations from four collaborative projects in Uganda, Jordan and Kenya over the last two years, that are relevant for future HCI studies in low resource settings with communities with disabilities. We do this through a lens of Disability Interaction and ICT4D.
Disability design and innovation in computing research in low resource settings
Dafne Zuleima Morgado-Ramirez, Giulia Barbareschi, Maggie Kate Donovan-Hall, Mohammad Sobuh, Nida' Elayyan, Brenda T Nakandi, Robert Tamale Ssekitoleko, joyce Olenja, Grace Nyachomba Magomere, Sibylle Daymond, Jake Honeywill, Ian Harris, Nancy Mbugua, Laurence Kenney, and Catherine Holloway. 2020. Disability design and innovation in computing research in low resource settings. In Proceedings of the 22nd International ACM SIGACCESS Conference on Computers and Accessibility (ASSETS '20). Association for Computing Machinery, New York, NY, USA, Article 11, 1–7.https://doi.org/10.1145/337362...
Disability design and innovation in computing research in low resource settings
Type
Article
Themes
Assistive & Accessible Technology
These tools help visually impaired scientists read data and journals
Alla Katsnelson
This article was featured in Nature and discusses tools that help visually impaired scientists read data and Journals. Innovation Manager, Daniel Hajas, was interviewed as part of this piece and highlights the need for an ecosystem approach, and access to data / visualisations for blind members of the research and science community.
Nature; 2023
Type
Book
Research Group
Disability Interactions
Disability Interactions Creating Inclusive Innovations
Catherine Holloway,Giulia Barbareschi
; 2021
Disability Interactions Creating Inclusive Innovations
Disability interactions (DIX) is a new approach to combining cross-disciplinary methods and theories from Human Computer Interaction (HCI), disability studies, assistive technology, and social development to co-create new technologies, experiences, and ways of working with disabled people. DIX focuses on the interactions people have with their technologies and the interactions which result because of technology use. A central theme of the approach is to tackle complex issues where disability problems are part of a system that does not have a simple solution. Therefore, DIX pushes researchers and practitioners to take a challenge-based approach, which enables both applied and basic research to happen alongside one another. DIX complements other frameworks and approaches that have been developed within HCI research and beyond. Traditional accessibility approaches are likely to focus on specific aspects of technology design and use without considering how features of large-scale assistive technology systems might influence the experiences of people with disabilities. DIX aims to embrace complexity from the start, to better translate the work of accessibility and assistive technology research into the real world. DIX also has a stronger focus on user-centered and participatory approaches across the whole value chain of technology, ensuring we design with the full system of technology in mind (from conceptualization and development to large-scale distribution and access). DIX also helps to acknowledge that solutions and approaches are often non-binary and that technologies and interactions that deliver value to disabled people in one situation can become a hindrance in a different context. Therefore, it offers a more nuanced guide to designing within the disability space, which expands the more traditional problem-solving approaches to designing for accessibility. This book explores why such a novel approach is needed and gives case studies of applications highlighting how different areas of focus—from education to health to work to global development—can benefit from applying a DIX perspective. We conclude with some lessons learned and a look ahead to the next 60 years of DIX.
Type
Conference Paper
Themes
Assistive & Accessible Technology
Value beyond function: analyzing the perception of wheelchair innovations in Kenya
Barbareschi, G; Daymond, S; Honeywill, J; Singh, A; Noble, D; Mbugua, N; Harris, I;Austin, V;Holloway, C
The World Health Organization (WHO) defines Assistive Technology (AT) as “an umbrella term covering the systems and services related to the delivery of assistive products and services” [6]. This definition highlights how AT encompasses not only the physical and digital products used by millions of persons with disabilities (PWDs) worldwide, but also the systems and services that accompany the provision of these devices [78].
ASSETS '20: The 22nd International ACM SIGACCESS Conference on Computers and Accessibility.; 2020
Abstract
Value beyond function: analyzing the perception of wheelchair innovations in Kenya
Innovations in the field of assistive technology are usually evaluated based on practical considerations related to their ability to perform certain functions. However, social and emotional aspects play a huge role in how people with disabilities interact with assistive products and services. Over a five months period, we tested an innovative wheelchair service provision model that leverages 3D printing and Computer Aided Design to provide bespoke wheelchairs in Kenya. The study involved eight expert wheelchair users and five healthcare professionals who routinely provide wheelchair services in their community. Results from the study show that both users and providers attributed great value to both the novel service delivery model and the wheelchairs produced as part of the study. The reasons for their appreciation went far beyond the practical considerations and were rooted in the fact that the service delivery model and the wheelchairs promoted core values of agency, empowerment and self-expression.
Value beyond function: analyzing the perception of wheelchair innovations in Kenya
Type
Conference Paper
Themes
Assistive & Accessible Technology
Culture and Participation
Inclusion and Independence: The impact of Mobile Technology on the Lives of Persons with Disabilities in Kenya and Bangladesh
Nusrat Jahan,Giulia Barbareschi, Clara Aranda Jan, Charles Musungu Mutuku, Naemur Rahman,Victoria Austin,Catherine Holloway
Worldwide it is estimated that there are over a billion people who live with some form of disability[1]. Approximately 80% of people with disabilities live in low-and-middle income countries (LMICs). The combination of an inaccessible environment compounded by socio-economic factors such as poverty and stigma, makes it more likely for people with disabilities to be marginalised and excluded from society[1]. Assistive Technologies (ATs) are known to bridge the accessibility gaps and allow for greater social inclusion. However, there is a lack of adequate access to ATs in LMICs, combined with often poorly designed services, which only magnifies these challenges, thus limiting the opportunities for persons with disabilities to live an independent life[2]. Despite the importance of AT, access to AT globally is inadequate with only 10 percent of those in need having access to the ATs that they need[2].
2020 IEEE Global Humanitarian Technology Conference
Abstract
Inclusion and Independence: The impact of Mobile Technology on the Lives of Persons with Disabilities in Kenya and Bangladesh
Globally, mobile technology plays a significant role connecting and supporting people with disabilities. However, there has been limited research focused on understanding the impact of mobile technology in the lives of persons with disabilities in low or middle- income countries. This paper presents the findings of a participatory photovoice study looking at the role that mobile phones play in the daily lives of 16 persons with disabilities in Kenya and Bangladesh. Participants used a combination of pictures and voice recordings to capture their own stories and illustrate the impact that mobile phone use has on their lives. Through thematic analysis, we categorized the benefits of mobile phones captured by participants as 1) Improved social connection; 2) Increased independence and 3) Access to opportunities. While mobile phones are ubiquitously used for communication, for persons with disabilities they become essential assistive technologies that bridge barriers to opportunities which are not accessible otherwise. Our paper adds evidence to the need for mobile phones for persons with disabilities to enable communication and connectivity in support of development.
Inclusion and Independence: The impact of Mobile Technology on the Lives of Persons with Disabilities in Kenya and Bangladesh
N. Jahan et al., "Inclusion and Independence: The impact of Mobile Technology on the Lives of Persons with Disabilities in Kenya and Bangladesh," 2020 IEEE Global Humanitarian Technology Conference (GHTC), Seattle, WA, USA, 2020, pp. 1-8, doi: 10.1109/GHTC46280.2020.9342934.
Inclusion and Independence: The impact of Mobile Technology on the Lives of Persons with Disabilities in Kenya and Bangladesh
Type
Conference Paper
Themes
Assistive & Accessible Technology
Research Group
Local Productions
A Preliminary Study to Understand How Mainstream Accessibility and Digital Assistive Technologies Reaches People in Lower- and Middle-Income Countries
Tigmanshu Bhatnagar, George Torrens, Ben Oldfrey, Priya MorjariaFelipe Ramos Barajas, Katherine PerryandCatherine Holloway
Access to information on digital platforms not only facilitates education, employment, entertainment, social interaction but also facilitates critical governmental services, ecommerce, healthcare services and entrepreneurship [1]. Article 9 of United Nations Convention on the Rights of Persons with Disabilities (UNCRPD) enforces its signatories to commit to provide full accessibility to every citizen of the nation [2]. This has helped to spearhead accessibility directives such as the European Accessibility Act [3] that aims to improve the functioning of markets for accessible products and services. Such directives contribute to ensure that mainstream digital technologies (smartphones, computers etc.) are accessible for everyone and without being socially remarkable, they are able to assist in daily living. Additionally, there is evidence that improving access in mainstream technologies improves product experience and usability for everyone [4]. However, mainstream access has not been fully realized, leading to inferior opportunities for people with disabilities, a disparity which is more prominent in lower and middle-income countries [5].
RESNA Annual Conference; 2021
A Preliminary Study to Understand How Mainstream Accessibility and Digital Assistive Technologies Reaches People in Lower- and Middle-Income Countries
Type
Working Paper
Themes
Culture and Participation
Research Group
Disability Interactions
Barriers to Access and Retain Formal Employment for Persons with Disabilities in Bangladesh and Kenya
Nusrat Jahan andCatherine Holloway
This working paper was developed to support the development of challenge statements for a GDI Hub innovation challenge fund call related to improving access to and retention of employment for persons with disabilities in Kenya and Bangladesh and is written by GDI Hub's Nusrat Jahan andProfessor Catherine Holloway.
The issue of disability and employment has taken centre stage on the global arena in part because it is recognised across several areas of the United Nations Sustainable Development Goals, in which confrontation of extreme poverty in its many manifestations is the number one goal [2]. The World Health Organization (2011) reports about 15 percent of the world’s population has a disability [1]. In developing countries, 80 to 90 percent of people with disabilities of working age are unemployed.
Abstract
Barriers to Access and Retain Formal Employment for Persons with Disabilities in Bangladesh and Kenya
Globally persons with disabilities have lower employment rates compared to the general population due to systemic barriers particularly in the formal sector. In developing countries, 80 percent to 90 percent of people with disabilities of working age are unemployed. There has been limited research in low-income and middle-income countries focused on the barriers to access and retain formal employment for persons with disabilities. The aim of this paper, based on desk research, is to analyse the barriers to access and retain formal employment of persons with disabilities which are framed in three categories according to where the barriers primarily manifest: 1. In the workplace among employers and co-workers without disabilities, 2. Among persons with disabilities seeking or engaged in formal employment and 3. In the wider social, physical and policy environment. Although the study mainly focuses on Kenya and Bangladesh other countries’ literature on access to and retention of employment of persons with disabilities were reviewed where relevant. In the current context where the global pandemic is breaking barriers to remote working one part of the solution will be to empower persons with disabilities with appropriate access to Information and Communication Technology, assistive devices and services, digital skills, creating more accessible and inclusive digital platforms for persons with disabilities which also hold the potential to improve working conditions and productivity for the whole workforce as well as enhancing resilience to potential future shocks.
Cite
Barriers to Access and Retain Formal Employment for Persons with Disabilities in Bangladesh and Kenya
Jahan & Holloway, 2020, Barriers to Access and Retain Formal Employment for Persons with Disabilities in Bangladesh and Kenya, GDI Hub Working Paper Series Issue 01
Barriers to Access and Retain Formal Employment for Persons with Disabilities in Bangladesh and Kenya
Type
Conference Paper
Themes
Assistive & Accessible Technology
Opportunities for Supporting Self-efficacy through Orientation and Mobility Training Technologies for Blind and Partially Sighted People
Maryam Bandukda,Catherine Holloway, Aneesha Singh,Giulia Barbareschi, Nadia Berthouze
We conducted semi-structured interviews with 20 BPS people and 8 Mobility and Orientation Trainers (MOT). The interviews were thematically analysed and organised into four overarching themes discussing factors influencing the self-efficacy belief of BPS people: Tools and Strategies for O&M training, Technology Use in O&M Training, Changing Personal and Social Circumstances, and Social Influences. We further highlight opportunities for combinations of multimodal technologies to increase access to and effectiveness of O&M training.
ASSETS '21: Proceedings of the 23rd International ACM SIGACCESS Conference on Computers and Accessibility
Abstract
Opportunities for Supporting Self-efficacy through Orientation and Mobility Training Technologies for Blind and Partially Sighted People
Orientation and mobility (O&M) training provides essential skills and techniques for safe and independent mobility for blind and partially sighted (BPS) people. The demand for O&M training is increasing as the number of people living with vision impairment increases. Despite the growing portfolio of HCI research on assistive technologies (AT), few studies have examined the experiences of BPS people during O&M training, including the use of technology to aid O&M training. To address this gap, we conducted semi-structured interviews with 20 BPS people and 8 Mobility and Orientation Trainers (MOT). The interviews were thematically analysed and organised into four overarching themes discussing factors influencing the self-efficacy belief of BPS people: Tools and Strategies for O&M training, Technology Use in O&M Training, Changing Personal and Social Circumstances, and Social Influences. We further highlight opportunities for combinations of multimodal technologies to increase access to and effectiveness of O&M training.
Opportunities for Supporting Self-efficacy through Orientation and Mobility Training Technologies for Blind and Partially Sighted People
Type
Conference Paper
Themes
Assistive & Accessible Technology
What difference does tech make? Conceptualizations of Disability and Assistive Technology among Kenyan Youth: Conceptualizations of Disability and AT
Giulia Barbareschi, Norah Shitawa Kopi,Ben Oldfrey,Catherine Holloway
In this paper, we examine how young Kenyans without disabilities view people with disabilities and AT users. Findings show that while the portrayal of disability is often shaped by negative emotion, participants felt that many of the barriers affecting people with disabilities were created by society. Perceptions of AT differed –devices were not only seen as a mark of disability but also as a sign of access to resources. Therefore, what we see is an emergent picture where social barriers can be reinforced by poverty, and where poverty reinforces social barriers faced by people with disabilities. We conclude that access to appropriate technology alongside societal interventions tackling incorrect beliefs about disability can help to overcome the stigma faced by people with disabilities.
ASSETS '21: Proceedings of the 23rd International ACM SIGACCESS Conference on Computers and Accessibility
Abstract
What difference does tech make? Conceptualizations of Disability and Assistive Technology among Kenyan Youth: Conceptualizations of Disability and AT
Most research which investigates stigma towards with people with disabilities and the use of Assistive Technology (AT) are based in the Global North and focus on the experiences of people with disabilities and the consequences that stigma has on choices surrounding AT. However, stigma is a societal construct rooted in the attitude and beliefs that people without disabilities hold on disability and AT. Furthermore, the portrayal of people with disabilities and AT is dependent on the social context. In this paper, we examine how young Kenyans without disabilities view people with disabilities and AT users. Findings show that while the portrayal of disability is often shaped by negative emotion, participants felt that many of the barriers affecting people with disabilities were created by society. Perceptions of AT differed –devices were not only seen as a mark of disability but also as a sign of access to resources. Therefore, what we see is an emergent picture where social barriers can be reinforced by poverty, and where poverty reinforces social barriers faced by people with disabilities. We conclude that access to appropriate technology alongside societal interventions tackling incorrect beliefs about disability can help to overcome the stigma faced by people with disabilities.
What difference does tech make? Conceptualizations of Disability and Assistive Technology among Kenyan Youth: Conceptualizations of Disability and AT
Giulia Barbareschi, Norah Shitawa Kopi, Ben Oldfrey, and Catherine Holloway. 2021. What difference does tech make? Conceptualizations of Disability and Assistive Technology among Kenyan Youth: Conceptualizations of Disability and AT. In The 23rd International ACM SIGACCESS Conference on Computers and Accessibility( ASSETS '21). Association for Computing Machinery, New York, NY, USA, Article 18, 1–13. DOI:https://doi.org/10.1145/3441852.3471226
What difference does tech make? Conceptualizations of Disability and Assistive Technology among Kenyan Youth: Conceptualizations of Disability and AT
Type
Conference Paper
Themes
Assistive & Accessible Technology
Inclusive Educational Technology
Transforming a Monolithic Sheet of Nitinol into a Passive Reconfigurable Tactile Pixel Array Display at Braille Resolution
Tigmanshu Bhatnagar, Nicolai Marquardt, Mark Miodownik,Catherine Holloway
Shape changing materials create a unique opportunity to design reconfigurable tactile display actuators. In this paper, we present a method that transforms a single thin monolithic sheet of Nitinol into a passive reconfigurable tactile pixel array at Braille resolution. We have designed a 27x27 tactile pixel array in which each pixel can be selectively actuated with an external source of heat. The pixels rise 0.4mm vertically with a peak blocked force of 0.28kg and have an average blocked force of 0.23kg at room temperature. After cooling, the pixels can be mechanically reconfigured back to their flat state for repeatable actuation. We demonstrate this actuator’s interactive capabilities through a novel erasable tactile drawing interface.
IEEE World Haptics Conference; 2021
Abstract
Transforming a Monolithic Sheet of Nitinol into a Passive Reconfigurable Tactile Pixel Array Display at Braille Resolution
Shape changing materials create a unique opportunity to design reconfigurable tactile display actuators. In this paper, we present a method that transforms a single thin monolithic sheet of Nitinol into a passive reconfigurable tactile pixel array at Braille resolution. We have designed a 27x27 tactile pixel array in which each pixel can be selectively actuated with an external source of heat. The pixels rise 0.4mm vertically with a peak blocked force of 0.28kg and have an average blocked force of 0.23kg at room temperature. After cooling, the pixels can be mechanically reconfigured back to their flat state for repeatable actuation. We demonstrate this actuator’s interactive capabilities through a novel erasable tactile drawing interface.
Cite
Transforming a Monolithic Sheet of Nitinol into a Passive Reconfigurable Tactile Pixel Array Display at Braille Resolution
T. Bhatnagar, N. Marquardt, M. Miodownik and C. Holloway, "Transforming a Monolithic Sheet of Nitinol into a Passive Reconfigurable Tactile Pixel Array Display at Braille Resolution," 2021 IEEE World Haptics Conference (WHC), 2021, pp. 409-414, doi: 10.1109/WHC49131.2021.9517239.
Transforming a Monolithic Sheet of Nitinol into a Passive Reconfigurable Tactile Pixel Array Display at Braille Resolution
| https://www.disabilityinnovation.com/publications?page=9&type=working-paper+article+book+conference-paper |
Let's Talk Kitty Litter!? - Pet forum for dogs cats and humans - Pets.ca
Let's Talk Kitty Litter!? Cat behavior forum - cat training
# 1 April 4th, 2008, 10:17 AM zztopp Member Join Date: Dec 2007 Location: Black River Posts: 79 Let's Talk Kitty Litter!? We live on a small farm (9 acres) and do our best to be environmentally friendly, which also helps with our land management. We use a straw-based bedding for the horses that breaks down fully in two weeks. Meaning, after 2 weeks we can spread it on our fields, which helps with space constraints, etc. The barn cats and the house cats each have kitty litter boxes .. and we use a clay based litter. Bad me, bad me ... I know!! We can't dispose of the kitty litter on the horsey manure pile, since they don't break down at the same rate. And I DON'T want to be spreading kitty litter on the fields that the horses eat from ... ick. Plus, our garbage bag limit is two bags a week ... and all that kitty litter takes up alot of space!! So, what are my choices for both economical and environmental kitty litters? Thanks everyone! -- zztopp __________________ "Say what you mean, mean what you say, do what you said you were going to do!" -- DJ, the best dog trainer ever <3 Owned by a very cute golden retriever; Kassie!! <3
# 2 April 4th, 2008, 10:22 AM SARAH Senior Contributor Join Date: Nov 2006 Posts: 1,718 Before the store I got it from closed (without warning!) I would get wood-chip/sawdust litter. It clumped and was flushable. Frankly, I wish I could find it again, because the clay, although scoopable is easier to clean than the non scoopable, does smell more and takes space in the garbage can (don't use a full bag/week though, and no limit here, so that's not the issue). See if you can find the wood stuff, it's worth it.
# 3 April 4th, 2008, 10:31 AM phoozles proud to be a cat slave Join Date: Oct 2007 Location: Southwestern Ontario Posts: 1,420 Thanks to growler I was recently introduced to Feline Fresh - it's a pine litter that comes in either pellet or scoopable form - it's a lot like sawdust, it clumps and is flushable.. It's also the same price as the clay stuff, which works well in my books! Here's their website: http://www.planetwiseproducts.com/feline.htm - they even have a rebate for a free first bag! Thanks again growler for the tip! __________________ Taken over by: Jake - grey DSH (Aug '98) Alley - spazzy grey tabby (Aug '07)
# 4 April 4th, 2008, 10:34 AM Kristin7 Senior Member Join Date: Jul 2006 Location: US Posts: 857 I have used a pine litter before, called Feline Pine. It was pretty good, flushable and I think clumpable too, though this was several years back. Now I use a wheat based litter called Sweat Scoop, which is clumping and flushable too. The cats like it and so do I __________________ http://www.catster.com/cats/702907 http://www.catster.com/cats/703259 http://www.catster.com/cats/703269 http://www.dogster.com/dogs/669963
# 5 April 4th, 2008, 10:36 AM sugarcatmom Senior Contributor Join Date: May 2007 Location: Calgary, AB Posts: 5,357 There's pine litter, which you can get in both pellet form (but not every cat likes it, although mine does) and in clumping format. Brands would be Feline Pine, Feline Fresh, Exquisicat, etc. There's also recycled newspaper pellets, like Yesterday's News (which also comes in a softer texture pellet that some cats might take to easier than the harder pine pellets). Then there's clumping wheat litter like Swheat Scoop, and clumping corn litter like World's Best Cat litter. I've also heard of corn cob litter (by One Earth). Here's an article on cat litter with links to many of the brands I mentioned: http://www.greenlivingonline.com/Hom...ty-litter-bad/ What I do is mix half pine pellets with half Yesterday's News. My cat loves this combo so much that he'll even come in from outside (where he has access to a gynormous dirt vegetable garden), to use the litter box. But then he's kinda weird. __________________ "To close your eyes will not ease another's pain." ~ Chinese Proverb “We must not refuse to see with our eyes what they must endure with their bodies.” ~ Gretchen Wyler
# 6 April 4th, 2008, 10:51 AM Chris21711 - Join Date: Apr 2007 Location: Queensville, Ontario Posts: 8,992 We can put cat litter in our Green Bin along with the dog poop.
# 7 April 4th, 2008, 10:57 AM ancientgirl Senior Contributor Join Date: May 2007 Location: Miami, FL Posts: 15,069 I use Swheat Scoop which is wheat based, as you may have guessed. It's clumping and flushable. Swheat Scoop __________________ There are only two rules at my house: House rule #1. Cats rule. House rule #2. See rule #1. http://nuriaandthegang.shutterfly.com/
# 8 April 4th, 2008, 11:16 AM sugarcatmom Senior Contributor Join Date: May 2007 Location: Calgary, AB Posts: 5,357 Depending on where you live, it may not be a good idea to flush cat litter: Quote: Although most of these green litters are septic- and sewer-safe, it’s best not to flush them into our waterways. Cat feces contains the Toxoplasmosis gondii (TG) parasite, dangerous to pregnant women and marine life, particularly sea otters. Unfortunately TG is not filtered out in most water treatment plants, so don’t flush your used litter. __________________ "To close your eyes will not ease another's pain." ~ Chinese Proverb “We must not refuse to see with our eyes what they must endure with their bodies.” ~ Gretchen Wyler
# 9 April 4th, 2008, 11:38 AM Kristin7 Senior Member Join Date: Jul 2006 Location: US Posts: 857 No sea otters around here! Regardless, I don't flush the litter but instead throw it in the garbage. The flushability is a good indicator that the litter biodegrades. Not sure, but I think cat litter waste can be composted, depending on type of litter? At least, only the urine part, probably not good to put the poop of a meat eater in the compost bin.... __________________ http://www.catster.com/cats/702907 http://www.catster.com/cats/703259 http://www.catster.com/cats/703269 http://www.dogster.com/dogs/669963
# 10 April 4th, 2008, 12:22 PM ancientgirl Senior Contributor Join Date: May 2007 Location: Miami, FL Posts: 15,069 Sugarcatmom, thanks for posting that. I'd read that a long time ago. We don't have any sea otters here, but I also throw mine in it's own little bin. I put it in a zip lock bag then place it in a small garbage pail next to the regular garbage. __________________ There are only two rules at my house: House rule #1. Cats rule. House rule #2. See rule #1. http://nuriaandthegang.shutterfly.com/
# 11 April 4th, 2008, 01:08 PM sugarcatmom Senior Contributor Join Date: May 2007 Location: Calgary, AB Posts: 5,357 Quote: Originally Posted by ancientgirl We don't have any sea otters here, Ha ha, ya I didn't think you did, but just in case anyone else reading thought flushing was a good idea....... Apparently this is a real problem on the California coast. Lots of sea otters dying from TG. __________________ "To close your eyes will not ease another's pain." ~ Chinese Proverb “We must not refuse to see with our eyes what they must endure with their bodies.” ~ Gretchen Wyler
# 12 April 4th, 2008, 01:15 PM SARAH Senior Contributor Join Date: Nov 2006 Posts: 1,718 Quote: Originally Posted by Chris21711 We can put cat litter in our Green Bin along with the dog poop. I only wish we did have a green bin. Only paper/plastic/glass/metal recyclable bin (huuuge) and a regular grabage bin for everything else, which is silly really, because a lot of it is bio degradable, except the styrofoam ...
# 13 April 4th, 2008, 01:31 PM ancientgirl Senior Contributor Join Date: May 2007 Location: Miami, FL Posts: 15,069 Quote: Originally Posted by sugarcatmom Ha ha, ya I didn't think you did, but just in case anyone else reading thought flushing was a good idea....... Apparently this is a real problem on the California coast. Lots of sea otters dying from TG. I did some snooping around and yeah, those poor little guys. Not to mention, a lot of people are still using that nasty clay stuff. I used to use clay until I started to do a little reading and because as a kitty Vlad had taken to laying in the litter. That was one of the main reasons I wanted to get him something natural enough so that if he ate it, it wouldn't make him sick. __________________ There are only two rules at my house: House rule #1. Cats rule. House rule #2. See rule #1. http://nuriaandthegang.shutterfly.com/
# 14 April 4th, 2008, 02:57 PM Jim Hall Kitty pimp Join Date: Jul 2007 Location: paterson new jersey Posts: 4,788 uhh whats wrong with clay litter?
# 15 April 4th, 2008, 03:09 PM sugarcatmom Senior Contributor Join Date: May 2007 Location: Calgary, AB Posts: 5,357 Quote: Originally Posted by Jim Hall uhh whats wrong with clay litter? From my link above: Quote: Clumping is bad for the health... The main culprit is sodium bentonite, a natural clay ingredient that expands into a hard mass when it comes into contact with moisture. While this is convenient for cleaning, it’s not great for kitty. Cats inhale fine sodium bentonite particles when they dig in the litter. Once inhaled, the clay expands when it hits their lungs, causing asthma and other lung problems. Cats can also ingest the clay while cleaning their paws and some even develop sores on their pads from it. Silica-based litters are not much better. This porous granular form of sodium silicate absorbs odours and moisture but is also easily inhaled by humans and felines. It’s been linked to lung cancer, bronchitis and tuberculosis. Some cats can end up with a fatal form of pulmonary tuberculosis called silico-tuberculosis. ...and bad for the planet Both these conventional litters have an adverse effect on the environment. Produced by the destructive method of strip-mining, clay and silica litter can’t decompose any further because they are already in their natural state. When you consider that we send about two million tons of cat litter every year to the landfill that adds up to a lot of fecal feline matter hanging around. __________________ "To close your eyes will not ease another's pain." ~ Chinese Proverb “We must not refuse to see with our eyes what they must endure with their bodies.” ~ Gretchen Wyler
# 16 April 4th, 2008, 04:16 PM zztopp Member Join Date: Dec 2007 Location: Black River Posts: 79 Wow! Thanks everyone for your help! And espcially to sugarcatmom for that link ... pretty scary how bad -- and common! -- clay cat litter is!! I can't find a website for Simply Pine -- ??!! I've found Feline Pine but still want to do some comparing We are leaning towards the pine based litters, for various reasons including human allergies. Thanks!! __________________ "Say what you mean, mean what you say, do what you said you were going to do!" -- DJ, the best dog trainer ever <3 Owned by a very cute golden retriever; Kassie!! <3
# 17 April 4th, 2008, 04:16 PM chico2 Senior Contributor Join Date: Jan 2004 Location: Oakville Ontario Posts: 26,591 I change my clumping clay-litter every 2 weeks,I would love to change it to something that's environmentally better and safer for the boys(kitties). Also every 2 weeks I have superheavy garbage-bags.. Swheat Scoop,Yesterdays News which I tried was a no go,but maybe I'll try the clumping Pine,first I have to find a place who sells it There was also another that was recommended to me,it was called something like"Best ever something..." but at $39 bag,was out of the question __________________ "The cruelest animal is the Human animal" 3 kitties,Rocky(r.i.p my boy),Chico,Vinnie
# 18 April 4th, 2008, 04:25 PM sugarcatmom Senior Contributor Join Date: May 2007 Location: Calgary, AB Posts: 5,357 Quote: Originally Posted by chico2 There was also another that was recommended to me,it was called something like"Best ever something..." but at $39 bag,was out of the question Probably World's Best Cat Litter, the corn-based one. It is expensive, but you typically use less of it because it clumps super well. I used to really like it, but when my cat started peeing massive amounts from diabetes, it wouldn't soak up his urine fast enough so it would pool around his feet. He hated that and started using the living room floor instead. I switched to the pellets, and he went back to using the box. Even though his urine amounts are normal now, he still prefers the pellets. __________________ "To close your eyes will not ease another's pain." ~ Chinese Proverb “We must not refuse to see with our eyes what they must endure with their bodies.” ~ Gretchen Wyler
# 19 April 4th, 2008, 05:06 PM duttypaws head in the clouds Join Date: Nov 2007 Location: Bonnie Banks of Loch Lomond Posts: 464 Quote: Originally Posted by SARAH Before the store I got it from closed (without warning!) I would get wood-chip/sawdust litter. It clumped and was flushable. Frankly, I wish I could find it again, because the clay, although scoopable is easier to clean than the non scoopable, does smell more and takes space in the garbage can (don't use a full bag/week though, and no limit here, so that's not the issue). See if you can find the wood stuff, it's worth it. you can buy Felinefresh in Canadian Tire its clumpable and flushable __________________ (>'.'<) "Princess" Lola ~ 5yrs black and white long hair (>'.'<) PoppyCat ~ 6 yrs grey and white short hair (>'.'<) Buffy ~ 14 yrs Calico (>'.'<) Zena ~ 14 yrs Calico long hair & Hugo ~ 10 yrs GBGV
# 20 April 4th, 2008, 06:02 PM clm Senior Contributor Join Date: Feb 2007 Location: Mississauga, Ontario Posts: 3,333 I use the Max cat multi cat litter. Non clumping. The boxes get totally changed out every week. We have a 2 bag limit here as well. We have to pay $1.00 apiece for tags for any additional bags. Now I'm forever cleaning out something in this house, and normally I'm over the 2 bag limit anyway. Cindy
# 21 April 5th, 2008, 12:46 AM growler~GateKeeper Moderator Join Date: May 2007 Posts: 17,568 Quote: Originally Posted by Kristin7 No sea otters around here! Regardless, I don't flush the litter but instead throw it in the garbage. The flushability is a good indicator that the litter biodegrades. Not sure, but I think cat litter waste can be composted, depending on type of litter? At least, only the urine part, probably not good to put the poop of a meat eater in the compost bin.... Toxoplasmosis is dangerous to all marine life so please don't flush it no matter where you live, whether you have sea otters or not, it will affect other species too. (not directed specifically @ you Kristin7) With the Pine litters of which I use Feline Fresh (your welcome Phoozles ) it is competely compostable only you would use it for flower beds etc not for veggie gardens, hay fields etc where someone would be eating from that land. __________________ Avoid biting when a simple growl will do The Spirit Lives As Long As Someone Who Lives Remembers You - Navaho Saying
# 22 April 5th, 2008, 06:25 AM Kristin7 Senior Member Join Date: Jul 2006 Location: US Posts: 857 Unfortunately I did used to flush it when I lived in San Diego, though never would have if I had known back then. Poor otters (and other species) :sad: I don't live near the ocean anymore and the waters in my state are very polluted, as in, it is recommended to not eat fish out of any of the waters. Still, I don't flush it, mostly because I am afraid it would clog my toilet. What is a green bin? is that a compost bin? Someday I'd like to start composting, no idea why I don't now. Do animals get in the bins?? __________________ http://www.catster.com/cats/702907 http://www.catster.com/cats/703259 http://www.catster.com/cats/703269 http://www.dogster.com/dogs/669963
# 23 April 5th, 2008, 09:54 AM krdahmer ~Cat Servent~ Join Date: Jul 2004 Location: Niagara Falls, Ontario Posts: 5,229 I use the swwheat scoop as well. Love the new multi-cat formula... clumps harder and faster. And I have never had a problem with stink. I do not flush it here, simply for the sheer amount I would be flushing... pee and poo times 6 really adds up! (Guess that's a good thing after all! Poor otters!:sad I dispose of it in the doggy poop bags every night when I scoop and then into the regular garbage. I only do a big clean out every two months and all that gets put in seperate bags and tagged. Ya Chico, at first the cost really put me off, but even though I spend $100 on litter, that's only once every two months (8-10 wks), and for 6 cats that's not bad. This litter clumps better so scooping is easier and cleaner and it also controls the smell a lot better than any clay I ever used. With my asthma I really had to look for a litter with no harmful dusts. I did also use the World's Best corn stuff, but didn't like the smell of it with the pee. The corn had a very sty type scent when used, and the swwheat is more of a bakery smell. Not a bakery I'd ever eat at mind you... __________________ Windy~Smoke~Buddy~Palomine~Fagan~Asker~Mickey Blue Eyes Venus “The greatness of a nation and its moral progress can be judged by the way its animals are treated” -Mahatma Gandhi "We're the renegades, we're the people; With our own philosophies; We change the course of history; Everyday people like you and me"- R A T M
# 24 April 5th, 2008, 11:36 AM ancientgirl Senior Contributor Join Date: May 2007 Location: Miami, FL Posts: 15,069 I wasn't able to find any Swheat Scoop at the market last week, which usually sells it for less than the pet store. Since I was on a very tight budget I went with the only other natural litter they had. Some corn based litter I'd never heard of. OMG, I can't wait to get paid again, because this stuff is terrible. I will never buy another corn litter again. What I saved by not going to the pet store and getting the SS isn't worth the smell. It's not pungent, but when I walk into my apartment I can smell there are cats living here, whereas with the SS there is no odor. I'd love to try the Feline Fresh, but I can't find it anywhere here and I've looked online on Petco and Petsmart and they don't sell it either. I'm going to try ordering it from the actual site to give it a try. In my opinion though, of all the litters I've used so far, Swheat Scoop is the best for me. __________________ There are only two rules at my house: House rule #1. Cats rule. House rule #2. See rule #1. http://nuriaandthegang.shutterfly.com/
# 25 April 7th, 2008, 10:02 PM katie&thecrew Slave to the fur Join Date: Feb 2008 Location: Sooke, BC Posts: 16 I used to swear by Swheat Scoop, but then I found that it wasn't clumping as well and there was a distinct smell that turned my stomach...I now use Nature's Miracle litter and whooooa boy!!! LOVE IT!! Better clumping, distinct pine smell (which I personally love)...I have turned on some old co workers at the humane society to it as well!! I think it's the best out there, and I find it has even less dust than swheat scoop (I am a sensitive soul )
# 26 April 8th, 2008, 10:07 AM krdahmer ~Cat Servent~ Join Date: Jul 2004 Location: Niagara Falls, Ontario Posts: 5,229 I would have given the pine a shot too.... but alas I am really really allergic to pine! __________________ Windy~Smoke~Buddy~Palomine~Fagan~Asker~Mickey Blue Eyes Venus “The greatness of a nation and its moral progress can be judged by the way its animals are treated” -Mahatma Gandhi "We're the renegades, we're the people; With our own philosophies; We change the course of history; Everyday people like you and me"- R A T M
# 27 April 10th, 2008, 06:20 PM zztopp Member Join Date: Dec 2007 Location: Black River Posts: 79 Awesome!! Just to update ... we went and bought some EnviroLitter, which is a pelleted pine-based litter. It's awesome!! Our cats eyeballs almost popped out when he caught a whiff of it ... he promptly left. Later that day I checked the box and there was, uh, evidence of him being in there! Have seen both cats happily coming and going, so I think they are happy. The farm house now has a lovely pine scent to it ... Also noticed that the kitties now have fresh, pine smelling toes LOL __________________ "Say what you mean, mean what you say, do what you said you were going to do!" -- DJ, the best dog trainer ever <3 Owned by a very cute golden retriever; Kassie!! <3
# 28 April 10th, 2008, 06:40 PM onster Senior Contributor Join Date: Feb 2007 Posts: 4,842 ok im sold, gonna try some pine stuff next time i go to buy litter. swheatscoop just isnt cutting it anymore. Doesnt clump well enough and i have the moral dilemna of my cats pooping in wheat when theres wheat shortages elsewhere in the world. I know its supposed to be non human grade, but still....
# 29 April 10th, 2008, 07:08 PM 14+kitties 150% PRO S/N Join Date: Nov 2007 Location: MYOB Posts: 15,408 Ok so...... silly question. I know this pine based litter says it will last forever and it's great for the environment. Great btw!! I have done some "googleing" (so not a word!) on it and they all say they are 100% recycled pine. Great again!!! My question is........... If this pine stuff is made with 100% pine than why pay the money for a small bag ($7.99 up) when you can go and buy 100% pine based softwood bedding (shavings) in a huge bag at hardware stores (78litres I think which expands 3 times the size) for $5.25? Is it the pellet shape? I am using the shavings out in the catuary. The kitties have an area they use and I just cover it with the shavings and clean as necessary. Then I can use the shavings as compost or mulch. I also have it in one litter box until they are used to it and then it will be in all of them. __________________ Assumptions do nothing but make an ass out of u and me. We can stick our heads in the sand for only so long before it starts choking us. Face it folks. The pet population is bad ALL OVER THE WORLD!
| http://www.pets.ca/forum/showthread.php?p=574583 |
Why so few women training? | Iain Abernethy
Why so few women training?
Why so few women training?
This is a conversation I've been trying to have for some time now and I can't seam able to develop it.
As a good example, the majority of people actually active here in the forum are men. The few women I was actually able to talk directly are already practitioners and their answers were not very insightful.
So, why does most martial arts gyms have so few women training?
The most common answer I found is, they don't feel safe.
This is the strange thing though, most people don't feel safe around martial arts gyms either. Most of my friends and random people I try to invite to come by have the same VERY immediate response "But I don't know anything, you people are going to hurt me!" and it doesn't matter what I say after....at least I never found a way around this.
Ok, sure, I get it, it's not the same for women, when they feel threatened is for very different and, most of the time, much more real and imminent reasons.
I don't like to frame the question like this at all, but....
What does a more "feminine friendly" martial arts environment would look like?
What would we need to change in order to be at least more open and address those concerns face on?
I have some theories of my own, but I would like to hear your thoughts about it. I'm sure there must be some among you with a very balanced presence of all sorts of people in your schools, so your experience would be very welcome.
And maybe a woman or two hiding here in the forum that could better guide this conversation???
Edit: maybe we should make clear from which country we are from? There may be some very interesting patterns there for us to dig deeper. I'm from Brasil o/
It's eternally vexing to me that the very people who may most benefit from self defence training and self confidence building are the same people who will often be most put off walking into a martial arts place.
While young fit active blokes are ten-a-penny. Although arguably they are among the most at risk demographic of being a victim of physical violence (at the hands of other young fit blokes!).
I got into martial arts as a very nervous young man looking to build confidence and it took weeks of build up and failed attempts at walking into a gym (I'll go next week...I'm busy tonight....I wasn't busy!) before I actually did it. I can see why it can be an intimidating undertaking.
I'm not sure I have the answers.
"Combat fitness" type classes (body-combat, etc) and boxercise have a more representative demographic as far as I can see (more women than men in some cases) so there must be something to the atmosphere and epxectations of those types of activities compared to a "regular" martial arts class? Maybe because you can't fail a bodycombat grading or boxercise class and know you won't be hit or hurt? I hate gradings personally. I know enough to know what I'm crap at and don't need someone officially reminding me of that!
One thing that came up talking to an instructor mate of mine was his decision (based on talking to his female students) to make his optional club uniforms a dark colour rather than the plain white he was going to go for. They have official grading/competition uniforms that are white.
So that at "certain times of the month" the female students could wear something suitable for training and not worry about it. If you get my meaning. White uniforms are not the best choice in that regard and yet they seem to be the default.
It's a bit of a catch 22 situation. I think any club wishing to attract more women (and keep them) needs women prominently in its identity and branding. Female safeguarding and child protection officers, female high grades, female only classes or starter classes. "Family" sessions perhaps? That kind of thing. But you can't do any of that unless women join your club in the first place!
Women would definitely be better contributors to this, but I can throw in my two cents. For what it's worth, though, the majority of my students are women and girls, and at both of the schools I have trained at as a student, the student population was close to 50% women and girls, so my experience may be a bit skewed. Bear in mind that I make the following statements as a cisgender, heterosexual male, so the female perspective is what I have learned from talking to women, and reading articles that women have written on such subjects, but but I am absolutely not the best source.
First, I feel it's important to clarify your point about people not feeling safe in a martial arts gym:
Men don't feel safe going to martial arts gyms because they are afraid of being embarrassed, or potentially injured.
Women don't feel safe going to martial arts gyms because, in addition to the potential of embarrassment (the white uniforms don't help) or injury, there are likely to be a lot of men at martial arts gyms (as you've alluded to), which in their experience means that they are at much higher risk of being harrassed or assaulted, because that is what they experience on a day-to-day basis. Additionally, martial arts training can be very triggering for someone who has been assaulted, before, which is approximately 25% of women.
Now, as to how to make a martial arts gym more inclusive? Well, I have some ideas but, again, it would be better to get input from women and girls, and members of the LGBTQIA+ community, so these are just a start.
• Don't embrace toxic masculinity, and don't use or reward outward displays of machismo or vulgarity
• Don't allow disrespectful, misogynistic, sexist, bigoted, or otherwise harmful speech/jokes/behavior
• Don't shame people for what they wear/how they look
• Don't tell women and girls they are "distracting," or otherwise sexualize them
• Allow dark colored uniforms that won't become see-through when sweaty, and won't show blood as easily
• Make sure students are communicating with each other and getting consent before making contact or engaging in a training exercise, and enforce that consent (this includes trying to make them do things they don't feel comfortable with in the name of "pushing them out of their comfort zone," unless you have explicitly discussed this ahead of time and gotten consent, and make it clear they have the right to revoke that consent at any point)
• Educate yourself about the dangers and issues women and girls face on a daily basis, and be open to having discussions with them to see how you can improve your understanding and your approach to training
• Be a safe space/person for your students to come to with concerns, and really listen to what they have to say
• Encourage the women and girls in your gym to lead, and be sure you are using them as examples as much as you use the men and boys
• Encourage students to have their parents and friends come in to watch training
• Participate in family-type activities as a gym (park outings, cookouts, etc.)
PASmith wrote:
"Combat fitness" type classes (body-combat, etc) and boxercise have a more representative demographic as far as I can see (more women than men in some cases) so there must be something to the atmosphere and epxectations of those types of activities compared to a "regular" martial arts class? Maybe because you can't fail a bodycombat grading or boxercise class and know you won't be hit or hurt? I hate gradings personally. I know enough to know what I'm crap at and don't need someone officially reminding me of that!
Actually, here in Brasil, Muay Thai and Jiujitsu have lot's of women on some academies. I don't believe it's 50/50 but it's quite close overall.
I could rationalize Muay Thai as being visually aggressive all the time may have an appeal for people looking to "feel" hipper aggressive as a self defense response.
But Jiujitsu?? You are constantly rolling in close proximity with someone trying to dominate you by "any means necessary".....I don't get it! I did Judo for 6 months (planing to try again at some point) and I found the ground work to be EXTREMELY psychologically demanding, you need a lot of trust on your fellow practitioners specially wile training chokes.
PASmith wrote:
It's a bit of a catch 22 situation. I think any club wishing to attract more women (and keep them) needs women prominently in its identity and branding... But you can't do any of that unless women join your club in the first place!
I see that too, in the place I traine, the doughter of the instructor were there form the begining and this makes a difference in helping other women to come by the door just to chat and sse whats going on.
Wastelander wrote:
First, I feel it's important to clarify your point about people not feeling safe in a martial arts gym:
Men don't feel safe going to martial arts gyms because they are afraid of being embarrassed, or potentially injured.
Women don't feel safe going to martial arts gyms because, in addition to the potential of embarrassment (the white uniforms don't help) or injury, there are likely to be a lot of men at martial arts gyms (as you've alluded to), which in their experience means that they are at much higher risk of being harrassed or assaulted, because that is what they experience on a day-to-day basis. Additionally, martial arts training can be very triggering for someone who has been assaulted, before, which is approximately 25% of women.
I thought I have said that, but thank you for explaining it much better than I did. You are right, of course.
I was luck to train my hole life with incredible teachers more than incredible athletes or martial artists and for sure! The instructors behavior defines the overall pace of the school in every single aspect of it. Being inclusive and creating a safe environment is their responsibility in first place.
But it's like PASmith said, we need first those people in the gym to than be able to apply any guidelines we may feel are needed.
I've never run things like ladies-only classes and currently have no intention of doing so. And yet around three years I found that one of my adult classes was 100% female with an age range of 15 to 30. Why? Let's be honest I'm no Jason Statham or Brad Pitt. I could claim it's my GSOH of course?
My suspicion is that it was the material that I was teaching especially given the honesty of their specific risks which we all know very few martial arts do. I suspect my occupation paid a part as there was no overt masculine ego at play. I talked freely about what my job had taught me about the reality of violence including for that group specifically. As a result all of these girls/ladies had gravitated towards me.
My question should therefore have been to the effect of why I wasn't attracting men into class. I've just checked my class database and discovered that currently 56% of my students are male. I suspect the 44% female number is unusual.
The environments many male martial arts teachers create are anathema to many women, that's the gist of it. At least this is the answer I've recevied when I've had candid conversations about this with the women I've taught. In addition the concerns mentioned about possible abuse and general poor treatment are (unfortunately) very realistic and reasonable concerns.
I will note that funnily enough my original Karate dojo in the 80's and 90's was nearly half female. Since then I've only seen numbers dwindle in the dojos I've been part of.
This was also in the state of New Mexico, now a somewhat famous place for MMA training, and martial arts have always been popular there, as well as a bit of a "family" thing. So, at my dojo growing up there were many couples and families training together. My Stepfather still runs a dojo (well, dojang) there and it sounds like it is much the same.
Also notable, the boxing gym I attended recently seems to have had a fair number of female attendees.
Where I live now in the state of Washington the ratio of women I have seen training at various dojos (and running my own) is much smaller, maybe 1 out of 5, if that.
I think Wastelander's post has some excellent suggestions, I have tried to follow some these over the years.
PASmith wrote:
It's eternally vexing to me that the very people who may most benefit from self defence training and self confidence building are the same people who will often be most put off walking into a martial arts place.
While young fit active blokes are ten-a-penny. Although arguably they are among the most at risk demographic of being a victim of physical violence (at the hands of other young fit blokes!).
I got into martial arts as a very nervous young man looking to build confidence and it took weeks of build up and failed attempts at walking into a gym (I'll go next week...I'm busy tonight....I wasn't busy!) before I actually did it. I can see why it can be an intimidating undertaking.
One thing I always try to keep in mind is that it is generally more difficult by orders of magnitude for a woman to walk into a martial arts Dojo or Gym than it is for a man. There are far more social, interpersonal, communication, and safety issues that a woman has to worry about when looking for training the first time. There is simply is no comparison between their experience and ours.
I have a physical disablity, which is part of what brought me to Karate training when I was young. Even with that, I would wager that my experience (primarily due to my gender and size) is somehow more overtly "welcomed" when I walk into a gym or Dojo than it is for many women. How much of that is the place and how much is the individual is of course different in each circumstance, and could be debated. However, I am personally convinced this is the case.
Tau wrote:
My suspicion is that it was the material that I was teaching especially given the honesty of their specific risks which we all know very few martial arts do. I suspect my occupation paid a part as there was no overt masculine ego at play. I talked freely about what my job had taught me about the reality of violence including for that group specifically. As a result all of these girls/ladies had gravitated towards me.
I'm new here and don't know anybody yet, would you mind elaborating?
What kind of explanation do you give? Whats is your job exactly?
There would remain the need to bring someone through the door to have this conversations, but your particular situation may give us some very good ideas about how to create a more credible relation with newcomers from the start.
Frazatto wrote:
Tau wrote:
My suspicion is that it was the material that I was teaching especially given the honesty of their specific risks which we all know very few martial arts do. I suspect my occupation paid a part as there was no overt masculine ego at play. I talked freely about what my job had taught me about the reality of violence including for that group specifically. As a result all of these girls/ladies had gravitated towards me.
I'm new here and don't know anybody yet, would you mind elaborating?
What kind of explanation do you give? Whats is your job exactly?
There would remain the need to bring someone through the door to have this conversations, but your particular situation may give us some very good ideas about how to create a more credible relation with newcomers from the start.
I'm a nurse. Much of my career was spent as an Emergency Nurse Practitioner and still is when I do agency shifts for some extra money. Essentially I'm a nurse but with specialist training to the point that these days I work essentially as a Dr. Working in emergency care means I got an insight into violence from different perspectives as I would treat the perpetrators of violence with the Police accompanying them and I would treat the victims. I'm trained to spot signs of abuse and to ask about it. It is thought that it takes something like an average of 37 encounters with a health care professional for a victim of domestic abuse to disclose that that is what is happening and I've been the "37th" encounter as it were.
This has directly influenced how I teach pragmatic self protection skills and increased the setting on my bullshit filter. I think my students see and respect that.
#11
So, why does most martial arts gyms have so few women training?
The most common answer I found is, they don't feel safe.
This is the strange thing though, most people don't feel safe around martial arts gyms either. Most of my friends and random people I try to invite to come by have the same VERY immediate response "But I don't know anything, you people are going to hurt me!" and it doesn't matter what I say after....at least I never found a way around this.
Ok, sure, I get it, it's not the same for women, when they feel threatened is for very different and, most of the time, much more real and imminent reasons.
I don't like to frame the question like this at all, but....
What does a more "feminine friendly" martial arts environment would look like?
And maybe a woman or two hiding here in the forum that could better guide this conversation???
Edit: maybe we should make clear from which country we are from? There may be some very interesting patterns there for us to dig deeper. I'm from Brasil o/
Well, one of the possible reasons is that their idea of Martial Arts might be different than what you think. When someone who is into Martial Arts are asked to associate something to the idea of Martial Arts to a lay person. They are thinking Mr. Miyagi, Bruce Lee, some old wise dude with a Fu Machu.
But to someone who has no interest but is being talked to about martial arts. Those might be something they think of. Or they might be thinking Warmachine and Christy Mack. Or any other big MMA person that abused their significant other.
So it can be a image thing, how to sell a traditional art to someone that will accomplish someome's goals but doesn't appear too agressive and scary. Which is why family martial arts works so well, because its not scary or intimidating.
| https://iainabernethy.co.uk/comment/18500 |
Why you need to move on mobile app testing - Information Age
Mobile app testing is perceived as expensive and time consuming, but it’s vital to ensure users have a positive experience. It helps identify navigation a
Why you need to move on mobile app testing
Mobile app testing is perceived as expensive and time consuming, but it’s vital to ensure users have a positive experience. It helps identify navigation and presentation errors, controls usage problems, and provides feedback about the apps general appeal and engagement level.
Unfortunately, a lot of marketers launching mobile apps take shortcuts to skimp on testing, or use a reactive approach and only worry about what users think once the app hits the market. They often put far too much emphasis on time-to-market, citing competitive reasons and the rapid technological pace of mobile as justification to get their mobile app out there fast.
Mobile apps should be tested proactively, not reactively. A Localytics study shows that 24% of users try out a downloaded app only once. That’s because when users find fault with an app, they simply don’t use it again.
The goal of testing efforts should not be just to find errors, but to understand the quality of the app. Does it work? Does it function as it was designed? Will it meet the needs of your users so that they come back, again and again?
A Perfecto Mobile benchmark survey this year found that users and not testers identify almost half of mobile application issues. In essence, that means users are the final QA step – obviously this is not the desired course of action. That means testing must be proactive to catch issues before the user experiences them.
The report also identified the top three challenges in mobile testing: insufficient coverage (63%), lack of reliable automation (48%), and needing more coverage to execute test scenarios than time permits (47%).
Respondents said that in order to reduce mobile app defects, more functional testing, device/OS coverage, and performance testing were needed.
Usability testing is not just a backend activity, it should occur throughout the development process from initial design to just before an app is released to allow you to address issues.
By testing an app prior to its release and during development, it is exponentially easier to fix problems. Addressing the issues discovered in the early stages of development will not only save the higher costs of fixing them post-release, but also avoid potential damage to a brand as a result of the bad reviews it will likely receive.
Testing should also be done at every phase of development, and user interaction should be recorded. Monitoring mobile apps is essential to examining their performance; it’s vital to monitor continuously, especially during performance testing so to isolate trends and differentiate between systems and root causes.
User testing vs. beta testing
While any testing is a both necessary and positive, beta testers get so familiar with a mobile app that they develop a kind of ‘white line fever’ – a fixation on a single point and lack fresh eyes – making them less likely to spot usability problems.
User testing, on the other hand, gives feedback from typical users who aren’t familiar with an app and have no bias or emotional attachment to it. These user tests help understand the needs and reactions of normal users, the types of people who write reviews in the app store.
Mobile apps differ from Web applications in their specific purpose. As such, when an app is created and deployed, there needs to be more upfront planning specific to the utilisation of the app – not simply a scaled-down version of the website.
Mobile apps are used under much different conditions than a website, so they must facilitate this with ease.
It’s important to remember that mobile consists of two devices: smartphones and tablets. If an app is designed to run on both, tests should be run on both because a screen layout may look good on a smartphone but cumbersome or unappealing on a tablet, or visa-versa. Additionally, user behavior on the two devices has subtle, yet distinct, differences.
Testing is often considered logical, planned and predictable, full of processes, test scripts, passes and fails – but this is not the full extent of what it encompasses.
Businesses need to do more than just test cases and find bugs; they need to find the issues that matter to users, and provide information of value that determines when it is okay to release an app and mitigates any issues beforehand.
By testing apps within the target audience during development, they are more likely to be not only wanted by the user but also engaging. Testing helps avoid naval gazing (looking at your own needs only); it gives the insights into what the users want and the type of app that will enhance the brand.
Sourced from Gregg Guzman, associate director of planning, Sq1
Applications
Development Process
| https://www.information-age.com/why-you-need-move-mobile-app-testing-30208/ |
Prognostic models for patients with brain metastases after stereotactic radiosurgery with or without whole brain radiotherapy: a validation study - [scite report]
Mentioning: 5 - All models under-predicted MS and only the BSKN and Lung-molGPA model stratified patients into three risk groups with statistically significant actual MS. The prognostic groupings of the adenocarcinoma Lung-molGPA group was the best predictor of MS, and showed that we are making improvements in our prognostic ability by utilizing molecular information that is much more widely available in the current treatment era.
Prognostic models for patients with brain metastases after stereotactic radiosurgery with or without whole brain radiotherapy: a validation study
et al.
Abstract: All models under-predicted MS and only the BSKN and Lung-molGPA model stratified patients into three risk groups with statistically significant actual MS. The prognostic groupings of the adenocarcinoma Lung-molGPA group was the best predictor of MS, and showed that we are making improvements in our prognostic ability by utilizing molecular information that is much more widely available in the current treatment era.
Retrospective Study of hypofractionated stereotactic radiotherapy Combined with whole brain radiotherapy for Patients with Brain Metastases
Peng
2
,
Zhang
3
et al.
2022
Preprint
Background and purpose
To evaluate the clinical outcomes of hypofractionated stereotactic radiotherapy (HFSRT) combined with whole brain radiotherapy (WBRT) in patients with brain metastases (BMs).
Materials and methods
From May 2018 to July 2020, 50 patients (111 lesions) received HFSRT (18Gy/3F) + WBRT (40Gy/20F). The RECIST 1.1 and RANO-BM criteria were used to evaluate treatment efficacy. Five prognostic indexes (RPA, GPA, SIR, BS-BM, and GGS) were applied. The primary endpoint was intracranial local control (iLC). Secondary endpoints were overall survival (OS) and the safety of treatment.
Results
Intracranial objective response rates (iORR) using the RECIST 1.1 and RANO-BM criteria were 62.1% and 58.6%, respectively. The iLC rate was 93.1%, the 6- and 12-month iLC rates were 90.8% and 57.4%, respectively. The median intracranial progression-free survival (iPFS) was not reached (range 0 − 23 months). The 6-, 12-, and 24-month OS rates were 74.2%, 58.2%, and 22.9%, respectively. The KPS score showed statistical significance in univariate analysis of survival. The 6, 12, and 24 month OS rates for patients with KPS ≥ 70 were 83.8%, 70.5%, and 29.7%, respectively. The median survival time (MST) for all patients and for patients with KPS ≥ 70 were 13.6 and 16.5 months, respectively. Sex, KPS score, and gross tumor volume were significant factors in the multivariate analysis of survival. OS was significantly associated with RPA, SIR, BS-BM, and GGS classes. No acute toxicities of grade 3 or higher were noted.
Conclusion
HFSRT combined with WBRT is a safe and effective local treatment modality for BM patients.
“…In addition, we found that the PIs in our study were not uniformly recommended in different studies, and there was a large discrepancy between the expected and actual survival[18, [40] [41] [42] . This nding supports the need for a better prognostic tool or index.…”
Section : Discussion mentioning confidence: 59%
Retrospective Study of hypofractionated stereotactic radiotherapy Combined with whole brain radiotherapy for Patients with Brain Metastases
Xie
1
,
Peng
2
,
et al.
2022
Preprint
Background and purpose
To evaluate the clinical outcomes of hypofractionated stereotactic radiotherapy (HFSRT) combined with whole brain radiotherapy (WBRT) in patients with brain metastases (BMs).
Materials and methods
From May 2018 to July 2020, 50 patients (111 lesions) received HFSRT (18Gy/3F) + WBRT (40Gy/20F). The RECIST 1.1 and RANO-BM criteria were used to evaluate treatment efficacy. Five prognostic indexes (RPA, GPA, SIR, BS-BM, and GGS) were applied. The primary endpoint was intracranial local control (iLC). Secondary endpoints were overall survival (OS) and the safety of treatment.
Results
Intracranial objective response rates (iORR) using the RECIST 1.1 and RANO-BM criteria were 62.1% and 58.6%, respectively. The iLC rate was 93.1%, the 6- and 12-month iLC rates were 90.8% and 57.4%, respectively. The median intracranial progression-free survival (iPFS) was not reached (range 0 − 23 months). The 6-, 12-, and 24-month OS rates were 74.2%, 58.2%, and 22.9%, respectively. The KPS score showed statistical significance in univariate analysis of survival. The 6, 12, and 24 month OS rates for patients with KPS ≥ 70 were 83.8%, 70.5%, and 29.7%, respectively. The median survival time (MST) for all patients and for patients with KPS ≥ 70 were 13.6 and 16.5 months, respectively. Sex, KPS score, and gross tumor volume were significant factors in the multivariate analysis of survival. OS was significantly associated with RPA, SIR, BS-BM, and GGS classes. No acute toxicities of grade 3 or higher were noted.
Conclusion
HFSRT combined with WBRT is a safe and effective local treatment modality for BM patients.
“…In the only study to date that validated the molGPA score, 70% of patients received WBRT and concurrent systemic therapy was likewise not recorded [18] . Other available scores have been shown to underestimate OS as these were all developed before widespread implementation of TT/IT [19] . Two studies have aimed to validate prognostic scores in TT/IT-treated patient cohorts that received concomitant SRT to date, albeit omitting the most widely used molGPA score [20, 21] .…”
Section : Introduction mentioning confidence: 99%
Schaule
1
,
Kroeze
2
,
Blanck
3
et al.
2020
Background: Melanoma patients frequently develop brain metastases. The most widely used score to predict survival is the molGPA based on a mixed treatment of stereotactic radiotherapy (SRT) and whole brain radiotherapy (WBRT). In addition, systemic therapy was not considered. We therefore aimed to evaluate the performance of the molGPA score in patients homogeneously treated with SRT and concurrent targeted therapy or immunotherapy (TT/IT). Methods: This retrospective analysis is based on an international multicenter database (TOaSTT) of melanoma patients treated with TT/IT and concurrent (≤30 days) SRT for brain metastases between May 2011 and May 2018. Overall survival (OS) was studied using Kaplan-Meier survival curves and log-rank testing. Uni-and multivariate analysis was performed to analyze prognostic factors for OS. Results: One hundred ten patients were analyzed. 61, 31 and 8% were treated with IT, TT and with a simultaneous combination, respectively. A median of two brain metastases were treated per patient. After a median follow-up of 8 months, median OS was 8.4 months (0-40 months). The molGPA score was not associated with OS. Instead, cumulative brain metastases volume, timing of metastases (syn-vs. metachronous) and systemic therapy with concurrent IT vs. TT influenced OS significantly. Based on these parameters, the VTS score (volume-timing-systemic therapy) was established that stratified patients into three groups with a median OS of 5.1, 18.9 and 34.5 months, respectively (p = 0.001 and 0.03).
“…Ideally, patients with limited prognosis would not be exposed to the unnecessary burden of intense treatment, whereas those with better prognosis would receive the therapeutic measures required to prevent neurologic death [11, 12] . Several tools (prognostic scores and nomograms with survival and other endpoints) have been developed to support decision-making [13] [14] [15] [16] [17] . Initially, they were heavily based on performance status and extracranial disease extent or control, and not stratified by primary cancer type.…”
| https://scite.ai/reports/prognostic-models-for-patients-with-RVGAGRN |
A low power and low distortion VCO based ADC using a pulse frequency modulator | Request PDF
Request PDF | A low power and low distortion VCO based ADC using a pulse frequency modulator | This paper shows a novel VCO based ADC which uses an inverter delay line as a monostable to implement a pulse frequency modulator. The inverter... | Find, read and cite all the research you need on ResearchGate
Conference Paper
A low power and low distortion VCO based ADC using a pulse frequency modulator
August 2014
DOI: 10.1109/MWSCAS.2014.6908458
Conference: 2014 IEEE 57th International Midwest Symposium on Circuits and Systems (MWSCAS)
Authors:
University Carlos III de Madrid
University Carlos III de Madrid
Sergio Walter
Abstract
This paper shows a novel VCO based ADC which uses an inverter delay line as a monostable to implement a pulse frequency modulator. The inverter delay line doubles as a Time to Digital converter, providing a multibit digital output similar to a ring oscillator. The pulse frequency modulator is based on a gm-C integrator, operating as a closed loop transconductor for the low bandwidth input signal path and as a charge pump for the monostable feedback. This way a high linearity is achieved while the total power consumption is kept on the order of a calibrated VCO-ADC. The paper shows the basic system level operation and behavioral simulations, and also a transistor level design example in 0.25μm CMOS technology.
0.04-mm² 103-dB-A Dynamic Range Second-Order VCO-Based Audio Σ Δ ADC in 0.13-μm CMOS
Feb 2018
IEEE J SOLID-ST CIRC
Fernando Cardes
Eric Gutierrez
Andres Quintero
Luis Hernandez
This paper presents a compact-area, low-power, highly digital analog-to-digital converter (ADC) for audio applications. The proposed converter is implemented using only oscillators and digital circuitry, without operational amplifiers nor other highly linear circuits. The ADC consists of two twin secondorder ΣA modulators, which can work both individually or in a pseudodifferential configuration. The proposed system has been implemented in a 0.13-μm standard CMOS technology. The single-ended configuration occupies an active area of 0.02 mm
<sup xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">2</sup>
, is powered at 1.8 V with a current consumption of 155 μA, and achieves an A-weighted dynamic range (DR) of 98 dB-A. The pseudodifferential configuration achieves 103 dB-A of A-weighted DR at the expense of doubling the area and power consumption.
A Pulse Frequency Modulation Interpretation of VCOs Enabling VCO-ADC Architectures With Extended Noise Shaping
Aug 2017
IEEE T CIRCUITS-I
Eric Gutierrez
L. Hernandez
Fernando Cardes
Pieter Rombouts
In this paper, we propose to study voltage controlled oscillators (VCOs) based on the equivalence with pulse frequency modulators (PFMs). This approach is applied to the analysis of VCO-based analog-to-digital converters (VCO-ADCs) and deviates significantly from the conventional interpretation, where VCO-ADCs have been described as the first-order ΔΣ modulators. A first advantage of our approach is that it unveils systematic error components not described by the equivalence with a conventional ΔΣ modulator. A second advantage is that, by a proper selection of the pulses generated by the PFM, we can theoretically construct an open loop VCO-ADC with an arbitrary noise shaping order. Unfortunately, with the exception of the first-order noise shaping case, the required pulse waveforms cannot easily be implemented on the circuit level. However, we describe circuit techniques to achieve a good approximation of the required pulse waveforms, which can easily be implemented by practical circuits. Finally, our approach enables a straightforward description of multistage ΔΣ modulator architectures, which is an alternative and practically feasible way to realize a VCO-ADC with extended noise shaping.
A digitally corrected ADC using a passive pulse frequency modulator
Feb 2015
Eric Gutierrez
L. Hernandez
Ulrich Gaier
Liang Zou
Pulse Frequency Modulators have been proposed recently as an alternative to ring oscillators in the implementation of Voltage-Controlled-Oscillators Analog to Digital Converters (VCO-ADC). In this paper, we propose a passive pulse frequency modulator in terms of the integration process that uses digital inverters only and provides a polyphase output similar to a ring oscillator. Oscillation depends on a passive RC circuit acting as oscillator time constant. The voltage-to-frequency characteristic of this oscillator shows a nonlinear relationship respect to the input voltage in a similar way as classical ring oscillators. However, in the proposed circuit the nonlinearity depends mainly in a predictable way from the RC product instead of supply voltage (Vdd), temperature or mismatch. We show in this paper how the nonlinearity can be corrected in the signal post-processing by a simple algorithm depending only on the RC time constant operating on the decimated data and circuit parameters that could be known.
A 12-Bit, 10-MHz Bandwidth, Continuous-Time ADC With a 5-Bit, 950-MS/s VCO-Based Quantizer
May 2008
IEEE J SOLID-ST CIRC
M.Z. Straayer
Michael H. Perrott
The use of VCO-based quantization within continuous-time (CT) SigmaDelta analog-to-digital converter (ADC) structures is explored, with a custom prototype in 0.13 mum CMOS showing measured performance of 86/72 dB SNR/SNDR with 10 MHz bandwidth while consuming 40 mW from a 1.2 V supply and occupying an active area of 640 mum times 660 mum. A key element of the ADC structure is a 5-bit VCO-based quantizer clocked at 950 MHz which achieves first-order noise shaping of its quantization noise. The quantizer structure allows the second-order CT SigmaDelta ADC topology to achieve third-order noise shaping, and direct connection of the VCO-based quantizer to the internal DACs of the ADC provides intrinsic dynamic element matching of the DAC elements.
Oversampled ADC based on pulse frequency modulator and TDC
Mar 2014
Eric Gutierrez
L. Hernandez
| https://www.researchgate.net/publication/286679443_A_low_power_and_low_distortion_VCO_based_ADC_using_a_pulse_frequency_modulator |
(PDF) Epidemiological and immunological features of obesity and SARS-CoV-2
PDF | Obesity is established as a key correlate of severe SARS-CoV-2 outcomes. Multiple other epidemiological and immunological features are less... | Find, read and cite all the research you need on ResearchGate
Epidemiological and immunological features of obesity and SARS-CoV-2
November 2020
DOI: 10.1101/2020.11.11.20229724
Abstract and Figures
Obesity is established as a key correlate of severe SARS-CoV-2 outcomes. Multiple other epidemiological and immunological features are less well-defined including if obesity enhances susceptibility to SARS-CoV-2 infection, influences symptom phenotype, or impedes or alters the immune response to infection. Given the substantial global burden of obesity and given these uncertainties, we examined the epidemiology and immunology of obesity and SARS-CoV-2.
Methods
Industry employees were invited to participate in a prospective SARS-CoV-2 serology-based cohort study. Blood and baseline survey measures that included demographics, comorbidities, and prior COVID-19 compatible symptoms were collected. Serological testing and interim symptom reporting were conducted monthly. SARS-CoV-2 immunoassays included an IgG ELISA targeting the spike RBD, multiarray Luminex targeting 20 viral antigens, pseudovirus neutralization, and T cell ELISPOT assays. Unadjusted and adjusted analyses were used to identify differences in seroprevalence, clinical features, and immune parameters by BMI.
Results
Of 4469 individuals enrolled, 322 (7.21%) were seropositive. Adjusted seroprevalence was non-significantly lower with higher BMI. Obesity was associated with increased reporting of fever (OR 3.43 [95% CI 1.58-7.60]) and multiple other symptoms and aggregate measures. There were no identifiable differences in immune response between obese and non-obese individuals.
Discussion
We present benchmark data from a prospective serology-based cohort on the immunoepidemiology of BMI and SARS-CoV-2. Our findings suggest obesity is not linked to an increased risk of SARS-CoV-2 infection; that symptom phenotype is strongly influenced by obesity; and that despite evidence of obesity-associated immune dysregulation in severe COVID-19, there is no evidence of a muted or suppressed immune response across multiple immune measures among non-severe infections.
1
Epidemiological and immunological features of obesity and SARS-CoV- 2
1 Brigham and Women’s Hospital, Boston, MA
2 Harvard Medical School, Boston, MA
3 Harvard Humanitarian Initiative, Boston, MA
4 Massachusetts Consortium on Pathogen Readiness, Boston, MA
6 Broad Institute of MIT and Harvard, Cambridge, MA.
8 Space Exploration Technologies Corp, Hawthorne, CA
9 Harvard T.H. Chan School of Public Health, Boston, MA
10 Howard Hughes Medical Institute, Chevy Chase, MD
11 Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Harvard Medical
School, Boston, MA
12 Department of Biological Engineering, Massachusetts Institute of Technology, Cambridge, MA
13 London School of Hygiene and Tropical Medicine, London
# Correspondence : Eric J Nilles: [email protected] ; Galit Alter: [email protected] ; Anil S
Menon: [email protected]
. CC-BY-NC-ND 4.0 International license It is made available under a
Abstract
Obesity is established as a key correlate of severe SARS-CoV-2 outcomes. Multiple other epidemiological
and immunological features are less well-defined including if obesity enhances susceptibility to SARS-
CoV-2 infection, influences symptom phenotype, or impedes or alters the immune response to infection.
Given the substantial global burden of obesity and given these uncertainties, we examined the
epidemiology and immunology of obesity and SARS-CoV-2.
Methods: Industry employees were invited to participate in a prospective SARS-CoV-2 serology-based
cohort study. Blood and baseline survey measures that included demographics, comorbidities, and prior
COVID-19 compatible symptoms were collected. Serological testing and interim symptom reporting
were conducted monthly. SARS-CoV-2 immunoassays included a n IgG ELISA targeting the spike RBD,
multiarray Luminex targeting 20 viral antigens, pseudovirus neutralization, and T cell ELISPOT assays .
Unadjusted and adjusted analyses were used to identify differences in seroprevalence, clinical features,
Results: Of 4469 individuals enrolled, 322 (7.21%) were seropositive. Adjusted seroprevalence was non-
significantly lower with higher BMI. Obesity was associated with increased reporting of fever (OR 3. 43
[95% CI 1. 58 -7.60]) and multiple other symptoms and aggregate measures. There were no identifiable
differences in immune response between obese and non-obese individuals.
Discussion: We present benchmark data from a prospective serology-based cohort on the
immunoepidemiology of BMI and SARS-CoV-2. Our findings suggest obesity is not linked to an increased
risk of SARS-CoV-2 infection; that symptom phenotype is strongly influenced by obesity; and that
despite evidence of obesity-associated immune dysregulation in severe COVID- 19 , there is no evidence
of a muted or suppressed immune response across multiple immune measures among non-severe
infections.
. CC-BY-NC-ND 4.0 International license It is made available under a
3
Background
Obesity is a key risk factor for severe disease and death from novel coronavirus disease 2019 (COVID-
19) , 1,2 the disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV- 2) . With over
1.9 billion people overweight or obese globally, 3 implications for SARS-CoV-2 pandemic morbidity and
mortality are substantial . Even after adjusting for age and obesity-related comorbidities such as
diabetes, hypertension and coronary heart disease, obesity remains a strong independent predictor of
excess morbidity and mortality. 1,4,5 Th ese findings although concerning are not entirely unexpected. 6
Obesity and poor clinical outcomes ha ve been described with other viral pathogens, most notably
influenza A (H1N1) during the 2009 pandemic, when obesity was associated with increased
hospitalizations, need for intensive care support, and deaths. 4,7,8
In addition to the relationship between obesity and clinical outcomes, emerging evidence suggests a link
between higher body mass index (BMI ) and higher incidence rates of COVID-19 or SARS-CoV-2 infection
4,9,10 suggesting increased BMI may enhance susceptibility to infection . If correct, there would be
important implications for individual-level risks and population-level transmission dynamics, particularly
among populations with high rates of obesity. 4 However, data supporting this association is limited, and
given the absence of convincing precedent from other pathogens additional evidence is required to
confirm these findings.
The influence of obesity specifically on the immune response to SARS-CoV-2 has also been the focus of
intense recent attention. 4,11 Obesity has been linked to less robust and/or effective immune response
after natural influenza infection 12 or vaccination, 13 raising concerns about diminished protective
immunity following natural SARS-CoV-2 infection or vaccination. 4,14 This is particularly relevant given
multiple phase II and III vaccine trials are underway, and the outcomes of these trials are likely to
reframe the pandemic trajectory. However, again, the immunological features of SARS-CoV-2 infection
and obesity are poorly characterized with limited directly relevant data.
. CC-BY-NC-ND 4.0 International license It is made available under a
4
Thus, given the essential connection between the epidemiology and immunology of infectious
pathogens including SARS-CoV-2 and given substantial uncertainly about multiple features of obesity
and SARS-CoV-2 we conducted an integrated immunoepidemiological investigation of obesity and SARS-
CoV- 2 through a prospective multi-site cohort study. This study aimed to identify if BMI is associated
with (i) differential risks of testing positive for anti-SARS-CoV-2 IgG antibodies among a population
unbiased to serostatus at study entry, (ii) variable reporting of COVID-19 compatible symptoms, and (iii)
measurable differences in adaptive immune features.
Methods
Ethical Disclosures
The study protocol was approved by the Western Institutional Review Board. The use of de -identified
data and biological samples was approved by the Mass General Brigham Healthcare Institutional Review
Board. All participants provided written informed consent.
Study design, setting and study population
This is a prospective observational cohort study using serial serological assessment to characterize the
immunoepidemiology of SARS-CoV-2 infection among a cohort of industry employees. Serostatus was
unknown at the time of subject enrollment. The study population was comprised of Space Exploration
Technologies Corporation employees, all of whom were invited to participate. A total of 44 69
participants were enrolled out of a total of ~8400 employees from seven primary work locations in four
U.S. states including California, Texas, Florida, and Washington. Study enrollment commenced 20 April
and employees were invited to participate on a rolling basis through 28 July 2020. Serial blood sampling
and interim symptom reporting were performed monthly.
Covariates
All participants completed a standardized baseline study survey that included demographic data (age,
sex, race, ethnicity, primary work location, and number of individuals and children <18 years living in the
. CC-BY-NC-ND 4.0 International license It is made available under a
is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. (which was not certified by peer review) preprint The copyright holder for this this version posted November 13, 2020. ; https://doi.org/10.1101/2020.11.11.20229724 doi: medRxiv preprint
5
subject household), medical history (weight, height, diabetes, asthma, chronic obstructive pulmonary
disease, other lung disease, coronary heart disease, heart failure, high blood pressure, chronic kidney
disease, stroke, any immunocompromised condition, any other significant medical condition, and
smoking status), and COVID-19 compatible symptoms between March 1, 2020, and study enrollment
including primary symptoms (fever, chills or feverish, cough, anosmia, ageusia) and other compatible
symptoms (body or muscle aches, sore throat, nausea or vomiting, diarrhea, congestion, and increased
fatigue/generalized weakness). Composite symptom measures included (i) any symptom, (ii) number o f
symptoms, (iii) ≥3 symptoms; (iv) ≥6 symptoms, (v) any primary symptom (v i) number of primary
symptoms and (v ii ) ≥3 primary symptoms. Sequential blood sampling and interim symptom reporting
using a standardized survey were performed monthly. The number of participants with missing data by
covariate is listed in Table 1.
Laboratory analys es
Serological analyses were performed on sera using the Ragon/MGH enzyme-linked immunosorbent
assay, which detects IgG against the receptor binding domain (RBD) of the SARS-CoV-2 spike
glycoprotein using a previously described method 15 (Supplemental 1). Assay performance has been
externally validated in a blinded fashion at 99·6% specific and benchmarked against commercial EUA
approved assays. 16 Immune profiling methods are detailed in Supplement 1. Briefly, specific antibody
subclasses, isotypes and FcγR binding against SARS-CoV-2 RBD, nucleocapsid and full spike proteins were
assessed using a custom Luminex multiplexed assay (Luminex Corp, TX, USA). Viral neutralization was
assessed on a 2019-nCoV pseudovirus neutralization assay, as described previously 17 with neutralization
titer defined as the sample dilution associated with a 50% reduction in luminescent units. The presence
of neutraliz ing activity was defined as a titer >20. T cell activity was assessed on an enzyme-linked
interferon-gamma immunospot assay (ELISPOT) with > 25 spot forming cells (SPC) per 10 6 peripheral
blood mononuclear cells (PBMCs) considered positive.
. CC-BY-NC-ND 4.0 International license It is made available under a
6
Data classification and analyses
Serostatus was determined by the presence or absence of IgG against SARS-CoV-2 RBD. BMI was
calculated by dividing weight in kilograms by height in meters squared and categorized by underweight
(<18·5 kg/m 2 ), normal weight (18·5 to 24 kg/m 2 ; reference), overweight (25 to 29 kg/m 2 ), obesity class 1
(30 to 34 kg/m 2 ), obesity class 2 (35 to 39 kg/m 2 ), and obesity class 3 or severe obesity (≥40 kg/m 2 )
according to the World Health Organization .
We performed discrete analyses to address the three aims of the study. For assessment of risk of
seropositivity by BMI, the primary exposure of interest was BMI and the outcome variable of interest
was seropositivity at any time point. We assessed the unadjusted and adjusted association between a
range of demographic (n=7) and medical history (n=17) covariates using χ2 to compare proportions and
ANOVA or Kruskal-Wallis tests to compare means. For adjusted analyses, we constructed a multivariable
logistic regression model that included, in addition to BMI and serostatus, age, sex, ethnicity, race,
comorbidities, primary work location, number of individuals in the household, and children in the
household.
To understand if obesity status is associated with differential reporting of symptoms, we computed the
proportion of seropositive individuals reporting each of 11 COVID-19 compatible symptoms stratified by
obesity status. Symptoms were analyzed from the period preceding the first seropositive result. For
example, if an individual w as seronegative at baseline and seropositive at the subsequent time point,
the symptoms reported between those timepoints were analyzed. The primary exposure of interest was
obesity, and the outcome variables of interest were symptoms and composite symptom measures.
Given recent data suggest ing the adverse impact of obesity on COVID- 19 mortality may decline with
age, 9 we assessed if similar age-dependent obesity risk may be observed for symptom reporting by
conducting subgroup analysis stratified by < or ≥ 40 years, with categorization selected due to sparsity of
older participants.
. CC-BY-NC-ND 4.0 International license It is made available under a
7
Lastly, given an accumulation of evidence that obesity impairs the immune response to a range of
pathogens 6,13,18 – 20 we stratified 20 discrete immune features by obesity status to identify univariate
differences. We also performed uniform manifold approximation and projection (UMAP) 21 a
mathematical approach for exploratory analyses that constructs a visualizable summary of multiple
subjects' characteristics, with each point representing an individual and clusters representing underlying
uniformities in subject characteristics.
Binomial exact 95% confidence intervals were calculated and p-values < 0·05 were considered
statistically significant· For adjusted analyses, variables with a p-value <0·10 were assessed by backward
elimination and excluded if the p-value was >0· 10 and did not meaningfully alter the point estimates of
the remaining variables. Luminex UMAP and Mann-Whitney U Tests were conducted using scikit-learn, a
machine learning toolkit for the Python programming language. Analyses were performed using the R
sof tware package (Version 4·0, www.R-project.org/) or the Python programming language (Version 3·7,
python.org).
Results
A total of 44 69 Space Exploration Technologies Corporation employees out of a total of ~ 84 00
employees (53%) were enrolled. Baseline characteristics are included in Table 1 . Mean BMI was 27·1
kg/m 2 (SD 5·4) with a median of 25· 8 kg/m 2 (range 15·6 — 60 ·9). Most subjects were normal weight
(18 ·5 — 24 kg/m 2 ) ( 16 86 , 39·5%) or overweight (25 — 29 kg/m 2 ) (1523, 35·7%), and 24·1% and 0· 80 % met
criteria for obese (≥30 kg/m 2 ) and underweight (≤18 · 5 kg/m 2 ) respectively.
IgG against the SARS-CoV-2 spike RBD protein was detected in 32 2/4469 (7·21%) of study participants .
Of the 322 seropositive individuals, five (1 ·6%) were hospitalized and none required critical care support
or died . Unadjusted seropositivity rates are detailed in Table 1; they were higher in South Texas (O dd
Ratio 4· 28 [95% CI, 2·54 to 7·21), p<0·0001]) and among Hispanics (2 · 91 [95% CI 2· 22 6 — 3· 75 ],
p<0·0001); and they were lower in Seattle, Washington (0·30 [95% CI, 0·11 to 0· 82 ], p=0·02]), and in the
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8
30 — 39 year compared to the 18 — 29 year age group (0 ·72 [ 95% CI, 0·56 to 0·94, p=0·02). Adjusted
associations for all covariates are listed in Table 1 ; only primary work location was retained as
significantly associated with serostatus with increased OR in South Texas (OR 4·28 [2·54 — 7·21],
p<0·0001) and lower in Seattle (OR 0·30 [0· 11 — 0·82], p=0·02 ) largely reflecting local transmission rates.
The strong univariate association between Hispanic ethnicity and serostatus was not retained after
adjusting for work location (OR 1·27 [0· 94 — 1·73], p=0·12).
BMI and serostatus
Of the 4469 participants, 4270 (9 5·5 %) provided weight and height data and are included in BMI
analyses. The unadjusted risks of seropositivit y stratified by BMI are listed in the Table 1; only BMI 30 to
34 kg/m 2 (versus normal/healthy weight, 18·5 — 24 kg/m 2 ) was associated with differential serostatus
(OR 1· 48 [1 ·06 to 2· 05 ], p<0·02). However, after adjusting for all candidate variables (Table 1 ), no
association was detected . In fact, higher BMI and in particular severe obesity (BMI ≥40 kg/m 2 ) trended
non-significantly to lower seroprevalence (Figure 1A) . Subgroup analysis from a single high prevalence
location where, given the high force of infection as evidenced by high seroprevalence (22·5% versus
4·2% for all other sites combined), we predict risks for infection — including any effect of BMI — would
be more clearly delineated (Supplementary 2) . Findings were similar to the primary analysis with no
evidence of increased seroprevalence with increasing BMI. Rather, point prevalence measures
consistently trend ed lower than normal/healthy weight (Figure 1B ).
BMI and COVID-19 compatible symptoms
Of 26 2 seropositive participants with complete symptom data, three (1 ·1%) were underweight
(BMI<18·5 kg/m 2 ), 89 (3 4·0%) normal weight (BMI 18·5 — 24 kg/m 2 ), 89 (34·0%) overweight (BMI 25 — 29
kg/m 2 ), and 81 (3 0·9%) obese (BMI ≥ 30 kg/m 2 ) . A total of 106/262 (4 0·5%) reported one or more of 11
COVID- 19 - compatible symptoms and 68 /262 (2 6·0%) reported one or more of five primary COVID- 19
symptom. When comparing symptoms between normal weight and overweight (but not obese)
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9
individuals, there were no meaningful differences or trends (Supplementary 3) and therefore
subsequent analyses were stratified by obese versus non-obese.
Obesity was associated with increased reporting of multiple symptoms including fever (OR 3· 43 [95% CI
1· 58 — 7· 60 ]), chills or feverish but no measured fever (OR 2· 64 [1 ·33 — 5·27]), myalgias (OR 2· 29 [1 ·18 —
4· 42 ]), and ≥6 symptoms ( OR 2· 26 [1 · 10 — 4· 64 ]). With the exception of congestion (0·87 [0· 43 — 1·70]), a
similar and consistent but non-significant trend was observed for all symptoms (Figure 2) . Overall, obese
individuals registered more symptoms (2 · 26 versus 1·40, OR 1·10 [1 ·02 — 1 ·22]) and more primary
symptoms (1· 05 versus 0· 58 , OR 1·24 [1 ·04 — 1·48] ) than non-obese. Differential symptom reporting was
mo re pronounced in those under 40 years of age. Fever was more commonly reported among obese vs
non-obese individuals under 40 years of age (OR 4· 99 [1 · 97 — 13· 35 ]) but not over 40 years (OR 1· 32
[0 ·30 — 5· 57 ]) . Similarly, reporting ≥6 symp toms was more common among obese vs non— obese unde r
40 years (OR 3·0 [1· 32 — 6·85]) but not for those greater than 40 years (OR 0·94 [0· 18 — 4·26]). A
strikingly similar trend was observed for the majority of other symptoms and aggregate symptom
measures (Figure 3). No similar age-dependent effect on obesity and symptomatology was observed
among age groups < 40 years of age (Supplementary 4).
Obesity and functional immune response
Among the same 26 2 seropositive individuals, peak SARS-CoV-2 RBD IgG titers were 0·92 ug/ml (SD 2·47 )
among obese (n=81) and 1· 12 ug/ml (SD 3·21 ) among non-obese (n=181) participants (p=0·601).
Deep immune profiling was performed among a subset of 77 participants including 25 obese and 52
non-obese individuals. Me an ELISA nucleocapsid titers were 0· 35 (SD 0·48 ) among obese individuals and
0· 30 (0· 34 ) for non-obese individuals (p=0· 57) . Viral neutralization activity (titer >20) was detected in
3/25 (12·0%) and 6/52 (11·5%) of obese and non-obese individuals respectively (p=0·95) . When
assessing 20 immune features measured by Luminex, n o univariate differences were observed between
obesity categories, with sparse levels across both obese and non-obese individuals tightly linked to
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10
antibody titers (Figure 4A, Supplementary 5). Similarly, no clustering or trends between BMI and
immunological features were identifiable either by UMAP (Figure 4B) or Spearman’s correlation (Figure
4C).
Lastly, given evidence that T cells may be key mediators of adaptive immunity in SARS-CoV-2, we
examined responses to nucleocapsids protein or spike protein overlapping peptide pools quantified by
IFN-g ELISpot among 12 obese and 28 non-obese individuals. There was no difference in the proportion
with SARS-CoV- 2 T cell activity (≥25 SFC/10 6 PBMCs) against nucleocapsid peptides (3/12 [25%] versus
7/28 [25·0%]) or spike peptides (3/12 [25%] versus 7/28 [25·0%]). In fact, the only difference observed
was higher SFC against nucleocapsid (mean 124 SFC /10 6 PBMCs [SD 77] versus 47 SFC/10 6 PBMCs [SD
14], p=0· 02 ) but not spike (44 SFC/10 6 PBMCs [SD 4·0] versus 44 SFC/10 6 PBMCs [SD 20·0], p=1· 00)
among obese versus non-obese individuals with T cell activity .
Discussion
We present data from a large multi-site prospective cohort of non-hospitalized individuals unbia sed to
serostatus at study entry to investigate the association between BMI, SARS-CoV-2 serostatus, COVID- 19
compatible symptoms, and functional and non-functional immune measures . Given the prevalence of
overweight/obese among adults is close to 70% in most high income countries and ≥50%, in many lower
and middle income countries, the scientific and public health implications for the current pandemic are
substantial 4 . Unlike prior studies, we did not observe an increase in infection or COVID- 19 prevalence
with increasing BMI but rather identified a trend to decreasing risk among the highest BMI classes . We
also provide benchmark data on the association between reported COVID- 19 symptoms and BMI,
identifying evidence for more frequent reporting of multiple symptoms including fever, myalgia, chills,
and total COVID-19 compatible symptoms among obese individuals. Finally, we examined immune
features of infection to probe for differential immune signatures associated with obesity status. By
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11
combining traditional epidemiological approaches with deep immun e profiling, we provide new insights
into the epidemiology and immune characteristics of obesity in SARS-CoV-2 infections.
Prior studies that report an association between increased risk of COVID-19 or SARS-CoV-2 infection
with higher BMI are intriguing and raise important questions about factors driving transmission. Given
the enormous global burden of overweight and obese adults, delineating risks for infection is a public
health priority. Interestingly, our findings appear to diverge from recent data that examines the risk for
COVID- 19 by BMI including a nationwide case-control study from South Korea 9 and a cross-sectional
study from a primary care surveillance network in the United Kingdom 22 that identify a n increased risk of
COVID-19 with increasing BMI; and a recent meta-analysis of 20 studies that reported a pooled
increased risk of 46·0% (OR = 1·46; 95% CI, 1· 30 – 1·65; p < 0·0001) with 18 of 20 studies demonstrating
higher COVID- 19 risk among obese individuals. 4 Our study did not identify an increase in adjusted
seroprevalence with increasing BMI and conversely identified a trend to lower infection risk with high er
obesity classes. This trend was consistent when both considering all data and when performing
subgroup analysis on a high transmission site where the increased force of infection would be expected
to more precisely delineate heterogeneity in infection risks. Reasons for the difference between our and
prior study outcomes may be multifactorial with differences in study design and population behaviors
likely influencing findings. However, we believe the primary difference is we examined SARS-CoV- 2
infection risk using serological methods unbiased to exposure risks or presence or absence of symptoms
at study entry versus other studies examining risks for clinically apparent infection (i.e. COVID- 19 ). Given
obese individuals exhibit more pronounced symptomatology including fever, as our data indicates, this
population is more likely to meet testing criteria, more likely to be tested and therefore more likely to
be over-represented in studies that identify cases through routine surveillance approaches. 23,24 As such,
although our study findings appear inconsistent with most prior studies of obesity risk, in fact the
question being asked was different. Our study examined SARS-CoV-2 infection risk, as measured by the
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12
presence of SARS-CoV-2 antibodies, while prior studies examined the risk of clinical disease.
Unfortunately, conflation of COVID-19 with SARS-CoV- 2 infection is commonplace, as evidenced by
confusion over case- versus infection-fatality rate. 24
Our finding that obesity is associated with increased COVID-19 compatible symptoms among SARS-CoV-
2 seropositive individuals provides benchmark data for understanding symptom heterogeneity in mild
infections by BMI. We demonstrate that not only are well established measures of severe disease such
as hospitalization, intensive care requirements and death more common among obese individuals 5,25,26 ,
but that obesity is also an important driver of increased symptomatology in non-severe infections . While
our data does not provide insights into the mechanism driving th ese findings, it informs our
understanding of symptomatology and obesity, guides our interpretation of epidemiological data, and
highlights the potential implication of using passively collected symptom-driven surveillance data to
characterize the epidemiology of infectious pathogens. We also identify an interesting influence of age
on obesity symptom reporting, with a compelling association below 40 years of age but near complete
absence of effect in older adults. These findings are notable given they imply the established interaction
between obesity and age on COVID-19 morbidity and mortality, with obesity disproportionately driving
increased disease severity among younger age groups, 5,25 extend throughout the spectrum of disease
and are not restricted to severe disease. The reasons for this phenomenon are unclear and deserve
study but do fit with in the broader understanding of obesity and age in which the all-cause relative risk
of death associated with increasing BMI decreases with age. 27
Given the fundamental role of the adaptive immune response in both the resolution of infection and the
severity of disease, 11 we also probed multiple binding and functional immune markers to assess
differential immune responses between obese and non-obese individuals . While, previous studies noted
poor seroconversion and inadequate seroprotection across vaccine trials, 28 we did not detect
meaningful differences in binding or neutralizing antibodies, T cell activity, or other functional humoral
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13
measures by BMI. These findings, while notable, should be considered in the context of this largely
asymptomatic and pauci-symptomatic cohort, that may not capture the full range of disease burden
associated with SARS-CoV-2 infection. Yet, the overlapping and indistinguishable antibody and T-cell
helper profiles point to unaltered adaptive immunity with BMI, raising the possibility that BMI-driven
immunological changes during SARS-CoV-2 infection may manifest largely within the innate immune
response. Significant alterations in chronic inflammation, particularly driven by persistent innate
cytokine responses from adipocytes, have been noted in the setting of obesity. 29 Dissecting the influence
of adipocyte inflammatory responses, associated cytokine storm, and enhanced symptomatology,
particularly among individuals with a high BMI, may point to mechanistic differences in viral sensing
across populations. These data point to remaining knowledge gaps on the relative importance and
interplay of the humoral, cellular and innate immunity in SARS-CoV-2 infection and disease. 30
Limitations
Although this study is unique in combining a large prospective, multisite serology-based SARS-CoV- 2
cohort with deep immune profiling, there are limitations. The study population are industry employees
with over-representation – compared to the US population -- of persons of Hispanic ethnicity, white
race, male sex, and younger individuals with lower rates of comorbidities including obesity and as such
findings may not be generalizable. Given 53% of the invited employee s participated in the study, a n
unmeasured selection bias may have been introduced. Several additional potential study limitations
should be noted but any impact of these limitations would be expected to be evenly distributed across
cohort participants and therefore not introduce a systematic bias and impact study findings. These
include (i) limited recall of COVID-19 compatible symptoms, (ii) delayed seroconversion relative to
reported symptoms, so depending on timing of infection and blood sampling, some registered
symptoms may not be due to SARS-CoV-2 infection, and (ii) false positive serological results. Lastly,
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behavioral factors, which can be critical drivers of transmission, and may be influenced by BMI, were not
assessed in this study.
Conclusion
We demonstrate that obesity is associated with increased symptomatology in mild COVID-19 infections,
suggesting obesity impacts the pathophysiology of COVID-19 throughout the spectrum of disease
severity. Our findings do not, however, suggest that obesity increases susceptibility to SARS-CoV- 2
infection, nor did we identify immunological features differentiating obese from non-obese individuals
in mild and asymptomatic infection.
Acknowledgements
We acknowledge support from Space Exploration Technologies Corporation, the Brigham and Women’s
Department of Emergency Medicine, the Ragon Institute of MGH, MIT and Harvard, the Massachusetts
Consortium on Pathogen Readiness (MassCPR), the NIH (3R37AI080289-11S1), FDA
HHSF223201810172C, and the Gates foundation Global Health Vaccine Accelerator Platform funding.
We thank Nancy Zimmerman, Mark and Lisa Schwartz, an anonymous donor (financial support), Terry
and Susan Ragon, and the SAMANA Kay MGH Research Scholars award for their support. EJN is
supported by the CDC (U01 GH002238). SMS was partially supported by the US Food and Drug
Administration (HHSF223201810172C). DAL was partially supported by the National Institute for Allergy
and Infectious Disease (U19 AI135995). We would also like to thank Eric Fischer for S protein production
efforts and Jared Feldman, Blake Marie Hauser, Tim Caradonna and Aaron Schmidt for generating
receptor binding domain antigen.
Author contribution
EJN, GZ, SMS, AK, DAL, and GA analyzed and interpreted the data. YCB, SF, CA, MJG, ALZ, JB and MS
performed Systems Serology and ELISA assays. JY, MGe, and DHB performed the neutralization assay.
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is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. (which was not certified by peer review) preprint The copyright holder for this this version posted November 13, 2020. ; https://doi.org/10.1101/2020.11.11.20229724 doi: medRxiv preprint
15
YCB, ZC and BDJ performed and analyzed T cell experiments. MG, SB, JR, EP, BM, ML, MSA, MAH, GJ, EB,
ERM, ASM, GJ, and EJN managed sample and data collection. EJN, ERM, ASM, and GA designed the
study. EJN drafted the manuscript. All authors critically reviewed the manuscript
Conflict of interest
GA is a founder of Seromyx Systems Inc., a company developing platform technology that describes the
antibody immune response. GA’s interests were reviewed and are managed by Massachusetts General
Hospital and Partners HealthCare in accordance with their conflict of interest policies. PS is a co-founder
of, shareholder in, and advisor to Sherlock Biosciences, Inc, as well as a Board member of and
shareholder in Danaher Corporation. MJG, SB, YH, JR, EP, BM, A SM and E RM are employees of Space
Exploration Technologies Corp. All other authors have declared that no conflict of interest exists.
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Table 1. Characteristics and serostatus of study participants (n=44 69 )
(n=4469)
N N %
Age group
18-29 y 1668 133 8.0% ref
40-49 y 584 50 8.6% 1.08 (0.77 to 1.5 2) 0.6 545
50-59 y 315 26 8.3% 1.04 (0.67 to 1.6 1) 0.8 666
60+ y 85 2 2.4% 0. 28 (0.0 7 to 1.1 4) 0.0 76
BMI
<18.5 34 3 8.8% 1.44 (0.43 to 4.8 0) 0.5 500
18.5 -<25 1686 106 6.3% ref
25-<30 1523 101 6.6% 1. 06 (0.8 0 to 1.4 0) 0 .6916
30-<35 676 61 9.0% 1.48 (1.06 to 2. 05) 0 .01 96*
35-<40 246 23 9.3% 1.54 (0.96 to 2. 47) 0.0 742
≥ 40 105 5 4.8% 0. 75 (0.3 0 to 1.8 7) 0 .53 08
Ethnici ty
Not Hispanic/Not Latinx 2492 113 4.5% ref
Hispanic/L atinx 1274 155 12. 2% 2.91 (2.26 to 3. 75) <0.00 01****
Race
White 2862 185 6.5% ref
Ameri ca n Indian/Alaska N ative 32 3 9.4% 1. 50 (0.4 5 to 4.9 6) 0 .50 92
Asian 442 18 4.1% 0.61 (0.37 to 1.01 ) 0. 053 5
Black 72 2 2.8% 0. 41 (0.1 0 to 1.7 0) 0 .2207
Native Hawa iian/Pacific Islander 29 2 6.9% 1. 07 (0.2 5 to 4.5 4) 0 .92 49
More than one race 292 13 4.5% 0.67 (0.38 to 1.20 ) 0 .179 6
Sex2
Female 600 40 6.7% ref
Childr en ≤ 18 y in household
No 3014 204 6.8% ref
Yes 1342 106 7.9% 1 .18 (0.93 to 1.5 1) 0.1 808
No. in household
1 640 41 6.4% ref
2-4 3027 214 7.1% 1.11 (0.79 to 1.5 7) 0.54 90
>4 659 51 7.7% 1.2 3 (0.80 to 1.88 ) 0. 349 9
Primary work location
Cape Canaveral, Florida 268 17 6.3% ref
Hawthorne, California 2859 111 3.9% 0 .60 (0.35 to 1.0 1) 0.05 44
McGre g or, Texas 257 21 8.2% 1.31 (0.6 8 to 2.5 5) 0 .42 02
Seattle, Was hington 253 5 2.0% 0.3 0 ( 0.11 to 0.82 ) 0.0 190 *
South Texas, Texas 712 160 22.5% 4 .28 (2.54 to 7.2 1) <0.00 01****
Other 69 1 1.4% 0 .23 (0.03 to 1.7 9) 0.1 623
Comorbid itie s3,4
Asthma 368 20 5.4% 0.72 (0.45 to 1.1 5) 0.1 721
Hyperte nsion 356 26 7.3% 1.02 (0.67 to 1.5 4) 0.94 05
Diabete s mellitus 101 11 10.9% 1.59 (0.8 4 to 3.01) 0 .1509
Coronary heart disease 17 1 5.9% 0 .80 (0.11 to 6. 08) 0.8 329
Stroke 9 2 22.2% 3.70 (0.76 to 17 .87 ) 0.1 039
Emphysema/COPD 9 1 11.1% 1.61 (0.20 to 12 .93 ) 0.65 32
Cancer - not recei ving treatment 39 2 5.1% 0.69 (0.17 to 2.8 9) 0.61 63
Other immunoc ompromise d 61 4 6.6% 0.92 (0.33 to 2. 55) 0.8 710
Other chroni c medic al conditi on 176 9 5.1% 0.7 2 ( 0.36 to 1.43 ) 0. 347 1
Smoking history
Never 3769 263 7.0% ref
Prior 367 24 6.5% 0.93 (0.61 to 1. 44) 0.7 514
Curren t 229 23 10.0% 1.49 (0.9 5 to 2.33) 0 .0826
2 Four (4) reported "other s ex", none we re s eropositi ve
3 For comorb idi ties refe rence value for OR is no. COPD chron ic obstu cti ve pulmonary disease
5 P-values unadjusted for multip le hypothesis testing: * < 0.05 . **< 0.01 , *** <0.001 , *** *< 0.00 01
1 Not reported data: age group (n=56), BMI (199), ethni city (703), race (740), sex ( 139 ), child ren in HH (113), No. in HH (143 ), primary
loc ation (51), co morbi dit ies (105)
4 Other comorbi dities with no seropositi ve particip ants: chroni c kidney disease (10), Heart f ailur e ( 4), Cancer receiving treatment (3),
Other heart disea se (22).
P-Value5
OR (95% CI)
Seropo sitive participant s (n=322)
Charact eristic1
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is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. (which was not certified by peer review) preprint The copyright holder for this this version posted November 13, 2020. ; https://doi.org/10.1101/2020.11.11.20229724 doi: medRxiv preprint
20
Figure 1. Forest plots of adjusted odds ratio for seropositivity by BMI as a categorical variable with
normal BMI (18·5-<25) as reference . (A) Includes participants with BMI measures and demonstrates a
non-significant trend to declining seroprevalence with BM I ≥40 kg/m 2 when compared to
normal/healthy weight (BMI 18·5-24 kg/m 2 ) (n=4270) . (B) Includes only participants from a single high
seroprevalence (22·5%) location in South Texas where the high force of infection may more clearly
delineate infection risks (n=629).
Odds ratio, log 10 scale
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is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. (which was not certified by peer review) preprint The copyright holder for this this version posted November 13, 2020. ; https://doi.org/10.1101/2020.11.11.20229724 doi: medRxiv preprint
21
Figure 2. Forest plot of odds ratios of reported COVID-19 compatible symptoms among obese (n=85)
versus non-obese (n=179) SARS-CoV-2 seropositive individuals
Odds ratio, log 10 scale
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is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. (which was not certified by peer review) preprint The copyright holder for this this version posted November 13, 2020. ; https://doi.org/10.1101/2020.11.11.20229724 doi: medRxiv preprint
22
Figure 3. Forest plot of odds ratios of COVID-19 compatible symptoms among obese versus non-obese
SARS-CoV-2 seropositive individuals stratified by (A) <40 years (n=195) and (B) ≥ 40 years (n=67)
Odds ratio, log 10 scale
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is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. (which was not certified by peer review) preprint The copyright holder for this this version posted November 13, 2020. ; https://doi.org/10.1101/2020.11.11.20229724 doi: medRxiv preprint
23
Figure 4. Limited influence of BMI on SARS-CoV-2 antibody profiles (n=77) . (A) The dot plots show
similar mean fluorescent intensity levels of IgG1, IgM, IgG3, and IgA levels across individuals classified as
normal weight (n=29), overweight (n=23), and obese (n=25). (B) The uniform manifold approximation
and projection (UMAP) shows the relationship between antibody profiles and BMI (dot size, color
intensity), highlighting the limited influence of BMI on shaping SARS-CoV-2 antibody responses. (C)
Correlation plot of shows limited correlation between BMI and 20 immunological features.
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is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. (which was not certified by peer review) preprint The copyright holder for this this version posted November 13, 2020. ; https://doi.org/10.1101/2020.11.11.20229724 doi: medRxiv preprint
... The two symptoms that were more frequent in patients with obesity were also the two most frequent in the general population 19 . The prospective cohort study by Nilles et al.
20
, which collected BMI information, sociodemographic data, comorbidities, and symptoms from patients with COVID-19, showed that obesity was associated with an increase in the reporting of symptoms, mainly selfreported fever, but not measured. Another interesting finding from the work of Nilles et al. 20 was that the clinical condition is strongly influenced by obesity among younger age groups. ...
... The prospective cohort study by Nilles et al. 20 , which collected BMI information, sociodemographic data, comorbidities, and symptoms from patients with COVID-19, showed that obesity was associated with an increase in the reporting of symptoms, mainly selfreported fever, but not measured. Another interesting finding from the work of Nilles et al.
20
was that the clinical condition is strongly influenced by obesity among younger age groups. The scientific literature says that patients with obesity have more expressive clinical conditions since the onset of symptoms and this is a possible explanation to justify the greater risk of hospitalization 5 . ...
Clinical, Laboratory and Tomographic characteristics associated with obesity and BMI at Hospital admission in adult patients with COVID-19: a cross-sectional study
Introduction: The pathological status of obesity can influence COVID-19 from its initial clinical presentation, therefore, the identification of clinical and laboratory parameters most affected in the presence of obesity can contribute to improving the treatment of the disease. Objective: To identify the clinical, laboratory, and tomographic characteristics associated with obesity and BMI at t hospital admission in adult patients with COVID-19. Methods: This is a cross-sectional observational study with a total of 315 participants with COVID-19 confirmed by rt-PCR. The participants were divided into non-Obese (n=203) and Obese (n=112). Physical examinations, laboratory tests, and computed tomography of the chest were performed during the first 2 days of hospitalization. Results: Patients with obesity were younger, and they had higher systolic and diastolic blood pressure, higher frequency of alcoholism, fever, cough, and headache, higher ALT, LDH, and red blood cell count (RBC), hemoglobin, hematocrit, and percentage of lymphocytes. Also, they presented a lower value of leukocyte count and Neutrophil/Lymphocyte Ratio (RNL). The parameters positively correlated with BMI were alcoholism, systolic and diastolic blood pressure, fever, cough, sore throat, number of symptoms, ALT in men, LDH, magnesium, RBC, hemoglobin, hematocrit, and percentage of lymphocytes. The parameters negatively correlated with the BMI were: age and RNL. Conclusion: Several parameters were associated with obesity at hospital admission, revealing better than expected results. However, these results should be interpreted with great caution, as there may be some influence of a phenomenon called the Obesity Paradox that can distort the severity and prognosis of the patient.
... A strong association between obesity, obesity-associated comorbidities, and severe outcomes of COVID-19 has indeed been shown [16], with adult COVID-19 symptomatic patients with Body Mass Index (BMI) >30 showing higher admission to acute and critical care compared to lean and overweight individuals (BMI < 30) [17]. These results have been confirmed in part in a multi-site prospective cohort of non-hospitalized individuals in which obesity was found to be associated with the presence of multiple COVID-19 symptoms
[18]
However, in this cohort obesity was not associated with increased risk of infection. ...
... The results from this study show that the majority of COVID-19 patients with obesity make almost undiscernible amounts of neutralizing anti-SARS-CoV-2 antibodies, suggesting that obese individuals may be at a higher risk to respond poorly to SARS-CoV-2 infection. Our results are in disagreement with another study in which obesity was associated with increased fever and multiple severe symptoms of disease caused by SARS-CoV-2 infection but not with dysfunctional B and T cell immune responses
[18]
. These differences may depend on the characteristics of the different cohorts recruited in the two studies. ...
The majority of SARS-CoV-2-specific antibodies in COVID-19 patients with obesity are autoimmune and not neutralizing
Daniela Frasca
Lisa Reidy
Maria Romero
Bonnie B Blomberg
Background/objectives
Obesity decreases the secretion of SARS-CoV-2-specific IgG antibodies in the blood of COVID-19 patients. How obesity impacts the quality of the antibodies secreted, however, is not understood. Therefore, the objective of this study is to evaluate the presence of neutralizing versus autoimmune antibodies in COVID-19 patients with obesity.
Subjects/methods
Thirty serum samples from individuals who tested positive for SARS-CoV-2 infection by RT-PCR were collected from inpatient and outpatient settings. Of these, 15 were lean (BMI < 25) and 15 were obese (BMI ≥ 30). Control serum samples were from 30 uninfected individuals, age-, gender-, and BMI-matched, recruited before the current pandemic. Neutralizing and autoimmune antibodies were measured by ELISA. IgG autoimmune antibodies were specific for malondialdehyde (MDA), a marker of oxidative stress and lipid peroxidation, and for adipocyte-derived protein antigens (AD), markers of virus-induced cell death in the obese adipose tissue.
Results
SARS-CoV-2 infection induces neutralizing antibodies in all lean but only in few obese COVID-19 patients. SARS-CoV-2 infection also induces anti-MDA and anti-AD autoimmune antibodies more in lean than in obese patients as compared to uninfected controls. Serum levels of these autoimmune antibodies, however, are always higher in obese versus lean COVID-19 patients. Moreover, because the autoimmune antibodies found in serum samples of COVID-19 patients have been correlated with serum levels of C-reactive protein (CRP), a general marker of inflammation, we also evaluated the association of anti-MDA and anti-AD antibodies with serum CRP and found a positive association between CRP and autoimmune antibodies.
Conclusions
Our results highlight the importance of evaluating the quality of the antibody response in COVID-19 patients with obesity, particularly the presence of autoimmune antibodies, and identify biomarkers of self-tolerance breakdown. This is crucial to protect this vulnerable population at higher risk of responding poorly to infection with SARS-CoV-2 than lean controls.
... This study aimed to evaluate the characteristics of the hospitalized patients, finding that severe obesity (≥ 35 kg / m 2 ), older age, and male sex were independently associated with mortality, the need for intubation, and oxygen requirement during hospital stay. Nilles et al.
[38]
conducted a prospective cohort study with 4469 non-hospitalized employees of Space Exploration Technologies Corporation; the most important finding was the association of obesity with the increase in symptoms of mild COVID-19 infections, otherwise not having an association with the increase of the susceptibility to infection by COVID-19. There were also no different immunological characteristics between obese and non-obese patients. ...
Covid obesity: A one-year narrative review
Susana Rodrigo-Cano
Aránzazu González
Jose M Soriano
On 11 March 2020, coronavirus disease 2019 (COVID-19) was declared a pandemic by the World Health Organization (WHO). This study focuses on a narrative review about the illness during the first year of the pandemic in relation to obesity. Databases were used to search studies published up to 8 December 2020. In total, 4430 articles and other scientific literature were found, and 24 articles were included in this one-year narrative review. The mean BMI value of severe COVID-19 patients ranged from 24.5 to 33.4 kg/m2, versus <18.5 to 24.3 kg/m2 for non-severe patients. Articles using the terms obesity or overweight without indicating the BMI value in these patients were common, but this is not useful, as the anthropometric parameters, when not defined by this index, are confusing due to the classification being different in the West compared to among Asian and Korean criteria-based adults. We proposed a new term, called COVID obesity, to define the importance of this anthropometric parameter, among others, in relation with this pandemic.
... A prospective seroprevalence survey in the US analyzing the presence of antibodies against multiple SARS-CoV-2 antigens in 4,469 people (24.1% with obesity) with a 7.2% rate of seropositivity did not detect any evidence for increased rates of SARS-CoV-2 infection in people with overweight or obesity. Furthermore, humoral immunity and helper T cell activity were not different in seropositive individuals with obesity
(Nilles et al., 2020)
. Analysis of anti-IgG responses directed against the S1 domain in 2,112 persons with confirmed symptomatic SARS-CoV-2 infection at~63 days after symptom onset revealed that people with overweight or obesity were less likely to be antibody-negative . ...
Diabetes, obesity, metabolism and SARS-CoV-2 infection: The end of the beginning
CELL METAB
The increased prevalence of obesity, diabetes and cardiovascular risk factors in people hospitalized with severe COVID-19 illness has engendered considerable interest in the metabolic aspects of SARS-CoV-2-induced pathophysiology. Here, I update concepts informing how metabolic disorders and their comorbidities modify the susceptibility to, natural history and potential treatment of SARS-CoV-2 infection, with a focus on human biology. New data informing genetic predisposition, epidemiology, immune responses, disease severity and therapy of COVID-19 in people with obesity and diabetes are highlighted. The emerging relationships of metabolic disorders to viral-induced immune responses and viral persistence, and the putative importance of adipose and islet ACE2 expression, glycemic control, cholesterol metabolism, and glucose- and lipid-lowering drugs is reviewed, with attention to controversies and unresolved questions. Rapid progress in these areas informs our growing understanding of SARS-CoV-2 infection in people with diabetes and obesity, while refining the therapeutic strategies and research priorities in this vulnerable population.
Kinetics of the SARS-CoV-2 antibody response in immunocompetent convalescent patients: nationwide multicenter 15-month follow-up cohort study
Preprint
Full-text available
Armine Chopikyan
Irina Kasparova
Konstantin Yenkoyan
The comprehension of a long-term humoral immune response against the SARS-CoV-2 virus can shed light on the treatment and vaccination of the disease, improve the control of the pandemic infection. We assessed the antibodies against SARS-CoV-2 nucleocapsid (N) protein in 1441 COVID-19 convalescent patients within 15 months longitudinal nationwide multicenter study from middle-developed country.
92.7 % of convalescent patients’ serum contained antibodies against N protein and only 1.3% of patients had a delayed antibody response. In the majority of convalescent patients’ the durability of antibodies lasted more than one year. The kinetics of neutralizing antibodies took a bell-shaped character – increased first 25-30 weeks, then started to decrease, but were still detectable for more than 15 months. Summing up, we found that anti-SARS-CoV-2 humoral response levels, in particular the level of peak antibodies, correlate with age, older patients developing more robust humoral response independently from sex, disease severity and BMI.
Obesity and COVID19
Chapter
Umair Mallick
Global statistics indicate a high prevalence of obesity, and elevated body mass index (BMI), across the regions, with increasing trends that have reached a pandemic level. Adipose tissue is no longer considered a structural support element of the body, but a complex organ with a diversity of metabolic, endocrine, and immune related functions, and is a potent risk factor. The risks and comorbidities associated with obesity and correlated conditions are likely to aggravate the impact of the CoViD19 pandemic across the populations. Several studies describe the associations of raised BMI and obesity in CoViD19 and possible risks. Although data show that the association of CoVID19 with obesity has a deleterious impact and robustly designed studies exploring obesity, associated factors, and pathogenetic mechanisms may be lacking, the impact of obesity in CoViD19 appears significant. This chapter is intended to provide a better understanding of obesity in CoViD19. We provide an overview of the epidemiological evidence linking obesity with CoViD19, risks, and the associated variabilities. We explore the pathological mechanisms associated with obesity and CoViD19 that may facilitate the harmful impact of obesity observed in CoViD19 patients. We highlight the need for further exploration of the epidemiological and pathogenetic links that determine the criticality of CoViD19 in obese patients.KeywordsIncidence obesity and CoViD19Raised BMI and CoViD19Obesity and CoViD19Obesity and severe CoViD19Obesity and mortalityVariations obesity incidenceObesity and critical CoViD19Inflammation and obesityImmune mechanisms and obesityObesity and thrombosisObesity and cardiovascular diseaseObesity and lung diseaseObesity challenges and CoViD19Increased BMIDefinition obesityPathogenetic mechanisms and obesityAdipose tissue and CoViD19Confounding in CoViD19 obesity studies
Journal Pre-proof Antigen-specific adaptive immunity to SARS-CoV-2 in acute COVID-19 and associations with age and disease severity
Limited knowledge is available on the relationship between antigen-specific immune responses and COVID-19 disease severity. We completed a combined examination of all three branches of adaptive immunity at the level of SARS-CoV-2-specific CD4+ and CD8+ T cell and neutralizing antibody responses in acute and convalescent subjects. SARS-CoV-2-specific CD4+ and CD8+ T cells were each associated with milder disease. Coordinated SARS-CoV-2-specific adaptive immune responses were associated with milder disease, suggesting roles for both CD4+ and CD8+ T cells in protective immunity in COVID-19. Notably, coordination of SARS-CoV-2 antigen-specific responses was disrupted in individuals > 65 years old. Scarcity of naive T cells was also associated with ageing and poor disease outcomes. A parsimonious explanation is that coordinated CD4+ T cell, CD8+ T cell, and antibody responses are protective, but uncoordinated responses frequently fail to control disease, with a connection between ageing and impaired adaptive immune responses to SARS-CoV-2.
The incidence of COVID-19 in patients with metabolic syndrome and non-alcoholic steatohepatitis: A population-based study
Background
The novel coronavirus disease (COVID-19) emerged from China in 2019 and rapidly spread worldwide. Patients with metabolic comorbid conditions are more susceptible to infection by COVID-19. Metabolic syndrome is a constellation of interlinked metabolic risk factors that predispose patients to increased risk of complications. Non-alcoholic fatty liver disease (NAFLD) is the hepatic manifestation of metabolic syndrome and non-alcoholic steatohepatitis (NASH) is the aggressive form of NAFLD.
Objective
The aim of this study is to determine the relationship between metabolic syndrome components and the risk of COVID-19.
Methods
We reviewed data from a large commercial database (Explorys IBM) that aggregates electronic health records from 26 large nationwide healthcare systems. Using systemized nomenclature of clinical medical terms (SNOMED-CT), we identified adults with the diagnosis of metabolic syndrome and its individual components from 1999-2019. We included patients with the diagnosis of COVID-19 from December 2019 to May 2020. Comorbidities known to be associated with COVID-19 and metabolic syndrome such as obesity, diabetes mellitus, dyslipidemia, smoking, male gender, African American, and hypertension were collected. Univariable and multivariable analyses were performed to investigate whether metabolic syndrome or its individual components are independently associated with the risk of COVID-19.
Results
Out of 61.4 million active adult patients in the database, 8,885 (0.01%) had documented COVID-19. The cumulative incidence of COVID-19 was higher if metabolic syndrome was the primary diagnosis (0.10% vs 0.01% OR 7.00 [6.11–8.01]). The adjusted odds (aOR) of having COVID-19 was higher in patients if they were African Americans (OR 7.45 [7.14- 7.77]), hypertensive (aOR 2.53 [2.40 - 2.68]), obese (aOR 2.20 [2.10 2.32]) , diabetic (aOR 1.41 [1.33- 1.48]), hyperlipidemic (OR 1.70 [1.56-1.74]), or diagnosed with NASH (OR 4.93 [4.06- 6.00]). There was a slight decrease in adjusted odds of having COVID-19 in males as compared to females (aOR 0.88 [0.84- 0.92]).
Conclusion
The incidence of COVID-19 in patients with metabolic syndrome is high. Among all comorbid metabolic conditions, NASH had the strongest association with COVID-19.
Association between Body Mass Index and Risk of COVID-19: A Nationwide Case-Control Study in South Korea
| https://www.researchgate.net/publication/346881504_Epidemiological_and_immunological_features_of_obesity_and_SARS-CoV-2 |
MATTER OF EWALD | 174 Misc. 939 | N.Y. Misc. | Judgment | Law | CaseMine
Get free access to the complete judgment in MATTER OF EWALD on CaseMine.
MATTER OF EWALD Surrogate's Court of the City of New York, New York County. Aug 12, 1940
MATTER OF EWALD
174 Misc. 939 22 N.Y.S.2d 299
Case Information
CITATION CODES
174 Misc. 939 22 N.Y.S.2d 299
ATTORNEY(S)
Margaret Mary J. Mangan, for the administratrix.
Morris L. Gussow, for Robert Hoffman, as receiver of George F. Ewald, distributee.
Benjamin Bernstein, for Robert E. McFadden, a judgment creditor of George F. Ewald, distributee.
William J. McArthur, for the United States Fidelity and Guaranty Company, surety.
Reisner Shenk, for Mae E. Walsh, claimant.
Barnett Shapiro, for Mary A. Betzag and Katherine Ewald Anderson.
Kupfer Levine, for Peter Eckert, assignee of George F. Ewald.
Martin S. Blate, for Charles Sobelson, assignee of Charles Ewald.
JUDGES
FOLEY, S.
ACTS
No Acts
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Important Paras
The note was concededly executed in January, 1932, and was payable on demand, since no time for payment was expressed. (Neg. Inst. Law, § 26.) The check for $500 was dated January 15, 1932. It was never presented for payment and was evidently regarded by the payee as merely security for the loan. The decedent died June 19, 1939, and there can be no doubt that at the time of his death his right of action against his brother on these two claims was barred by the Statute of Limitations. It is well settled, however, that the statute does not extinguish the debt but merely bars the remedy. The defense is one that must be pleaded by the debtor in order to be available and in the event of suit thereon a failure to plead the statute would result in making the obligations enforcible at law. It is possible also to revive the right of action on such debts by a written acknowledgment or by a promise contained in writing and signed by the party to be charged. (Civ. Prac. Act, § 59; Manchester v. Braedner, 107 N.Y. 346 ; Connecticut Trust S.D. Co. v. Wead, 172 id. 497; Lincoln-Alliance Bank Trust Co. v. Fisher, 247 A.D. 465 .) In order to constitute such an acknowledgment, "the writing must recognize an existing debt, and should contain nothing inconsistent with an intention on the part of the debtor to pay it. * * * The document need contain nothing more than `a clear recognition of the claim as one presently existing.'" ( Lincoln-Alliance Bank Trust Co. v. Fisher, supra, p. 466.) In his letter to the administratrix, the debtor not only recognized his obligation in a specific amount but gave her express authority to liquidate the debt by applying a portion of his share to it. Go to
(1) The main controversy revolves around the one-seventh distributive share of George F. Ewald, a brother of the intestate. The questions here presented for determination involve, first, the right of the administratrix to set off against this distributive share the amount of several loans made by the decedent to the distributee; second, the interest of one Peter Eckert under an instrument of assignment in which the distributee assigned to him all of the money, property or other interest in this estate which was due him or to become due him to the extent of $11,000; and, finally, the rights and interest of the receiver of the property of the distributee, appointed in proceedings supplementary to execution on two judgments against him. Go to
It is clear, therefore, that the receiver of the property of the distributee has no standing in law to object to the transaction between the distributee and the estate whereby the debts were revived and the bar of the statute lifted. That transaction was not fraudulent because the debts were bona fide obligations. The Statute of Limitations does not discharge a debt but merely bars the remedy thereon; and the waiver of the statute does not create a new obligation, but simply permits enforcement of the old promise. ( Central Hanover Bank Trust Co. v. United Traction Co., supra; Hulbert v. Clark, 128 N.Y. 295 ; House v. Carr, 185 id. 453.) The right of an executor or administrator to set off an enforcible debt owing to decedent by a legatee or distributee, against his legacy or distributive share, is firmly established. ( Smith v. Kearney, 2 Barb. Ch. 533, 547 ; Close v. Van Husen, 19 Barb. 505, 509 ; Ferris v. Burrows, 34 Hun, 104; affd., 99 N.Y. 616 ; Matter of James, 149 Misc. 135, 136 ; Matter of Flint, 120 id. 230; affd., 206 A.D. 778 ; Matter of Grifenhagen, 174 Misc. 559 ; Matter of Macneal, Id. 947.) Go to
MATTER OF EWALD
FOLEY, S.
In this contested accounting proceeding the issues are disposed of as follows:
(1) The main controversy revolves around the one-seventh distributive share of George F. Ewald, a brother of the intestate. The questions here presented for determination involve, first,the right of the administratrix to set off against this distributive share the amount of several loans made by the decedent to the distributee; second,the interest of one Peter Eckert under an instrument of assignment in which the distributee assigned to him all of the money, property or other interest in this estate which was due him or to become due him to the extent of $11,000; and, finally,the rights and interest of the receiver of the property of the distributee, appointed in proceedings supplementary to execution on two judgments against him.
The decedent had on numerous occasions made loans to his brother George F. After the former's death on June 19, 1939, certain instruments evidencing indebtedness to him were discovered among his effects. The administratrix, after examination of the intestate's records, made demand upon George F. Ewald for repayment of sums which she believed to be due the estate from him by reason of these loans.
On July 29, 1939, George F. Ewald wrote a letter to the administratrix apparently in response to her oral demands upon him. He denied that the amount owing by him was as large as that claimed by her, and he disclaimed certain particular obligations charged against him. He expressly admitted, however, specific loans that were made to him by the deceased. One was in the sum of $3,000, as security for which the decedent had received a promissory note signed by George F. Ewald and his wife in which neither the amount nor the date was filled in. This note was stated by Ewald to have been executed in January, 1932. Another obligation was evidenced by a check in the sum of $500, representing a loan made January 15, 1932, and conceded by George F. Ewald to be his obligation. He further admitted that he had received other smaller loans in the form of checks amounting to not more than $100. He stated that all of these loans had been made to him and that he had intended to repay them, and he suggested that the administratrix deduct from his share the sum of $3,600 in payment of these debts.
The administratrix accepted the amounts thus stated to be due. She has listed them in her account as assets of the estate and has charged against the share of George F. Ewald the sum of $3,600 as suggested in his letter.
George F. Ewald was called as a witness in this proceeding, and he affirmed his obligations to the decedent in the amount which has been charged against his share. It is apparent from his testimony that he had borrowed from his brother even larger sums than those admitted by him, but he claimed that deduction of certain sums in payment of legal services performed by him for his brother reduced the indebtedness to the amount conceded due by him. He described the various loans, and he reiterated his intention and desire to repay them. The surrogate finds upon the evidence that George F. Ewald borrowed from the decedent, and has never repaid, the sums admitted in his letter of July 29, 1939, aggregating in amount $3,600.
The receiver of the property appointed under two judgments obtained against George F. Ewald has filed objections to the account, in which he attacks the inclusion of the $3,000 note and the $500 check as assets of the estate and the charging of those amounts against the distributive share of George F. Ewald. The basis of his objection is that both of those claims have been barred by the Statute of Limitations, and that they cannot be revived, particularly where the rights of creditors of the distributee intervene.
The note was concededly executed in January, 1932, and was payable on demand, since no time for payment was expressed. (Neg. Inst. Law, § 26.) The check for $500 was dated January 15, 1932. It was never presented for payment and was evidently regarded by the payee as merely security for the loan. The decedent died June 19, 1939, and there can be no doubt that at the time of his death his right of action against his brother on these two claims was barred by the Statute of Limitations. It is well settled, however, that the statute does not extinguish the debt but merely bars the remedy. The defense is one that must be pleaded by the debtor in order to be available and in the event of suit thereon a failure to plead the statute would result in making the obligations enforcible at law. It is possible also to revive the right of action on such debts by a written acknowledgment or by a promise contained in writing and signed by the party to be charged. (Civ. Prac. Act, § 59; Manchesterv. Braedner,107 N.Y. 346; Connecticut Trust S.D. Co.v. Wead,172 id. 497; Lincoln-Alliance Bank Trust Co.v. Fisher,247 A.D. 465.) In order to constitute such an acknowledgment, "the writing must recognize an existing debt, and should contain nothing inconsistent with an intention on the part of the debtor to pay it. * * * The document need contain nothing more than `a clear recognition of the claim as one presently existing.'" ( Lincoln-Alliance Bank Trust Co.v. Fisher, supra,p. 466.) In his letter to the administratrix, the debtor not only recognized his obligation in a specific amount but gave her express authority to liquidate the debt by applying a portion of his share to it.
The receiver contends that there was no clear and unqualified acknowledgment of an existing debt, but that there was at most an offer to compromise a demand barred by the statute. Without conceding that there is any force in this argument, it is a sufficient answer to point out that both the debtor and creditor interpret the letter as an acknowledgment of the debt, as well as authority to make the setoff, and that the liquidation of his debts by means of the charge against his distributive share as set forth in the account meets with the satisfaction of both debtor and creditoralike. This is evident not only from the debtor's written acknowledgment, but from his testimony given from the witness stand.
In view of the permission thus granted by the debtor to retain a sufficient part of his distributive share to extinguish his indebtedness to the estate, it becomes necessary to determine whether the receiver appointed on behalf of the judgment creditors of the distributee has any basis in law for attacking that transaction. The rule appears firmly to be established that the creditors of a person have no standing to object to his failure to plead the Statute of Limitations against the stale claim of another against him, or to his waiving of the statute or revival of the claim. ( Allenv. Smith,129 U.S. 465; Central Hanover Bank Trust Co.v. United Traction Co.,95 F. [2d] 50; Del Vallev. Hyland,76 Hun, 493; affd.,148 N.Y. 751; McConnellv. Barber,86 Hun, 360, 362; Livermorev. Northrup,44 N.Y. 107; Matter of Sheppard,180 Penn. St. 57;36 A. 422; Brookville Nat. Bankv. Kimble,76 Ind. 195.) In Central Hanover Bank Trust Co.v. United Traction Co.( supra) Judge SWAN said: "It has never been deemed a fraudulent conveyance to pay an honest debt or to perform an obligation which the obligor was under a moral duty to perform, although the debt or obligation was legally unenforceable because of some statutory provision." Judge LEARNED HAND, in concurring, said: "I agree that, as the law stands, we cannot hold that the revival by an insolvent of a debt barred by the statute of limitations is a fraudulent conveyance."
The decision of the Supreme Court of Pennsylvania, in Matter of Sheppard( supra) is particularly in point. There a judgment on confession was entered by the executrix against a distributee on a claim against which the Statute of Limitations had run. Attachment creditors of the distributee contended that, by reason of their prior attachment, they acquired a lien upon the share of their debtor in the estate which deprived him of the power to waive the statute. In the opinion of the lower court, which was approved by the Supreme Court, it was said: "The attachment binds only the interest of the debtor in the estate of the testator, and the interest does not arise until it has been ascertained how much of the estate has already been received by him. The lien does not extend to the conscience of the debtor. If, instead of obtaining the confession of judgment, the executrix had brought suit for recovery of the debt, nothing short of the pleading of the statute could have prevented an adverse judgment. It can scarcely be pretended that an attaching creditor of the defendant to the suit would have the right to intervene, and make defense."
In Allenv. Smith(129 U.S. 465) certain judgment creditors of one Todd brought a proceeding against his administrator and heirs in an effort to have set aside a certain judgment obtained against him by his son-in-law on the ground that it was collusively obtained and was in fraud of his creditors. The United States Supreme Court held that the plaintiffs had not sustained their burden of proving that the judgment was dishonestly obtained. In language particularly pertinent to the situation in the pending proceeding, the court said: "Much comment is made on the fact that Todd did not plead the statute of limitations of the State to a part of Smith's claim. But this is not an objection of which the plaintiffs can avail themselves. Todd was at liberty to waive the plea, and there was evidently sufficient in the relations of the parties and in the circumstances of the case to warrant him in doing so" (p. 470).
It is clear, therefore, that the receiver of the property of the distributee has no standing in law to object to the transaction between the distributee and the estate whereby the debts were revived and the bar of the statute lifted. That transaction was not fraudulent because the debts were bona fideobligations. The Statute of Limitations does not discharge a debt but merely bars the remedy thereon; and the waiver of the statute does not create a new obligation, but simply permits enforcement of the old promise. ( Central Hanover Bank Trust Co.v. United Traction Co., supra; Hulbertv. Clark,128 N.Y. 295; Housev. Carr,185 id. 453.) The right of an executor or administrator to set off an enforcible debt owing to decedent by a legatee or distributee, against his legacy or distributive share, is firmly established. ( Smithv. Kearney,2 Barb. Ch. 533, 547; Closev. Van Husen,19 Barb. 505, 509; Ferrisv. Burrows,34 Hun, 104; affd.,99 N.Y. 616; Matter of James,149 Misc. 135, 136; Matter of Flint,120 id. 230; affd.,206 A.D. 778; Matter of Grifenhagen,174 Misc. 559; Matter of Macneal,Id. 947.)
The surrogate, therefore, holds that the setoff of the debts against the distributive share of George F. Ewald must be allowed.
There remains for consideration the relative rights of the assignee and the receiver to the balance of the distributive share that is left over and above the amount set off by the administratrix. The assignment by George F. Ewald to Peter Eckert of all his property and interest in this estate to the extent of $11,000 was executed on June 27, 1939, and was recorded in the office of the clerk of this court on June 30, 1939. This assignment was made for the purpose of reimbursing the assignee for loans made to the distributee, who was his son-in-law.
The property of George F. Ewald did not vest in the receiver until after the recording of the above assignment. The property of a judgment debtor, whether acquired before or after the appointment of a receiver, is vested in the receiver from the time of filing the order appointing him, or extending his receivership, as the case may be. (Civ. Prac. Act, § 807.) Where the receiver's title has become vested, it may extend back by relation, for the benefit of the judgment creditor, to the time of the service of the order or subpoena upon the judgment debtor in supplementary proceedings, or to the time of the service of a third-party order. (Civ. Prac. Act, § 808.) In the latter case the receiver's title extends to the personal property of the judgment debtor which was in the hands or under the control of the person thus required to attend and be examined at the time of the service of the order or subpoena. Tested by these rules, the receiver's title vested on February 27, 1940, the date of the filing of the order appointing him under the Herold judgment. The order extending the receivership to include the McFadden judgment was filed April 18, 1940. The earliest that the title of the receiver can be made to extend back is August 1, 1939, when the administratrix was served with a subpoena for examination as a third party in proceedings supplementary to the execution of the McFadden judgment. No order or subpoena for his examination was ever served upon the judgment debtor personally. He voluntarily appeared and submitted to examination.
It thus becomes evident that at the earliest date on which title can be said to have vested in the receiver, even under the theory of relation back, the judgment debtor had no interest in this estate. The assignment, which had been theretofore duly recorded, disposed of his interest to the extent of $11,000, an amount greatly in excess of any possible interest he might have had. The title had, therefore, passed to the assignee before any title had vested in the receiver. The receiver can take priority over the assignee only if he can impeach the assignment as a fraudulent conveyance.
That George F. Ewald was insolvent at the time he made this assignment cannot be doubted. It is clear, too, that the assignment was made for the purpose of preferring the assignee over other creditors of the assignor. This, however, is not decisive of the question. "That a debtor has the right to pay the claim of one creditor in preference to and to the exclusion of all the others, has been many times decided." ( Del Vallev. Hyland,76 Hun, 493; affd.,148 N.Y. 751.) The important consideration is whether it was made to defraud the other creditors. Every conveyance made by an insolvent person is fraudulent as to creditors without regard to his actual intent if the conveyance is made without a fair consideration.(Debtor and Creditor Law, § 273.) "Fair consideration is given for property, or obligation, (a) When in exchange for such property, or obligation, as a fair equivalent therefor, and in good faith, * * * an antecedent debt is satisfied, or (b) when such property, or obligation, is received in good faith to secure a present advance or antecedent debt in amount not disproportionately small as compared with the value of the property, or obligation obtained." (Debtor and Creditor Law, § 272.)
Prior to the assignment to Peter Eckert, the distributee, George F. Ewald, was indebted to him in the sum of approximately $11,000. He had borrowed large sums from Mr. Eckert, who was his father-in-law, and had never repaid them. The total indebtedness was far greater than any sum the distributee might receive from the estate. The assignment was, therefore, based upon a fair consideration, and was not fraudulent as to other creditors. The assignee is entitled to receive any money due on account of the distributive share over and above that necessary to effect the setoff of the estate.
(2) The written agreement of settlement of the debt of Charles Ewald, one of the distributees, is approved and an appropriate provision may be included in the decree to that effect.
(3) The claim of Mae E. Walsh is disallowed upon the merits.
(4) The objections to the account filed by Robert Hoffman, receiver of the property of George F. Ewald, are disposed of as follows: Objections 1, 2, 3, 4(a), 4(b) and subdivisions a, b and c of objection 6 are overruled. Objection 5 and subdivisions d and e of objection 6 have been withdrawn.
(5) Schedule A of the account sets forth the total sum of $3,590 as due from George F. Ewald. The total should read $3,600. The corresponding amount of $3,590 deducted in Schedule B-1 as uncollectible debts must be eliminated from the account and from the summary statement in the decree.
In other words, by the foregoing disposition as to the indebtedness of George F. Ewald, gross assets must be increased by the sum of $3,600. The shares of the various distributees must be computed upon the net estate after the proper deductions are made from the gross estate.
| https://www.casemine.com/judgement/us/5914cbe0add7b04934805ef9 |
Bendamustine Hydrochloride and Rituximab With or Without Bortezomib Followed by Rituximab With or Without Lenalidomide in Treating Patients With High-Risk Stage II, Stage III, or Stage IV Follicular Lymphoma - Full Text View - ClinicalTrials.gov
Bendamustine Hydrochloride and Rituximab With or Without Bortezomib Followed by Rituximab With or Without Lenalidomide in Treating Patients With High-Risk Stage II, Stage III, or Stage IV Follicular Lymphoma
ClinicalTrials.gov Identifier: NCT01216683 Recruitment Status :
Completed First Posted : October 7, 2010 Results First Posted : February 23, 2021 Last Update Posted : January 17, 2023
Sponsor:
National Cancer Institute (NCI)
Information provided by (Responsible Party):
Eastern Cooperative Oncology Group ( ECOG-ACRIN Cancer Research Group )
Study Details
Study Description
Brief Summary:
RATIONALE: Drugs used in chemotherapy, such as bendamustine hydrochloride, work in different ways to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. Monoclonal antibodies, such as rituximab, can block cancer growth in different ways. Some block the ability of cancer cells to grow and spread. Others find cancer cells and help kill them or carry cancer-killing substances to them. Bortezomib may stop the growth of cancer cells by blocking some of the enzymes needed for cell growth. Biological therapies, such as lenalidomide, may stimulate the immune system in different ways and stop cancer cells from growing. It is not yet known whether giving bendamustine hydrochloride and rituximab together alone is more effective than giving bendamustine hydrochloride and rituximab together with bortezomib or lenalidomide in treating follicular lymphoma.
PURPOSE: This randomized phase II trial is studying giving bendamustine hydrochloride and rituximab together with or without bortezomib followed by rituximab with or without lenalidomide to see how well they work in treating patients with high-risk stage II, stage III, or stage IV follicular lymphoma.
Condition or disease Intervention/treatment Phase Lymphoma Biological: rituximab Drug: Bendamustin Drug: bortezomib Drug: lenalidomide Phase 2
Detailed Description:
OBJECTIVES:
Primary
To compare the complete remission rate in patients with high-risk follicular lymphoma receiving induction therapy comprising bendamustine hydrochloride and rituximab with vs without bortezomib.
Secondary
To determine the 3-year progression-free survival and the 5-year overall survival of these patients.
To evaluate patient-reported outcomes at baseline and during treatment to determine differences in symptom palliation, treatment-related symptoms, and overall health-related quality of life.
To examine the association between baseline Follicular Lymphoma International Prognostic Index (FLIPI) information and outcome of these patients.
To examine the association between baseline and end-of-treatment patient comorbidities assessed by the Cumulative Illness Rating Scale (CIRS) and outcome.
To create an image and tissue bank including serial PET/CT scans, diagnostic paraffin-embedded tissue, germline DNA, and serial blood and bone marrow samples sufficient to support proposed and future studies of tumor and host characteristics that may predict for clinical outcome, including treatment arm effects, and enhance existing prognostic indices. (exploratory)
To evaluate the rate of peripheral neuropathy associated with subcutaneous and intravenous bortezomib.
OUTLINE: Patients are stratified according to FLIPI-1score (0-2 vs 3 vs 4-5) and Groupe d'Etude des Lymphomes Folliculaires (GELF) tumor burden (low vs high). Patients are randomized to 1 of 3 treatment arms.
Arm A then Arm D
Arm A (induction): Patients receive rituximab intravenously (IV) on day 1 and bendamustine hydrochloride IV over 1 hour on days 1 and 2. Treatment repeats every 28 days for 6 courses in the absence of disease progression or unacceptable toxicity.
Arm D (continuation): Beginning 4 weeks after the completion of induction therapy, patients who have stable disease or better at time of post-induction restaging receive rituximab IV on day 1. Treatment repeats every 8 weeks for 2 years in the absence of disease progression or unacceptable toxicity.
Arm B then Arm E
Arm B (induction): Patients receive rituximab IV on day 1; bortezomib IV on days 1, 4, 8, and 11; and bendamustine hydrochloride IV over 1 hour on days 1 and 4. Treatment repeats every 28 days for 6 courses in the absence of disease progression or unacceptable toxicity.
Arm E (continuation): Beginning 4 weeks after the completion of induction therapy, patients who have stable disease or better at time of post-induction restaging receive rituximab as in arm D.
Arm C then Arm F
Arm C (induction): Patients receive rituximab IV on day 1 and bendamustine hydrochloride IV over 1 hour on days 1 and 2. Treatment repeats every 28 days for 6 courses in the absence of disease progression or unacceptable toxicity.
Arm F (continuation): Immediately after completing induction therapy, patients who have stable disease or better at time of post-induction restaging receive oral lenalidomide on days 1-21. Treatment repeats every 4 weeks for 13 courses in the absence of disease progression or unacceptable toxicity. Beginning 4 weeks after the completion of induction therapy, these patients receive rituximab IV on day 1. Treatment repeats every 8 weeks for 2 years in the absence of disease progression or unacceptable toxicity.
Quality of life (including fatigue, neurotoxicity, anxiety, and depression) is assessed by questionnaire at baseline and periodically during study therapy.
Blood, bone marrow, and tissue samples may be collected periodically for correlative studies and for a repository.
After completion of study therapy, patients are followed up periodically for 15 years.
Study Design
Top of Page Study Description Study Design Arms and Interventions Outcome Measures Eligibility Criteria Contacts and Locations More Information
Layout table for study information Study Type : Interventional
(Clinical Trial) Actual Enrollment : 289 participants Allocation: Randomized Intervention Model: Parallel Assignment Masking: None (Open Label) Primary Purpose: Treatment Official Title: A 3-Arm Randomized Phase II Trial of Bendamustine-Rituximab (BR) Followed by Rituximab vs Bortezomib-BR (BVR) Followed by Rituximab vs BR Followed by Lenalidomide/Rituximab in High Risk Follicular Lymphoma Actual Study Start Date : December 13, 2010 Actual Primary Completion Date : December 2, 2019 Actual Study Completion Date : December 2, 2019
Resource links provided by the National Library of Medicine
MedlinePlus related topics: Lymphoma
Drug Information available for: Bendamustine hydrochloride Bendamustine Rituximab Bortezomib Lenalidomide
Genetic and Rare Diseases Information Center resources: Lymphosarcoma Follicular Lymphoma
U.S. FDA Resources
Arms and Interventions
Top of Page Study Description Study Design Arms and Interventions Outcome Measures Eligibility Criteria Contacts and Locations More Information
Arm Intervention/treatment Experimental: Arm A then Arm D (Induction with Bendamustine + Rituximab; Continuation with Rituximab)Arm A (induction): Patients receive rituximab intravenously (IV) on day 1 and bendamustine hydrochloride IV over 1 hour on days 1 and 2. Treatment repeats every 28 days for 6 courses in the absence of disease progression or unacceptable toxicity.Arm D (continuation): Beginning 4 weeks after the completion of induction therapy, patients who have stable disease or better at time of post-induction restaging receive rituximab IV on day 1. Treatment repeats every 8 weeks for 2 years in the absence of disease progression or unacceptable toxicity. Biological: rituximab Given IV Other Names: IDEC-C2B8 Chimeric anti-CD20 monoclonal antibody Rituxan Drug: Bendamustin Given IV Other Names: Bendamustine hydrochloride CEP-18083 TREANDA Experimental: Arm B then Arm E (Induction with Bendamustine + Rituximab + Bortezomib; Continuation with Rituximab)Arm B (induction): Patients receive rituximab IV on day 1; bortezomib IV on days 1, 4, 8, and 11; and bendamustine hydrochloride IV over 1 hour on days 1 and 4. Treatment repeats every 28 days for 6 courses in the absence of disease progression or unacceptable toxicity.Arm E (continuation): Beginning 4 weeks after the completion of induction therapy, patients who have stable disease or better at time of post-induction restaging receive rituximab as in arm D. Biological: rituximab Given IV Other Names: IDEC-C2B8 Chimeric anti-CD20 monoclonal antibody Rituxan Drug: Bendamustin Given IV Other Names: Bendamustine hydrochloride CEP-18083 TREANDA Drug: bortezomib Given IV Other Names: MLN341 LDP-341 Velcade® PS-341 Experimental: Arm C then Arm F (Induction with Bendamustine+Rituximab; Continuation with Lenalidomide + Rituximab)Arm C (induction): Patients receive rituximab IV on day 1 and bendamustine hydrochloride IV over 1 hour on days 1 and 2. Treatment repeats every 28 days for 6 courses in the absence of disease progression or unacceptable toxicity.Arm F (continuation): Immediately after completing induction therapy, patients who have stable disease or better at time of post-induction restaging receive oral lenalidomide on days 1-21. Treatment repeats every 4 weeks for 13 courses in the absence of disease progression or unacceptable toxicity. Beginning 4 weeks after the completion of induction therapy, these patients receive rituximab IV on day 1. Treatment repeats every 8 weeks for 2 years in the absence of disease progression or unacceptable toxicity. Biological: rituximab Given IV Other Names: IDEC-C2B8 Chimeric anti-CD20 monoclonal antibody Rituxan Drug: Bendamustin Given IV Other Names: Bendamustine hydrochloride CEP-18083 TREANDA Drug: lenalidomide Given orally Other Names: IMiD compound CC-5013 Revlimid®
Outcome Measures
Top of Page Study Description Study Design Arms and Interventions Outcome Measures Eligibility Criteria Contacts and Locations More Information
Primary Outcome Measures
:
Complete Remission (CR) Rate [ Time Frame: Assessed every 4 weeks during induction treatment and every 8 weeks during continuation treatment, up to 2 years ]
Complete remission is defined as complete disappearance of all detectable clinical evidence of disease and disease-related symptoms if present prior to therapy.
This analysis was conducted among 222 evaluable patients for the primary analysis. The purpose of this analysis is to compare the complete remission rate of rituximab + bendamustine vs. bortezomib + rituximab + bendamustine as induction therapy, therefore, the proportion of patients with complete remission was compared between Arm B (bortezomib + rituximab + bendamustine) and Arms A and C combined (rituximab + bendamustine).
1-year Post-induction Disease-free Survival (DFS) Rate [ Time Frame: Assessed at 1 year post-induction, approximately 1.5 years ]
1-year post induction disease-free survival rate is defined as the proportion of patients achieving complete remission during induction treatment and are alive and maintaining complete remission at 1 year after induction completion.
The purpose of this analysis is to compare the 1-year post-induction disease-free survival (DFS) rate with rituximab plus lenalidomide to rituximab alone as continuation therapy following induction treatment of bendamustine+rituximab, therefore, patients with induction treatment of bendamustine + rituximab + bortezomib were not included in this analysis.
Secondary Outcome Measures
:
3-year Progression-free Survival Rate [ Time Frame: Assessed every cycle during treatment and every 6 months between 2 and 5 years from study entry ]
Progression-free survival is defined as the time from registration of induction treatment to progression, relapse or death, whichever occurs first. Patients alive without documented progression are censored at last disease assessment. 3-year progression-free survival rate is the proportion of patients who were progression-free and alive at 3 years estimated using the method of Kaplan-Meier.
Progression/relapse is defined as appearance of any new lesion more than 1.5 cm in any axis during or at the end of therapy, >=50% increase from nadir in the SPD of any previously involved nodes or extranodal masses or the size of other lesions, or >=50% increase in the longest diameter of any single previously identified node or extranodal mass more than 1 cm in its short axis.
5-year Overall Survival Rate [ Time Frame: Assessed every cycle during treatment and every 6 months between 2 and 5 years from study entry ]
Overall survival is defined as the time from randomization to death or date last known alive. 5-year overall survival rate is the proportion of patients who were alive at 5 years estimated using the method of Kaplan-Meier.
Complete Remission (CR) Rate [ Time Frame: Assessed every 4 weeks during induction treatment and every 8 weeks during continuation treatment, up to 2 years ]
Complete remission is defined as complete disappearance of all detectable clinical evidence of disease and disease-related symptoms if present prior to therapy.
This analysis was conducted among 222 evaluable patients. The proportion of patients with complete remission was compared between patients with Follicular Lymphoma International Prognostic Index (FLIPI) of 3-5 and patients with FLIPI of 0-2/unknown.
The FLIPI was developed in order to predict prognosis of patients with newly diagnosed follicular lymphoma (FL). The five FLIPI risk factors were: age > 60 years, Ann Arbor stage III-IV, hemoglobin level < 12 gm/dL, >4 nodal areas, and serum LDH level above normal. The FLIPI score was calculated by summing the number of risk factors. The higher the FLIPI score, the worse the prognosis.
1-year Disease-free Survival (DFS) Rate [ Time Frame: Assessed at 1 year post-induction, approximately 1.5 years ]
1-year post induction disease-free survival rate is defined as the proportion of patients achieving complete remission during induction treatment and are alive and maintaining complete remission at 1 year after induction completion.
This analysis was conducted among 203 evaluable patients in the continuation treatment portion of the study. The 1-year post induction disease-free survival rate was compared between patients with FLIPI of 3-5 and patients with FLIPI of 0-2/unknown.
The FLIPI was developed in order to predict prognosis of patients with newly diagnosed follicular lymphoma (FL). The five FLIPI risk factors were: age > 60 years, Ann Arbor stage III-IV, hemoglobin level < 12 gm/dL, >4 nodal areas, and serum LDH level above normal. The FLIPI score was calculated by summing the number of risk factors. The higher the FLIPI score, the worse the prognosis.
Progression-free Survival [ Time Frame: Assessed every cycle during treatment and every 6 months between 2 and 5 years from study entry ]
Progression-free survival is defined as the time from registration of induction treatment to progression, relapse or death, whichever occurs first. Patients alive without documented progression are censored at last disease assessment. Progression/relapse is defined as appearance of any new lesion more than 1.5 cm in any axis during or at the end of therapy, >=50% increase from nadir in the SPD of any previously involved nodes or extranodal masses or the size of other lesions, or >=50% increase in the longest diameter of any single previously identified node or extranodal mass more than 1 cm in its short axis.
The five FLIPI risk factors were: age > 60 years, Ann Arbor stage III-IV, hemoglobin level < 12 gm/dL, >4 nodal areas, and serum LDH level above normal. The FLIPI score was calculated by summing the number of risk factors. The higher the FLIPI score, the worse the prognosis.
5-year Overall Survival Rate [ Time Frame: Assessed every cycle during treatment and every 6 months between 2 and 5 years from study entry ]
Overall survival is defined as the time from randomization to death or date last known alive. 5-year overall survival rate is the proportion of patients who were alive at 5 years estimated using the method of Kaplan-Meier.
The FLIPI was developed in order to predict prognosis of patients with newly diagnosed follicular lymphoma (FL). The five FLIPI risk factors were: age > 60 years, Ann Arbor stage III-IV, hemoglobin level < 12 gm/dL, >4 nodal areas, and serum LDH level above normal. The FLIPI score was calculated by summing the number of risk factors. The higher the FLIPI score, the worse the prognosis.
Complete Remission (CR) Rate [ Time Frame: Assessed every 4 weeks during induction treatment and every 8 weeks during continuation treatment, up to 2 years ]
Complete remission is defined as complete disappearance of all detectable clinical evidence of disease and disease-related symptoms if present prior to therapy.
This analysis was conducted among 250 evaluable patients with Cumulative Illness Rating Scale (CIRS) data available. The proportion of patients with complete remission was compared between patients with CIRS <10 and patients with CIRS >=10. Higher CIRS scores indicate higher severity with max score of 56 points.
1-year Disease-free Survival (DFS) Rate [ Time Frame: Assessed at 1 year post-induction, approximately 1.5 years ]
1-year post induction disease-free survival rate is defined as the proportion of patients achieving complete remission during induction treatment and are alive and maintaining complete remission at 1 year after induction completion.
This analysis was conducted among 250 evaluable patients with Cumulative Illness Rating Scale (CIRS) data available. The proportion of patients disease-free and alive at 1 year post induction treatment was compared between patients with CIRS <10 and patients with CIRS >=10. Higher CIRS scores indicate higher severity with max score of 56 points.
3-year Progression-free Survival Rate [ Time Frame: Assessed every cycle during treatment and every 6 months between 2 and 5 years from study entry ]
Progression-free survival is defined as the time from registration of induction treatment to progression, relapse or death, whichever occurs first. Patients alive without documented progression are censored at last disease assessment. 3-year progression-free survival rate is the proportion of patients who were progression-free and alive at 3 years estimated using the method of Kaplan-Meier.
Progression/relapse is defined as appearance of any new lesion more than 1.5 cm in any axis during or at the end of therapy, >=50% increase from nadir in the SPD of any previously involved nodes or extranodal masses or the size of other lesions, or >=50% increase in the longest diameter of any single previously identified node or extranodal mass more than 1 cm in its short axis.
The 3-year progression-free survival rate is reported by Cumulative Illness Rating Scale (CIRS) score (<10 vs. >=10). Higher CIRS scores indicate higher severity with max score of 56 points.
5-year Overall Survival Rate [ Time Frame: Assessed every cycle during treatment and every 6 months between 2 and 5 years from study entry ]
Overall survival is defined as the time from randomization to death or date last known alive. 5-year overall survival rate is the proportion of patients who were alive at 5 years estimated using the method of Kaplan-Meier.
The 5-year overall survival rate is reported by Cumulative Illness Rating Scale (CIRS) score (<10 vs. >=10). Higher CIRS scores indicate higher severity with max score of 56 points.
Proportion of Patients With Grade 3 or Higher Peripheral Neuropathy [ Time Frame: Assessed every cycle during treatment and for 30 days after discontinuation of treatment, up to 15 years ]
Peripheral neuropathy was assessed using NCI Common Terminology Criteria for Adverse Events (CTCAE) version 4.0. Proportion of patients with grade 3 or higher peripheral neuropathy was compared between patients with subcutaneous bortezomib and patients with intravenous bortezomib.
Functional Assessment of Cancer Therapy - General (FACT-G) Total Score at Baseline [ Time Frame: Assessed at baseline ]
The Functional Assessment of Cancer Therapy - General (FACT-G) is a 27-item questionnaire that has four areas of measurements (physical well-being, social/family well-being, emotional well-being and functional well-being) with a scale of 0-4. The FACT-G total score ranges between 0 and 108. The higher the score, the better the quality of life.
Functional Assessment of Cancer Therapy - General (FACT-G) Total Score at Mid-treatment [ Time Frame: Assessed at cycle 3 or cycle 4, approximately 3 or 4 months ]
The Functional Assessment of Cancer Therapy - General (FACT-G) is a 27-item questionnaire that has four areas of measurements (physical well-being, social/family well-being, emotional well-being and functional well-being) with a scale of 0-4. The FACT-G total score ranges between 0 and 108. The higher the score, the better the quality of life.
FACT-G total score at cycle 3 is considered as mid-treatment score. If FACT-G total score at cycle 3 is not available, the score at cycle 4 will be used as the mid-treatment score.
Functional Assessment of Cancer Therapy - General (FACT-G) Total Score at End of Induction Treatment [ Time Frame: Assessed at cycle 6, approximately 6 months ]
The Functional Assessment of Cancer Therapy - General (FACT-G) is a 27-item questionnaire that has four areas of measurements (physical well-being, social/family well-being, emotional well-being and functional well-being) with a scale of 0-4. The FACT-G total score ranges between 0 and 108. The higher the score, the better the quality of life.
Functional Assessment of Cancer Therapy - Lymphoma (FACT-Lym) Subscale Score at Baseline [ Time Frame: Assessed at baseline ]
The Functional Assessment of Cancer Therapy - Lymphoma (FACT-Lym) is a 15-item questionnaire that evaluates disease-related symptoms and concerns specific to lymphoma with a scale of 0-4. The FACT-Lym subscale score ranges between 0 and 60. The higher the score, the better the quality of life.
Functional Assessment of Cancer Therapy - Lymphoma (FACT-Lym) Subscale Score at Mid-induction Treatment [ Time Frame: Assessed at cycle 3 or cycle 4, approximately 3 or 4 months ]
The Functional Assessment of Cancer Therapy - Lymphoma (FACT-Lym) is a 15-item questionnaire that evaluates disease-related symptoms and concerns specific to lymphoma with a scale of 0-4. The FACT-Lym subscale score ranges between 0 and 60. The higher the score, the better the quality of life.
FACT-Lym subscale score at cycle 3 is considered as mid-treatment score. If FACT-Lym subscale score at cycle 3 is not available, the score at cycle 4 will be used as the mid-treatment score.
Functional Assessment of Cancer Therapy - Lymphoma (FACT-Lym) Subscale Score at End of Induction Treatment [ Time Frame: Assessed at cycle 6, approximately 6 months ]
The Functional Assessment of Cancer Therapy - Lymphoma (FACT-Lym) is a 15-item questionnaire that evaluates disease-related symptoms and concerns specific to lymphoma with a scale of 0-4. The FACT-Lym subscale score ranges between 0 and 60. The higher the score, the better the quality of life.
Functional Assessment of Chronic Illness Therapy - Fatigue (FACIT-Fatigue) Subscale Score at Baseline [ Time Frame: Assessed at baseline ]
The Functional Assessment of Chronic Illness Therapy - Fatigue (FACIT-Fatigue) is comprised of 13 items that assess fatigue and its impact with a scale of 0-4. The FACIT-Fatigue subscale score ranges between 0 and 52. The higher the score, the better the quality of life.
Functional Assessment of Chronic Illness Therapy - Fatigue (FACIT-Fatigue) Subscale Score at Mid-induction Treatment [ Time Frame: Assessed at cycle 3 or cycle 4, approximately 3 or 4 months ]
The Functional Assessment of Chronic Illness Therapy - Fatigue (FACIT-Fatigue) is comprised of 13 items that assess fatigue and its impact with a scale of 0-4. The FACIT-Fatigue subscale score ranges between 0 and 52. The higher the score, the better the quality of life.
FACIT-Fatigue subscale score at cycle 3 is considered as mid-treatment score. If FACIT-Fatigue subscale score at cycle 3 is not available, the score at cycle 4 will be used as the mid-treatment score.
Functional Assessment of Chronic Illness Therapy - Fatigue (FACIT-Fatigue) Subscale Score at End of Induction Treatment [ Time Frame: Assessed at cycle 6, approximately 6 months ]
The Functional Assessment of Chronic Illness Therapy - Fatigue (FACIT-Fatigue) is comprised of 13 items that assess fatigue and its impact with a scale of 0-4. The FACIT-Fatigue subscale score ranges between 0 and 52. The higher the score, the better the quality of life.
Functional Assessment of Cancer Therapy/Gynecologic Oncology Group - Neurotoxicity (FACT-GOG-NTX) Subscale Score at Baseline [ Time Frame: Assessed at baseline ]
The Functional Assessment of Cancer Therapy/Gynecologic Oncology Group - Neurotoxicity (FACT-GOG-NTX) subscale is comprised of 11 items that assess neurotoxicity with a scale of 0-4. The FACT-GOG-NTX subscale score ranges between 0 and 44. The higher the score, the better the quality of life.
Functional Assessment of Cancer Therapy/Gynecologic Oncology Group - Neurotoxicity (FACT-GOG-NTX) Subscale Score at Mid-induction Treatment [ Time Frame: Assessed at cycle 3, approximately 3 months ]
The Functional Assessment of Cancer Therapy/Gynecologic Oncology Group - Neurotoxicity (FACT-GOG-NTX) subscale is comprised of 11 items that assess neurotoxicity with a scale of 0-4. The FACT-GOG-NTX subscale score ranges between 0 and 44. The higher the score, the better the quality of life.
Functional Assessment of Cancer Therapy/Gynecologic Oncology Group - Neurotoxicity (FACT-GOG-NTX) Subscale Score at the End of Induction Treatment [ Time Frame: Assessed at end of induction treatment (cycle 6), approximately 6 months ]
The Functional Assessment of Cancer Therapy/Gynecologic Oncology Group - Neurotoxicity (FACT-GOG-NTX) subscale is comprised of 11 items that assess neurotoxicity with a scale of 0-4. The FACT-GOG-NTX subscale score ranges between 0 and 44. The higher the score, the better the quality of life.
Eligibility Criteria
Top of Page Study Description Study Design Arms and Interventions Outcome Measures Eligibility Criteria Contacts and Locations More Information
Information from the National Library of Medicine
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Layout table for eligibility information Ages Eligible for Study: 18 Years and older (Adult, Older Adult) Sexes Eligible for Study: All Accepts Healthy Volunteers: No
Criteria
Inclusion Criteria (Induction):
Histologically confirmed (biopsy-proven) diagnosis of follicular B-cell non-Hodgkin lymphoma with no evidence of transformation to large cell histology
Patients having both diffuse and follicular architectural elements are eligible if the histology is predominantly follicular (i.e., ≥ 50% of the cross-sectional area) and there is no evidence of transformation to a large cell histology
Diagnostic confirmation (i.e., core needle or excisional lymph node biopsy) required if the interval since tissue diagnosis of low-grade malignant lymphoma is > 24 months
Bone marrow biopsy alone not acceptable
Stage II, III, or IV AND grade 1, 2, or 3a disease
Must meet criteria for High Tumor Burden (higher risk) as defined by either the Groupe D'Etude des Lymphomes Follicularies (GELF) criteria OR the follicular lymphoma international prognostic index (FLIPI) as defined below:
Patient must meet ≥ 1 of the following GELF criteria:
Nodal or extranodal mass ≥ 7 cm
At least 3 nodal masses > 3.0 cm in diameter
Systemic symptoms due to lymphoma or B symptoms
Splenomegaly with spleen > 16 cm by CT scan
Evidence of compression syndrome (e.g., ureteral, orbital, gastrointestinal) or pleural or peritoneal serous effusion due to lymphoma (irrespective of cell content)
Leukemic presentation (≥ 5.0 x 10^9/L malignant circulating follicular cells)
Cytopenias (polymorphonuclear leukocytes < 1.0 X 10^9/L, hemoglobin < 10 g/dL, and/or platelets < 100 x 10^9/L)
Patient must have a FLIPI-1 score of 3, 4, or 5 (1 point per criterion below):
Age ≥ 60 years
Stage III-IV disease
Hemoglobin level < 12 g/dL
> 4 nodal areas
Serum lactate dehydrogenase (LDH) level above normal
At least 1 objective measurable disease parameter
Baseline measurements and evaluations (PET and CT) obtained within 6 weeks of randomization
Measurable disease in the liver is required if the liver is the only site of lymphoma
HIV-positive patients must meet all of the following criteria:
HIV is sensitive to antiretroviral therapy
Must be willing to take effective antiretroviral therapy if indicated
No history of CD4 < 300 cells/mm³ prior to or at the time of lymphoma diagnosis
No history of AIDS-defining conditions
If on antiretroviral therapy, must not be taking zidovudine or stavudine
Must be willing to take prophylaxis for Pneumocystis jiroveci pneumonia (PCP) during therapy and ≥ 2 months following completion of study therapy or until the CD4 cells recover to over 250 cells/mm³
ECOG performance status 0-2
Absolute neutrophil count (ANC) ≥ 1,500/mm³ (includes neutrophils and bands)
Platelet count ≥ 100,000/mm³
Creatinine ≤ 2.0 mg/dL
Aspartate aminotransferase (AST) and alanine transaminase (ALT) ≤ 5 x upper limit of normal (ULN)
Alkaline phosphatase ≤ 5 x ULN
Total bilirubin ≤ 1.5 x ULN (patients with known Gilbert disease should contact the study PI)
Negative pregnancy test
Fertile patients must use 2 effective methods (1 highly effective and 1 additional effective method) of contraception ≥ 28 days before, during, and for ≥ 28 days after completing study treatment
Must register into the mandatory RevAssist® program and be willing and able to comply with the requirements of RevAssist® (for patients randomized to arm C and proceed onto arm F)
Exclusion Criteria (Induction):
Prior chemotherapy, radiotherapy, or immunotherapy for lymphoma
Prednisone or other corticosteroids used for non-lymphomatous conditions will not be considered as prior chemotherapy
A prior/recent short course (< 2 weeks) of steroids for symptom relief of lymphoma-related symptoms is allowed
Recent history of malignancy except for adequately treated basal cell or squamous cell skin cancer, in situ cervical cancer, or other cancer for which the patient has been disease-free for ≥ 2 years
Pregnant or nursing
Active, uncontrolled infections (afebrile for > 48 hours off antibiotics)
≥ grade 2 neuropathy
Myocardial infarction within the past 6 months
NYHA class III-IV heart failure, uncontrolled angina, severe uncontrolled ventricular arrhythmias, or electrocardiographic evidence of acute ischemia or active conduction system abnormalities
Serious medical or psychiatric illness likely to interfere with participation in this clinical study
Known hypersensitivity to boron or mannitol
Chronic carriers of hepatitis B virus (HBV) with positive hepatitis surface antigen (HBsAg +)
Inclusion Criteria (Continuation):
Patient must have improved their response or have had no interval change in their tumor measurements with restaging from Induction cycle 3 to 6 as determined at Cycle 6 restaging.
Adequate organ function
ECOG performance status 0-2
Patients with a prior history of HBV infection, but immune, with only IgG hepatitis core antibody positive (HBcAb+), must receive antiviral prophylaxis (e.g., lamivudine 100 mg po daily) for ≥ 1 week prior to course 1 and throughout induction and continuation therapy and for ≥ 12 months after the last rituximab dose
Additional requirements for Arm C induction patients registering to arm F:
Patients must be willing to take deep vein thrombosis (DVT) prophylaxis. Subjects with a history of a thrombotic vascular event will be required to have full anticoagulation, therapeutic doses of low molecular weight heparin or warfarin to maintain an INR between 2.0 - 3.0, or any other accepted full anticoagulation regimen (e.g. direct thrombin inhibitors or Factor Xa inhibitors) with appropriate monitoring for that agent. Subjects without a history of a thromboembolic event are required to take a daily aspirin (81 mg or 325 mg) for DVT prophylaxis. Subjects who are unable to tolerate aspirin should receive low molecular weight heparin therapy or warfarin treatment or another accepted full anticoagulation regimen.
Females of childbearing potential (FCBP) must agree to use two reliable forms of contraception simultaneously or to practice complete abstinence from heterosexual intercourse during the following time periods related to this study/lenalidomide: 1) for at least 28 days before starting lenalidomide; 2) while participating in the study; and 3) for at least 28 days after discontinuation/stopping lenalidomide. The two methods of reliable contraception must include one highly effective method (i.e. intrauterine device (IUD), hormonal [birth control pills, injections, or implants], tubal ligation, partner's vasectomy) and one additional effective (barrier) method (i.e. latex condom, diaphragm, cervical cap). FCBP must be referred to a qualified provider of contraceptive methods if needed.
Patient must agree to abstain from donating blood during study participation and for at least 28 days after discontinuation from protocol treatment.
All males, regardless of whether they have undergone a successful vasectomy, must agree to use a latex condom during sexual contact with a female of childbearing potential, or to practice complete abstinence from heterosexual intercourse with any female of childbearing potential during the cycles of continuation therapy of which lenalidomide are taken and for at least 28 days after discontinuation/stopping lenalidomide. Patient must agree to abstain from donating blood, semen, or sperm during study participation and for at least 28 days after discontinuation from protocol treatment.
Must register into the mandatory RevAssist® program and be willing and able to comply with the requirements of RevAssist®
Exclusion Criteria (Continuation):
Active, uncontrolled infections (afebrile for > 48 hours off antibiotics)
≥ grade 2 neuropathy
Additional requirements for Arm C induction patients registering to arm F:
Not pregnant or breast-feeding
Study Documents (Full-Text)
Documents provided by Eastern Cooperative Oncology Group ( ECOG-ACRIN Cancer Research Group ):
Study Protocol and Statistical Analysis Plan [PDF] June 15, 2016
Publications of Results:
Evens AM, Hong F, Habermann TM, Advani RH, Gascoyne RD, Witzig TE, Quon A, Ranheim EA, Ansell SM, Cheema PS, Dy PA, O'Brien TE, Winter JN, Cescon TP, Chang JE, Kahl BS. A Three-Arm Randomized Phase II Study of Bendamustine/Rituximab with Bortezomib Induction or Lenalidomide Continuation in Untreated Follicular Lymphoma: ECOG-ACRIN E2408. Clin Cancer Res. 2020 Sep 1;26(17):4468-4477. doi: 10.1158/1078-0432.CCR-20-1345. Epub 2020 Jun 12.
Layout table for additonal information Responsible Party: ECOG-ACRIN Cancer Research Group ClinicalTrials.gov Identifier: NCT01216683 History of Changes Other Study ID Numbers: E2408 E2408 ( Other Identifier: ECOG-ACRIN ) NCI-2011-02644 ( Other Identifier: NCI ) CDR0000683312 ( Other Identifier: NCI ) First Posted: October 7, 2010 Key Record Dates Results First Posted: February 23, 2021 Last Update Posted: January 17, 2023 Last Verified: January 2023 Individual Participant Data (IPD) Sharing Statement: Plan to Share IPD: Yes Plan Description: Individual participant data may be made available upon request as per the ECOG-ACRIN Data Sharing Policy.
Layout table for additional information Studies a U.S. FDA-regulated Drug Product: Yes Studies a U.S. FDA-regulated Device Product: No
Keywords provided by Eastern Cooperative Oncology Group ( ECOG-ACRIN Cancer Research Group ):
contiguous stage II grade 1 follicular lymphoma contiguous stage II grade 2 follicular lymphoma contiguous stage II grade 3 follicular lymphoma noncontiguous stage II grade 1 follicular lymphoma noncontiguous stage II grade 2 follicular lymphoma noncontiguous stage II grade 3 follicular lymphoma stage III grade 1 follicular lymphoma stage III grade 2 follicular lymphoma stage III grade 3 follicular lymphoma stage IV grade 1 follicular lymphoma stage IV grade 2 follicular lymphoma stage IV grade 3 follicular lymphoma
Additional relevant MeSH terms:
Layout table for MeSH terms Lymphoma Lymphoma, Follicular Neoplasms by Histologic Type Neoplasms Lymphoproliferative Disorders Lymphatic Diseases Immunoproliferative Disorders Immune System Diseases Lymphoma, Non-Hodgkin Rituximab Lenalidomide Bortezomib Bendamustine Hydrochloride Antineoplastic Agents, Immunological Antineoplastic Agents Immunologic Factors Physiological Effects of Drugs Antirheumatic Agents Angiogenesis Inhibitors Angiogenesis Modulating Agents Growth Substances Growth Inhibitors Antineoplastic Agents, Alkylating Alkylating Agents Molecular Mechanisms of Pharmacological Action
| https://clinicaltrials.gov/ct2/show/study/NCT01216683?show_desc=Y |
Heritage | Free Full-Text | Deep Water Archaeology in Italy and in the Tyrrhenian Sea
This paper presents an overview of the history of the research in deep water archaeology in Italy and the recent activities carried out by Fondazione Azionemare, in collaboration with the Dipartimento di Studi Umanistici of the Università Ca’ Foscari Venezia, in the Tyrrhenian Sea. Through a preliminary presentation of some shipwrecks dated to the Roman period, discovered by the Fondazione Azionemare and investigated, thanks also to photogrammetry, with the archaeologists of the Venetian university, this article analyses the characteristics and the potentialities of these contexts, which present an excellent level of conservation.
Deep Water Archaeology in Italy and in the Tyrrhenian Sea
by Carlo Beltrame 1,* , Elisa Costa 1 and Guido Gay 2
Dipartimento di Studi Umanistici, Università Ca’ Foscari Venezia, Dorsoduro 3484/D, 30123 Venezia, VE, Italy
Fondazione Guido Gay Azionemare, via Lavizzari 4, 6900 Lugano, Switzerland
Heritage 2022 , 5 (3), 2106-2122; https://doi.org/10.3390/heritage5030110
Abstract
:
This paper presents an overview of the history of the research in deep water archaeology in Italy and the recent activities carried out by Fondazione Azionemare, in collaboration with the Dipartimento di Studi Umanistici of the Università Ca’ Foscari Venezia, in the Tyrrhenian Sea. Through a preliminary presentation of some shipwrecks dated to the Roman period, discovered by the Fondazione Azionemare and investigated, thanks also to photogrammetry, with the archaeologists of the Venetian university, this article analyses the characteristics and the potentialities of these contexts, which present an excellent level of conservation.
Keywords:
underwater archaeology
ROV
deep wreck
shipwreck
conservation
1. Introduction
Underwater archaeology is traditionally very permeable to technologies that it is able to acquire from other disciplines. Indeed, technology offers a great opportunity to go beyond the limits of submerged environments (depth, visibility, etc.) and to reduce working time, which consequently saves money and reduces risks [ 1 ]. Therefore, whereas technology is simply an opportunity when working in shallow waters, the same technology becomes indispensable when investigating deep waters.
Marine technology offers more and more opportunities for the deep water exploration of our cultural heritage. Compared to the past, such technology is also becoming more accessible for archaeologists, because costs are progressively diminishing. In many cases, this kind of research is possible thanks to the collaboration of specialized private companies, trusts, or other better-equipped and resource-rich institutions, which see in these activities the chance to conduct research and improve visibility. Although the chances for archaeological institutions to use this technology can be quite frequent, it is of course desirable, in the future, for diminishing costs and increased simplicity in the use of these tools to encourage independent research activity.
2. Potentialities of Deep Water Shipwreck Investigation
Deep water contexts are of great interest for many reasons. They are very important to the study of direct and offshore routes [ 2 ] given that 98% of known shipwrecks lie a few miles from the coast, which means that known sites in deep waters, far from the coast, are still very rare.
On the other hand, the location of a shipwreck more than 4 or 5 miles from the coast does not automatically mean that the ship was sailing an offshore route without the possibility of visually following the coast. Instead, storms or the loss of the ability to control the route, because of the rudder or the sail breaking, could push the ship adrift. An example is the story of the Querina ship which, in 1431, after a storm that dismantled its rudder and its sails, was pushed by the sea from the Channel to the coasts of Norway after more than one month of sailing without any control [ 3 ].
1
Shipwrecks located offshore can also be useful in studying the techniques of sailing and navigation. This is particularly interesting for the Ancient and Medieval periods of which we have poor information from traditional sources. For example, it seems very important to understand whether the ships that frequented the Mediterranean in the Greek and in the Early Medieval periods, which, according to what we know, had a limited tonnage, were technically able to sail for long distances offshore, like the Roman onerariae represented by the Madrague de Giens and the Albenga shipwrecks, and by many ships carrying marble stones [ 6 ].
Deep shipwrecks often retain a relatively “good” level of conservation. Given that these ships did not impact against reefs or crags, and that they usually sank intact, their aspect is seldom compromised by the dynamic of the shipwreck. Indeed, the ships can reach the sea bottom in correspondence with the position of navigation, and remain intact on the sand, often with the cargo in a whole state, as it had been on the surface. This is evident from the observation of hundreds of shipwrecks, especially ancient cargos of amphoras, stones blocks, or building materials dated from the Greek to the Medieval period.
The depth, then, permits relatively good protection from treasure hunters, who can seldom exceed a depth of 100 metres, although very well-equipped pirates, breaking national laws and the UNESCO Convention on the Protection of the Underwater Cultural Heritage (2001), visited deeper sites such as the 1000 m deep wreck of the Nuestra Senora de las Mercedes [ 7 ] and the Spanish galleon San José , sunk off Columbia on a seabed at 600 m deep ( https://www.cbsnews.com/news/san-jose-shipwreck-colombia-200-tons-treasure/ (accessed on 20 July 2022)).
The depth also provides protection from the impact of trawling nets. In the Mediterranean, down to many hundreds of metres, these are the most devastating actors for shipwrecks [ 8 ]. The depth can permit the survival of the sites, which either are sufficiently deep or are protected by the morphology of the seabed or are in an area not attended by fishing vessels. On the other hand, the experience of the shipwrecks of the Adriatic demonstrates that, in shallow waters, underwater sites can survive only thanks to the protection of very irregular rocky sea bottoms, with deep cavities, or the covering of a thick layer of sand [ 9 ].
Xylophaga
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Xylophaga
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A totally different case can be found in the formation processes in the deep sea bottoms of the Baltic Sea [ 13 , 14 ] and the Black Sea [ 15 ], where recent and less recent discoveries have returned shipwrecks with wood in excellent states of conservation.
3. The First Steps of the Deep Water Archaeology in Italy and Tuscany
Asherad
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Deutsches Archäologisches Institut
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In the same years, another Italian company, the Snamprogetti, in the Sicily Channel, made a quick survey, through images and remote sensing for the position, with a mini submarine of a shipwreck with 5th century BC amphoras at a depth of 530 m [ 18 ]. After these cases, we had to wait many years before an Italian company or institution carried out other missions of this kind.
At the end of the 1980s, the French technical service Infremer, while engaged in the recovery of pieces of the DC 9 airplane off Ustica on a sea bottom that was 3200 m deep, happened to discover a cargo of the 6th century AD with African amphoras [ 19 ]. This find offered us the first evidence of the potentialities of deep-water archaeology, albeit as the result of a non-scientific mission.
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A study carried out quite close to the Italian coast, and which left its mark on the discipline, was the JASON project, coordinated by the oceanographer R.D. Ballard and the archaeologist A.M. McCann on the Skerki Bank in the Channel of Sicily [ 21 ]. Here, in 1989, a US mission using a ROV on a sea bottom of 818 m recovered some finds in international waters. This mission then continued over several years, also along the Italian coasts [ 4 ], and received critical reactions among some Italian archaeologists (La Repubblica, 2.8.1997, https://ricerca.repubblica.it/repubblica/archivio/repubblica/1997/08/02/america-ruba-nostri-tesori.html (accessed on 20 July 2022)). Ballard’s team, in 1999, west of Israel, surveyed also two 400 m deep Phoenician shipwrecks of the 8th century AD [ 22 ].
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www.archeomedia.net
dolia
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Other Italian superintendencies, such as the Soprintendenza del Mare of Sicily, collaborated with the Aurora Trust Foundation to carry out investigations on deep shipwrecks at Ventotene (2008–9), Capri (2010–11), Panarea (2010 and 2015) and Messina [ 25 , 26 ] ( www.auroratrust.com , accessed on 20 July 2022). Since 2005, the Soprintendenza del Mare, thanks to the collaboration of the RPM Foundation, has also worked with ROVs on the 90 m deep sea bottom of the Favignana island where the rostra were found [ 26 ]. In this case, technology was used to assist the work of technical divers at a depth that could be reached by human divers. The same kind of experience of ROVs in collaboration with divers was carried out, in 2009–2010, on the 65 m-deep shipwrecks with dolia of Marciana Marina (LI) by the Soprintendenza of Tuscany and the Politecnico della Marche [ 24 ].
With the exception of the latter, all these studies undertaken by Italian institutions were possible thanks to the collaboration of French and USA companies and trusts—sometimes under contract, as in the case of the Archeomar project. Other discoveries and investigations were made by chance on the occasion of offshore works, such as the recently explored Archaic shipwreck investigated at 780 m in the Canale d’Otranto under the coordination of the Soprintendenza Nazionale per il Patrimonio Culturale Subacqueo during the installation of pipes ( www.ansa.it , accessed on 16 October 2021); www.patrimoniosubacqueo.it/il-relitto-alto-arcaico-del-canale-di-otranto/ (accessed on 20 July 2022)).
4. Experiences of Deep Water Investigation by ROVs in the Tyrrenian Sea with the Azionemare Foundation
In recent years, ROVs have been increasingly used to explore the depths, playing an important role in various fields of marine scientific research, and allowing the broadening of knowledge in the field of maritime archaeology [ 27 , 28 ]. ROVs suitable for deep water investigations (>300 m) are generally heavy and bulky, and must be supported by large expensive survey vessels, the associated costs being well beyond the reach of scientific researchers who, in most cases, do not have adequate funds. The Azionemare Foundation has tackled the problem and has adopted non-standard and intelligent solutions.
The main tools needed for the research and study of a wreck at depths between 150 and 1000 m are:
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a long-range sonar able to detect the morphology of the bottom and the presence of any object;
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capacity for georeferencing a particular anomaly detected by the sonar on the seabed;
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a vessel equipped with dynamic positioning, capable of moving to the vertical above the anomaly and remaining stationary, automatically controlled by a computer;
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an ROV to be sent to the bottom to recognize the nature of the anomaly and to study it in the case of an ancient wreck.
Guido Gay has created a company that, for 40 years, has been producing Pluto ROVs ( Figure 1 ) used by the Military in mine-hunting jobs. Years ago, he had the opportunity to build a vessel also suitable for experimenting with the Plutos. Among various solutions, he chose to design and build a sailing catamaran. Thus was born the Daedalus, a 21 m long catamaran completely different from the shapes currently in use ( Figure 2 ). This was a fast, stable, spacious and comfortable boat, equipped with dynamic positioning and all the instruments necessary to explore the deep seabed, as well as a workshop-laboratory and a control room ( Figure 3 ) for working with two Pluto wire-guided submarine vehicles. Automatisms and servos allow a single person to maneuver the whole boat.
Figure 4
Figure 5
Except in difficult weather conditions, the long-range sonar is always activated when underway. The emission occurs with a 50 kHz ultrasound beam in the shape of a vertical fan oriented laterally perpendicular to the motion of the boat, so as to strike a strip of seabed about one kilometer wide on the left side of the catamaran. The beam is quite narrow, at about two degrees, and the advancement of the boat allows one to construct an image of the bottom seen not perpendicularly downwards but in profile; in this way any objects stand out very clearly.
Generally speaking, only medium or large vessels specialized for research or underwater work are equipped with this system. In Italy, none of the research vessels available are equipped with dynamic positioning. Only oil works vessels or military mine-hunters are fitted with dynamic positioning capabilities.
The Daedalus catamaran has been designed as an innovative sailing pleasure yacht with the addition of several features designed and built in house, suitable for scientific activity. One of them is the DP, a propeller that is normally hidden in the hull, which can extend out into the water when necessary. The computer controls its orientation and rotation speed in order to keep the boat steady against the current and against the wind. This is a job that could also be done manually but would require a dedicated person. The DP will maintain the position of Daedalus under the conditions of 12-knot wind and 2-knot tide, in seastate 3.
The project concepts of the Pluto Palla and Multipluto are original and unusual. The original idea behind these developments lies in the extreme homogeneity of the project, which includes the development and production of most of the subsystems, to better match the characteristics of each other and to obtain a vehicle with maximum performance with the lowest mass, as well as a very compact footprint. In fact, nothing exists today that comes close to the performance of the Pluto, which can explore as deep as 2000 m with a 60 kg vehicle, as well as another 60 kg remote-controlled cable drum, and which remains there to work for 8 h.
Normally, to go down to depths of, for example, a thousand meters, heavy equipment must be used that can only be installed on ships of adequate tonnage, for example the André Malraux of the French DRASSM (233 tons versus 29 tons of the Daedalus); the Plutos, on the other hand, is battery-powered, thus eliminating the large umbilical cable that carries energy from the surface down to the vehicle. The roller of this cable constitutes the bulk and is the most important weight of all the other vehicles, which imposes the use of ships. The potential benefits of such a light and compact instrument are many, such as for the recovery of instrumentation (in one case, Multipluto recovered a disabled Hugin AUV from 700 m, and in another a military object of 500 kg from 1000 m depth), as well as for the identification and inspection of ancient and modern wrecks, as in the case of the cruiser Giovanni dalle Bande Nere sunk in World War II and lying at a depth of 1750 m.
The Multipluto ROV can be transported in a normal car, loaded by hand on boats and used without the need for system installation. Recovery and deployment can be done by sliding the vehicle by hand or using a small davit. All these tools make the Daedalus catamaran capable of replacing an expensive research vessel for exploration, investigation, surveying and study at great depth, which may also involve light manipulation.
In ten years of navigation exploring the Ligurian and the Tyrrhenian Seas, the Daedalus has discovered 43 wrecks from the Roman era lying at depths between 150 m and 900 m, as well as 24 modern wrecks including the Battleship Roma at 1200 m deep. By considering only the 43 ancient Roman wrecks, Azionemare has located, inspected and identified each and all of them. In general, it was immediately realized that all but three had been affected by damage due to the passage of trawling nets. Many deposits have been totally devastated by the fishing nets, while others show only the first layer of amphorae upset and crushing. This was believed to be the most serious conservation problem, as opposed to looting on coastal deposits accessible to scuba divers.
Studies and samplings have been carried out on some of these wrecks in collaboration with the competent authorities. For example, on the Daedalus 26 wreck located south of Portofino at a depth of 710 m, two photomosaics were made at a two-year interval: they were almost unrecognizable, so significant was the upheaval and the dispersion of the amphorae [ 29 ].
Sampling operations of finds were carried out on about ten wrecks thanks to the use either of a special hook, carried out by the ROV and linked to the boat by a thin line capable of lifting a maximum of one hundred kilos of weight, and to the manipulator arm, which can tighten with delicately adjustable force in order not to damage fragile objects. When it has been planned to recover a certain number of small finds, the manipulator can place a container on the bottom, and each object can be deposited inside it; when full, the same manipulator can grab the container and bring it back to the surface together with the vehicle.
5. Experience of Photogrammetric Documentation on Tyrrhenian Deep Shipwreck
ROVs are widely used for mapping and monitoring cultural and natural heritage, or to document the phases of the work of archaeologist during excavation; their main application is linked to photogrammetric surveys for documentation [ 15 , 30 , 31 ]. Important results of the application of the photogrammetric technique in deep waters have been obtained from recent studies through collaboration with the Azionemare Foundation.
After some short studies with low-cost self-built ROVs, in which the quality of the underwater photogrammetric survey was tested through an accurate comparison between images and video footage of different cameras [ 32 ], the team of the Ca’ Foscari University of Venice had the opportunity to create synergy between its photogrammetric skills and the most advanced technologies of Azionemare. As part of the projects “The routes of ancient marble” and “Digital photogrammetry in underwater archaeology”, it was possible to document and study two important wrecks in the Tyrrhenian Sea, Dae37 and Dae27 3 . The documentation of the two shipwrecks was realized using a professional camera directly mounted inside the head of the ROV with the support of eight lateral external lights for environmental illumination. The processing and the alignment of extrapolated frames (831 for Dae37 and 3668 for Dae27) from the videos was realized with Agisoft Metashape and resulted in an accurate photogrammetric model. The versatility of photogrammetry allows the application of this technique in contexts where natural light is totally absent and the archaeological site is visible only with powerful artificial lights; the effect of the changing shadows on the subject is reduced thanks to the wide overlap between the strips, realized in a bustrophedic way, and it is largely resolved through the algorithms of the latest generation of photogrammetric software [ 15 , 30 , 33 ].
The first experimentation of the photogrammetric technique was carried out on Dae37, a large cargo of 17 lithic (presumably marble) blocks, with dimensions from 2 to 4 m, with a minimum thickness of 20 to 100 cm and Dressel two to four amphoras dated to the 1st century AD, which sank a few miles northwest of the island of Gorgona at a depth of 280 m ( Figure 6 ). The survey was carried out with the use of Multipluto which, through remote-controlled navigation, documented the site with parallel and overlapping strips realized in both directions (longitudinal and transversal to the shape of the site) in order to represent the details of the blocks and obtain an accurate model of the complete cargo.
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With this technique, it was possible to weigh the biggest block, which was 100 tons, and then double the weight of all the other blocks, resulting in an apparently unbalanced configuration and assessment of the marble cargo, with much more weight on one extremity than on the other one.
A second mission was carried out on the Dae27 wreck, a cargo of Roman Dressel 1 amphoras and tiles, sunk at a depth of 640 m off the island of Pianosa. This archaeological site is really important for different reasons: the cargo is preserved inside a pit, probably created by the impact of the shipwreck on the sea bottom, presenting an interesting situation regarding the formation process of shipwrecks, and it represents rare evidence of the long-range transport of material for roof construction. The shipwreck could be dated around the 2nd or 1st century BC, but extensive study and analysis will be conducted after the recovery of an amphora and a tile during the next campaign.
This survey, as for the Dae37, was made using the images taken by the Multipluto, which, in this case, made radial and concentric strips following the mound conformation of the wreck; the survey was particularly difficult due to the numerous objects and the conformation of the finds, which required thousands of frames to represent the cargo in detail ( Figure 7 and Figure 8 ). The photogrammetric 3D model provided documentary evidence of the characteristic of the mound of the cargo and the pit that contains the shipwreck, thus allowing important analysis of the shipwreck; it is possible to approximately calculate the number of amphoras and tiles and the hypothetical volume and weight of the cargo, as completed in other contexts [ 9 ].
6. Aspect of the Mediterranean Deep Shipwrecks
When observing the ancient shipwrecks investigated by the Azionemare Foundation, we can make some interesting observations regarding their aspect in comparison with other shipwrecks of the Mediterranean. Indeed, the facies of these sites are similar, with most of them being dated to the Greek or Roman period; they are cargoes of non-perishable goods, such as amphoras, stone blocks, tiles, pottery and metal ingots. These are of course the less perishable materials, but also the more visible cargoes. Their appearance is often coherent, retaining the organization they had aboard.
The result of the disappearance of the wooden deck is particularly evident in the Dae 39 shipwreck, a cargo of Dressel 1B amphoras preliminarily dated to between the end of the 2nd and the end of the 1st century BC. The location on the top of the amphoras cargo of a doliolum ( Figure 9 a), a few tiles ( Figure 9 b) and a rotary milestone (made by meta and catillus ) ( Figure 9 b) indicates that, originally, these objects were, of course, on the deck and that, after the degradation of the wood, they collapsed. The location of the rotary millstone on the top of the cargo can also be seen on other Mediterranean archaeological sites, such as the Roman cargo documented by the Aurora Trust off Messina ( www.auroratrust.com (accessed on 20 July 2022)) or the wreck at Skerki bank [ 21 ]. We know that millstones were often used aboard to mill the grain, and that they were not merely the object of trading [ 35 ].
The location on an extremity of the shipwreck of lead stocks of unpreserved wooden anchors is evidence of their original position on the presumed bow of the ship [ 36 ]. This is a frequently recurring situation, which can be seen in the Dae 22, 33/34, but which is particularly evident on the Dae 27, on the Dae 42 ( Figure 10 a) and on the Dae 39. On this last shipwreck, the extremity of the presumed bow also hosts an iron arrow-shaped anchor ( Figure 9 c). The presence of the anchors in this position is fairly frequent on other deep shipwrecks.
A careful observation of these sites sometimes allows pottery items to be identified, which were presumably part of the crew’s equipment. The distinction between this pottery and the cargo is possible thanks to the limited numbers of pieces and their isolated position on an extremity. This can be appreciated on the Dae 42 shipwreck, a cargo of Dressel 1C, Brindisine and Lamboglia 2 amphoras, preliminarily dated between the end of the 2nd and the middle of the 1st century BC ( Figure 10 a–c). On this site, it is also possible to see some lead ingots, which could be a secondary part of the cargo ( Figure 10 b).
On none of these sites did we recognize organic finds, a situation that confirms the fact that, aboard an ancient ship, differently to what happened on Late-Medieval or later vessels, both the equipment and the personal belongings, except for very small objects, which are not easy to recognize on the seabed, and the pottery, were mainly made of perishable materials [ 37 ]. The recent discovery of Roman ships in excellent conditions in the deep waters of the Black Sea confirms this image, because its preliminary observation does not show objects made with materials different from wood and ropes, such as metal [ 15 ] and the numerous images and videos on the web].
Among the post-depositional formation processes of these deep shipwrecks, we can include the entrapment of garbage. Indeed, the shipwreck is a trap on the seabed for plastic, glass, ropes and any kind of garbage lost by fishing boats and other vessels ( Figure 11 ).
7. Conclusions
The deep waters of the Tyrrhenian Sea conserve a significant number of shipwrecks, mainly from the Roman period, of great interest both due to the quality of their conservation and because of the historical information they can offer us. One of them has a precious cargo of tiles useful for reconstructing the dynamic of traffic of this product; another one has a cargo of stone blocks (possibly marble blocks) offering exceptional data, which need to be better investigated. The others present interesting information for the study both of the traffic of goods in amphoras, and of navigation and life aboard in antiquity. They also offer important data, helping us to better know the formation processes of the archaeological record at this depth.
This developing frontier raises important challenges that nautical archaeologists can take on thanks to collaborations with institutions and private entities, such as the Azionemare Foundation, equipped with technology still not available to archaeological institutions. This collaboration allows us to both develop new practices in deep-water research and to acquire precious archaeological data. It also would be a significant help for institutions working on the monitoring and safeguarding of submerged heritage, as in the Italian archaeological superintendency.
While we wait for increased autonomy in such institutes (working both in the research and in the safeguarding of the heritage), which too often suffer because of the very limited budget available for research, the collaboration between these two realities, which would place them in a position to share technology and historical research, if carried out according to modern archaeological practices and respecting the UNESCO Convention on the Protection of the Cultural Heritage, will play an important part in documenting and reconstructing, over the decades to come, the technological and economic history of the Mediterranean. Thanks to this collaboration, deep water sites are no longer off limit for archaeological institutions.
Author Contributions
Introduction, history of the research, shipwrecks analysis, C.B.; ROV technique, G.G.; photogrammetry, E.C. All authors have read and agreed to the published version of the manuscript.
Funding
This research received no external funding.
Informed Consent Statement
Not applicable.
Conflicts of Interest
The authors declare no conflict of interest.
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Notes
1 There are a pair of shipwrecks sunk in the channel of Sicily that have been tentatively interpreted as evidence of the annona [ 4 , 5 ].
2 ROVs (Remote Operated Vehicles) are underwater vehicles with no crew on board, which are remote controlled from the surface and which have reached such perfection and dexterity that they can replace humans in complex jobs up to depths exceeding 3000 m.
3 We want to thanks dott. Andrea Camilli (Soprintendenza Archeologia Belle Arti e Paesaggio per le Provincie di Pisa e Livorno) for the permission to carry out research activities on these two sites.
Figure 1. The ROV MultiPluto in action (Photo: G. Gay).
Figure 1. The ROV MultiPluto in action (Photo: G. Gay).
Figure 2. The 29-tonne catamaran Daedalus ready to dive the ROV Pluto palla (Photo: G. Gay).
Figure 2. The 29-tonne catamaran Daedalus ready to dive the ROV Pluto palla (Photo: G. Gay).
Figure 3. Guido Gay piloting a ROV in the control room of the Daedalus (Photo: C. Lucarini).
Figure 3. Guido Gay piloting a ROV in the control room of the Daedalus (Photo: C. Lucarini).
Figure 4. The ROV Pluto palla on the Dae 27 Roman shipwreck (Photo: G. Gay).
Figure 5. The ROV Multipluto using its arm for the recovery of pottery (Photo: G. Gay).
Figure 5. The ROV Multipluto using its arm for the recovery of pottery (Photo: G. Gay).
Figure 6. Orotophoto from the photogrammetry made on the Dae 37 Roman shipwreck with a cargo of stone blocks (off Gorgona Island) (Photo: E. Costa).
Figure 6. Orotophoto from the photogrammetry made on the Dae 37 Roman shipwreck with a cargo of stone blocks (off Gorgona Island) (Photo: E. Costa).
Figure 7. Orotophoto from the photogrammetry made on the Dae 27 Roman shipwreck with a cargo of tiles (off Pianosa Island) (Photo: E. Costa).
Figure 7. Orotophoto from the photogrammetry made on the Dae 27 Roman shipwreck with a cargo of tiles (off Pianosa Island) (Photo: E. Costa).
Figure 8. Frames from the photogrammetry of the Dae 27 shipwreck (Photo: E. Costa).
Figure 8. Frames from the photogrammetry of the Dae 27 shipwreck (Photo: E. Costa).
Figure 9. Cargo of the Dae 39 (north of Corsica) shipwreck: ( a ) Doliolum. ( b ) Tile and millstone. ( c ) Iron arrow shape anchor (from top to bottom is ( a – c ), Photo: G. Gay).
Figure 9. Cargo of the Dae 39 (north of Corsica) shipwreck: ( a ) Doliolum. ( b ) Tile and millstone. ( c ) Iron arrow shape anchor (from top to bottom is ( a – c ), Photo: G. Gay).
Figure 10. Cargo of Dae 42 (East of Corsica) shipwreck: ( a ) Lead anchor stocks and pottery vessels. ( b ) Lead ingots. ( c ) Dressel 1C amphoras (from top to bottom is ( a – c ), Photo: G. Gay).
Figure 10. Cargo of Dae 42 (East of Corsica) shipwreck: ( a ) Lead anchor stocks and pottery vessels. ( b ) Lead ingots. ( c ) Dressel 1C amphoras (from top to bottom is ( a – c ), Photo: G. Gay).
Figure 11. Plastic and other garbage in the Dae 37 shipwreck (Photo: G. Gay).
Figure 11. Plastic and other garbage in the Dae 37 shipwreck (Photo: G. Gay).
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Sexual Dysfunction in Infertile Women With PCOS Undergoing Fertility...
Infertility, defined as the inability to become pregnant after one year of regular unprotected sexual intercourse. It is estimated that around 20 % of...
Sexual Dysfunction in Infertile Women With PCOS Undergoing Fertility Treatment
Phase: | Start Date: January 1, 2022
Overall Status: Recruiting | Estimated Enrollment: 186
Overview
Infertility, defined as the inability to become pregnant after one year of regular
unprotected sexual intercourse. It is estimated that around 20 % of couples suffer from
infertility with prevalence rates of infertility differing substantial among countries .
Sexual function in females is very complex and is affected by many factors. The prevalence of
sexual dysfunction is higher in infertile patients compared to the normal population .
Whether sexual dysfunction is the cause or consequence of subfertility is difficult to
establish. For instance, sexual dysfunction might result in decreased coital frequency
compounding the issue of subfertility due to reduced exposure. On the other hand, the
psychological pressure to get pregnant stemming from sex on demand could result in a
reduction in enjoyment of sex aggravating sexual dysfunction. Indeed, situational sexual
dysfunction and loss of a couple's intimacy may occur as a consequence of timed intercourse
where focus for coitus is no longer pleasure but conception .
Study Type
Study Type: Observational
Study Design
Time Perspective: Cross-Sectional
Study Primary Completion Date: June 1, 2022
Detailed Description
Our work is an observational analytic cross-sectional study that included an Egyptian
convenient sample of 186 females with primary infertility due to polycystic ovary syndrome.
Patients aged 18-35 were recruited from Kasr Al-Ainy Gynecology Clinic (Infertility Clinic)
Medicine Hospital, Faculty of Medicine, Cairo University. They were diagnosed with primary
infertility and polycystic ovary by Rotterdam criteria .
Patients with medical conditions (apart from PCOS complications like type II diabetes,
obesity and metabolic syndrome) or receiving antidepressant therapy were excluded. Females
with other causes of infertility associated with PCOS (e.g uterine factors, tubal factors)
were not included. Patients with history of psychotic disorders or substance abuse were
excluded. All patients approved to participate in the study and signed an informed consent to
confirm this approval.
Intervention :
A- Gynecological Assessment :
Using Kasr Al Ainy infertility sheet that include clinical history taking of amenorrhea or
oligomenorrhea. assessment of age years and type of infertility, medical history, surgical
history, weight , height, history of hirsutism, ultrasound finding, speculum examination and
hormonal profile including (FSH, LH, E2, Prolactin, TSH and progesterone) also history of any
surgical intervention and type of fertility treatment were obtained . Vaginal ultrasound and
speculum examination were done to every patient. PCOS was diagnosed using Rotterdam criteria
based on identifying at least two of the following three features: oligo/anovulation ,
hyperandrogenism: clinical (hirsutism or male pattern alopecia) or biochemical (raised free
androgen index or free testosterone) & polycystic ovaries on ultrasound (a follicle number
per ovary of > 10).
Other etiologies must be excluded such as congenital adrenal hyperplasia, androgen secreting
tumours, Cushing syndrome, thyroid dysfunction and hyperprolactinaemia .
Laboratory work up including :
1. LH/FSH ratio: Many women with PCOS have LH and FSH levels still within the 5-20 mlU/ml
range, but their LH level is often two or three times that of the FSH level
2. Prolactin level: (1-20 ng/mL)
3. Estradiol level : (ranging from 20-400 pg/mL in healthy normal women)
4. TSH level : (normally 0.35- 5 μU/mL). TSH is checked to rule out other problems, such as
an underactive or overactive thyroid, which often cause irregular or lack of periods and
anovulation .
All blood samples (FSH-LH- E2 -PRL-TSH) were obtained at the second day of menstrual cycle in
all women within the last six months before the interview
B-Data collection tool was a questionnaire completed through interviews in private meetings
by the researcher. The questionnaire was composed of two parts: demographic characteristics
and information about sexual relationship (such as frequency of sexual contacts per week,
satisfaction with sexual and non-sexual relationships). Sexual dysfunction measurement were
done by gynecologists/sexologists in infertility center on the basis of a diagnostic
interview according to the Female Sexual Functioning Index (FSFI) The FSFI is a reliable test
for the assessment of sexual function in women. The Arabic version of this test, was used.
The FSFI is comprised of six domains (desire, arousal, lubrication, orgasm, satisfaction, and
pain) with score ranges of 0 (or 1) to 5. The total FSFI score ranges from 2.0 to 36. The
translated version of the FSFI test was used in this study. All questions in the FSFI
questionnaire were explained by the physician one by one, and they were filled in a suitable
and silent environment where patients could comfortably share such intimate information.
Analysis of data will be done by using SPSS ( statistical program for social science version
23 ) . Quantitative data will be statistically represented in terms of mean ± standard
deviation (± SD) while categorical data will be represented as frequency and percentage.
Comparison of quantitative data will be done using (Mann Whitney U ) test for independent
samples while categorical data will be compared using ( Chi squared test ) or ( Fisher exact
test ) when appropriate.
Correlation coefficient test will be used to rank different variables against each other
where a probability value (p value) > 0.05 will be considered statistically insignificant , a
probability value (p value) < 0.05 will be considered statistically significant & a
probability value (p value) < 0.001 will be considered statistically highly significant.
Interventions
Other: FSFI questionnaire
The FSFI is a reliable test for the assessment of sexual function in women. The Arabic version of this test, was used. The FSFI is comprised of six domains (desire, arousal, lubrication, orgasm, satisfaction, and pain) with score ranges of 0 (or 1) to 5. The total FSFI score ranges from 2.0 to 36. The translated version of the FSFI test was used in this study. All questions in the FSFI questionnaire were explained by the physician one by one, and they were filled in a suitable and silent environment where patients could comfortably share such intimate information
Clinical Trial Outcome Measures
Primary Measures
prevalence of sexual dysfunction in PCOS
Time Frame: 6 months
prevalence of sexual dysfunction in PCOS
Secondary Measures
Risk factors for sexual dysfunction in PCO
Time Frame: 6 months
Risk factors for sexual dysfunction in PCO
Relation of sexual dysfunction to different fertility treatments in PCO
Time Frame: 6 months
Relation of sexual dysfunction to different fertility treatments in PCO
Participating in This Clinical Trial
Inclusion Criteria
1. Infertility .
2. PCOS.
3. Age from 18-35 years
Exclusion Criteria:
1. chronic medical condition previously associated with FSD (e.g. diabetes mellitus and
cardiovascular diseases, such as hypertension) or using antidepressant medications.
2. Refusing participation in study.
3. Other causes of infertility
Gender Eligibility: Female
Minimum Age: 18 Years
Maximum Age: 35 Years
Are Healthy Volunteers Accepted: Accepts Healthy Volunteers
Investigator Details
Lead Sponsor
Cairo University
Provider of Information About this Clinical Study
Principal Investigator: Bassiony Dabian, lecturer of obstetrics and gynecology – Cairo University
References
World Health Organization. Report of a WHO meeting. In: Vayena E, Rowe PJ, Griffin PD, editors. Current practices and controversies in assisted reproduction. Geneva: Byword Editorial Consultants; 2002. p. 1-396
Fassino S, Piero A, Boggio S, Piccioni V, Garzaro L. Anxiety, depression and anger suppression in infertile couples: a controlled study. Hum Reprod. 2002 Nov;17(11):2986-94. doi: 10.1093/humrep/17.11.2986.
Malin M, Hemmink E, Raikkonen O, Sihvo S, Perala ML. What do women want? Women's experiences of infertility treatment. Soc Sci Med. 2001 Jul;53(1):123-33. doi: 10.1016/s0277-9536(00)00317-8.
Ercan CM, Coksuer H, Aydogan U, Alanbay I, Keskin U, Karasahin KE, Baser I. Sexual dysfunction assessment and hormonal correlations in patients with polycystic ovary syndrome. Int J Impot Res. 2013 Jul-Aug;25(4):127-32. doi: 10.1038/ijir.2013.2. Epub 2013 Feb 14.
Keye WR Jr. Psychosexual responses to infertility. Clin Obstet Gynecol. 1984 Sep;27(3):760-6. doi: 10.1097/00003081-198409000-00024.
Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertil Steril. 2004 Jan;81(1):19-25. doi: 10.1016/j.fertnstert.2003.10.004.
2 June 2022
Conditions in This Trial
Sexual Dysfunction
PCOS
Interventions in This Trial
FSFI questionnaire
Condition MeSH Term(s)
Infertility
Information Source
ID Number: 12A34
NCT Identifier: NCT05402800
NCT05402800, June 28, 2023
| https://trialbulletin.com/lib/entry/ct-05402800 |
(PDF) Psychological distress, depression and generalised anxiety in Turkish and Moroccan immigrants in Belgium
PDF | This study assesses the prevalence of and risk and protective factors for common mental health complaints in a general population sample of... | Find, read and cite all the research you need on ResearchGate
Psychological distress, depression and generalised anxiety in Turkish and Moroccan immigrants in Belgium
September 2008
Social Psychiatry and Psychiatric Epidemiology 44(3):188-97
DOI: 10.1007/s00127-008-0431-0
Abstract
This study assesses the prevalence of and risk and protective factors for common mental health complaints in a general population sample of Turkish and Moroccan immigrants living in Belgium. Focus is on between- and within-group variation.
The study is based on pooled data from the Belgian Health Interview Surveys 2001 and 2004 and focuses on the Turkish and Moroccan immigrant population aged 18-65 (N = 147 Turks, N = 359 Moroccans). Mental health status is assessed with the General Health Questionnaire-12 and the Symptom Checklist 90-R subscales for depression and generalised anxiety. Risk and protective factors considered are gender, age, household type, labor market position, educational level, household income, homeownership, being foreign- or native born and social support.
Between-group variance was not significant. Within-group analysis showed significant effects of gender and social support. Although not significant, the results suggested positive associations between social adversity and mood status. In addition, there was a tendency for higher risks for psychological distress, depression and generalised anxiety in foreign-born as compared to Belgian-born Turkish and Moroccan immigrants.
ORIGINAL PAPER
Katia Levecque Æ Ina Lodewyckx Æ Piet Bracke
Psychological distress, depression and generalised anxiety
in Turkish and Moroccan immigrants in Belgium
A general population study
Received: 2 January 2008 / Accepted: 31 July 2008 / Published online: 25 August 2008
j Abstract Background This study assesses the
prevalence of and risk and protective factors for
common mental health complaints in a general
population sample of Turkish and Moroccan immi-
grants living in Belgium. Focus is on between- and
within-group variation. Methods The study is based
on pooled data from the Belgian Health Interview
Surveys 2001 and 2004 and focuses on the Turkish and
Moroccan immigrant population aged 18–65 ( N = 147
Turks, N = 359 Moroccans). Mental health status is
assessed with the General Health Questionnaire—12
and the Symptom Checklist 90-R subscales for
depression and generalised anxiety. Risk and protec-
tive factors considered are gender, age, household
type, labor market position, educational level, house-
hold income, homeownership, being foreign- or native
born and social support. Results Between-group
variance was not significant. Within-group analysis
showed significant effects of gender and social sup-
port. Although not significant, the results suggested
positive associations between social adversity and
mood status. In addition, there was a tendency for
higher risks for psychological distress, depression and
generalised anxiety in foreign-born as compared to
Belgian-born Turkish and Moroccan immigrants.
j Key words depression – anxiety – community
sample – risk factors – immigrants
Introduction
In the United States, early population studies on the
relationship between migration and mental health
suggested that there was a strong association between
migrant status and psychological disorder, but more
recent research reveals contradictory results, with
some studies suggesting an increased risk, whereas
others demonstrating a lower risk for psychiatric dis-
order among immigrants than among native-born [ 28 ,
46 ]. The early studies highlighted the stresses of
migration and the disadvantages faced by immigrants,
contrasting these with the positive effects of accultur-
ation and assimilation into mainstream society of the
United States [ 20 ]. More recent findings however,
challenge these long standing tenets in psychiatry and
psychology by finding lower levels of psychopathology
in first-generation immigrants as compared to immi-
grants born in the host country [e.g. 10 ]. This rising
new evidence suggest that the intergenerational process
of adjustment to American society leads to increasing
risk for psychiatric disorder, while retention to the
cultural traditions socialized into in the home country
has a positive effect on mental health [ 21 ].
European research on mental disorders in immi-
grants is less developed. Most studies carried out are
clinical, mostly limited to private medical practices or
health care facilities and usually reveal higher preva-
lences and higher admission rates in (some) immi-
grant groups [ 13 , 33 ]. Most studies are directed at less
common conditions such as schizophrenia [e.g. 27 ];
for mood disorders, empirical evidence is more
limited and inconclusive [a.o. 53 , 58 , 65 ]. Knowledge
on mental health gathered through patient studies
SPPE 431
K. Levecque
Research Foundation – Flanders
Brussels, Belgium
K. Levecque ( & ) Æ P. Bracke
Dept. of Sociology, Faculty of Political and Social Sciences
University of Ghent
Korte Meer 3-5
9000 Ghent, Belgium
Tel.: +32-9/264-8436
Fax: +32-9/264-9198
E-Mail: [email protected]
I. Lodewyckx
Centre for Migration and Intercultural Studies
University of Antwerp
Antwerp, Belgium
Soc Psychiatry Psychiatr Epidemiol (2009) 44:188–197 DOI 10.1007/s00127-008-0431-0
should be seen as having some limitations due to the
use of small and, frequently, biased samples [ 14 ]. Bias
may, among others, be related to group differences in
treatment-seeking and admission practices [ 65 ].
Epidemiological studies informing on the mental
health status of immigrants in the general population
of European countries are still very scant [ 14 ].
According to Carta et al. [ 14 ] there is little data at
our disposal with regard to the level of mental health
among those who are culturally different owing to
inadequate systems of registration. These systems
have recently started to be modified in some coun-
tries in order to provide with useful data. Never-
theless, some epidemiological non-patient studies on
the mental health status of immigrants do exist, but
its distribution across European countries is patchy
[ 14 , 16 ] and only a few studies actually inform about
depression and anxiety [see e.g. 5 , 15 , 34 ] for
exceptions. Those that do, usually report higher
prevalence rates of affective problems in immigrants
than in natives. Mavreas and Bebbington [ 44 ] sug-
gest a greater risk of anxiety disorders in southern
and of depression in northern European countries.
Only in a handful of countries, nationwide or re-
gional epidemiological studies are available on
immigrants [ 14 ].
Recently, an epidemiological study by Levecque
et al. [ 38 ] reported on generalised anxiety and
depression in the native and immigrant general
population in Belgium. The data used was the
nationally representative Health Interview Survey
conducted in 2001. It was found that all European
immigrant groups considered showed no differential
pattern in mental health status as compared to Bel-
gian natives, but immigrants originating from Turkey
and Morocco reported significantly higher levels of
depression and anxiety (as assessed with the relevant
SCL 90-R subscales) [ 37 ]. Multivariate analyses
showed the higher risk for anxiety to be attributable
to lower socioeconomic status, suggesting a signifi-
cant role for stress-related conditions and processes
such as social exclusion, impoverishment, discrimi-
nation and racism. In the case of depression, multi-
variate findings showed only a partial decrease in risk,
leaving a significant association with Turkish or
Moroccan origin. In the Netherlands, a neighbouring
country of Belgium, a similar finding was reported for
Turkish and Moroccan elderly immigrants [ 68 ].
In the present study we use the same dataset as
Levecque et al. [ 38 ], but extend their analysis in
several ways. First, focus will not only be on depres-
sion and generalised anxiety as assessed with the
relevant subscales of the Symptom Checklist 90-R, but
also on mental health complaints indicated by the 12-
item version of the General Health Questionnaire.
Second, we consider the same classic list of risk fac-
tors (i.e. gender, age, household type, educational le-
vel, labor market position, home ownership and
income), but in line with more recent American evi-
dence on the link between migration and mental
health, we add information on nativity, indicating
whether one is foreign-born or born in Belgium.
Third, as international epidemiological research has
consistently shown social support to be a significant
protective factor in the development of common
mental health problems, we add information on per-
ceived social support. As a buffering factor, social
support may be especially relevant in immigrant
communities [ 12 ]. Finally, we concentrate solely on
the Turkish and Moroccan immigrant population, as
former analysis has shown these groups to be espe-
cially at risk for depression and anxiety. Focussing on
the Turkish and Moroccan immigrants, we first assess
whether the between-group variation in mental health
is significant, thus asking whether differentiation
between both immigrant communities in further
mental health analysis is necessary.
Although there are many similarities in migration
history and in the current cultural, demographic and
socioeconomic profile of Turkish and Moroccan
immigrants, critical differences remain that might be
relevant for the development of common mental
problems [ 7 , 8 , 35 ]. Similarities in patterns of
migration history, for example, show both groups to
come from mainly rural areas in an Islamic country of
origin. Originally, migration to Belgium started in the
1960s within the context of labor market shortage, but
since 1973 most migration flows from Turkey and
Morocco are mainly organized within the context of
family reunions and marriage [ 52 , 64 ]. Most immi-
grants from the same region in the home country
have moved to the same region of destination in
Belgium, resulting in ‘transplanted communities’.
According to Surkyn and Reniers [ 63 ], Turkish
immigrants believed in the temporary character of
their stay in Belgium, while Moroccans saw it as a
steadier move. As concerns marriage migration and
second generation immigrants of Turkish and
Moroccan origin, recent findings show that both
communities differ significantly in the choice of
marriage partner: nearly 70% of the Turkish immi-
grants choose a partner from the country of origin,
while almost 50% of the Moroccan second generation
immigrants opt for an inter-ethnic marriage [ 64 , 66 ].
Concerning motherhood, Turkish mothers begin and
end the family-forming process earlier, resulting in
lower Turkish fertility rates [ 41 , 57 ]. Concerning
socioeconomic status, research has shown significant
between-group differences on some aspects (e.g.
higher illiteracy rates in first generation Morrocans,
50% home owners in the Turkish community versus
29% in the Moroccan) [ 48 , 69 ], but a lack of differ-
entiation on others (e.g. poverty rate, housing and
living conditions, educational level in second gener-
ation migrants, labor market position) [ 49 , 69 ]. In
addition, there is a strong gender dimension on the
labor market, resulting in an extremely low activity
rate for Turkish and Moroccan women.
189
Methods
j Sample
Analyses are based on the pooled data of the 2001 and 2004 health
interview survey (HIS), which are the second and third national
health surveys to be organised in the general population in Bel-
gium. An extensive description of the methods, sampling frame and
respondents of both surveys is provided elsewhere [ 61 ]. Suffice it to
say that these cross-sectional surveys are representative of the
population in private and collective households and that they are
based on a multistage stratified cluster sample (pooled N = 12,057
households, 26,601 individuals). Both surveys provide information
on respondents physical and mental health and on their use of
healthcare resources. Household characteristics are assessed with a
household questionnaire; individual characteristics are assessed by
means of a verbal and written questionnaire administered to up to
three additional household members. Household members in
psychiatric care were not contacted. All questionnaires are available
in Dutch, French, German and English, but when necessary, help
with translation was provided. Response rate at household level is
61.4% in both survey years. Information on mental health is col-
lected by written questionnaire for all participating respondents
aged 15 or more. Proxies were not allowed. In our analysis, we
restrict the sample to the population aged 18–65 because of the
small number of elderly immigrants. This restriction results in a
sample of N = 147 Turkish and N = 359 Moroccans immigrants.
j Mental health status
Mental health is assessed with the 12-item version of the general
health questionnaire (GHQ) and the symptom checklist (SCL) 90-R
subscales for depression and anxiety. All scales are frequently used
in international epidemiology and have shown good psychometric
properties within a general population context e.g. [ 39 , 45 , 56 ]. The
GHQ asks about symptoms that are experienced more or less than
usual in the recent few weeks [ 22 ], while the SCL-R subscales tap
the severity of symptoms suffered by an individual in the week
prior to the interview [ 18 ]. In the present study, we use the 12-item
version of the GHQ, which has several indicators of severe
depression. From the SCL-R, we use the depression subscale (13
items) and the subscale for generalised anxiety (10 items). (Sub)-
scale scores are computed as advised by their developers. Reli-
ability of the GHQ and both SCL-R-subscales in our sample was
accurate, as indicated by a Cronbach alpha of at least 0.85 for the
GHQ and at least 0.92 for both SCL-R-subscales in the two immi-
grant groups. Cultural validity of the scales is assumed based on
published GHQ- and SCL - research in Turkey [e.g. 23 , 25 , 30 , 31 ,
50 ]. Except for Levecque et al. [ 28 ], no study for Moroccan
immigrants or for the Moroccan context could be found.
Although both the GHQ and the SCL-R are dimensional scales,
we opt for the use of thresholds in order to focus at the most severe
mental health complaints in the Turkish and Moroccan immigrant
population. For the GHQ-12, international literature suggests a cut-
off at a crude scale score of 2, indicating psychological distress [ 22 ].
For the SCL-R-subscales, there are no validly established cut-offs
[ 55 ]. We therefore opt for a 90% severity threshold: if a subscale
score is above the 90th percentile in the scale score distribution in
the general population in Belgium, we consider the complaints to
be severe and label them as expressions of depression or anxiety
[see also 38 ].
j Risk factors
Turkish or Moroccan immigrant status is the main variable in our
study. In health research, migrant status is often determined based
on nationality [e.g. 29 ], but since the drastic change in the 1990s to
Belgian legislation on naturalisation, current nationality is no
longer a good indicator for the identification of one’s foreign roots.
Under the new law, large numbers of immigrants from Turkey and
Morocco have acquired Belgian nationality and descendents of
immigrants now automatically receive Belgian nationality when
they are born on Belgian soil. An alternative way of differentiating
according to region of origin is to consider country of birth [e.g.
47 ], but if research focus is not on first-generation immigrants
only, this too is an inadequate strategy since it would categorise
large numbers of individuals with Turkish or Moroccan roots as
Belgian. In the present study, we opt for a combination of infor-
mation on current nationality and country of birth in order to get a
more accurate identification of Turkish and Moroccan immigrants
[see also 38 , 42 ].
Next to immigrant status, we look at eight additional risk fac-
tors, which previous research has found to be relevant for common
mental health problems in the general population in Belgium and
elsewhere [see 7 , 9 , 35 , 36 , 43 , 70 ]. We consider three sociodemo-
graphic factors: gender (two categories: male, female), age (in
years) and household type (five categories, combining information
on cohabitation status and dependent children). As for the socio-
economic risk factors, we look at educational attainment (four
categories: low/none, medium, high and still studying), labor
market position (four categories: employed, unemployed, sick/
disabled, other inactive), homeownership (two categories: owners,
renters) and equivalent household income (five categories: <750,
750–1,000, 1,000–1,500, 1,500–2,500, > 2,500 EURO). Adjustments
for differences in the size and composition of households were
made using the modified organization for economic cooperation
and development (OECD) equivalence scale. In addition to these
‘classic’ risk factors, we also consider country of birth, indicating
whether the Turkish and Moroccan immigrants were foreign-born
or born in Belgium.
One of the best known protective factors in the development of
mental health problems, namely social support, is measured with
the medical outcome social support scale (MOSS) [ 59 ]. This scale
measures the perception of social support based on combined
information on emotional, instrumental and affective support and
positive social interaction. Scale scores range from 0 to 100, with
higher scores indicating a more positive perception of social sup-
port. International literature reports the scale to be highly reliable
and valid [e.g. 60 , 72 ].
j Analysis procedure
Prevalence rates are assessed with percentages; between-group
differences were calculated with v
2
analyses, using P = 0.05 as the
level set to determine statistical significance. Profiles of risk and
protective factors are established using multivariate logistic
regression. Odds ratios (ORs) are calculated, as are 95% confidence
intervals (CIs). In order to ensure that the sample data represents
the general population of interest, weights are applied to adjust for
the probability of selection within the household, for municipality,
province and region and for interview timing [ 61 ]. The significance
of individual indicators is assessed by means of the Wald v
2
test.
The overall goodness of model fit is assessed on the basis of the
Likelihood Ratio v
2
test [ 26 ]. We also report the Nagelkerke R
2
[ 1 ].
Results
j Prevalence
As Table 1 shows, Turks and Moroccans are worse of
in terms of psychological distress, severe depression
and severe generalised anxiety as compared to the
Belgian population. Differences between the Turkish
and Moroccan immigrant population are not signifi-
cant.
190
j Risk and protective factors
Next, we consider whether the classic risk and pro-
tective factors identified in international mental
health research, are also relevant in explaining mental
health complaints in Turkish and Moroccan immi-
grants. Comparisons in terms of these factors are
reported in Table 2 . As in Table 1 , we add informa-
tion on the native population.
Table 2 shows that Turkish and Moroccan immi-
grants are significantly younger, less single and/or
childless and have a lower socioeconomic status as
compared to the native population. There is no sig-
nificant difference in gender composition or in per-
ceived social support. When looking at the between-
group variation, the Turkish and Moroccan commu-
type, educational level and home-ownership. There is
no significant difference in terms of gender, age, labor
market position, income and the percentage of for-
eign-born migrants. Because of the small number of
retired immigrants in our sample, the categories ‘re-
tired’ and ‘non-active’ are combined in further
analyses, of which results are shown in Table 3 . This
table informs on the risk and protective factors in the
development of psychological distress, depression
and anxiety in the Turkish and Moroccan immigrant
community.
Table 3 shows that for all common mental health
problems considered, only gender and social support
are statistically significant. In the case of social sup-
port, results confirm the international pattern that
suggests lower prevalence rates of psychological dis-
tress, depression and anxiety when affective, instru-
mental and emotional support and possibilities for
positive interaction are available [e.g. 17 , 32 ]. Con-
cerning gender, Table 3 reports a partial OR = 2.20
for psychological distress, and OR = 3.82 and OR =
4.47 for depression and anxiety respectively. These
gender differences in mental health complaints [ 51 ],
but compared to former evidence for the general
population in Belgium [ 7 , 8 , 36 , 70 ], the ORs in the
Turkish and Moroccan immigrant population are
much larger, especially for depression and generalised
anxiety.
Although the other risk factors in Table 3 are not
statistically significant, a similar pattern for all three
mental health statuses can be observed for country of
birth: a tendency to more mood problems in foreign-
born as compared to Belgian-born immigrants. In
terms of socioeconomic status, our findings suggest a
small but positive association with educational level, a
higher risk of complaints when sick or handicapped,
and less mood problems when financially better off.
Discussion
j Key findings
In this study, we concentrated on psychological dis-
tress, depression and generalised anxiety in the
Turkish and Moroccan immigrant population that has
settled in Belgium. We first assessed prevalence rates
and confirmed the finding by Levecque et al. [ 38 ] that
rience higher levels of psychopathology as compared
to Belgian natives. The within-group variation in the
immigrant sample was found to be non-significant for
all health indicators used. Levels of psychological
distress, as assessed with the GHQ-12, were found to
be as high as 32%, a percentage resembling the 33.4%
reported for the same scale for a general population
sample of Turkish immigrants in the Netherlands, a
neighbouring country of Belgium [ 5 ].
In the second phase of our study, we tested whe-
ther the classic risk and protective factors identified in
international epidemiology were also significant
determinants for psychopathology in Turkish and
Moroccan immigrants. In line with international lit-
erature, our findings for gender as a risk factor, and
social support as a protective factor, were statistically
significant. All other covariates in our model missed
significance at the P < 0.05-level, due to a limited
statistical power. However, the findings suggest some
tendencies in the risk profile for all three mental
health problems considered.
of psychological distress, depression and anxiety in the adult population (aged 18–65) in Belgium, 2001 and 2004: differentiated according to
region of origin (absolute N , weighted %)
Region of origin
Belgium (B)
( N = 11,747)
Turkey (T)
( N = 147)
Morocco (M)
( N = 359)
Difference (B–T–M)
( P > v
2
)
Difference (T–M)
( P > v
2
)
Psychological distress (GHQ 2+) 26.42 31.90 32.05 # NS
Depression (SCL-R subscale 90% severity threshold) 9.14 15.41 14.21 * NS
Anxiety (SCL-R 90% severity threshold) 10.41 17.04 15.17 * NS
Belgian Health Interview Survey 2001 and 2004—own calculations
NS not significant
#
P < 0.05; * P < 0.01
a
Age and sex direct standardization with the Belgian population as reference
191
Concerning age, the findings suggest no effect,
which is consistent with prior research based on the
same data-set in different population groups in Bel-
gium [e.g. 35 , 36 ] and with Dutch empirical evidence
on severe depression and anxiety in Turkish non-
patients living in the Netherlands [ 5 ]. This lack of an
age-effect should be considered independent of the
generation-effect that was tested based on knowledge
of one’s country of birth. While early American re-
search of ethnic variation in health highlighted the
positive effects of acculturation and assimilation into
mainstream society [ 20 ], more recent studies chal-
lenge this hypothesis by reporting lower levels of
psychopathology in first-generation immigrants as
compared to immigrants born in the host country
[e.g. 10 , 21 ]. Our findings do not support the more
recent idea of deleterious effects of acculturation since
ORs for first-generation immigrants were systemati-
cally higher than for immigrants born in Belgium.
When turning to the tendencies reported for
socioeconomic status, the pattern for educational le-
vel was similar for all three emotional problems: lower
health risks for individuals at school compared to
adults who have already finished education. For the
latter, higher educational levels seem to increase the
risk for psychological distress, depression and gen-
eralised anxiety. In the case of home ownership, re-
sults show renters to be less depressed or
experiencing generalised anxiety, but they report
slightly more psychological distress as assessed with
the GHQ-12. In a Dutch study on psychological dis-
tress in Turkish immigrants [ 5 ], poor housing was
modelled as a risk factor, but no significant effect was
found. Both other socioeconomic status variables in
Table 2 Characteristics of the adult population (aged 18–65) in Belgium, 2001 and 2004: differentiated according to region of origin (absolute N , weighted %,
weighted mean and standard deviation SD)
Region of origin
Belgium (B)
( N = 11747)
Turkey (T)
( N = 147)
Morocco (M)
( N = 359)
Difference (B–T–M)
( P > v
2
)
Difference (T–M)
( P > v
2
)
Gender (%) NS NS
Male 48.05 54.42 51.81
Female 51.95 45.58 48.19
Age *** NS
Mean age (year) 41.98 36.81 38.74
SD age (year) 13.12 10.24 10.89
Household type (%) *** #
Single, no children 17.14 11.56 14.21
Single, with children 5.18 3.40 5.01
Couple, no children 29.07 6.80 15.60
Couple, with children 33.28 58.50 46.80
Other household type 15.32 19.73 18.38
Educational level (%) *** #
None/low 31.55 54.01 41.42
Middle 32.73 16.79 21.36
High 28.44 22.63 24.60
Studying 7.28 6.57 12.62
Labor market position (%) *** NS
Employed 69.02 43.07 44.51
Unemployed 7.31 25.55 18.81
Retired 10.68 0.73 4.39
Sick/handicapped 3.72 5.84 4.70
Other inactive 9.28 24.82 27.59
Equivalent income *** NS
<750 EURO 4.25 6.98 5.21
750–1,000 EURO 7.01 19.38 19.94
1,000–1,500 EURO 20.04 31.78 35.28
1,500–2,500 EURO 36.13 36.43 33.13
>2,500 EURO 32.56 5.43 6.44
Home ownership (%) *** **
Owner 72.69 48.28 30.40
Renter 27.31 51.72 69.60
Country of birth (%) NA NA NS
Belgium 6.80 3.90
Turkey/Morocco 93.20 96.10
Social support (scale range 0–100) NS NS
Mean MOSS-score 76.62 73.71 71.61
SD MOSS-score 23.82 26.86 27.41
Belgian Health Interview Survey 2001 and 2004—own calculations
NA not applicable, NS not significant
#
P < 0.05, ** P < 0.001; *** P < 0.0001
192
our model, namely income and labor market position,
confirm the tendency of a positive association be-
tween social adversity and common mental health
complaints. This is in line with many other studies on
ethnic variation in psychopathology [e.g. 5 , 20 ]. In
our analysis, the positive association is most apparent
for the income-indicator, a finding which should be
seen within the context of very large poverty figures
for both immigrant communities in Belgium. Poverty
figures for 2001, for example, show 10.16% of Belgian
natives to experience poverty, compared to 58.94 and
55.66% among the Turkish and Moroccan popula-
tions respectively [ 69 ]. In both immigrant groups,
processes of impoverishment are strongly related to
ongoing discrimination and racism, especially on the
labor market. These processes result in high levels of
unemployment which might be experienced as
stressful and health-damaging, especially by Turkish
and Moroccan males since Turkish and Moroccan
culture prescribe males to provide for their family’s
financial needs [ 24 ]. This health-damaging effect of
unemployment is however not suggested by the
findings reported in Table 3 . When we compare our
results with those of a Dutch study of Turkish male
immigrants, we see a similar non-significance for
depression, but higher levels of anxiety and psycho-
logical distress (based on the GHQ) when unem-
ployed [ 5 ]. We repeat that the lack of non-significance
in our analysis is related to limited statistical power,
but the possibility should not be ignored that addi-
tional processes are operative, leading to a real lack of
health differences in working and non-working
Table 3 Risk factors for psychological distress, depression and anxiety in the Turkish and Moroccan immigrant population (aged 18–65) in Belgium, 2001 and 2004
(weighted odds ratios, 95% CI and v
2
)
Psychological distress (GHQ 2+) Depression (SCL-90-R 90% severity
threshold)
Anxiety(SCL-90-R 90% severity
threshold)
OR 95% CI P > v
2
OR 95% CI P > v
2
OR 95% CI P > v
2
Region of origin NS NS NS
Morocco 1.00 1.00 1.00
Turkey 1.10 (0.59–2.06) 0.76 (0.32–1.84) 0.77 (0.33–1.81)
Gender ** ** ***
Male 1.00 1.00 1.00
Female 2.20 (1.14–4.23) 3.82 (1.54–9.49) 4.47 (1.84–10.84)
Age NS NS NS
1.00 (0.96–1.01) 0.98 (0.93–1.02) 0.99 (0.95–1.03)
Household type NS NS NS
Single, no children 1.00 1.00 1.00
Single, with children 0.67 (0.13–2.54) 1.69 (0.24–11.82) 2.23 (0.32–15.52)
Couple, no children 1.30 (0.43–3.98) 2.48 (0.55–11.12) 3.36 (0.75–15.03)
Couple, with children 1.58 (0.52–4.84) 0.69 (0.13–3.66) 1.16 (0.24–5.70)
Other household type 0.76 (0.30–1.95) 0.55 (0.14–2.12) 0.78 (0.21–2.94)
Educational level NS NS NS
None/low 1.00 1.00 1.00
Middle 1.09 (0.50–2.37) 1.35 (0.48–3.81) 1.29 (0.47–3.55)
High 1.36 (0.66–2.80) 1.39 (0.90–3.90) 1.36 (0.58–4.08)
Studying 0.84 (0.31–2.26) 0.72 (0.16–3.33) 0.65 (0.14–3.04)
Labor market position NS NS NS
Employed 1.00 1.00 1.00
Unemployed 1.17 (0.54–2.54) 1.51 (0.53–4.34) 0.80 (0.28–2.32)
Sick/handicapped 1.98 (0.44–8.89) 4.06 (0.72–22.91) 4.28 (0.79–23.02)
Other inactive 0.51 (0.21–1.20) 0.44 (0.13–1.48) 0.41 (0.13–1.26)
Income NS NS NS
<750 EURO 1.00 1.00 1.00
750–1,000 EURO 0.45 (0.11–1.87) 0.27 (0.04–1.95) 0.26 (0.04–1.78)
1,000–1,500 EURO 0.37 (0.09–1.59) 0.54 (0.08–3.83) 0.34 (0.05–2.33)
1,500–2,500 EURO 0.48 (0.10–2.27) 0.52 (0.06–4.29) 0.26 (0.03–2.14)
>2,500 EURO 0.43 (0.07–2.79) 0.65 (0.06–7.55) 0.47 (0.05–4.93)
Home ownership NS NS NS
Owner 1.00 1.00 1.00
Renter 1.15 (0.59–2.24) 0.95 (0.38–2.37) 0.76 (0.32–1.82)
Country of birth NS NS NS
Belgium 1.00 1.00 1.00
Turkey/Morocco 3.34 (0.66–16.91) 2.15 (0.36–13.05) 1.99 (0.34–11.52)
Social support ***
0.99 (0.97–0.99) 0.98 (0.97–0.99) 0.98 (0.97–0.99)
:
11.85. Model fit severe depression: LR = 43.03, df = 20, P = 0.002, ) R
2
: 25.23. Model fit severe anxiety: LR = 44.27, df = 20, P < 0.001, ) R
2
: 25.11
NS not significant
* P < 0.01; ** P < 0.001; *** P < 0.0001
193
Turkish and Moroccan males. One such process
might be related to the fact that Turkish and
Moroccan males are disproportionally employed in
jobs and labor market segments that are more
stressful. Another reason might be that irrespective of
employment status, the Belgian welfare state secures
direct and indirect money transfers to attain a certain
living standard, and thus in some ways, ‘discharges’
males from the economic responsibility imposed
upon them by their culture. A third possibility is
related to processes of social comparison, which play
a significant role in the development of mental health
problems such as depression [ 71 ]. When total
Moroccan communities, feelings of relative depriva-
tion might be less sharp, and therefore unemployment
might be less health-damaging compared to individuals
in communities with high employment levels. Com-
pared to their male counterparts, unemployment is not
an issue for Turkish and Moroccan women, at least as
far as traditional Turkish and Moroccan culture is
concerned [ 24 ]. Women are mostly responsible for
the affairs within their family and unemployment
suits this role. In Table 3 , house-keeping is catego-
rized as ‘non-active’ on the labor market. Results
show low levels of psychological distress, depression
and anxiety, when controlled for the other variables in
the model. This lack of a significant employment ef-
fect on the mental health status of Turkish and
Moroccan women is consistent with findings for
Turkish women in the Netherlands [ 5 ].
Finally, we want to stress that gender differences in
depression and anxiety in the immigrant population
are nearly double those found in the native Belgian
population. This is remarkable because most of the
abovementioned labor market related processes
of immigrant men than immigrant women, leading us
to expect a diminished, rather than an enlarged gen-
der ratio in depression. This brings us to speculate
about gender specific social processes influencing the
mental health of both immigrant men and women not
directly linked to their socio-economic position. First,
one cannot rule out the influence of emigration as a
selective process. The emigration of Turkish and
Moroccan men is to a large amount based on eco-
nomic motives, while the emigration of Turkish and
Moroccan women is more function of family reunion
[ 40 ]. Hence, these selection effects differentially affect
men and women. One study found that emigration
based on economic motives favors persons who are
more work-oriented, who have higher achievement
and power motivation, but lower affiliation motiva-
tion and family centrality [ 6 ]. So, selection processes
could be present favoring men who are less, and
women who are more vulnerable for internalizing
problem behavior. Second, the migration process it-
self, as far as it concerns the disruption of family ties,
could differentially affect women and men, as in tra-
ditional strong male breadwinner systems the mental
health of women as kin keepers is more strongly
linked to the quality and strength of the relationships
with kin. Finally, a post-migration acculturation
process amplifying the imbalance of power among
women and men should be considered as another
possible reason. The lack of independent control over
economic resources linked to the presence of male
dominated kinship based ethnic ties and the sense of
rupture women experience as a result of the feelings
of disconnectedness linked with attempts to maintain
membership in both their country of origin and their
country of settlement [ 54 ], probably accounts for a
substantial part of the enhanced prevalence of
depression among Turkish and Moroccan immigrant
women. Most of these post hoc explanations are mere
speculations. Needless to say that, as concerns the
nexus between emigration to Europe, gender and
mental health, the adage ‘more research is needed’ is
more than just loose saying.
j Implications
Our findings call for further research, both cross-sec-
tional and cohort studies, as well as intervention
studies in order to discover the complex network of
influences of migration on common mental health
problems. When focussing on the Turkish and
Moroccan immigrant populations, gender-specific is-
sues should be given special attention, since our
analysis showed high gender-differences in psycho-
pathology. Although additional analyses showed no
significant gender-ethnicity interaction effect in
addition to both main effects (results not shown), the
high ORs reported for gender in Table 3 are remark-
able especially when compared to the findings on
depression in Turkish and Moroccan immigrants in
the Netherlands based on data on first hospital
admissions. In their Dutch study, Selten, van Os and
Nolen [ 58 ] found significantly higher first admission
rates for Turkish and Moroccan males as compared to
Dutch natives, but significantly lower health services
use in Turkish and Moroccan females. If this pattern of
service use is also relevant for the Belgian context, then
our findings may indicate a seriously under serving of
Turkish and Moroccan female immigrants suffering
common mental health problems. This possible un-
derserving should be studied thoroughly, given special
attention to ethnic and gender-related differentials in
psychiatric diagnoses or treatment, and thresholds
experienced in help-seeking processes. While some of
these thresholds, such as fear for stigmatisation,
arguably apply to all population groups, Turkish and
Moroccan immigrants might in addition have to
contend with culture-bound factors (e.g. language
barriers) or aspects that are related to their socioeco-
nomic position (e.g. financial thresholds).
From a public health perspective, the higher rates of
psychological distress, depression and anxiety in
194
Turkish and Moroccan immigrants underline the need
for an answer to several urgent questions. One such
question is whether special health or social inclusion-
programmes are required, a question that is becoming
more prominent with rising numbers of Turkish and
Moroccan immigrants due to marriage migration and
high fertility rates. Another question is how demo-
graphic changes in the composition of the Turkish and
Moroccan community, with rising numbers of elderly
immigrants, will affect levels of psychopathology and
health service use in the near future.
j Strengths and limitations
Our study has a number of strengths and limitations.
The main strength is that it provides nationwide
community-based evidence on the prevalence and
determinants of psychological distress and severe
complaints of depression and generalised anxiety in
two immigrant populations in a European setting.
Such evidence is scarce since most European studies
on the link between migration and health concentrate
on less common mental disorders, and more often
than not, use data on patients which may influence
the results due to ethnicity-related and country-spe-
cific differences in treatment-seeking and admission
practices [ 13 , 65 ]. Our study focuses on Turkish and
Moroccan immigrants in the general population, two
population groups that have not only formed large
communities in Belgium, but also in several other
European countries, including France, Germany, the
Netherlands, Spain and Italy.
Another important strength is that our study
identifies one’s immigrant status based on informa-
tion regarding nationality as well as country of birth
[see also 38 ]. To consider country of birth only would
limit the analysis to first-generation immigrants,
thereby neglecting a growing number of subsequent-
generation immigrants. On the other hand, to consider
current nationality only would inadequately reflect the
social reality of immigrants in Belgium, especially
since recent legislative change has resulted in many
people of foreign origin acquiring Belgian nationality.
The combined information on nationality and country
of birth enabled us to identify Belgians with foreign
roots as immigrants. However, people with foreign
roots who were born in Belgium and who hold Belgian
nationality could not be identified as immigrants. It is
unclear whether there are significant differences be-
tween identified and non-identified second or third
generation immigrants in terms of acculturation and
other processes or characteristics that are relevant to
depression and anxiety. If non-identified immigrants
are worse off, then reported prevalence rates and ORs
may be underestimations; if they are better off, actual
risks may be smaller than those reported.
The main limitation of our study is related to the
fact that for the SCL-R scales, no established cut-offs
are available [ 55 ]. We therefore opted for an indica-
tion of severe depression and anxiety on the basis of a
pragmatic 90% severity threshold. This strategy en-
abled us to look at severe syndromes without claiming
to assess psychiatric disorder, but has the potential
drawback of miscategorising individuals, thereby
compromising our study’s ability to identify valid risk
factor patterns. However, additional analysis based on
a 95 and 80% threshold shows the reported risk
profile to be robust (analysis not shown).
Another point to consider relates to the cross-cul-
tural validity of the scales used and the culture-bound
expression and subjective experience of the syndromes
being studied. These may have introduced some bias in
our analyses [see 2 ]. In research on Turks and
Moroccans, a recurrent consideration is that they fre-
quently use somatic complaints as a metaphor and as a
pathway to medical care for mood disorders [ 11 , 19 ]
and that they may show a tendency to exaggerate
symptoms [ 67 ]. If somatisation is in order, this may
have led to an underestimation of prevalence rates,
while exaggeration of symptoms may have introduced
overestimation of levels of experienced psychopathol-
ogy. However, if both tendencies are equally present
in both immigrant communities, the comparisons
between and within both population groups were not
affected by these forms of bias. The same holds for
possible bias introduced by differential familiarity with
European idioms of mental health in subsequent
generations of immigrants, leading to differential re-
sponse behaviour to the survey questions used to assess
psychiatric problems. If such differential response
behaviour exist, this may have biased reported levels of
psychopathology for the different immigrant genera-
tions, but since the proportion of first-generation mi-
grants in our sample is not significantly different in
both migrant communities, our comparisons between
the Turkish and Moroccan communities remains
unaffected.
A third limitation of our study is that the written
questionnaires used for gathering mental health
information, were only available in Dutch, English,
French or German. Although help with translation
was allowed, this fact may have skewed our sample
towards more acculturated immigrants. If the classic
acculturation hypothesis of positive effects on mental
health is correct, then our prevalence estimates may
underestimate the levels of psychopathology experi-
enced in first-generation immigrants and overesti-
mate those in later generation Turks and Moroccans.
However, recent studies on the positive or negative
effect of the acculturation process have come to
inconsistent conclusions [ 21 ].
A final limitation pertains to the overall response
rate of 61.4% for the total Belgian Health Interview
Survey, which falls well in the range of 52–95% ob-
served in other European health interview surveys [ 3 ].
For the specific age groups considered in our study, the
actual response rate was somewhat larger, varying from
63.0 to 70.6%. Analysis also showed non-EU citizens to
195
be more inclined to participate than Belgians or EU-
immigrants, and less than 2% of non-response was due
to language problems [ 61 ]. Although the link between
participation and survey error is not straightforward
and studies with low response rates may in fact be less
biased than studies with high response rates [ 62 ],
selection bias related to nationality could have been an
issue in our study, but research by Lorant et al. [ 43 ] has
shown it is not. What should be taken into account, is
selection bias related to socioeconomic status: com-
... The only Belgian study
[49]
was performed on a national community sample. The study showed that the prevalence of high-severity depressive disorder (90% cut-off on the SCL-90 depression subscale) was higher among both Turkish (15.4%) and Moroccan immigrants (14.2%) than among native Belgian (9.1%). ...
... Turkish identity) or a low education level were more likely to report depressive symptoms. Among Dutch-and Belgian Moroccan mainly community samples, about half of the studies found female sex positively related to depressive symptoms [37,41,
49,
65]. On the other hand, also about the half of the studies examining large Moroccan-Dutch and Turkish community and patient populations of Germany, The Netherlands, and the UK found sex neither to be related to nor predictive of depressive symptoms [43,52,56,59,60,63,[70][71][72]. ...
... The vast majority of the studies examining age in Turkish or Moroccan groups found no relationship with depressive symptoms in Belgium
[49]
, the Netherlands [43,60,71], Germany [50,56,59,63,[72][73][74] and UK [75]. The remaining studies showed mixed results, stating older age as a predictor of higher depressive symptomatology in Turkish-German [51, 53, 57] -Dutch populations [37]. ...
Depression among Turkish and Moroccan immigrant populations in Northwestern Europe: a systematic review of prevalence and correlates
BMC PSYCHIATRY
Gabriela Sempértegui
Christos Baliatsas
Jeroen W Knipscheer
Marrie H J Bekker
Background
This systematic review aimed to synthesize the prevalence and correlates of depressive disorders and symptoms of Turkish and Moroccan immigrant populations in Northwestern Europe, formulating evidence-informed recommendations for clinical practice.
Methods
We conducted a systematic search in PsycINFO, MEDLINE, Science Direct, Web of Knowledge, and Cochrane databases for records up to March 2021. Peer-reviewed studies on adult populations that included instruments assessing prevalence and/or correlates of depression in Turkish and Moroccan immigrant populations met inclusion criteria and were assessed in terms of methodological quality. The review followed the relevant sections of the Preferred Reporting Items for Systematic Reviews and Meta-analyses reporting (PRISMA) guideline.
Results
We identified 51 relevant studies of observational design. Prevalence of depression was consistently higher among people who had an immigrant background, compared to those who did not. This difference seemed to be more pronounced for Turkish immigrants (especially older adults, women, and outpatients with psychosomatic complaints). Ethnicity and ethnic discrimination were identified as salient, positive, independent correlates of depressive psychopathology. Acculturation strategy (high maintenance) was related to higher depressive psychopathology in Turkish groups, while religiousness appeared protective in Moroccan groups. Current research gaps concern psychological correlates, second- and third-generation populations, and sexual and gender minorities.
Conclusion
Compared to native-born populations, Turkish immigrants consistently showed the highest prevalence of depressive disorder, while Moroccan immigrants showed similar to rather moderately elevated rates. Ethnic discrimination and acculturation were more often related to depressive symptomatology than socio-demographic correlates. Ethnicity seems to be a salient, independent correlate of depression among Turkish and Moroccan immigrant populations in Northwestern Europe.
... Migrant populations experience discrimination more frequently, which constitutes an additional mental health risk factor
(Levecque et al., 2009;
Missinne & Bracke, 2012). Although mental health problems are often identified by primary healthcare services, some studies, however, have shown that general practitioners' (GPs') therapeutic decisions regarding patients with a migration background are suboptimal: breakdowns in communication and in the relationship between a migrant patient and a GP can be a frequent source of misunderstanding, the time devoted to a consultation is often shorter for migrants, and GPs' diagnostic, treatment and referral decisions are sometimes biased by their behaviours and beliefs of migrant patients (Gaya-Sancho et al., 2021;Lepièce et al., 2014;Shannon et al., 2016). ...
... We chose to recruit Belgian GPs. Belgium is an interesting case study because firstly, it is a country with a long history of immigration and secondly, there is a higher prevalence of depression among migrants, especially those from Morocco, and this difference is more significant in Belgium than in other European countries
(Levecque et al., 2009;
Missinne & Bracke, 2012). The study was carried out with licensed and trainee GPs practising in two of the three Belgian regions: Brussels and Wallonia. ...
Unintentional Discrimination Against Patients with a Migration Background by General Practitioners in Mental Health Management: An Experimental Study
Katrijn Delaruelle
Vincent Lorant
Populations with a migration background have a higher prevalence of mental health problems than their native counterparts. They are also more likely to have unmet medical needs and are less frequently referred to mental health services. One potential explanation for this is that physicians, such as general practitioners (GPs), may unintentionally discriminate against migrant patients, particularly when they lack humanization. To date, no experimental study has investigated this hypothesis. This paper assesses the influence of humanization on GPs' discriminatory decisions regarding migrant patients with depression. A balanced 2 × 2 factorial experiment was carried out with Belgian GPs (N = 797) who received video-vignettes depicting either a native patient or a migrant patient with depression. Half of the respondents were exposed to a text that humanized the patient by providing more details about the patient's life story. Decisions related to diagnosis, treatment and referral were collected, as well as the time spent on each video and text, and were analysed using ANOVA. Migrant patients' symptoms were judged to be less severe than those of native patients (F = 7.71, p < 0.05). For almost all treatments, the decision was less favourable for the migrant patient. Humanization had little effect on medical decisions. We observed that GPs spent significantly more time on the vignette with the humanization intervention, especially for the migrant patients. The results indicate that ethnic differences in the management of depression persist in primary care. Humanization, however, does not mitigate those differences in medical decisions.
... This means that migrating can have a negative impact on individuals' health due to multiple physical and psychosocial tensions suffered during the migration process [10,11]. These tensions can lead to high levels of stress and an increase in risk-behaviors in immigrants, thus affecting their overall health [12][13]
[14]
[15] and potentially causing them to develop certain chronic diseases or worsening existing conditions. The long-term negative consequences of chronic diseases on health are widely known. ...
... The protective nature of social support networks has been seen in multiple studies, as it can also be seen in the recent revision by Garcini et al. (2016) [22]. These studies show the protective nature of social support networks in the development of diseases in immigrant populations
[14,
27,28]. Social support can act as a coping agent and a mediating variable between stress due to acculturation suffered by immigrants and their health [15,29,30]. ...
Psychosocial and Sociodemographic Determinants Related to Chronic Diseases in Immigrants Residing in Spain
Mar 2022
Int J Environ Res Publ Health
María José Martos-Méndez
Luis Gómez Jacinto
Isabel Hombrados-Mendieta
Iván Ruiz-Rodríguez
The aim of the study is to analyze the effect of the psychosocial determinants of satisfaction with social support, resilience and satisfaction with life, and the sociodemographic determinants of age, gender and length of residence on chronic diseases in immigrants living in Spain. The sample was composed of 1131 immigrants from Africa, Eastern Europe, Latin America and Asia. 47.1% were men and 52.9% were women. Most relevant results point to age as the sociodemographic variable with the highest predictive effect in the six chronic diseases analyzed. Gender, in this case female, predicts arthrosis, chronic back pain and migraine, whereas length of residence was only significant in the case of chronic allergies. Regarding psychosocial variables, resilience is a good predictor of hypertension, chronic allergies and arthrosis. However, satisfaction with social support appears to be the best predictor for chronic back pain in the regression equation, satisfaction with life being a significant variable in migraine, arthrosis, allergies and high cholesterol. Results are notably relevant for the design of preventive health programs in immigrants, as well as in ensuring their appropriate access to the health system so that their chronic diseases can be diagnosed. Given the relevance and incidence of the chronic diseases analyzed in immigrants, preventive strategies should be improved to tackle chronic diseases that can have a serious impact on immigrants’ health.
... There is a lack of data on unintentional ethnic and racial discrimination among general practitioners in Europe and too little attention has been paid to the North African population. This applies particularly to people of Moroccan descent, who constitute the largest and fastest-growing minority group in countries in the European Union (EU), including Belgium, where the Moroccan population doubled between 1991 and 2014. 1 This ethnic group is also disproportionately at risk of poor health outcomes, such as more depressive symptoms
[18]
and higher mortality caused by diabetes and infectious diseases [19]. ...
Implicit and explicit ethnic biases in multicultural primary care: the case of trainee general practitioners
Apr 2022
Duveau Camille
Stéphanie Demoulin
Marie Dauvrin
Vincent Lorant
Background
General Practitioners (GPs) are the first point of contact for people from ethnic and migrant groups who have health problems. Discrimination can occur in this health care sector. Few studies, however, have investigated implicit and explicit biases in general practice against ethnic and migrant groups. This study, therefore, investigated the extent of implicit ethnic biases and willingness to adapt care to migrant patients among trainee GPs, and the factors involved therein, in order to measure explicit bias and explore a dimension of cultural competence.
Methods
In 2021, data were collected from 207 trainee GPs in the French-speaking part of Belgium. The respondents passed an Implicit Association Test (IAT), a validated tool used to measure implicit biases against ethnic groups. An explicit attitude of willingness to adapt care to diversity, one of the dimensions of cultural competence, was measured using the Hudelson scale.
Results
The overwhelming majority of trainee GPs (82.6%, 95% CI: 0.77 – 0.88) had implicit preferences for their ingroup to the detriment of ethnic and migrant groups. Overall, the majority of respondents considered it the responsibility of GPs to adapt their attitudes and practices to migrants’ needs. More than 50% of trainee GPs, however, considered it the responsibility of migrant patients to adapt to the values and habits of the host country.
Conclusions
This study found that the trainee GPs had high to very high levels of implicit ethnic bias and that they were not always willing to adapt care to the values of migrants. We therefore recommend that they are made aware of this bias and we recommend using the IAT and Hudelson scales as educational tools to address ethnic biases in primary care.
... Studies conducted in the USA and Europe related to immigration and mental health have indicated a relationship between maintaining social support networks for immigrants and improved mental health. The more migrants have and maintain social support networks, the fewer problems they have with their mental health
(Levecque et al., 2009)
. In Belgium, many formal and informal services are offered to immigrants, and they can benefit from health care services, whether registered or not, under the legal framework of eligibility. ...
Social Support Effectiveness of the Mental Health of Immigrants Living in Belgium Belçika'da Yaşayan Göçmenlerin Ruh Sağlığının Sosyal Destek Etkinliği
BRIT J SOC WORK
Yaser Snoubar
Oguzhan Zengin
The increase in immigration has required social workers to focus more on this field and understand the social support systems of immigrants and the effects of their relationships with these systems to improve their effectiveness. Subsequently, this study examined the perceived social support, psychological resilience and coping strategies of immigrants living in Belgium, which has a significant immigrant population compared with its population. Using a cross-sectional design, data were collected from 289 participants living in Belgium. According to our findings, immigrants with a high perceived level of social support also have high psychological resilience. However, immigrants’ high levels of perceived social support lead to more intense use of problem-focused and emotion-focused coping styles. These findings emphasise the functionality of the social support system for immigrants and shed light on the issues that social workers should focus on when working with immigrants.
... In the study, the analyses were performed with Stata package software using the data set obtained from the questionnaires. Because logit and probit models were more useful in practice (Gujarati, 2004, p.582-583), the ordered Elif AKKAŞ, Mustafa AKKUŞ & Ömer Selçuk EMSEN [3964] probit model (Diette et al., 2018) was preferred due to its being easy in mathematical operations as the analysis method because the studies with similar subjects
(Levecque et al., 2009;
Doherty et al., 2008) offered differences due to frequently analyzing with logit model (Greene, 2002, p.667). ...
INVESTIGATING THE RELATIONSHIP BETWEEN SOCIO-ECONOMIC CHARACTERISTICS AND DURATION OF DEPRESSION TREATMENT IN PATIENTS DIAGNOSED WITH DEPRESSION
Jan 2021
Elif AKKAŞ
Mustafa Akkuş
... As we found in a previous study (Toselli et al., 2018), one of the main reasons for the migration of the examined sample of women is family reunification, followed by the search for a job. It is also clear from the literature
(Levecque et al., 2009)
that the relationships between relatives have a significant impact in activating the migration process. In particular, an Italian demographic study, based on a recent survey conducted by the Italian Institute with the NA cultural values linked to the family (Toselli et al., 2018). ...
Psychosocial health and quality of life among North African women
Studies on relationships between psychosocial factors and health among North African (NA) women are scarce. This research investigated the self-perceived psychosocial well-being of NA women by a structured questionnaire and anthropometric survey examining the possible explanatory variables of their mental health in comparison to a sample of NA migrants. The association of endogenous stress, psychological well-being, discomfort, and quality of life with migrant/non-migrant status, demographic characteristics, and adiposity indices was examined. Moreover, the internal consistency of the questionnaire was tested using Cronbach's alpha. A sample of 228 women living in Tunis and Casablanca participated in a survey in Tunisia and Morocco. According to multiple regression models, migrant/non-migrant status was the best explanatory variable of well-being and quality of life, marital status, educational level and the number of children were explanatory variables of discomfort and endogenous stress. Among anthropometric variables, central adiposity was a significant explanatory variable of well-being. The comparison with women who migrated mainly from Morocco and Tunisia to Italy (NA migrants) exhibited higher weight status and central adiposity in NA migrants. The perceived stress and discomfort were the same in the two groups; the migrants, despite reporting lower psychological well-being, presented a higher quality of life than residents. Our findings emphasise the potential to promote monitoring of the psychosocial health of NA women, planning effective interventions.
... Studies in different European countries: Sweden, London, Belgium and Germany reported that migrants usually had poorer access to preventive health care offers compared to the respective native populations [104,
105]
. Consequently due to infrequent use of prevention programmes they are overrepresented in emergency units [50,54]. Unfortunately at the same time many European countries still are not able to grant full equality in health care access for migrants [38] although the proportion of migrants living in Europe is quite high. ...
Transcultural differences in suicide attempts among children and adolescents with and without migration background, a multicentre study: in Vienna, Berlin, Istanbul
While suicide can occur throughout the lifespan, worldwide suicide is the second leading cause of death among young people aged between 15 and 29 years. The aim of this multicentre study, conducted in Austria, Germany and Turkey, is to investigate the transcultural differences of suicide attempts among children and adolescents with and without migration background. The present study is a retrospective analyses of the records of 247 young people, who were admitted after a suicide attempt to Emergency Outpatient Clinics of Departments of Child and Adolescent Psychiatry of the collaborating Universities including Medical University of Vienna, Charité University Medicine Berlin and Cerrahpaşa School of Medicine and Bakirkoy Training and Research Hospital for Mental Health in Istanbul over a 3-year period. The results of the present study show significant transcultural differences between minors with and without migration background in regard to triggering reasons, method of suicide attempts and psychiatric diagnosis. The trigger event “intra-familial conflicts” and the use of “low-risk methods” for their suicide attempt were more frequent among patients with migration background. Moreover among native parents living in Vienna and Berlin divorce of parents were more frequent compared to parents living in Istanbul and migrants in Vienna. These results can be partly explained by cultural differences between migrants and host society. Also disadvantages in socio-economic situations of migrants and their poorer access to the healthcare system can mostly lead to acute and delayed treatments. Larger longitudinal studies are needed to understand better the impact of migration on the suicidal behaviour of young people.
Background
Resilience has proved to be a versatile notion to explain why people are not defeated by hardship and adversity, yet so far, we know little of how it might apply to communities and cultures in low to middle income countries.
Aim
This paper aims to explore the notion of resilience in cross-cultural context through considering the lived experience of internal migration.
Methods
A sample of 30 participants with experience of migration was recruited from a low-income slum dwelling neighbourhood in the city of Pune, India. These individuals participated in biographical narrative interviews in which they were encouraged to talk about their experience of migration, their adaptation to life in their new environment and making new lives for themselves.
Results
Participants referred to a variety of intra-individual and external factors that sustained their resilience, including acceptance of their circumstances, the importance of memory, hope for their children’s futures as well as kindness from family friends and community members and aspects of the physical environment which were conducive to an improvement in their lives.
Conclusions
By analogy with the widely used term ‘idioms of distress’, we advocate attention to the locally nuanced and culturally inflected ‘idioms of resilience’ or ‘eudaemonic idioms’ which are of crucial importance as migration and movement become ever more prominent in discussions of human problems. The nature and extent of people’s coping abilities, their aspirations and strategies for tackling adversity, their idioms of resilience and eudaemonic repertoires merit attention so that services can genuinely support their adjustment and progress in their new-found circumstances.
Using data from the 1991 census, the occupational outcomes of the entire Turkish and Moroccan labour force aged 18 to 29 are mapped relative to the occupational status of the Belgian labour force in the same age category. The analyses provide evidence of ethnic underachievement, taking the form of unemployment levels being disproportionately high among ethnic minorities and an overrepresentation in non-skilled labour categories. In accounting for ethnic underachievement, particular significance has been attached to the deficit-thesis, stating that the overrepresentation of ethnic minorities in unemployment is due to an ethnic labour force being underqualified and thus unable to compete with the indigenous labour force. The analyses of the census data clearly challenge the validity of the deficit argument, however, indicating that even in the case of equal qualifications the occupational outcomes of ethnic minorities fall short to those of the Belgian labour force. Additional analyses demonstrate that educational attainment and occupational outcomes of ethnic minorities are nevertheless sequentially linked. Both for the indigenous and the ethnic labour force, education thus turns out to be an important factor in gaining access to employment. In addition, the analyses suggest that characteristics such as age, educational attainment and settlement patterns are more relevant to the occupational outcomes of ethnic minorities than nationality or the age-at-immigration.
Education and the transition to employment: young Turkish and Moroccan adults in Belgium
Using data from two national surveys conducted in 1994-1996, the educational attainment is examined for both the second generation and the young first generation of immigrants. Different effects of migration on the educational outcomes emerge depending on the timing of the disruption in the educational career. Disruptions at more advanced stages generally result in an early ending of the educational career, especially in the case of the Turkish immigrants. The bilingual educational system in Morocco is an additional factor causing the educational careers of Moroccan immigrants to deviate from what is found for Turkish students. The unemployment spells of Turkish and Moroccan school-leavers entering the labour market are examined subsequently, expanding on the results of the previous analyses by explicitly introducing the educational trajectory of respondents as an explanatory variable. One year after leaving school, 23 percent of the Turkish and 31 percent of the Moroccan school-leavers have been unemployed without interruption. Consistent with the higher proportion of men having graduated from higher education and the stronger orientation on general subjects at the secondary level, Moroccans show a stronger inclination toward 'white collar' employment. The majority of Turkish and Moroccan school-leavers, however, are found taking up 'blue collar' occupations after leaving school. In addition, 'white collar' employment largely boils down to employment as 'clerks' or 'service workers'. A very limited number of Turkish and Moroccan school-leavers find their way to positions at the managerial level.
This article examines the intensity and trends of marriages of Turks and Moroccans living in Belgium to partners from their countries of origin (‘imported partners’) and the motives for marrying such partners. Using data from the 1991 Belgian census, we show that large proportions of the migrant groups choose a partner from the country of origin and that marrying such a partner is certainly not dying out. Furthermore, the results of logit analyses reveal that marrying an imported partner is more than merely an act of traditional behavior: women may marry an imported partner in order to satisfy ‘modern’ goals.
| https://www.researchgate.net/publication/23193250_Psychological_distress_depression_and_generalised_anxiety_in_Turkish_and_Moroccan_immigrants_in_Belgium |
BCM-HGSC | Eric Boerwinkle, Ph.D. | page 11
Associate Director, Baylor College of Medicine Human Genome Sequencing Center Contact information [email protected] Other positions Dean, UTHealth School of Public Health M. David Low Chair in Public Health Kozmetsky Family Chair in Human Genetics Professor, Human Genetics Center and Dept. of Epidemiology Research interests The research interests of Dr. Boerwinkle encompass the
Eric Boerwinkle, Ph.D.
Associate Director, Baylor College of Medicine Human Genome Sequencing Center
Contact information
[email protected] (link sends e-mail)
Other positions
Dean, UTHealth School of Public Health
M. David Low Chair in Public Health
Kozmetsky Family Chair in Human Genetics
Professor, Human Genetics Center and Dept. of Epidemiology
Research interests
The research interests of Dr. Boerwinkle encompass the genetic analysis of the common chronic diseases in humans, including coronary artery disease, hypertension, and non-insulin dependent (type II) diabetes.
Dr. Boerwinkle received his B.S. in Biology from the University of Cincinnati in 1980, an M.A. in Statistics (1984), and M.S. and Ph.D. in Human Genetics (1985) from the University of Michigan, Ann Arbor where he served as Senior Research Associate in the Department of Human Genetics from 1985-1986. He joined the University of Texas-Houston Center for Demographic/ Population Genetics in 1986 as a Research Assistant and became Assistant Professor in the same year. In 1991 he joined the Department of Human Genetics at the School of Public Health, University of Texas-Houston Health Science Center as Associate Professor, in 1996 was promoted to Professor, and in 1997, Director of the Human Genetics Center. He became a faculty member of the Institute of Molecular Medicine in 1996 and became Professor and Director of the Research Center for Human Genetics.
Dr. Boerwinkle is a member of the American Diabetes Association and the American Society of Human Genetics. The research interests of Dr. Boerwinkle encompass the genetic analysis of common chronic diseases in humans, including coronary artery disease, hypertension, and non-insulin dependent (type II) diabetes. This work includes localizing genes which contribute to disease risk, identification of potentially functional mutations within these genes, testing these candidate functional mutations in experimental systems, defining the impact of gene variation on the epidemiology of disease, and determining the extent to which these genes interact with environmental factors to contribute to disease risk. Activities include both statistical analysis and laboratory work. A large part of Dr. Boerwinkle's current research effort consist of localizing genes contributing to disease risk using modern genome-wide mapping methods. Success depends on keeping up with the latest genomic technical advances. The laboratory is set-up and operating as a high through-put sequencing and genotyping facility in which speed, accuracy and efficiency are monitored continuously. However, we are constantly seeking out more efficient methods to collect and manage genetic information.
Dr. Boerwinkle and colleagues have completed the world's first genome-wide analyses for a variety of CAD risk factors, including diabetes and hypertension. These investigations have lead to the identification of novel susceptibility genes in both cases. Dr. Boerwinkle is particularly interested in methods for identifying potentially functional mutations within a gene region. This seemingly simple objective is made difficult because the functional mutations are expected to have small effects and are imbedded in a sea of silent genetic variation. Once nearly all of the variation is catalogued directly by DNA sequencing, individuals are genotyped for each variable site. Both novel and traditional statistical methods are applied to relate the array of genetic information to a wealth of phenotypic data. This algorithm generates "candidate functional mutations" that are then tested in an in vitro or mouse model system. Once a functional mutation has been identified, Dr. Boerwinkle's group evaluates the ability of the variable site to predict the onset of disease (e.g. myocardial infarction or stroke) above and beyond traditional risk factors. This work is carried out as part of multiple prospective studies of cardiovascular disease and its risk factors in tens of thousands of individuals representing the major American ethnic groups.
Finally, he is working on experimental designs for studying genotype by environment interaction in humans. In particular, we are working on the extent to which interindividual variation in lipid lowering and anti-hypertensive medications are influenced by genetic factors. The practical objective of the research is to use genetic information to identify individuals at increase risk of disease and to design more efficacious interventions. Genetic studies are defining, at the molecular level, novel mechanisms of disease risk, onset and progression. Dr. Boerwinkle and collaborators address the localization of genes which contribute to disease risk in cardiovascular diseases, hypertension and diabetes. The methodology used involves screening of families having the disease and linking the presence of disease with known markers of the human genome. In this manner, the genomic region in which relevant mutations are located can be mapped and the relevant DNA sequenced. By assessing the structural change the mutation may have caused in the gene product (protein), it is possible to infer how it may affect biological function. In order to determine experimentally whether a mutation is functional, it is necessary to introduce the mutated gene into an animal, usually a mouse, and assess its biological effects on the animal's phenotype.
Dr. Boerwinkle has participated in multiple notable discoveries since joining the Institute. Only two will be highlighted here. First, Dr. Boerwinkle's group has completed the first ever genome-wide search for genes contributing to inter-individual blood pressure levels. This initial effort has lead to the identification of an important gene (an adrenergic receptor) which influences blood pressure levels and the risk to hypertension. This is the first time that such a genome-wide approach has led to the identification of a susceptibility gene to a major cardiovascular disease risk factor. Second, Dr. Boerwinkle has participated in similar efforts to identify genes contributing to the risk of developing non-insulin dependent (type II) diabetes. In this case, however, there were no genes in the region that were suspects for the disease. A team of collaborating investigators have painstakingly characterized the genetic region and identified the mutated gene (in this case a protease). This is the first time that anyone has ever positionally cloned a gene contributing to any common chronic disease. This work is of obvious potential clinical importance. It may lead to improved prediction of those at increased risk of disease and the design of more efficacious intervention strategies. The technologies and information from the human genome project provide new tools for lessening the burden of ill-health. Dr. Boerwinkle's accomplishments in developing an internationally recognized team of investigators targeting the genetics of cardiovascular disease and its risk factors ensures a productive future and further discoveries.
Publications
2017
Stray-Pedersen A,Sorte HSørmo,Samarakoon P,Gambin T,Chinn IK,Akdemir ZHCoban, et al..Primary immunodeficiency diseases: Genomic approaches delineate heterogeneous Mendelian disorders.J Allergy Clin Immunol. 2017;139(1):232-245. PubMed DOI Google Scholar Tagged
Simino J,Wang Z,Bressler J,Chouraki V,Yang Q,Younkin SG, et al..Whole exome sequence-based association analyses of plasma amyloid-β in African and European Americans; the Atherosclerosis Risk in Communities-Neurocognitive Study.PLoS One. 2017;12(7):e0180046. PubMed DOI Google Scholar Tagged
Nandakumar P,Tin A,Grove ML,Ma J,Boerwinkle E,Coresh J, et al..MicroRNAs in the miR-17 and miR-15 families are downregulated in chronic kidney disease with hypertension.PLoS One. 2017;12(8):e0176734. PubMed DOI Google Scholar Tagged
2016
Huang Z,Rustagi N,Veeraraghavan N,Carroll A,Gibbs RA,Boerwinkle E, et al..A hybrid computational strategy to address WGS variant analysis in >5000 samples.BMC Bioinformatics. 2016;17(1):361. PubMed DOI Google Scholar Tagged
Guo D-chuan,Grove ML,Prakash SK,Eriksson P,Hostetler EM,LeMaire SA, et al..Genetic Variants in LRP1 and ULK4 Are Associated with Acute Aortic Dissections.Am J Hum Genet. 2016;99(3):762-9. PubMed DOI Google Scholar Tagged
Lubitz SA,Brody JA,Bihlmeyer NA,Roselli C,Weng L-C,Christophersen IE, et al..Whole Exome Sequencing in Atrial Fibrillation.PLoS Genet. 2016;12(9):e1006284. PubMed DOI Google Scholar Tagged
Yazdani A,Yazdani A,Liu X, Boerwinkle E.Identification of Rare Variants in Metabolites of the Carnitine Pathway by Whole Genome Sequencing Analysis.Genet Epidemiol. 2016;40(6):486-91. PubMed DOI Google Scholar Tagged
Ogunwale AN,Morrison AC,Sun W,Dodge RC,Virani SS,Taylor A, et al..The impact of multiple single day blood pressure readings on cardiovascular risk estimation: The Atherosclerosis Risk in Communities study.Eur J Prev Cardiol. 2016;23(14):1529-36. PubMed DOI Google Scholar Tagged
Harel T,Yoon WHee,Garone C,Gu S,Coban-Akdemir Z,Eldomery MK, et al..Recurrent De Novo and Biallelic Variation of ATAD3A, Encoding a Mitochondrial Membrane Protein, Results in Distinct Neurological Syndromes.Am J Hum Genet. 2016;99(4):831-845. PubMed DOI Google Scholar Tagged
Jakobsdottir J,van der Lee SJ,Bis JC,Chouraki V,Li-Kroeger D,Yamamoto S, et al..Rare Functional Variant in TM2D3 is Associated with Late-Onset Alzheimer's Disease.PLoS Genet. 2016;12(10):e1006327. PubMed DOI Google Scholar Tagged
J Smith G,Felix JF,Morrison AC,Kalogeropoulos A,Trompet S,Wilk JB, et al..Discovery of Genetic Variation on Chromosome 5q22 Associated with Mortality in Heart Failure.PLoS Genet. 2016;12(5):e1006034. PubMed DOI Google Scholar Tagged
Harel T,Yesil G,Bayram Y,Coban-Akdemir Z,Charng W-L,Karaca E, et al..Monoallelic and Biallelic Variants in EMC1 Identified in Individuals with Global Developmental Delay, Hypotonia, Scoliosis, and Cerebellar Atrophy.Am J Hum Genet. 2016;98(3):562-70. PubMed DOI Google Scholar Tagged
Huang J,Wang K,Wei P,Liu X,Liu X,Tan K, et al..FLAGS: A Flexible and Adaptive Association Test for Gene Sets Using Summary Statistics.Genetics. 2016;202(3):919-29. PubMed DOI Google Scholar Tagged
Liu X,Wu C,Li C, Boerwinkle E.dbNSFP v3.0: A One-Stop Database of Functional Predictions and Annotations for Human Nonsynonymous and Splice-Site SNVs.Hum Mutat. 2016;37(3):235-41. PubMed DOI Google Scholar Tagged
Campbell IM,Gambin T,Jhangiani SN,Grove ML,Veeraraghavan N,Muzny DM, et al..Multiallelic Positions in the Human Genome: Challenges for Genetic Analyses.Hum Mutat. 2016;37(3):231-4. PubMed DOI Google Scholar Tagged
Scott RA,Freitag DF,Li L,Chu AY,Surendran P,Young R, et al..A genomic approach to therapeutic target validation identifies a glucose-lowering GLP1R variant protective for coronary heart disease.Sci Transl Med. 2016;8(341):341ra76. PubMed DOI Google Scholar Tagged
Rhee EP,Yang Q,Yu B,Liu X,Cheng S,Deik A, et al..An exome array study of the plasma metabolome.Nat Commun. 2016;7:12360. PubMed DOI Google Scholar Tagged
Charng W-L,Karaca E,Akdemir ZCoban,Gambin T,Atik MM,Gu S, et al..Exome sequencing in mostly consanguineous Arab families with neurologic disease provides a high potential molecular diagnosis rate.BMC Med Genomics. 2016;9(1):42. PubMed DOI Google Scholar Tagged
Mirzaa GM,Campbell CD,Solovieff N,Goold CP,Jansen LA,Menon S, et al..Association of MTOR Mutations With Developmental Brain Disorders, Including Megalencephaly, Focal Cortical Dysplasia, and Pigmentary Mosaicism.JAMA Neurol. 2016;73(7):836-45. PubMed DOI Google Scholar Tagged
Tajuddin SM,Schick UM,Eicher JD,Chami N,Giri A,Brody JA, et al..Large-Scale Exome-wide Association Analysis Identifies Loci for White Blood Cell Traits and Pleiotropy with Immune-Mediated Diseases.Am J Hum Genet. 2016;99(1):22-39. PubMed DOI Google Scholar Tagged
| https://www.hgsc.bcm.edu/people/boerwinkle-e?f%5Bauthor%5D=4691&page=10 |
Microorganisms | Free Full-Text | The Best of All Worlds: Streptococcus pneumoniae Conjunctivitis through the Lens of Community Ecology and Microbial Biogeography
The study of the forces which govern the geographical distributions of life is known as biogeography, a subject which has fascinated zoologists, botanists and ecologists for centuries. Advances in our understanding of community ecology and biogeography—supported by rapid improvements in next generation sequencing technology—have now made it possible to identify and explain where and why life exists as it does, including within the microbial world. In this review, we highlight how a unified model of microbial biogeography, one which incorporates the classic ecological principles of selection, diversification, dispersion and ecological drift, can be used to explain community dynamics in the settings of both health and disease. These concepts operate on a multiplicity of temporal and spatial scales, and together form a powerful lens through which to study microbial population structures even at the finest anatomical resolutions. When applied specifically to curious strains of conjunctivitis-causing, nonencapsulated Streptococcus pneumoniae, we show how this conceptual framework can be used to explain the possible evolutionary and disease-causing mechanisms which allowed these lineages to colonize and invade a separate biogeography. An intimate knowledge of this radical bifurcation in phylogeny, still the only known niche subspecialization for S. pneumoniae to date, is critical to understanding the pathogenesis of ocular surface infections, nature of host-pathogen interactions, and developing strategies to curb disease transmission.
Lawson Ung 1,2 ,
Paulo J. M. Bispo 1,2 ,
Noelle C. Bryan 2,3 ,
Camille Andre 1,2 ,
James Chodosh 1,2 and
Michael S. Gilmore 1,2,*
1
Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA 02114, USA
2
Infectious Disease Institute, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA 02114, USA
3
Massachusetts Institute of Technology, Department of Earth, Atmospheric and Planetary Sciences, Cambridge, MA 02139, USA
*
Author to whom correspondence should be addressed.
Microorganisms 2020 , 8 (1), 46; https://doi.org/10.3390/microorganisms8010046
Received: 1 November 2019 / Revised: 16 December 2019 / Accepted: 21 December 2019 / Published: 25 December 2019
(This article belongs to the Special Issue Insights Into The Molecular Pathogenesis of Ocular Infections )
The study of the forces which govern the geographical distributions of life is known as biogeography, a subject which has fascinated zoologists, botanists and ecologists for centuries. Advances in our understanding of community ecology and biogeography—supported by rapid improvements in next generation sequencing technology—have now made it possible to identify and explain where and why life exists as it does, including within the microbial world. In this review, we highlight how a unified model of microbial biogeography, one which incorporates the classic ecological principles of selection, diversification, dispersion and ecological drift, can be used to explain community dynamics in the settings of both health and disease. These concepts operate on a multiplicity of temporal and spatial scales, and together form a powerful lens through which to study microbial population structures even at the finest anatomical resolutions. When applied specifically to curious strains of conjunctivitis-causing, nonencapsulated
Streptococcus pneumoniae
, we show how this conceptual framework can be used to explain the possible evolutionary and disease-causing mechanisms which allowed these lineages to colonize and invade a separate biogeography. An intimate knowledge of this radical bifurcation in phylogeny, still the only known niche subspecialization for
S. pneumoniae
to date, is critical to understanding the pathogenesis of ocular surface infections, nature of host-pathogen interactions, and developing strategies to curb disease transmission.
Keywords:
biogeography
;
community ecology
;
selection
;
diversification
;
drift
;
dispersion
;
Streptococcus pneumoniae
;
epidemic conjunctivitis
;
nonencapsulated
1. Introduction
The study of biogeography is primarily concerned with understanding how ecological and geographical forces shape spatial distributions of life in our natural world [ 1 , 2 ]. While this concept may evoke images of Darwin and his legendary explorations of the Galapagos, the principles of biogeography have now transcended their epistemological roots in zoology and botany, and are beginning to guide our understanding of microbiology and microbial ecology. The notion of biogeography was touched on in the now-canonized words of Dutch scientist Lourens Baas-Becking, who in 1934 wrote, “everything is everywhere, but the environment selects” [ 3 ]. This statement includes two keys as to why microorganisms colonize in the patterns we observe: opportunity or access, and selection for fitness in that habitat. However, more contemporaneous renderings of microbial biogeography have used models of community ecology in an attempt to explain the processes underlying all microbial assemblage [ 1 , 2 , 4 ]. Such models now point to four fundamental and synergistic principles, which shape all patterns of life in the natural world: selection, diversification, dispersion and ecological (stochastic, i.e., random) drift, which operate on a multiplicity of spatial and temporal scales. Indeed, if life were to be considered a continuum, then it is intuitively obvious that the forces affecting macroorganisms might also influence the distribution of life in the microbial universe—including bacteria, viruses, archaea and fungi [ 5 ]. As data emerges from high-resolution, high-throughput, microbial sequencing at unprecedented levels of quantity and complexity, a unifying model of biogeography seems an appropriate starting point to explain where and why life exists as it does in a chosen environment, with special reference to sites of infection.
The literature regarding microbial biogeography and community ecology has hitherto focused primarily on characterizing microbial populations on a “macro” scale—for instance, within non-spatially resolved environments such as soil and water [ 6 , 7 , 8 ]. Yet studies defining microbial consortia at various anatomical geographies now highlight the notion that microorganisms also display clear distribution patterns on this anatomical level, from site to site and tissue to tissue, varying in states of health and disease [ 9 ]. One of the best examples of the importance of biogeography for human pathogens comes from the evolution of a highly specialized clade of nonencapsulated Streptococcus pneumoniae —the epidemic conjunctivitis cluster (ECC)—which has a near exclusive predilection to infect the conjunctiva [ 10 ]. In this review, we explore this unique specialization through the lens of biogeography and community ecology, with a focus on new insights regarding the molecular epidemiology of this rogue S. pneumoniae clade which enabled it to become a leading cause of epidemic bacterial conjunctivitis. We explore the mechanisms that allowed this lineage to extend its range into a new biogeography, and the functional consequences of their genomic adaptations in the context of its unique tropism to the ocular surface. We offer critical and perhaps generalizable insight regarding fundamental questions of disease pathogenesis, acquisition of virulence factors and the nature of host–pathogen interactions, which are key to the study of all microbiology.
2. The Intersection of Community Ecology and Microbial Biogeography
2.1. Towards a Unified Model of Community Assembly
Current conceptions of biogeography and ecology have become inextricably bound, and the observation of distinct biogeographical patterns in nature has proven to be a watershed moment in shaping the discourse surrounding the forces governing all community assembly. The most recent and widely cited of these ecological approaches have drawn on broader principles in evolutionary biology and population genetics, including neutral [ 11 , 12 , 13 , 14 ] and metacommunity theory [ 15 , 16 , 17 ]. Other models have examined the relative contributions of historical contingencies in explaining these spatial relationships [ 2 , 18 , 19 , 20 ]. However, recognizing that the literature had become replete with seemingly divergent frameworks which differed more in the emphases placed on ecological phenomena rather than the concepts themselves—a “mess”, as described by prominent British ecologist John Lawton [ 21 ]—Mark Vellend proposed an elegant framework to explain ecological (and by extension, biogeographical) patterns by considering the interplay between four factors: selection, drift, speciation and dispersal [ 22 ]. Importantly, Vellend does not contend that all four factors are equally important in determining the composition of any given ecosystem; on the contrary, it is the ecosystem and its inhabitants within this environment that determine the relative importance of any given factor. The model’s inherent simplicity, structure, and above all conciliation of the age-old niche (deterministic) vs. neutral (stochastic) debates has seen it become an attractive framework for studying both macrobial and microbial communities [ 1 , 23 , 24 ]. Vellend did not explicitly intend for his model to be applied to microbial ecology or biogeography per se; however, the pace at which sequencing data is now being acquired from metagenomic studies demands a sufficiently robust model to provide fundamental insights and hypotheses that may be used to inform current and future biological inquiry [ 25 ].
2.2. The Four Tenets of Vellend’s Model
Selection, in its broadest sense, refers to the patterns of community assembly which occur as a result of disparities in survival fitness among community inhabitants, usually conceived in terms of environmental factors [ 22 ]. These environmental factors can be further subdivided into biotic factors (microbe–microbe interactions including competition, commensalism, mutualism and parasitism [ 23 ]) and abiotic factors (nutrient availability, pH, climate, mechanisms of adherence, surface area, to name a few). These selective pressures lie at the core of the Baas–Becking hypothesis, though more recent conceptions of selection now take into account the effect of its pressures on whole communities, where adaptations acquired on a social level [ 26 ] confer a survival advantage for entire microbial communities (e.g., through the phenomenon of “quorum sensing” [ 27 , 28 ]). Ecological drift, or demographic stochasticity, introduces the role of chance in determining community composition. The effect of chance on community assembly is greatest when selective pressures are weakest [ 11 , 29 ]. This principle recognizes that processes such as birth, death and reproduction are inherently random events, and that low-abundance organisms are the most vulnerable to local extinction due to sampling effects [ 30 ]. Speciation refers to the evolutionary processes by which new species arise through genetic diversification [ 22 ], with classical driving forces including genomic recombination (e.g., with horizontal gene transfer [ 31 , 32 , 33 , 34 ], phage interactions [ 35 , 36 ] and highly mobile iterative and conjugative elements (ICEs) [ 37 , 38 ]), exposure of microorganisms to antibiotics [ 39 , 40 ], and physical isolation [ 41 , 42 ]. Finally, dispersal refers to the migration of organisms on both spatial and temporal scales. On a worldwide level, we might consider the effect of natural vehicles for dispersion (atmospheric currents and water; climate, weather and natural disasters; mass human migration and urbanization), while factors such as microbial motility, displacement and physical barriers between host compartments, are important on an individual level. However, the extent to which dispersal may explain community composition, or indeed be subject to empirical demonstration, remains a contentious issue [ 43 ]. Certain bacterial species, such as Staphylococcus aureus , S. pneumoniae , Haemophilus influenzae and Escherichia coli are widely distributed, but little agreement exists regarding the drivers of such cosmopolitanism.
2.3. Anatomical Biogeography
In addition to the broad principles of biogeography outlined above, there is also increasing recognition that specific microbial distributions also exist on the finest of spatial scales: that of the individual anatomical level, from body compartment to compartment, from tissue to tissue and even from cell to cell [ 9 , 44 , 45 , 46 ]. In other words, the distribution of microbes in and on humans is not the result of stochastic (random) events alone. The clearest evidence for this is the observation of species endemism, or the lack thereof, within particular niches in human bodies, such as the exclusive residence of Helicobacter pylori within the pylorus of the stomach [ 47 , 48 ], or the sterile and immune-privileged nature of cerebrospinal fluid, which in healthy states is protected by the blood–brain barrier [ 49 ]. Utilizing the main pillars of Vellend’s model, it is likely that the residence of specific microbes at particular locations is therefore determined by numerous factors, including: (1) comparative fitness for the physical and chemical attributes of that habitat as described above; (2) prior occurrence and degree of establishment of other organisms that may be antagonistic or synergistic; and (3) opportunities for potential displacement by more fit microbes, as determined by the population size achievable and access to an open microbial-rich environment. The patterns of microbial populations evolve as the environment changes, whether it is a host environment evolving in response to a senescent immune system, or host surfaces or other environments evolving because of changing ambient temperatures. Therefore, we propose an extension of Vellend’s conceptual synthesis by adding a fourth spatial scale beyond the originally conceived global, regional and local dimensions, emphasizing the notion that the principles of community assembly also apply at the level of individual anatomical sites within hosts ( Figure 1 ).
2.4. Infection through the Lens of Community Microbial Ecology and Biogeography
Observing microbial assemblages through community ecology theory at an anatomical scale lends itself particularly well to cases of infection for several reasons [ 50 , 51 , 52 ]. The first and most obvious reason is that these frameworks facilitate a practical conceptualization of the forces which underpin all infectious disease ecology, which can be considered a very specific biogeographical phenomenon involving distinct patterns of community organization. Secondly, such models steer us away from reductionist paradigms which reflect a historical tendency to study microorganisms in isolation [ 53 , 54 ], where little consideration was given to how ecological interactions may influence both health and disease. At its most basic level, successful pathogens must be able to establish infection by colonizing, and proliferating within a suitable niche, and these processes of dispersion must occur in sufficiently large numbers to overcome stochastic events that may lead to the organism’s local extinction. This may occur with immigration of the pathogen into this niche, or replacement colonization, where a resident microbe with invasive potential outcompetes and displaces other resident microbes by exploiting local opportunities and resources, often following disturbances to the local microbial community. In all cases, the resident diversity of the environment is important, because with greater diversity comes a greater likelihood that these residents will possess a competitive advantage over the invading species, thereby providing “colonization resistance” against infection [ 55 , 56 , 57 ]. Furthermore, the pathogen must possess traits or virulence factors which allow it to survive in the face of mounting and shifting selective pressures. This includes the ability to evade host immune responses; to resist human interventions such as the introduction of antimicrobials; diversify by acquiring locally advantageous adaptations which may suppress resident microbial reconstitution; to persist in a way that may not be solely dependent on a population abundance or density threshold [ 58 ]; and the ability to facilitate efficient transmission from host to host, particularly “dead-end” hosts. Finally, while the role of drift is difficult to quantify empirically, few would argue its importance particularly in low-abundance and/or highly isolated communities where microbes are most likely to experience “fadeout” [ 59 ].
Understanding whether infectious diseases are primarily driven by niche-based effects or stochastic events—or a combination of the two—may also offer critical insight to inform clinical decision making and public health interventions [ 4 ]. If dispersion is the primary force governing the spread of disease, as is the case in recent rapid Ebola and Zika virus outbreaks [ 60 ], then interventions geared towards quarantine, isolation, hospital cohorting and border control would appear most appropriate. Under dispersal-limited conditions, other mechanisms may be at play. For instance, local disturbances in intestinal flora induced by antibiotic use is now considered a major risk factor for Clostridium difficile colitis, increasingly treated with fecal transplantation [ 61 , 62 ]. Alternatively, where diversification is a major driver of disease dynamics, as is the case in multi-drug resistant tuberculosis [ 63 ], a multi-drug regimen combined with directly observed therapy (DOT) for pathogen eradication may stall the evolutionary acquisition of further genetic mutations conferring antimicrobial resistance. Importantly, modeling infectious diseases dynamics through a community ecology approach also sheds light on parasite interactions in the setting of coinfection within hosts, with some prominent examples including the increased risk of more severe Plasmodium infection in children coinfected by soil-based helminths [ 64 , 65 ], and the copathogenicity of S. pneumoniae and respiratory viruses in precipitating infectious pneumonia (the risk of which is ameliorated with pneumococcal vaccines) [ 66 ].
3. The Curious Case of Streptococcus pneumoniae Conjunctivitis
3.1. Streptococcus pneumoniae: An Old Foe
Streptococcus pneumoniae (the pneumococcus) is a Gram-positive, facultative, anaerobic bacterium which appears as lanceolate diplococci, single cocci and/or in short chains under microscopy. S. pneumoniae colonizes the human upper respiratory tract mucosa, including that of the nasopharynx, larynx and trachea [ 67 ], beginning in the first few months of life [ 68 ]. It has been estimated that over 60% of children will become asymptomatic nasopharyngeal carriers of S. pneumoniae by preschool age [ 69 , 70 , 71 ], with the highest prevalence documented in developing countries [ 72 , 73 ]. Following this childhood peak, an age-related decline into adulthood is observed, with an 8–20% carriage rate past the age of 18 [ 72 , 74 ]. In most cases under healthy conditions, S. pneumoniae forms a part of the normal respiratory flora. Following colonization, however, opportunistic infection may occur following local (e.g., ear, sinus) or systemic (e.g., lung, bloodstream) spread, which is more likely to occur in states of immune dysfunction or immaturity, such as that associated with extremes of age, asplenism and malignancy [ 75 ]. Historically, the clinical manifestations of pneumococcal infection have been divided into the potentially lethal “invasive pneumococcal diseases” [ 76 ] of pneumonia, meningitis and septicemia, and the non-systemic diseases of otitis media, sinusitis and conjunctivitis [ 77 ], which are collectively associated with significant morbidity, mortality and profound costs to human society [ 78 , 79 , 80 , 81 , 82 ]. To mitigate the burden of disease, pneumococcal conjugate vaccines have been in widespread use since 2000, albeit with limited coverage against the most common encapsulated strains and consequences to human pneumococcal population structures which continue to unfold [ 83 , 84 ].
3.2. Nonencapsulated Strains of S. pneumoniae
The virulence of S. pneumoniae has long been attributed to its anionic polysaccharide capsule, the basis on which its now over 100 serotypes have been described [ 85 , 86 ]. The presence of a capsule enables S. pneumoniae to evade the physical and chemical elements of the host immune response, and confers protection from clearance by respiratory mucosa, and from complement-mediated opsonophagocytosis [ 87 , 88 ]. Both factors therefore facilitate nasopharyngeal colonization [ 89 ]. However, reports of nonencapsulated strains of S. pneumoniae (NESp) surfaced in the early 1980s [ 90 ]. Early descriptions reported “atypical” and “non-typeable” lineages which did not react to capsule-specific antisera [ 91 , 92 ], but were nonetheless phenotypically consistent with S. pneumoniae on the basis of agar hemolysis patterns, sensitivity to optochin and bile solubility [ 93 ]. These strains were historically overlooked due to their small, “rough” and non-mucoid appearance on agar, but have likely been in intercontinental circulation for decades [ 90 , 94 , 95 , 96 ]. These nonencapsulated strains are now recognized as a significant cause of human disease, capable of causing both systemic and local infections, including “invasive” pneumococcal disease [ 97 , 98 , 99 ], bacterial conjunctivitis [ 91 , 100 , 101 , 102 ], and otitis media [ 103 , 104 ]. Recent comparative genomic analyses now allow us to characterize these NESp strains into two groups based on alterations in their capsular polysaccharide synthesis ( cps ) loci: group I NESp, which contains mutationally defunct or absent cps genes; and group II NESp, where these cps genes are replaced almost entirely by novel gene content [ 87 , 105 ]. The latter group contains a distinct phyletic cluster of mostly nonencapsulated S. pneumoniae with an almost exclusive proclivity for causing epidemic conjunctivitis [ 10 , 106 , 107 , 108 ]. If one basic assumption of all evolutionary biology is that genetic change is driven mostly by the underlying pursuit for survival, then the loss of encapsulation and the acquisition of virulence factors in this rogue clade must also confer a basic survival advantage within a new environmental niche. Using the principles of community ecology described earlier, we explore the driving forces and ecological relationships behind this radical divergence in phylogeny, which may have contributed to the establishment of this new disease phenotype within a new anatomical biogeography.
3.3. A New Biogeography: The Epidemic Conjunctivitis Cluster (ECC) of S. pneumoniae
This deeply resolved classic lineage of NESp has now been described by a number of national and international studies [ 10 , 94 , 107 , 108 ], and is the only known example of niche subspecialization in S. pneumoniae . We investigated the molecular epidemiology of 271 epidemic conjunctivitis-causing isolates of S. pneumoniae , collected from 32 states in the US. Using multilocus sequence typing, these lineages localized to a distinct and closely-related group including ST448, ST344, ST1186, ST1270 and ST2315 [ 10 ]. These strains were labeled the epidemic conjunctivitis cluster (ECC) of S. pneumoniae , as they accounted for approximately 90% of conjunctivitis cases in our study ( Figure 2 and Figure 3 ). Conversely, less common causes of conjunctivitis, including the encapsulated strains ST632, ST667, ST180, ST199, ST42 and ST190, were dispersed among non-ocular reference strains. These results were consistent with another study conducted by Croucher and colleagues who described the Sequence Cluster 12 (SC12), a group of nonencapsulated strains including ST448 and ST344, which were the most phylogenetically distant group in 616 isolates of asymptomatically-carried pneumococci [ 109 ]. Assuming that the mutation rate of ECC lineages approximates that of non-ECC S. pneumoniae , the divergence of ECC and its non-ocular counterparts occurred approximately 8400 years ago [ 10 ], rather than as a response to the introduction of pneumococcal vaccines, as previously suggested. Curiously, this timeframe also corresponds with other instances of clade divergence in other bacteria, including Enterococcus faecium [ 110 ] and S. aureus [ 111 ], which have been hypothesized to have arisen around the time of accelerated human urbanization, animal domestication, agriculture and possibly improved hygiene practices [ 112 ]. The ECC lineages do not meet the standard threshold for speciation, as determined by the requirement for a shared average nucleotide identity (ANI) of <95% between the candidate organism and its nearest relatives [ 113 , 114 ]. However, a large proportion (>10%) of ECC genomes is occupied by novel gene content within a prolific accessory genome [ 10 ].
3.4. Modes of Diversification in ECC Strains Differ from Encapsulated Strains
It has been known for many decades that S. pneumoniae as a species displays remarkable genetic plasticity, with genetic diversification dominated by recombination [ 116 , 117 , 118 , 119 , 120 ]. Although S. pneumoniae population structures and recombination differ across different time scales [ 107 ], the observation that S. pneumoniae efficiently takes up and incorporates DNA [ 121 ] even in the absence of species-specific uptake sequences [ 122 , 123 , 124 ] suggests that diversification is fueled mostly by gene transfer from both pneumococcal and non-pneumococcal (e.g., oral streptococci) sources within its environmental niche [ 118 , 125 ]. The downstream consequences of such rapid transformation are demonstrated by recombination hotspots in the pneumococcal genome. In one example, the presence of highly conserved, non-capsular genes ( dexB and aliA ) which flank the cps gene locus allows remarkably rapid switching of capsular phenotype in response to selective challenges such as vaccination and the host immune response [ 83 , 126 , 127 , 128 ]. Horizontal gene transfer is augmented by “pneumococcal fratricide” [ 129 ], where competent (or highly transformable) clones destroy their poorly competent (and presumably less fit) neighbors, releasing their genomic material which can fuel downstream recombination events. In addition, transduction via bacteriophages [ 130 , 131 ] and conjugation with mobile elements such as ICEs [ 132 , 133 ] are also potent evolutionary drivers for S. pneumoniae diversification, although to a less appreciated degree [ 134 ].
The extent to which ECC population structure is driven by these forces, however, is unclear. Previously, it has been suggested that NESp, by virtue of lacking the barrier function of a capsule, may be more readily amenable to transformation and recombination than encapsulated strains [ 135 , 136 , 137 , 138 ]. However, inconsistencies in reported transformation efficiencies suggest that recombination alone is insufficient to explain this population structure [ 10 , 108 ]. For example, Hilty and colleagues found that the classical NESp types ST344 and ST488 were characterized by a lower rate of recombination when compared to a highly recombinogenic, non-typable strain (BC3-NT) retrieved from a refugee camp on the Thailand–Myanmar border [ 108 , 135 ]. This finding was recapitulated in our study, wherein distinct ECC phylogeny was preserved even after removing recombinogenic sequences from analysis [ 10 ]. This may suggest that ECC genomes are relatively stable, and that diversification is driven at least in part by other mechanisms, including endogenous mutation. Over millennia, they have become adapted to both nasopharyngeal and conjunctival colonization even in the absence of a capsule. Moving forward, it will be of primary importance to understand the mechanisms driving NESp genetic diversification, not least because instances of clade divergence may augur the future emergence of particularly virulent bacterial strains, as seen with vancomycin-resistant E. faecium and methicillin-resistant S. aureus (MRSA).
3.5. Extensive Cell Wall Remodeling Is Important for Conjunctival Colonization among ECC Lineages
One of the most striking features of ECC strains of pneumococcus is their extensive cell surface remodeling. This reflects the influence of the capsule in defining the environment in which surface features occur on encapsulated strains, and novel selective pressures occur in its absence. Much of the novel genomic content in ECC strains appears to have been donated by unencapsulated oral streptococci [ 10 , 106 , 139 ]. Novel cell wall proteins, encoded by novel genes found at the cps locus, allow ECC strains to overcome or evade the robust suite of physical and chemical protections that characterize the conjunctival microenvironment. These include: the oligopeptide binding proteins AliC and AliD (encoded by AliC and AliD , respectively) [ 10 , 98 ], which may enhance mucosal colonization by conferring resistance to leukocyte cytotoxicity and complement deposition [ 98 ]; the choline binding protein A (CbpA) variants CbpAC1 and CbpAC2, which among other functions may be involved in binding to the secretory component of IgA [ 10 ] and also in preventing complement deposition [ 98 ]; surface exposed adhesins (SspBC1/SspBC2), which may be important in cell agglutination and conjunctival epithelial adhesion [ 10 , 106 ]; the neuraminidases (NanO1/NanO2) [ 10 ], which putatively cleave sialic acids on the surface of mucosal glycans and mucins [ 140 ]; and zinc metalloprotease C (zmpC1/zmpC2) [ 10 ], which reportedly cleaves the ectodomain portion of the membrane-bound mucin MUC16, thereby exposing the underlying epithelial cell to infection [ 10 , 141 ].
With a cell wall highly adapted for conjunctival colonization and invasion, it is tempting to speculate that NESp may have lost its capsule because it simply became an unnecessary metabolic burden [ 93 , 137 ]. An alternative hypothesis is that NESp strains are resistant to opsonization within complement-laden conjunctival tissues, where innate immune responses may preferentially target encapsulated organisms [ 142 ]. However, while the loss of capsule suggests that ECC strains have developed other specialized ways to overcome the unique defense mechanisms of the conjunctiva, this loss alone cannot be the sole reason for their peculiar ocular surface tropism. Many non-ECC unencapsulated strains are phylogenetically grouped with the majority of pneumococcal strains, and conversely, some encapsulated strains are capable of causing sporadic conjunctivitis. As a distinct cluster of NESp, ECC lineages are particularly well adapted specifically for conjunctival colonization and infection [ 10 , 106 ], most likely by virtue of their novel gene content. These adaptations do not appear to extend to isolates which invade other ocular sites: sequencing data from our laboratory (unpublished) and that of Antic and colleagues [ 106 ], suggest that clinical isolates of S. pneumoniae from keratitis and endophthalmitis (aqueous/vitreous) are clustered within the major phyletic group.
3.6. Dispersion and Transmission of ECC
Having established that NESp follow cosmopolitan distributions worldwide, what can be made of colonization and dispersion dynamics within individual hosts? Comparative genomic analyses demonstrating the genomic equivalence of nasopharyngeal and conjunctival ECC isolates suggest that nasopharyngeal colonization is likely to precede conjunctival infection, favoring the hypothesis that ECC strains migrate freely between both host compartments [ 10 , 106 ]. This lack of evidence for a distance–decay relationship—which classically suggests that populations should become increasingly diversified with increasing physical displacement from its reservoir [ 143 , 144 ]—raises several questions regarding how these ECC strains have evolved to be able to physically straddle these two disparate biogeographies. It is feasible that a combination of factors govern the dispersion of ECC strains: the close physical proximity between the conjunctiva and the nasopharynx; the histological similarities between respiratory and conjunctival epithelia, which may be amenable to similar colonization mechanisms; and the paucimicrobial nature of the conjunctiva [ 145 ], which offers little colonization resistance from its resident commensals. Furthermore, we cannot discount the possibility of aerosolized dispersion of ECC strains, which may partly explain why conjunctivitis outbreaks are so common.
The source–sink model of dispersion–evolution dynamics may be useful in understanding the spatial distribution and translocation of these ECC strains [ 146 , 147 , 148 , 149 ]. This model places organisms within distinct anatomical compartments: their source, referring to its reservoir habitat(s) which facilitates persistent colonization; and their sinks, referring to the environments which accommodate transient colonization. These source–sink dynamics confer differential rates of adaptation, depending on the nature of migration and the hostility of the sink habitat. Migration from a source to a “closed” sink is a one-way process, isolating the organism in its transient habitat, where it must adapt rapidly or face local extinction. A “black hole” sink supports continuous, one-way migration from a source, in a way which maintains population abundance within this new niche [ 150 ]. Finally, migration from a source to a “reciprocal” sink allows free physical exchange between the two compartments [ 146 ]. Over time, adaptation to these new sink environments (e.g., with the acquisition of novel surface proteins) results in colonization persistence, and the organism no longer relies on source migration to maintain viable populations [ 151 ]. Of all these possibilities, ecological drift is most likely to affect small populations within hostile, “closed” sink environments. With no current empirical data relating to the evolutionary consequences of S. pneumoniae migration between separate biogeographies, one fascinating line of inquiry would be to unearth genomic evidence of these source–sink relationships, and the extent to which physical isolation from a source habitat (e.g., the nasopharynx) drives adaptation in other niches (e.g., the conjunctiva), as famously articulated by Ernst Mayr (1904–2005) [ 42 ]. Elucidating such evidence may also provide critical insight regarding the mechanisms of genomic adaptation, because relative physical isolation may reduce opportunities for recombination and explain why the literature has been inconsistent with regard to the extent to which ECC population structures are driven by recombination events. What source–sink models do not explain, however, are the factors which govern asymptomatic colonization versus disease, and the relationships between pathogen load, host responses and other factors which influence these phenotypes.
3.7. Changes in Community Composition Following Human Intervention
Earlier, we alluded to potential changes to community microbial composition that may occur as a response to human intervention. The most pertinent example of one such intervention is the population-wide use of the pneumococcal conjugate vaccine (PCV), which has resulted in sweeping reductions in the incidence of invasive pneumococcal diseases, particularly in young children and the elderly [ 152 , 153 , 154 , 155 , 156 ]. However, PCV has also had an effect on shaping the microbial social networks of which S. pneumoniae are part. A community ecology approach asks us to predict what may occur when a subgroup of a taxonomically diverse and heterogenous microbial consortium is removed from its natural source habitat. While a trend towards serotype replacement with less virulent clones has been observed following PCV [ 157 , 158 ], we are now witnessing a rise in the incidence of invasive pneumococcal disease associated with non-target serotypes (e.g., 19-A [ 159 , 160 ]). Furthermore, evidence of replacement colonization by the natural competitors of these target strains, including S. aureus and H. influenzae, has been reported [ 161 , 162 ]. The inverse relationship between encapsulated S. pneumoniae and MRSA carriage in particular has been an area of intensive debate [ 163 ], with some researchers observing a temporal rise in overall MRSA infection (particularly community-acquired strains) and the coincident fall in the human carriage of PCV-targeted encapsulated strains of pneumococcus [ 164 , 165 ]. Presumably, some of this vacant niche might also be filled by NESp [ 83 , 166 ], demonstrated by rising carriage among humans—now estimated to be in the order of 5–15% [ 100 , 135 ]. Disturbances such as vaccination are likely to have ripple effects through whole ecosystems, though the consequences are difficult to discern [ 167 ]. One possibility is that such effects may fundamentally alter the role of certain populations within their community. If NESp are a reservoir for antibiotic resistance genes as previously suggested [ 168 ], or a privileged intermediary between encapsulated pneumococcus and the related oral streptococci, what impact might this have on both carriage and disease transmission? Inevitably, human interventions entail collateral damage, and future hypothesis-driven testing may look at changes to the population structure of all pneumococcal strains, including the ECC, in the wake of the empty-niche turbulence induced by interventions including vaccination and antimicrobial use.
4. Conclusions
A community ecology model which unites the core principles of selection, diversification, dispersion and ecological drift is a useful framework to study the microbial world, which continues to rapidly evolve in response to changing environmental stimuli. When applied to NESp, this hypothesis-generating model highlights the mechanistic underpinnings of how these atypical strains have been able to persist and evolve across temporal and multiple spatial scales, providing access to, colonization of, and adaptation to, disparate biogeographies in the absence of the famed pneumococcal capsule. Furthermore, biogeographical study highlights the large void in our understanding of host–bacteria relationships within anatomical niches, and how disturbances may lead to altered phenotypes, including infection. The current literature on this rogue pneumococcal clade provides more questions than answers at this early stage of our understanding, and many of our proposed lines of inquiry remain speculative. The evolutionary story of all microbiological communities—including those of which
S. pneumoniae
plays a prominent role—is still unfolding, and we have yet to fully understand the true impact of human interventions such as antimicrobial use and vaccination on its population structures. However, as with all biological endeavors, particularly as metagenomic and other “-omics” research become increasingly available, perhaps the answers will come by first asking better questions. A structured understanding of the biogeographical forces which govern community assortment on the smallest of anatomical levels may provide the calculus to help us understand the most basic elements of microbiology in states of both health and disease.
Author Contributions
Conceptualization, M.S.G., J.C., L.U., P.J.M.B.; literature search, L.U., P.J.M.B.; writing—original draft preparation, L.U.; writing—reviewing and editing—M.S.G., J.C., P.J.M.B., N.C.B., C.A., L.U. All authors have read and agreed to the published version of the manuscript.
Funding
This research was supported in part by EY024285 and AI083214 from the National Institutes of Health, and an unrestricted grant to the Department of Ophthalmology, Harvard Medical school, from Research to Prevent Blindness, NY, NY. L.U. was also supported by the Dozoretz Family Foundation. N.C.B. was supported by a NASA Space Biology Fellowship, award 80NSSC17K0688.
Conflicts of Interest
The authors declare no conflict of interest.
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Figure 1. Synthesis of interdependent ecological factors which explain patterns of microbial biogeography across a variety of spatial scales, as proposed by Vellend’s Conceptual Synthesis in Community Ecology (2010) [ 22 ]. We included a fourth dimension—that of individual anatomy, to demonstrate that specific biogeographical patterns occur even on a tissue and cellular level.
Figure 1. Synthesis of interdependent ecological factors which explain patterns of microbial biogeography across a variety of spatial scales, as proposed by Vellend’s Conceptual Synthesis in Community Ecology (2010) [ 22 ]. We included a fourth dimension—that of individual anatomy, to demonstrate that specific biogeographical patterns occur even on a tissue and cellular level.
Figure 2. Phylogenetic tree of conjunctivitis strains of S. pneumoniae based on multilocus sequence typing, constructed using the phylogeny software PhyML [ 115 ]. An associated bar graph demonstrates the percentage prevalence in 271 sequenced strains from the US. The analysis of single nucleotide polymorphisms within these strains demonstrated that the overwhelming majority of nonencapsulated conjunctivitis strains localized to a distinct phylogenetic cluster. Reprinted with author permission [ 10 ].
Figure 2. Phylogenetic tree of conjunctivitis strains of S. pneumoniae based on multilocus sequence typing, constructed using the phylogeny software PhyML [ 115 ]. An associated bar graph demonstrates the percentage prevalence in 271 sequenced strains from the US. The analysis of single nucleotide polymorphisms within these strains demonstrated that the overwhelming majority of nonencapsulated conjunctivitis strains localized to a distinct phylogenetic cluster. Reprinted with author permission [ 10 ].
Figure 3. The distinct epidemic conjunctivitis cluster (ECC) of S. pneumoniae , consisting of ST448, ST344, ST1186, ST1270 and ST2315 (printed in red). Like Figure 2 , this phylogenetic tree was constructed using PhyML, based on a concatenated set of 1160 core orthogroups, and which included S. mitis (strain B6) as a related group. Reprinted with author permission [ 10 ].
Figure 3. The distinct epidemic conjunctivitis cluster (ECC) of S. pneumoniae , consisting of ST448, ST344, ST1186, ST1270 and ST2315 (printed in red). Like Figure 2 , this phylogenetic tree was constructed using PhyML, based on a concatenated set of 1160 core orthogroups, and which included S. mitis (strain B6) as a related group. Reprinted with author permission [ 10 ].
Ung, L.; Bispo, P.J.M.; Bryan, N.C.; Andre, C.; Chodosh, J.; Gilmore, M.S. The Best of All Worlds: Streptococcus pneumoniaeConjunctivitis through the Lens of Community Ecology and Microbial Biogeography. Microorganisms 2020, 8, 46.
https://doi.org/10.3390/microorganisms8010046
Ung L, Bispo PJM, Bryan NC, Andre C, Chodosh J, Gilmore MS. The Best of All Worlds: Streptococcus pneumoniaeConjunctivitis through the Lens of Community Ecology and Microbial Biogeography. Microorganisms. 2020; 8(1):46.
https://doi.org/10.3390/microorganisms8010046
Ung, Lawson, Paulo J. M. Bispo, Noelle C. Bryan, Camille Andre, James Chodosh, and Michael S. Gilmore. 2020. "The Best of All Worlds: Streptococcus pneumoniaeConjunctivitis through the Lens of Community Ecology and Microbial Biogeography" Microorganisms8, no. 1: 46.
https://doi.org/10.3390/microorganisms8010046
| https://www.mdpi.com/2076-2607/8/1/46/xml |
Towards safer risperidone prescribing in Alzheimer’s disease | medRxiv
medRxiv - The Preprint Server for Health Sciences
Towards safer risperidone prescribing in Alzheimer’s disease
Suzanne Reeves , Julie Bertrand , Hiroyuki Uchida , Kazunari Yoshida , Yohei Otani , Mikail Ozer , Kathy Y Liu , Elvira Bramon , Robert Bies , Bruce Pollock , Robert Howard
doi: https://doi.org/10.1101/2020.08.12.20173310
Now published in The British Journal of Psychiatry doi: 10.1192/bjp.2020.225
Abstract
Full Text
Abstract
BackgroundIn the treatment of psychosis, agitation and aggression in Alzheimer’s disease (AD), guidelines emphasise the need to ‘use the lowest possible dose’ of antipsychotic drugs, but provide no information on optimal dosing.
AimsThis analysis investigated the pharmacokinetic profiles of risperidone and active metabolite, 9-hydroxy (OH)-risperidone, and how this related to emergent extrapyramidal side effects (EPS), using data from The Clinical Antipsychotic Trials of Intervention Effectiveness-AD study.
MethodA statistical model, which described the concentration-time course of risperidone and 9-OH-risperidone, was used to predict peak, trough and average concentrations of risperidone, 9-OH-risperidone and ‘active moiety’ (combined concentrations) (108 CATIE-AD participants). Logistic regression was used to investigate the associations of pharmacokinetic biomarkers with EPS. Model based predictions were used to simulate the dose adjustments needed to avoid EPS.
ResultsThe model showed an age-related reduction in risperidone clearance (p<0.0001), and estimated that 22% of patients had slower active moiety clearance (concentration-to-dose ratio 20.2±7.2 versus 7.6±4.9 ng/mL per mg/day, Mann Whitney U, p<0.0001). Higher average and trough 9-OH-risperidone concentrations ( p<0.0001), and lower Mini-Mental State Examination (MMSE) scores (p<0.0001), were associated with EPS. Model based predictions suggest the optimum dose ranged from 0.25mg/day in those aged 85 years with MMSEs of 5, to 1mg/day in those aged 75 years with MMSEs of 15, with alternate day dosing required for those with slower drug clearance.
ConclusionsOur findings argue for age- and MMSE -related dose adjustments and suggest that a single plasma sample could be used to identify those with slower drug clearance.
Introduction
Antipsychotic drug use in Alzheimer’s disease
Alzheimer’s disease affects around 35 million people worldwide, fifty percent of whom will experience psychosis symptoms (delusions and hallucinations). (1) Psychosis symptoms are often distressing, increase the risk of aggression towards caregivers, predict faster cognitive and functional decline, and reduce ability to live independently (2). Although symptoms sometimes respond to psychosocial interventions, for those with severe persistent symptoms, antipsychotic medication is required to reduce distress and associated risks. (3) The best evidence of efficacy is for second generation antipsychotic drugs. (4) However, concerns about side-effects (sedation, falls, parkinsonism, and stroke) and increased mortality in people with dementia, (5,6) particularly in those aged over 80 years, (7) has led to a restriction in prescribing. In England, National Institute for Clinical Excellence (NICE) guidance emphasises the need to treat with ‘the lowest effective dose for the shortest possible time’ but provides little practical information on the optimal dose range for individual drugs. We have shown that amisulpride therapeutic plasma concentrations for the treatment of AD psychosis (40-100 ng/mL), are lower than those recommended for the treatment of schizophrenia (100-320 ng/mL), due to a leftwards shift in the dopamine D 2/3receptor concentration-occupancy curve. (8) These findings raise questions regarding the mechanisms of antipsychotic sensitivity in AD and suggest that, for amisulpride at least, 50 mg/day (compared to 400-800mg/day in young adults), may optimally balance the risks and benefits of treatment. (9) It is, however, not clear how far we can extrapolate this approach to other antipsychotic drugs.
Pharmacokinetics and consensus guidance on risperidone prescribing
Risperidone, an antipsychotic drug with high affinity for dopamine D 2/3and serotonin 5HT 2Areceptors, is the only drug licensed for short-term use in the treatment of aggression and psychosis in dementia in the European Union, and is typically prescribed across a 0.5-2 mg/day dose range in this indication. (5,10) Oral risperidone has high (70-85%) bioavailability and is extensively metabolized in the liver by cytochrome P450 2D6 (CYP2D6) to the active metabolite 9-hydroxy (OH)-risperidone. (11) Peak concentrations of risperidone and 9-OH-risperidone are reached after 1 and 3 hours respectively, and steady state concentrations of the active moiety (combined concentrations of risperidone and 9-OH-risperidone) are achieved after 4-5 days. The elimination half-life (t 1/2) of risperidone is dependent on multiple factors. Genetic variation in CYP2D6 genotype accounts for around 50% of the variability in risperidone concentrations (t 1/2for risperidone ranges from 4.7 hours in normal metabolisers to 22 hours in poor metabolisers); with age, hepatobiliary dysfunction, and use of CYP2D6 inhibitors (paroxetine) or inducers (carbamazepine) further contributing to variability (12,13). The metabolite is renally excreted, with a t 1/2of 20 hours; increased to 25 hours in the over-65s and in moderate renal failure.
Consensus guidelines, based on therapeutic drug monitoring, (11,14) pharmacokinetic modelling, (15) and imaging of striatal D 2/3receptor occupancy (16) in risperidone treated patients with schizophrenia, recommend active moiety concentrations of 20–40 ng/mL (3-6 mg/day), (15) as higher concentrations increase occupancy beyond 80% and increase the risk of extrapyramidal side-effects (EPS). Recent guidance on personalised risperidone prescribing advocates dose reductions for those with slower clearance of the active moiety, indexed by concentration to dose (C/D) ratios of the active moiety over 14 ng/mL per mg/day. (17) There is a lack of empirical data from people with AD.
Aims
To investigate sources of variability in plasma concentration-time profiles of risperidone and 9-OH-risperidone, using an approach that allowed estimation of risperidone clearance (metabolism) in distinct subpopulations.
To estimate pharmacokinetic indices (peak, trough and average concentrations of risperidone, 9-OH-risperidone and active moiety) for each individual, across the prescribed dose range.
To investigate the relationship between the above pharmacokinetic indices with EPS.
Method
Data source
CATIE-AD (6,18) was a randomized, double-blind, parallel group study comparing olanzapine, quetiapine, risperidone and placebo in the treatment of psychosis and aggression in AD (Clinicaltrials.gov identifier:NCT00015548). In phase 1, participants were randomized to receive risperidone, olanzapine, quetiapine, or placebo in a 1:1:1:1 allocation ratio, with study physicians having a choice of two capsule strengths (low or high). For risperidone, this corresponded to 0.5 mg or 1.0 mg. Doses were adjusted as clinically indicated by study physicians. If the physician judged that the patient’s response was not adequate at any time after the first 2 weeks, then treatment could be discontinued, with a further decision point being made at 12 weeks. Patients with an adequate response continued treatment for up to 36 weeks. Patients whose initial treatment was discontinued during phase 1 could be enrolled in phase 2 and randomly assigned under double-blind conditions to receive one of the antipsychotic drugs to which they were not initially assigned, or to receive citalopram. In phase 3, treatment was prescribed in an open manner. Within each phase, plasma drug concentration was measured at 2, 4 and 12 weeks, or when a medication switch was made (6,18).Clinical assessment (Baseline, every 2-4 weeks during dose titration) included the Simpson Angus Scale (SAS), (19) and Barnes Akathisia Scale (BAS). (20) Plasma concentrations of risperidone and the active metabolite 9-OH-risperidone were determined using a liquid chromatography-tandem mass spectrometry method with a detection limit of 0.1 ng/mL. The authors assert that all procedures contributing to this work comply with the ethical standards of the relevant national and institutional committees on human experimentation and with the Helsinki Declaration of 1975, as revised in 2008. Written informed consent was obtained from all patients. (6) A comprehensive plan was developed to ensure that all institutional, National Institute for Health, and federal regulations concerning informed consent were fulfilled. The plan included careful assessment of risks and benefits, review by the CATIE protocol and ethics committees, and re-view by the National Institute of Mental Health Data Safety and Monitoring Board. (18)
Data Extraction
Data available from risperidone treated participants included study identification number, phase, visit, dose (mg), timing of blood draw (hours post dose), number of days of treatment, dosage interval (daily), physiological characteristics (age, gender, height, weight, ethnicity (coded as white/other), and smoking (currently smoking or not), Mini-Mental State Examination (MMSE) scores, and plasma concentrations of risperidone and 9-OH-risperidone (ng/mL). Treatment emergent EPS were coded as present if SAS total scores were six or more, or BAS global scores were two or more at follow-up, in individuals with Baseline SAS ratings less than six and BAS scores less than two. Only participants without Baseline EPS were included in our analysis of outcome data. Information was cross-checked with adverse event data, to establish if the event was reported during the relevant phase of treatment; coded under Medical Dictionary for Regulatory Activities (MedDRA 4.0) (preferred terms ‘Parkinsonism’, ‘Parkinsonism aggravated’, ‘cogwheel rigidity’, ‘masked facies’, ‘bradykinesia’, ‘tremor’, ‘extrapy rami dal disorder’, ‘drooling’, ‘gait festinating’, akinesia, akathisia, or tardive dyskinesia); and rated as possibly or probably related to treatment. Data extracted on other adverse events included sedation (preferred terms ‘sedation’, ‘somnolence’, ‘hypersomnia’, ‘lethargy’), falls (preferred term ‘fall’), and postural hypotension (preferred term ‘hypotension or hypotension not otherwise specified’). Rating scales and recorded adverse events were checked for consistency with pharmacokinetic data, using phase, number of days treatment, and the timing of blood sampling.
Statistical Analysis
Demographics
Demographic data were analysed using statistical package for social sciences version 22.0. Mann Whitney U tests were used to describe group comparisons. Chi-squared tests were used to compare frequencies between groups.
Pharmacokinetic model development
Plasma concentration-time profiles of risperidone and 9-OH-risperidone were evaluated using a statistical model (21) that linked parent risperidone and metabolite 9-OH-risperidone via a metabolism rate constant ( km), with the following parameters: i) Risperidone clearance ( CL RISP), ii) Risperidone volume of distribution ( V RISP), iii) Absorption rate constant (ka), iv) 9-OH risperidone volume of distribution ( V 9-OH-RISP), and v) 9-OH-risperidone clearance ( CL 9-OH-RISP). The analysis estimated fixed effects (parameters describing dose-concentration relationships), and random effects, comprised of inter-individual variability (difference between individual and predicted model parameter values for the sample), and residual variability (system noise, dosage history errors). (22) Model development was carried out using Monolix software (version 2018r;www.lixoft.eu). Parameters were estimated using an iterative approach which provided maximum likelihood estimates and standard errors. Plasma concentration was converted from ng/mL to mcg/L for use in model building. The model allowed estimation of the probability of there being more than one subpopulation in relation to risperidone clearance, by including a latent covariate. No assumption was made that latent categories corresponded solely to CYP2D6 genotype, as multiple factors contribute to hepatic metabolism in older people. Residual variability was estimated separately for risperidone and 9-OH-risperidone. Covariates (height, age, gender, smoking, ethnicity, weight) were incorporated in a stepwise manner, through visual inspection of covariate plots and regression analysis in R for categorical covariates. Models were evaluated using goodness-of-fit criteria, including diagnostic scatter plots, visual predictive checks, degree of shrinkage, change in inter-individual variability, model precision, and approximate likelihood ratio tests. A change in log likelihood estimate was considered significant if =>4 (equivalent to p<0.05, one degree of freedom), and accompanied by no change or a decrease in Bayesian Information Criteria.
Pharmacokinetic biomarkers and clinical outcome
Model based estimates were used to calculate peak, trough, and average concentrations of risperidone, 9-OH-risperidone and active moiety (their combined concentrations) for each individual, across the dosage interval. Concentration-to-dose ratio for the active moiety was calculated from trough estimates, to allow comparison with recommendations regarding personalised dosing of risperidone. (17) Each pharmacokinetic biomarker was individually considered as an independent variable (regressor) in a binary logistic model which described the probability of EPS.. The model accounted for random effects, and adjusted for potential confounders (age, sex, MMSE, height, weight). Best fit models were used to simulate and predict plasma concentrations and probability of response and EPS, accounting for factors that contributed to variability.
Results
Sample characteristics
Of 110 risperidone treated patients, 65 (59.1%) were randomised to risperidone treatment in phase one, 31 (28.2%) in phase two, and 14 (12.7%) in phase three (188 plasma samples, collected 26.9±69.9 hours post dose). After excluding four samples, taken after 180 hours (above six half-lives post dose), data from 108 patients remained (52 (47.3%) men, aged 78.4±6.7 years, weight 68.9±14.7 kg, height 1.6±0.1m, MMSE 14.6 ±6.2); sampled 18.1±26.8 hours post dose, after 92.4±76.8 days treatment with 1.0±0.7 mg/day of risperidone (risperidone plasma concentrations 2.4±3.1ng/mL, 9-OH-risperidone plasma concentrations 10.0±8.4 ng/mL).
Eight participants with Baseline SAS scores of six or more (indicating EPS prior to commencing risperidone), were excluded from the analysis of outcome data. Those with Baseline EPS had greater global cognitive impairment (MMSE 7.8±7.0 versus 15.2±5.8, Mann Whitney U, p<0.0001) but there were no differences in other characteristics (Table 1). Treatment emergent EPS occurred in 14 (14%), sedation in 13 (13%), falls in five (5%), postural hypotension in two (2%) and ECG abnormalities in three (3%) patients (Table 1). Those with EPS were prescribed a higher risperidone dose (1.7±0.9mg versus 0.9±0.5mg; Mann Whitney U, p<0.003), had lower MMSE scores (10.2±4.2 versus 16.0±5.6, Mann Whitney U, p<0.0001) and a greater proportion (5 (37.5%) versus 6 (7.0%) patients) were treated with concomitant anti-depressant medication (trazodone) (chi-squared p=0.007, odds ratio = 7.4, 95% CI 1.9-29.2).
Table 1.
Demographic and Clinical Characteristics of Risperidone-Treated CATIE-AD Participants
Pharmacokinetic model
The base model included a latent covariate with two categories (the model failed to converge using a covariate with three categories). Parameters were estimated with good precision, apart from V 9-OH-RISP(relative standard error 60.1%). Residual variability was 0.1 mcg/L (56.2%) for risperidone and 0.7 mcg/L (28.2%) for 9-OH-risperidone. Covariate testing identified a significant contribution of log transformed age (tAge) to the variability in risperidone clearance (β =-0.3, p=9.13e-04). Inclusion of an age effect on CL RISPincreased the precision of the model (Supplementary Table 1) and reduced the estimated probability of being in latent category 1 from 32% to 22%. Stepwise testing of other covariates on clearance parameters did not improve the precision or model fit.
Model based predictions, based on the mean age (78.4 years) of the sample, suggested that for patients assigned to latent category one, risperidone clearance was 8.7L/hr (t 1/222 hours), compared to 34.2L/hr (t 1/25 hours) for those in latent category two. Patients in latent category one were thus considered to represent ‘functionally poor’ metabolisers (PM). Predictions based on the observed contribution of age to risperidone clearance estimated that, for those aged 88 years, risperidone clearance would be reduced by 22% (t 1/228.8 hours in PM and 6.5 hours in functionally normal metabolisers (NM). Based on V 9-OH-RISPand CL 9-OH-RISP, t 1/29-OH-risperidone was 27 hours. Visual predictive checks, (VPCs) shown as percentile plots, superimposed on observed data, are shown inSupplementary Fig 1.
Pharmacokinetic biomarkers and functional metaboliser status
Of the 100 participants included in the analysis of clinical outcome, 18 were categorised as PM. There were no differences in clinical or demographic or clinical variables in PM and NM. Cholinesterase inhibitors were prescribed in a higher proportion of PM (four (77.8%) versus 37 (45.1%), chi squared p=0.01, odds ratio 1.27, 95% confidence interval (CI) 1.04-1.53), and a higher proportion of PM were women (14 (77.8%) versus 39 (47.6%), chi squared p= 0.02, odds ratio 1.24, 95% CI 1.04-1.49). PM were prescribed a lower dose of risperidone (0.7±0.4 mg/day versus 1.1±0.7mg/day, Mann Whitney U, p=0.007), and had higher concentrations across all pharmacokinetic biomarkers (Supplementary Table 2). Trough active moiety concentration-to-dose ratio was markedly increased in PM (20.2±7.2 versus 7.6±4.9 ng/mL per mg/day, Mann Whitney U, p<0.0001), shown inFig 1. There were no differences in the proportion of participants with emergent EPS in PM and NM.
Fig 1.
Active moiety concentration to dose ratio
Estimated concentration to dose (C/D) ratios for the active moiety (ng/mL per mg/day) are shown at trough in those categorised as functionally poor (PM) and functionally normal (NM) metabolisers, aged 75 and 85 years, prescribed 250, 500 and 1000mcg risperidone daily. The red line (7ng/mL per mg/day) represents typical estimates for C/D in a reference group, based on therapeutic drug monitoring studies of risperidone.
Pharmacokinetic biomarkers and clinical outcome
Associations between individual pharmacokinetic biomarkers and EPS are detailed inTable 2. Pharmacokinetic biomarkers showed a significant association with EPS, achieving greatest significance in relation to trough and average concentrations of 9-OH-risperidone and the active moiety (Wald test p<0.0001). MMSE and height also contributed to the best fit regression models ( p<0.0001).
Table 2.
Pharmacokinetic Biomarkers and Emergent EPS (n=100)
Model-based simulations (seeFig 2) suggest that for NM aged 75 years with an MMSE of 15, 1mg/day risperidone would be associated with minimal risk of EPS. For those aged 75 years with an MMSE of 5, a dose reduction to 0.5mg/day would be required. For those aged 85 years, the dose would need to be reduced by 50% to achieve equivalent plasma concentrations, and PM would require very low alternate daily dosing (0.25-0.5mg/48 hours in those aged 75 years, and 0.125-0.25mg/48 hours in those aged 85 years).
For completeness, the same analysis was carried out in relation to sedation, but there were no significant associations. The number of participants with other emergent side effects was too small to investigate through the use of logistic regression.
Fig 2.
Simulated trough 9-OH-risperidone concentrations and EPS
Simulated trough 9-OH-risperidone concentrations and the probability of extrapyramidal side effects (EPS) are shown for a population of 100 people in each of the following categories: 75 or 85 years old; with an MMSE score of 5, 10 or 15; prescribed 250, 500 or 100mcg risperidone daily in A) Functionally normal metabolisers (NM) and B) Functionally poor metabolisers (PM).
Discussion
Age and functional metaboliser status contribute to pharmacokinetic variability
The consensus, based on meta-analyses of placebo controlled trials of risperidone in people with psychosis in AD, is that 1 mg/day risperidone may optimally balance efficacy and adverse effects. (4-6,10) However, meta-analyses can only inform the ‘average’ dose requirements, but are less able to identify subgroups who are most susceptible to side-effects. In this analysis we have investigated the pharmacokinetic (dose-concentrations) and pharmacodynamic (concentration-outcome) contribution to EPS, to guide safer prescribing. We estimated that 22% of patients were functionally poor metabolisers and observed an independent effect of age on risperidone clearance.
Pharmacokinetic biomarkers were robust predictors of EPS, with higher trough and average concentrations of 9-OH-risperidone providing the best fit for the data. Lower MMSE, a marker of more severe global cognitive impairment, was an independent predictor of EPS. Model based simulations suggest that, for NM aged 75 years with an MMSE of 15 (moderate AD severity), 1mg/day would be associated with minimal risk of EPS, but a dose reduction to 0.5mg/day would be required for those with an MMSE of 5. For those aged 85 years, a 50% dose reduction would be required and, for PM, alternate day dosing would be required to avoid excessive exposure.
Drug metabolism is a major contributor to pharmacokinetic variability (23) and, in older adults, the relative importance of genotype is difficult to disentangle from physiological and clinical factors. (17) In the absence of information on CYP2D6genotype, the extent of any genetic contribution to functional metaboliser status is unclear, although estimates of risperidone clearance in PM and NM were broadly consistent with estimates for CYP2D6-predicted ‘poor’ and ‘extensive’ metabolisers. (13) Age was independently associated with risperidone clearance and, when incorporated into the model, led to the reassignment of six patients who were initially categorised as PM. Although previous research has not shown an effect of age specifically on risperidone clearance, (13) a 30% decrease in hepatic metabolism in those aged over 70 years has been observed for other CYP2D6 substrates (24) and it is thus likely that our findings are explained by the older age of CATIE-AD participants. Similarly the absence of an association between age and 9-OH-risperidone clearance reflects the older age of CATIE-AD participants compared to previous analyses.
Mechanistic insights into emergent EPS
Statistical modelling of the relationship between risperidone active moiety plasma concentrations and D 2/3receptor occupancy (25) in adults with schizophrenia, suggests that trough concentrations of 10.5-38.2 ng/mL are associated with 60-78% occupancy in the striatum, and 6.5 ng/mL (95% CI, 3-10 ng/mL) is associated with 50% occupancy. In CATIE-AD participants, EPS emerged from trough active moiety concentrations of 3.4 ng/mL (of which 3.2 ng/mL was 9-OH-risperidone), and concentrations exceeded 10ng/mL (60% occupancy) in eight of 14 patients with EPS. In the absence of occupancy data, it is unclear whether the emergence of EPS at such low concentrations signifies a leftwards shift in the concentration-occupancy curve, similar to that observed during amisulpride treatment. (8) This is possible, as risperidone and 9-OH-risperidone are substrates for P-glycoprotein, (26) a blood brain barrier efflux transporter that is marked reduced older people with AD. (27) However age or disease-specific changes in brain drug distribution, clearance, and competition with endogenous dopamine at receptor sites need to be considered. (8)
Pharmacodynamic changes (reduced D 2/3receptor reserve, altered signal transduction) which lead to a greater functional outcome for a given occupancy are also important. We have previously observed EPS at low striatal D 2/3receptor occupancies (60% compared to 80% in young people), in risperidone-treated older people with schizophrenia, (28,29) and amisulpride-treated older people with psychosis in AD. (8) Given the error margin of occupancy predictions, we cannot rule out the possibility that occupancy was under-estimated in a proportion of those with active moiety concentrations less than 10ng/mL. (25)
To our knowledge, this is the first demonstration of the contribution of MMSE score, a marker of increasing dementia severity, to the risk of antipsychotic related EPS. An association between agitation, antipsychotic use and death in those with more severe dementia has however been reported in a recently published cohort study (30). The mechanisms of antipsychotic-induced EPS are not fully understood, but D 2/3receptor antagonism of inhibitory dopaminergic inputs to striatal medium spiny neurones and cholinergic interneurones may play a key role. (3) It is unclear whether the risk of EPS in those with lower MMSE scores reflects greater in networks that modulate motor control, or is associated with as yet unidentified factors that potentiate EPS.
Limitations
Limitations to the analysis include sparse sampling, which meant it was not possible to estimate within-subject variability in clearance of risperidone or 9-OH-risperidone, or to investigate the contribution of concomitant medications to pharmacokinetic variability. Neither was it possible to investigate the contribution of comorbid medical conditions to variability in pharmacokinetics or emergent side effects. We cannot account for the fact that those with emergent EPS were more likely to have been prescribed concomitant trazodone, given the small sample size and uncertain exposure (dose, continuity of the prescribed drug) of individual participants to trazodone. However, we cannot rule out the possibility of potential drug-drug interactions, including an interaction with P-glycoprotein (trazodone is a substrate), or potentiated EPS through the inhibition of serotonin uptake. (3) Other limitations relate to the CATIE-AD study design, which may have reduced our ability to detect associations between pharmacokinetic indices and clinical outcome. This includes flexibility in starting dose (low or high), the option of making adjustments or of discontinuing a phase, based on clinician judgement.
Dose adjustments needed to avoid treatment emergent EPS
This analysis represents a step towards safer risperidone prescribing and argues strongly for age- and MMSE-related dose reductions. From a pragmatic perspective, clinicians should ‘start low go slow’ (0.5-1mg/day) in those aged 75 years with moderate stage AD, and ‘start low, stay low’ (maximum 0.5mg/day) in those aged 75 years with severe AD. For those aged 85 years, the dose should be halved, and alternate daily dosing considered if side effects emerge, as it is likely that the person has slower active moiety clearance.
Personalised prescribing should ideally incorporate knowledge of genetic, environmental and personal variables to determine dosing. This is currently happening in clinical practice and there has been a lack of empirical data in older people to justify the use of routine therapeutic drug monitoring. Consistent with a recently proposed personalised prescribing algorithm, CATIE-AD participants categorised as PM had high active moiety concentration-to-dose ratios. (17) Therapeutic drug monitoring thus offers the opportunity to guide dose adjustments with greater precision, as this measure could be derived from a single plasma sample, to identify those with slower drug clearance. Future research should test our proposed dose predictions and could evaluate the clinical utility of therapeutic drug ‘screening’ (measurement from a single plasma sample).
Contributors
SR led the study design, carried out data extraction, carried out data analysis and led on the writing of the paper; JB, HU, RB, BP and RH gave input into the study design and analysis plan; KY, YO and KL extracted data on clinical outcome measures; MO extracted data on adverse events; JB supervised SR in the analysis of the data, carried out simulations, and led on data presentation; EB and RH gave input into the interpretation and presentation of pharmacokinetic data; all authors contributed to the interpretation of the clinical findings and the writing of the paper, and approved the submitted manuscript.
Competing interests
There are no competing interests
Funding
R.H. is supported by the NIHR University College London Hospital Biomedical Research Centre (UCLH BRC)
Supplementary Material
Supplementary Table 1.
Pharmacokinetic Model for Risperidone and 9-hydroxy-risperidone (n=108)
Supplementary Fig 1.
Visual predictive checks
Visual predictive checks (VPC): 95% prediction intervals around the 10th (lower blue shaded area), 50th (pink shaded area) and 90th (upper blue shaded area) percentiles are shown for the final model overlaid to observed data for risperidone in A) Functionally poor metabolisers and B) Functionally normal metabolisers. Each blue circle represents a single plasma sample. Blue lines represent the empirical predictions for each percentile and outliers are circled in red.
Supplementary Table 2:
Pharmacokinetic Biomarkers and Functional Metaboliser Status
Acknowledgements
Data used in the preparation of this article were obtained from the limited access datasets distributed from the NIH supported “Clinical Antipsychotic Trials of Intervention Effectiveness in AD” (CATIE-AD) (MH64173, MH90001). This is a multisite, clinical trial of people with psychosis and/or agitation in the content of AD, which compared the effectiveness of randomly assigned medication treatment. This manuscript reflects the views of the authors and may not reflect the opinions or views of the CATIE Study Investigators or the NIH. No funding was provided for this analysis. Suzanne Reeves had full access to the data included in this analysis, and had final responsibility for the decision to submit for publication.
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| https://www.medrxiv.org/content/10.1101/2020.08.12.20173310v1.full |
Use of Fertility Awareness-Based Methods for Pregnancy Prevention Among Ghanaian Women: A Nationally Representative Cross-Sectional Survey | Global Health: Science and Practice
ORIGINAL ARTICLE
Use of Fertility Awareness-Based Methods for Pregnancy Prevention Among Ghanaian Women: A Nationally Representative Cross-Sectional Survey
Chelsea B. Polis , Easmon Otupiri , Suzanne O. Bell and Roderick Larsen-Reindorf
Global Health: Science and Practice June 2021, 9(2):318-331; https://doi.org/10.9745/GHSP-D-20-00601
Article
Key Findings
Standard approaches underestimate fertility awareness-based method (FABM) use; we posit that at least 18% of contracepting Ghanaian women likely use an FABM.
Economically and educationally advantaged women had higher odds of current FABM use (versus intrauterine device/hormonal method), which may suggest deliberateness of method selection (as opposed to limited access to alternatives).
Most (92%) rhythm users wish to improve the effectiveness of their method, and many are willing to track additional biomarkers, but only 17% ever discussed their method with a health professional.
Key Implications
Researchers, programmers, and funders should better understand and address FABM users' needs, in commitment to reproductive autonomy and choice.
ABSTRACT
Few studies in low- and middle-income countries have examined the use of fertility awareness-based methods (FABMs) for pregnancy prevention. Understanding the prevalence of FABM use among Ghanaian contraceptors and the characteristics and practices of users is essential. Our 2018 nationally representative survey of Ghanaian women included detailed questions on the use of rhythm and Standard Days Method/Cycle Beads (SDM). After considering multimethod use patterns, we estimated likely FABM prevalence among contraceptors, identified characteristics associated with current use of an FABM (vs. current use of a hormonal method/intrauterine device [IUD]), and described how women report using FABMs. At least 18% of contracepting Ghanaian women likely use an FABM, though this may be underreported. Among FABM users, 57% reported current use of an FABM alone; the remainder reported concurrent use of other methods. Women who were older, richer, more educated, and had fewer children had higher odds of current FABM use versus IUD/hormonal method. Although FABM users were more likely than other contraceptors to correctly identify the approximate fertile time, only 50% of FABM users did so correctly. Most (92%) rhythm users were interested in making their method use more effective. While 72% had heard of SDM, less than 25% had heard of various other ways to make the rhythm method more effective. Only 17% of rhythm users had ever discussed the method with a health professional. Rhythm users indicated substantial willingness to track additional biomarkers (e.g., daily temperature or cervical mucus) or to use a phone to enhance the effectiveness of their method, and most indicated no substantial difficulty getting partners to abstain or withdraw on fertile days. A nontrivial proportion of reproductive age Ghanaian women are using an FABM, nearly all of whom are interested in learning how to improve its effectiveness. The family planning field should better address these women's contraceptive needs in commitment to reproductive autonomy and choice.
INTRODUCTION
Understanding the extent of people's reliance on fertility awareness-based contraceptive methods (FABMs) and the characteristics and practices of such users is essential to comprehensively meeting reproductive needs. A concise introduction to FABMs can be found elsewhere. 1In brief, FABMs aim to identify the span of days during each menstrual cycle when sexual intercourse is most likely to result in pregnancy (the “fertile window”). Depending on the requirements of the specific FABM, users track changes in 1 or more fertility biomarkers (e.g., menstrual start dates, basal body temperatures, cervical mucus or cervical position, and urinary hormone metabolites) in attempts to identify their fertile window during each menstrual cycle. Certain FABMs can be used to either plan or prevent pregnancy. If pregnancy prevention is desired, users can either avoid penile-vaginal intercourse or use other methods (e.g., barrier methods, withdrawal, etc.) on days the method identifies as fertile.
Such FABM users are taking action to avoid conceiving but may be more vulnerable to unintended pregnancy compared with users of certain other contraceptive methods. For example, in low-income countries, an estimated 19% of those who report using the rhythm method (a type of FABM, described in greater detail below) will experience an unintended pregnancy in the first year of use, compared with 0.3% of implant users. 2Contraceptive effectiveness is a key attribute for many people choosing a method, but other method characteristics influence contraceptive decision making, such as safety, side effects, impact on bleeding patterns, cost, ease of use, protection from sexually transmitted infections, privacy, etc. 3 – 7Despite a common assumption that people resort to less effective contraceptive methods due to a lack of access to more effective options, these choices often reflect user preferences. 8 – 13For example, side effects and health concerns are the most common reasons for nonuse or discontinuation of hormonal contraception among women in low-income countries who do not desire pregnancy, 14 , 15whereas methods perceived as “natural” may appeal to people with these concerns. 12
Despite a common assumption that people resort to less effective contraceptive methods due to a lack of access to more effective options, these choices often reflect user preferences.
FABMs have received relatively limited attention in the contraceptive literature. Rhythm is perhaps the most widely known FABM, although many who report using rhythm are not likely using its formal requirements. 16Relatively little is known about how those who identify as rhythm users actually use the method and the extent to which they rely on other contraceptive methods during the fertile window versus abstaining from sex during this period (i.e., practice periodic abstinence). Rhythm is typically classified as a traditional method. However, certain other FABMs (e.g., Standard Days Method [SDM], TwoDay Method, etc.) are often classified as modern—although these classifications are not universal (e.g., the United Nations Population Division does not classify these methods as modern)—and the nomenclature is imperfect. 17 – 21In addition to FABMs, some people use menstrual tracking smartphone apps or devices to time sexual intercourse for pregnancy prevention. Although 2 apps have received clearance from the United States Food and Drug Administration for use as a contraceptive method (Natural Cycles in 2018, 22which also received CE Marking in Europe, and Clue in 2021 23), most such apps or devices are not tested or indicated for this purpose and may offer predictions of unknown accuracy regarding the timing of fertile days. 24 , 25
Research focused specifically on FABM use in low- and middle-income countries (LMICs) has been particularly limited (with exceptions from the United States Agency for International Development and the Institute for Reproductive Health at Georgetown University 18 , 26 – 31). However, there are existing and emerging reasons for greater understanding around FABM use in LMICs. First, our understanding of contraceptive decision making is incomplete without understanding people who select contraceptive options that are not among the most highly effective. Understanding such choices can help to support client-centered approaches to contraceptive counseling, programming, and method development. Second, FABMs use is increasing in some contexts, 32and multiple researchers have identified substantial underestimation of methods (including rhythm) in nationally representative surveys. 12 , 13 , 33 – 35This suggests incomplete existing information on the prevalence of FABM use, which impacts our understanding of who chooses FABMs and impacts estimation of other key metrics (e.g., unmet need for contraception). Third, without understanding how people employ these methods, we have little ability to identify approaches that enhance the effectiveness of their contraceptive practices while respecting their contraceptive preferences.
Our understanding of contraceptive decision making is incomplete without understanding people who select contraceptive options that are not among the most highly effective.
Additional reasons for understanding FABM use in LMICs have emerged more recently. First, the coronavirus disease (COVID-19) pandemic has limited access to contraceptive services, prompting calls by some international organizations for counseling on FABMs, 36which are less vulnerable than other methods to commodity supply chain disruptions. 37Furthermore, there is an increasing understanding of the application of principles of self-care to sexual and reproductive health worldwide, 38as well as emerging literature on whether fertility knowledge (e.g., regarding the timing of ovulation or impacts of age on fertility) impacts reproductive outcomes. 39 , 40Although FABMs are not appropriate for all individuals, they can assist certain couples to avoid (or seek) pregnancy with limited or no clinical support after being trained in and correctly using the method. Finally, the increasing development of new technologies will continue to provide new tools that facilitate use of FABMs and may increase their prevalence. The contraceptive field can play a useful role in helping people who prefer a method they may perceive as “natural” in understanding if new technologies have reliable evidence on contraceptive effectiveness 41and to optimize the effectiveness of chosen methods.
To expand understanding of FABM use in LMICs, we aimed to examine the use of 2 FABMs (rhythm method and SDM/CycleBeads) in a nationally representative sample of Ghanaian women. Our objectives were to estimate the prevalence of FABM use among Ghanaian contraceptors (including careful consideration of multimethod use patterns), understand characteristics associated with choosing an FABM (relative to choosing an intrauterine device [IUD] or hormonal method), and collect detailed information on various aspects of how Ghanaian women use FABMs. This article also aims to contribute to improvements in measuring FABM use across diverse contexts by detailing methodological considerations around terminology and definitions used for FABMs in large-scale surveys and how these might be improved.
We aimed to estimate the prevalence of FABM use among Ghanaian contraceptors, understand characteristics associated with choosing an FABM, and collect information on how Ghanaian women use FABMs.
METHODS
Survey Design and Implementation
Our survey design and sampling have been described in detail elsewhere. 42Briefly, data for this analysis were drawn from a nationally representative, community-based survey of reproductive-aged (15–49 years) women in Ghana (N=4,722), conducted in 2018 as part of a larger study on abortion incidence in Ghana. 43The survey was a collaborative effort between the Guttmacher Institute, the Kwame Nkrumah University of Science and Technology (KNUST), and the Performance Monitoring and Accountability 2020 team at the Johns Hopkins Bloomberg School of Public Health. We used a multistage stratified cluster sampling design and probability-proportional-to-size sampling to select 100 enumeration areas, each consisting of approximately 200 households. We then listed, mapped, and randomly selected 42 households in each selected enumeration area. In those households, we conducted a short household survey to collect socioeconomic information and to identify eligible female respondents. We invited all eligible women to give informed consent and participate in the full survey. Trained resident enumerators collected data for both surveys in a private area, using an Android smartphone enabled with Open Data Kit electronic data collection software. Households with one or more participating respondents who completed the full survey received a bar of soap. The Institutional Review Boards of the Guttmacher Institute, the KNUST Committee on Human Research, Publication and Ethics, and the Johns Hopkins Bloomberg School of Public Health provided ethical approval. Prior analyses of these data showed that among all respondents aged 15–49 years in our sample who had ever had sex (n=4,139), 33.7% currently reported using any contraceptive method. 44
Identifying Rhythm or SDM Users
Traditional methods and modern FABMs are likely underreported in many surveys, including Demographic and Health Surveys (DHS). Studies suggest that some respondents interpret filtering questions (e.g., “are you or your partner currently doing something or using any method to delay or avoid getting pregnant?”) as pertaining only to modern or non-“natural” methods. 12 , 13 , 33 , 34Additionally, when asked to spontaneously name methods used, a qualitative study of 48 Ghanaian women found that “fertility awareness methods were rarely spontaneously mentioned as a way to prevent pregnancy…yet counting days was almost universally used at one time or another and participants described it as a taken-for-granted part of a woman's life.” 34Other studies suggest that women using multiple methods (e.g., an FABM with condoms during the fertile window) may potentially report only condom use, 12unless, for example, she is asked about the use of all potential methods.
Our study did not address the first concern as we did use the filtering question, but it did address the second concern by asking about the use of each method among those who affirmed using a method. Specifically, survey respondents were asked, “Have you or a partner ever done something or used any method to delay or avoid getting pregnant?” We asked respondents who said “yes” to spontaneously list methods ever used, and then the interviewer asked about each of the possible methods to capture users who self-identified as using any of these methods (female and male sterilization, implants, IUDs, injectables (3 month and 1 month), pill, emergency contraception (EC), male and female condoms, diaphragm, foam or jelly, SDM/Cycle Beads, lactational amenorrhea method, N-tablet, rhythm method, withdrawal, washing, or “other traditional method”). The interviewer next followed a similar process for current method use by asking nonpregnant women, “Are you or your partner currently doing something or using any method to delay or avoid getting pregnant?” Again, we only asked respondents who said “yes” to list methods currently used, before being asked about each possible method, to self-identify as current users.
Like DHS and other surveys, our survey may suffer from underreporting of traditional or “natural” methods, if respondents answered “no” to both filtering questions under the assumption that traditional or “natural” methods do not count. Therefore, we interpret our prevalence estimates as a lower bound. However, each respondent who acknowledged ever or currently doing something or using any method to delay or avoid pregnancy was probed on all possible contraceptive methods.
Data Analysis
Method-specific prevalence is typically calculated based upon the most effective method a person reports currently using. For example, each DHS survey contains a hierarchical list of methods, ordered by typical use contraceptive effectiveness estimates. If a DHS respondent reports currently using both SDM and condoms, she is considered a condom user in prevalence estimation. This approach may underestimate FABM prevalence, as some FABM users use barrier methods or EC during the fertile window 34 , 45and would thus be coded as a barrier or EC user, despite having sex with no contraception on days that the method (correctly or incorrectly) identifies as infertile.
Method-specific prevalence is typically calculated based on the most effective method a person reports currently using, but this approach may underestimate FABM prevalence.
To address this underestimation issue, we used an approach previously applied to data from the United States 46to estimate likely FABM prevalence among Ghanaian contraceptors. First, we calculated a standard prevalence estimate based on “most effective” method (using the ordering represented inTable 1); as already noted, this approach may underestimate FABM use. Next, we recalculated prevalence, incorporating information on multiple method use. That is, a person who reported currently using 2 or more methods would be included in all reported method categories for method-specific prevalence estimation. These are likely overestimates since some women use an FABM with a highly effective method (such as sterilization, an IUD, or hormonal contraception), which likely serves as their primary mode of contraception. Therefore, to identify the most likely FABM prevalence estimate, it is necessary to examine specific patterns of multiple method use among FABM users. We classified respondents who reported any current use of an FABM into 3 categories:
Category A: Reported current use of an FABM alone or with current use of a less effective method (i.e., withdrawal, washing, etc.)
Category B: Reported current use of an FABM in conjunction with current use of barrier methods and/or EC
Category C: Reported current use of an FABM in conjunction with current use of a highly effective method (i.e., hormonal contraception, an IUD, or sterilization).
TABLE 1.
Percent Distribution of Contraceptors aAged 15–49, by Current Contraceptive Method(s) Used at Interview, Ghana, 2018
As in a prior study, 46we considered women in Category A as definite FABM users, women in Category B as likely FABM users, and women in Category C as relying primarily on a highly effective (non-FABM) method. Thus, we included women in Categories A or B in our FABM prevalence estimation.
We calculated prevalence estimates among “contraceptors,”*excluding women who: did not report that they (or their partner) were “currently doing something or using any method to delay or avoid getting pregnant”; women who were currently trying for pregnancy, women who were currently pregnant, and women who reported never having had sexual intercourse. We considered the remaining 1,165 participants “contraceptors.”
Next, we conducted bivariate and multivariable logistic regressions to identify characteristics we hypothesized to be associated with being a current (definite or likely) FABM user versus a current user of hormonal contraceptives or an IUD, and that were available in these data. Characteristics we examined included ecological zone (Northern, Middle, Central), residence (urban vs. rural), age (continuous), marital status (currently married/cohabiting, formerly married or cohabiting, never married or cohabiting), parity (continuous), education (none, primary or middle, secondary), religion (none, any Christian, Muslim, traditional/other), wealth (poorest 60% vs. richest 40%), importance of avoiding a pregnancy now (very important, somewhat important, not at all important), and correct knowledge of approximate fertility time (incorrect vs. correct). We present a multivariable model including all variables hypothesized to be relevant (a sensitivity analysis demonstrated similar results when including only those variables significant at P≤.05). Finally, we calculated descriptive statistics on a series of detailed questions asking FABM users about their knowledge of and ways in which they practice FABMs.
We performed analysis in Stata version 16, accounting for the complex survey design using survey weights to adjust for the probability of selection and the Taylor Linearization method to calculate standard errors that correctly account for clustering. We also used the subpopoption to restrict to appropriate analytic populations.
RESULTS
FABM Prevalence Among Contraceptors
Among contraceptors, 9.2% reported rhythm and 4.3% reported SDM as their most effective method (Table 1). As previously noted, these are likely underestimates. Calculating prevalence among contraceptors based on all methods reported increased rhythm prevalence to 13.6% and SDM prevalence to 6% (Table 1). As mentioned, these are likely overestimates, so we examined specific patterns of multimethod use among FABM users.
Our data revealed a diverse range of FABM method use patterns. Among all women who reported currently using rhythm or SDM, over half (57.3%) reported using that FABM without any additional methods (Table 2). The next most common pattern of multimethod use among rhythm users involved either EC or withdrawal (among 5.9% and 5.6% of women who reported rhythm use, respectively), and among SDM users, involved either withdrawal or male condoms (among 11.9% and 8.6% of women who reported SDM, respectively). If classified by most effective method, 68% and 72% of women who reported currently using rhythm or SDM, respectively, would be classified as a user of the FABM they reported (Table 2, category A). Approximately 23% and 28% of women who reported using rhythm or SDM, respectively, would be classified as either a user of male condoms or EC using the standard prevalence estimation approach; though these women may rely primarily on an FABM and use condoms and/or EC episodically during their presumed fertile window (Table 2, category B). Finally, 9% of women who reported using rhythm (and 0% of women who reported using SDM), reported also currently using a permanent, long-acting reversible, or hormonal method, and would be classified as a user of that more highly effective method using the standard prevalence estimation approach (Table 2, category C).
Our data revealed a diverse range of FABM method use patterns.
TABLE 2.
Use Patterns Among Women Reporting Current Use of Rhythm or SDM, With or Without Current Use of Other Methods
We assumed that respondents in categories A and B (Table 2) should be counted as FABM users, suggesting that at least 18.1% of contraceptors in Ghana relied primarily on an FABM, whether modern (SDM: 6%) or traditional (rhythm: 12.4%) (Table 3). In other words, taking multiple method use (i.e., among women using an FABM plus (fe)male condoms and/or EC) into account increased the percentage of women who likely relied on an FABM from 13.5% (95% confidence interval [CI]=10.9, 16.7, and composed of 9.2% rhythm users and 4.3% SDM users) to 18.1% (95% CI=14.9, 21.8).
TABLE 3.
Prevalence of FABMs by Estimation Method and Population Subgroup
Characteristics Associated With FABM Use vs. Hormonal Contraception/IUD Use
In bivariate analyses, factors associated with approximately twice the odds of FABM use relative to hormonal contraception/IUD use included: living in the Middle or Central zone (vs. Northern zone), having never been (vs. currently being) married or cohabitating, feeling that avoiding pregnancy now was not at all (vs. very) important, identifying with any Christian religion (vs. no religion), and correctly identifying the approximate fertile time (vs. not knowing or correctly identifying it) (Table 4). Living in an urban (vs. rural) area and being in the richest 40% (vs. poorest 60%) of the population were associated with approximately 3 times the odds. Having attended secondary school (vs. no school) was associated with over 4 times the odds of FABM use (vs. hormonal contraception/IUD use). Each additional child born was associated with 20% lower odds of FABM use. Age was not significantly associated with FABM use.
TABLE 4.
Odds Ratio Associated With Use of an FABM Relative to Use of Hormonal Contraception or an IUD
In multivariable analysis, factors significantly associated with FABM use (vs. hormonal contraception/IUD use) included: age (each year was associated with an increase in odds of FABM use by 10%), parity (each child was associated with a decrease in odds of FABM use by 30%), and being richer or having attended secondary school or higher, each of which was associated with approximately double the odds of FABM use (Table 4). Feeling that avoiding pregnancy was not at all important and correct knowledge of the approximate fertile time were associated with an elevated odds ratio in bivariate analysis but did not reach statistical significance at P≤.05 in multivariable analysis.
Interestingly, among contraceptors, 34% of those not using an FABM and 50% of FABM users correctly identified the approximate fertile time (i.e., “halfway between 2 periods”) ( P-value for chi 2= 0.01,SupplementB). It is also worth noting that most (80%) FABM users felt it was “very important” for them to avoid pregnancy now (SupplementB).
How Women Report Using the Rhythm Method
The vast majority (85%) of rhythm users noted that they identify their fertile and nonfertile days by counting days of a menstrual cycle using a calendar (SupplementC) (participants could report more than 1 response). We did not obtain more detailed information on which rules, specifically, were used to determine fertile days using a calendar. About 1 in 6 rhythm users (17%) used an unspecified approach to determine her fertile window, and 9% did so by observing changes in cervical mucus. Alternative approaches were reported by 5% or less of rhythm users: using a mobile phone app (5%), observing the position or texture of their cervix (3%), recording daily temperature (1%), or using CycleBeads to determine her fertile days (0%).
Among rhythm users, 12% believed there was no chance of getting pregnant over the course of a year while using the method, and 64% reported believing that there was a ≥50% chance.
Nearly three-quarters (72%) of rhythm users had heard of the SDM. Less than one-quarter had heard of ways to make FABMs easier to use, such as CycleBeads (22%) or the CycleBeads mobile app (17%), other mobile FABM apps (23%), or other simple-to-use FABMs like TwoDay method (22%).
Nearly all rhythm users (92%) expressed interest in learning how to make the rhythm method more effective at pregnancy prevention. Among women who wanted to make their rhythm use more effective (and were not already using the given approach mentioned), a majority would be willing to learn about approaches facilitated by a phone (82%) or to record their daily temperature (76%). Slightly over half (53%) expressed a willingness to collect their cervical mucus daily or to observe the texture of their cervix by inserting their fingers into their vagina daily.
Only half of rhythm users knew where to go for advice on using rhythm effectively. Among those who knew, most (53%) would go to a family planning service provider. However, only 17% of rhythm users had ever discussed using the rhythm method with a health professional.
How Women Report Using FABMs (Rhythm or SDM) Overall
When FABM users were asked how they avoided pregnancy on days identified as fertile (and permitted to list as many responses as desired), 74% reported avoiding intercourse (SupplementD). The next most common answer (19%) was withdrawal, followed by using condoms or another barrier method (16% among rhythm users, and 13% among SDM users), and EC (12% among rhythm users and 11% among SDM users).
The majority (64%) of FABM users who abstained from sex during the fertile window reported that it was “very easy” to get their partner to abstain on these days, with another 22% reporting that it was somewhat easy. Only 14% reporting that this was somewhat or very hard. Among FABM users who reported using withdrawal during fertile days, 68% said very easy, 10% somewhat easy, and 22% somewhat or very hard. We asked a similar question about condom use, but an ODK programming error precluded calculating estimates for this question.
When FABM users were asked whether menstruation affects sexual activity with their partner, 76% said “yes, we generally avoid sex when I am menstruating,” but 20% stated, “no, because we don't have sex regularly.” Only 4% responded, “no, we generally have sex when I am menstruating.”
DISCUSSION
We posit that at least 18% of contracepting women in Ghana likely relied primarily on an FABM for pregnancy prevention. Had we relied on the most effective method reported, as is standard procedure, the estimate would be 13.5% (9.2% rhythm, 4.3% SDM). Our 18% estimate likely represents a lower bound, because, like the 2014 Ghana DHS 47and 2017 Ghana Maternal Health Survey, 48we used a filtering question. †However, unlike those surveys, among women who acknowledged ever or currently doing something or using a method to prevent pregnancy, our survey asked about all methods. Also, unlike those surveys, we assessed patterns of multiple method use to ascertain likely FABM users.
We posit that at least 18% of contracepting women in Ghana likely relied primarily on an FABM for pregnancy prevention.
Our rhythm prevalence estimates (based on most effective method) were slightly lower than those from the 2017 Ghana Maternal Health Survey for all women, currently married women, and sexually active unmarried women (SupplementA). This may be because SDM users may have reported themselves as rhythm users in that survey; combining our rhythm and SDM estimates results in estimates similar to estimates for rhythm in that survey. Overall, based on our estimate that 18% of contracepting Ghanaian women likely rely primarily on an FABM, we estimate that a minimum of 343,890 Ghanaian women (of an estimated 1,899,943 Ghanaian female contraceptors) currently rely primarily on an FABM 49; a larger number than those using oral contraceptive pills or using male condoms, and nearly as many as those using 3-monthly injectables.
Among FABM users, more than half (57%) reported currently using only their FABM, while the remainder also reported current use of condoms, withdrawal, EC, and/or other methods. Prior studies in Ghana suggest that such contraceptive “mosaics” of methods that are viewed as natural are common. These methods are believed to help protect the regular flow of menses from bleeding changes induced by other methods 50as bleeding changes are perceived as linked with infertility. 7 , 51 – 53These contraceptive patterns have implications for how FABM prevalence is calculated in large-scale surveys and merits re-examination of the use of terms like “periodic abstinence” and the definition of “rhythm” currently used in DHS and other survey questions. For example, the Ghana 2017 Maternal Health Survey describes rhythm as “to avoid pregnancy, women do not have sexual intercourse on the days of the month they think they can get pregnant”; this definition inaccurately implies that rhythm is always practiced with abstinence. We elaborate upon this concern inSupplementE, where we advocate that the term “periodic abstinence” be replaced with a less assumption-laden term, such as “fertility awareness-based method.” Similarly, we describe how language used to describe FABMs to respondents should be revised to avoid the assumption of abstinence during the fertile time.
Contraceptors who reported currently using FABMs (versus IUDs or hormonal methods) appeared to have several relatively advantaged characteristics: after controlling for multiple sociodemographic factors, they are more likely to be older, richer, more educated, and to have fewer children. This corroborates other findings from Ghana, in which contraceptors who were older, urban, more educated, and had fewer children were more likely to choose a traditional instead of modern method, 12though these patterns do not necessarily hold in other countries. 11Use of FABMs by relatively advantaged women may reflect distinct preferences for these methods, as identified in other Ghanaian studies 10 , 13and elsewhere 8 , 9or may reflect that aspects of FABMs may be less accessible to more disadvantaged women (e.g., power differentials negating an ability to negotiate the timing and circumstances of sexual activity with a partner, which women in our sample did not report particular difficulty in doing). Though only borderline statistically significant in our multivariable model, correct knowledge of the approximate fertile time did appear to be higher among likely FABM users, which has been observed previously in Ghana, 48yet only 50% of FABM users correctly identified the approximate fertile time, indicating substantial room for improvement among individuals relying upon this information to prevent pregnancy.
The majority (85%) of rhythm users reported identifying fertile and nonfertile days using a calendar, though it remains unclear exactly what rules they used to determine fertile and infertile days. Many were likely not using the formal rules of the rhythm method and may have simply avoided unprotected sex on days when they believed—possibly inaccurately—that pregnancy was possible. 16InSupplementE, we elaborate upon impreciseness in current use of the term “rhythm,” which has come to be used as a generic word for a diverse array of nonformalized practices, 54perhaps better described as “informal rhythm.” Furthermore, less than a quarter of rhythm users had heard of ways to make FABM use easier, and few reported using tools like CycleBeads or apps indicated for pregnancy prevention. Yet, nearly all rhythm users expressed interest in learning how to make use of their method more effective, and a substantial proportion of rhythm users expressed willingness to collect additional biomarkers (i.e., temperature, cervical mucus, cervical position) or to use tools such as mobile phone apps. Given that only 17% of rhythm users had ever discussed use of the rhythm method with a health professional, there appears to be a substantial missed opportunity to assist rhythm users in identifying ways to improve the effectiveness of their chosen contraceptive method.
Given that only 17% of rhythm users had ever discussed using the method with a health professional, there appears to be a substantial missed opportunity to assist users in identifying ways to improve the effectiveness of their chosen contraceptive method.
This missed opportunity has also been reflected in prior work in Ghana. For example, in a small (n=85) survey in central Ghana conducted in 2010 on contraceptive self-care options, only 36% of respondents indicated interest in self-administered injections, but 75% indicated wanting to learn more about FABMs. 55In a monitoring study of a free FABM app, 60.8% of Ghanaian women who downloaded the app for the purpose of pregnancy prevention were not using a method of contraception in the prior 3 months, and 23% noted that it was the first method they had ever used, 26suggesting that FABMs may attract new users. Researchers have recommended that family planning programs in Ghana consider the promotion of modern FABMs along with other modern methods, 55 , 56which would require health professionals (particularly community health nurses and midwives who commonly offer and provide family planning methods in Ghana) to be trained to offer FABMs. Furthermore, certain FABMs (e.g., CycleBeads) require commodities, but to the best of our knowledge, nationally representative, facility-based, reproductive health commodities and service surveys in Ghana funded by United Nations Population Fund have not included FABM-related commodities when assessing the availability of modern methods at service delivery points.
Strengths of this study include the use of a nationally representative sample of Ghanaian women and the incorporation of probing on the ever or current use of all methods of contraception. This builds upon an approach used by Rossier et al. in Burkina Faso, wherein investigators probed on all traditional methods. 33Finally, as far as we are aware, this is one of the first studies in a low- or middle-income country to ask detailed questions on FABM use, eliciting information that could be used to inform better outreach to and counseling for rhythm method users, who appear to be interested in understanding how to improve the effectiveness of their chosen contraceptive method.
Limitations
Our study has multiple limitations, key among them being that our prevalence estimates suffer from some of the same methodological flaws as other nationally representative studies in Ghana, given that we used a filtering question in asking about method use, which may lead to underreporting of FABMs and other methods. We believe this would have been more impactful in soliciting “ever” use (vs. current use). If a participant acknowledged having ever used anymethod, interviewers would eventually ask about all methods, priming the respondent (before answering the current method question), that rhythm and SDM “count” as contraceptive methods. In addition, we did not specifically ask about the use of FABMs other than rhythm or SDM in our survey, which could potentially mean that users of methods such as TwoDay, symptothermal, or others are undercounted; however, we expect this to be highly unlikely, particularly given the responses to questions on knowledge of other FABMs. One of our questions on rhythm suffered from the same definitional errors as seen in other large-scale survey questions on rhythm. Specifically, one of our questions asked, “You noted that you use the rhythm method, or avoiding sex on days when you are more likely to get pregnant. Can you please state all of the ways in which you identify your fertile and non-fertile days?” The implicit assumption that rhythm users abstain from sexual activity on days they believe they are more likely to get pregnant should be discontinued in survey research on FABMs, as described above and elaborated upon inSupplementE. We do not know whether Ghanaian women who refer to their practice as “counting days” (as identified in other studies 34) would label themselves as a rhythm user, an SDM user, a nonuser, or something else.SupplementE also highlights that the way in which users of specific FABMs (such as SDM, symptothermal method, etc.) are classified in DHS may depend upon whether the survey specifically asks about these methods or not; a point which researchers should be cognizant of when analyzing survey data.
Future surveys might more deeply investigate the use of menstrual trackers and how they are perceived, as well as examine whether variables not available in our data (i.e., distance to health facility) may be associated with FABM use. Finally, as noted previously, 46our approach to FABM prevalence estimation assumes that women reporting multiple contraceptive methods use them in conjunction with one another (rather than that, for example, a user was switching permanently from an FABM to condom use during the month of interview). Another complexity of understanding patterns of multiple method use is that our labeling of individuals being “primarily” FABM users is somewhat subjective; such users may perceive their “primary” method to be condoms or EC, for example, even if the FABM is being “used” throughout the cycle and condoms or EC are being used episodically during periods believed to be infertile.
CONCLUSION
Our study indicates that a nontrivial proportion of reproductive age Ghanaian contracepting women (18%) are using a traditional or modern FABM (rhythm or SDM); more than those who report using oral contraceptive pills and nearly as many as report using 3-monthly injectables. Findings reiterate that standard approaches to measuring these methods underestimate their use, but additional survey methodological changes are required to further improve the accuracy of FABM use estimates. Results showed that more advantaged women were more likely to be using an FABM, suggesting that FABM use among this population may be a preference and not simply a lack of access to alternative options. Understanding these choices can help to support client-centered contraceptive counseling and programs for women and couples interested in using these methods. As side effects and health concerns are increasingly the main reasons for contraceptive nonuse in low- and middle-income countries, FABMs may offer an approach to pregnancy prevention to women whose contraceptive needs are not met by other options. 12Family planning programs should work to respectfully address these needs as part of a commitment to reproductive autonomy and choice.
Acknowledgments
We are grateful to our entire fielding team and all study participants.
Funding
This study was made possible by United Kingdom Aid from the United Kingdom Government and a grant from the Dutch Ministry of Foreign Affairs.
Disclaimer
The views expressed are those of the authors and do not necessarily reflect the positions and policies of the donors.
Author contributions
CBP led the conceptualization of the analysis, programmed the analytical code and conducted the analysis, and verified the overall reproducibility of the results. CBP and SOB managed and cleaned data. EO and RL-R led data collection efforts. CBP, EO, SOB, and RL-R provided resources in terms of study materials, contact with respondents, and computing resources. CBP wrote the original draft of the manuscript. CBP, EO, SOB, and RL-R participated in reviewing and editing the draft.
Data availability
De-identified versions of the Community-Based Survey collected by the authors and used in this analysis are available from the Guttmacher Institute upon reasonable request to researchers who wish to use the data for scholarly analysis. To discuss obtaining copies of these datasets, please contact [email protected] the detailed protocol for your proposed study, and information about the funding and resources you have to carry out the study.
Competing interests
None declared.
Footnotes
↵ *For comparability to other existing estimates, we also calculated contraceptive prevalence among all women, married women, and sexually active unmarried women (SupplementA).
↵ †As described in the methods section, the filtering question excluded women who do not perceive themselves as “doing anything or using any method to delay or avoid getting pregnant.”
Notes
Peer Reviewed
First published online:June 17, 2021.
Cite this article as:Polis CB, Otupiri E, Bell SO, Larsen-Reindorf R. Use of fertility awareness-based methods for pregnancy prevention among Ghanaian women: a nationally representative cross-sectional survey. Glob Health Sci Pract. 2021;9(2):318-331.https://doi.org/10.9745/GHSP-D-20-00601
Received: October 16, 2020.
Accepted: May 11, 2021.
Published: June 30, 2021.
© Polis et al.
This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International License (CC BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly cited. To view a copy of the license, visithttps://creativecommons.org/licenses/by/4.0/. When linking to this article, please use the following permanent link:https://doi.org/10.9745/GHSP-D-20-00601
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No. 2
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U.S. v. SCHLIFER | 403 F.3d 849 (2005) | f3d84911153 | Leagle.com
WILLIAMS Circuit Judge. James Schlifer appeals his sentence of 120 months on the ground that the district court violated the Sixth...f3d84911153
U.S. v. SCHLIFER
No. 04-3398.
View Case
Cited Cases
Citing Case
403 F.3d 849 (2005)
UNITED STATES of America, Plaintiff-Appellee,
v.
James T. SCHLIFER, Defendant-Appellant.
United States Court of Appeals, Seventh Circuit. https://leagle.com/images/logo.png
Argued March 1, 2005.
Decided April 7, 2005.
Attorney(s) appearing for the Case
Paul W. Connell (argued), Office of the United States Attorney, Madison, WI, for Plaintiff-Appellee.
T. Christopher Kelly (argued), Kelly & Habermehl, Madison, WI, for Defendant-Appellant.
Before KANNE, EVANS and WILLIAMS, Circuit Judges.
United States Court of Appeals, Seventh Circuit.
WILLIAMS, Circuit Judge.
James Schlifer appeals his sentence of 120 months on the ground that the district court violated the Sixth Amendment by sentencing him as a career offender without presenting the facts underlying his prior convictions to a jury. He also argues that in light of the Supreme Court's decision in United States v. Booker,___ U.S. ___, 125 S.Ct. 738, 160 L.Ed.2d 621 (2005), the district court erred in applying the guidelines under the prior mandatory sentencing scheme. Although Schlifer's Sixth Amendment argument lacks merit, we vacate his sentence and remand for resentencing because the district court erred under Bookerby sentencing Schlifer under a mandatory guidelines system, and the government has not demonstrated that the error was harmless.
I. BACKGROUND
In June 2004 Schlifer pleaded guilty to one count of conspiracy to manufacture methamphetamine, in violation of 21 U.S.C. §§ 846 and 841(a)(1). Under the November 2003 sentencing guidelines, Schlifer's crime ordinarily would have carried a base offense level of 30 based on evidence that the quantity of methamphetamine was at least 360 grams. U.S.S.G. § 2D1.1(c)(5). However, the probation officer who prepared the presentence investigation report (PSR) recommended that the court sentence Schlifer as a career offender because among his prior crimes were two unrelated convictions for aggravated assault. SeeU.S.S.G. § 4B1.1. Under the career offender guideline, Schlifer's base offense level increased to 32 and his criminal history category was VI regardless. U.S.S.G. § 4B1.1. The court then deducted three levels for acceptance of responsibility. SeeU.S.S.G. § 3E1.1. This resulted in a total offense level of 29, which, combined with Schlifer's criminal history category of VI, yielded a sentencing range of 151 to 188 months.
In response to the PSR and again at his sentencing hearing, Schlifer objected to being sentenced as a career offender. He argued that in order to classify him as a career offender the district court was required to find facts beyond the mere existence of two prior convictions. Specifically, he argued that the district court had to determine whether his prior convictions were for crimes of violence and whether the two crimes were unrelated. SeeU.S.S.G. §§ 4B1.2(c), 4A1.2(a) & cmt. n. 3. These determinations, Schlifer argued, required the district court to go beyond the "fact of a prior conviction" and thus exceeded the judicial factfinding exception for recidivism recognized in Almendarez-Torres v. United States,523 U.S. 224, 118 S.Ct. 1219, 140 L.Ed.2d 350 (1998), and preserved in Apprendi v. New Jersey,530 U.S. 466, 120 S.Ct. 2348, 147 L.Ed.2d 435 (2000). Accordingly, Schlifer contended that under Blakely v. Washington,___ U.S. ___, 124 S.Ct. 2531, 159 L.Ed.2d 403 (2004), and United States v. Booker,375 F.3d 508(7th Cir.2004), these facts must be admitted or proven beyond a reasonable doubt before they could be used to increase his guideline range. The district court rejected Schlifer's argument, concluding that Blakelyand this court's opinion in Bookerdo not apply to prior convictions.
The district court denied Schlifer's motion to depart under U.S.S.G. § 5K2.0, rejecting his argument that his offense primarily involved manufacturing methamphetamine for personal use and thus fell outside of the "heartland" of drug
[403 F.3d 852]
manufacturing and distribution cases contemplated by the guidelines. The court, however, granted the government's motion for a downward departure based on Schlifer's substantial assistance. See U.S.S.G. § 5K1.1. The court calculated a new effective range of 120 to 150 months by departing the equivalent of three levels, and sentenced Schlifer to 120 months' imprisonment.
II. ANALYSIS
Schlifer argues in his opening brief that the district court impermissibly sentenced him as a career offender without submitting the issue to a jury. After that brief was filed, and after his case had already been set for oral argument, the Supreme Court decided Booker.We granted Schlifer's motion to file a supplemental brief in light of Booker.Schlifer now argues in addition that his sentence is erroneous because the district court imposed it under the mandatory guidelines system that existed prior to Booker.He thus contends that his sentence should be vacated and his case remanded for resentencing in light of the Court's decision that the guidelines are advisory.
A defendant is a career offender under U.S.S.G. § 4B1.1 if he commits a felony drug offense after the age of 18 and has at least two prior felony convictions for crimes of violence or drug trafficking offenses. The prior offenses must be unrelated. Schlifer argues in his opening brief that these determinations require a sentencing court to find facts outside the judgment of conviction and thus entail impermissible factfinding by the court.
Prior to the Supreme Court's decision in Booker,Schlifer's appeal would have been frivolous. Neither the Supreme Court's decision in Blakelynor this court's opinion in Bookerdisturbed the principle that the "fact of a prior conviction" falls outside the Apprendirule that facts increasing a sentence beyond the otherwise applicable statutory maximum must be proved to a jury beyond a reasonable doubt. See United States v. Pittman,388 F.3d 1104, 1109 (7th Cir.2004). Thus in Pittmanthis court held that imposing a career offender sentence under § 4B1.1 without resort to a jury or proof beyond a reasonable doubt of the prior convictions did not violate Blakelyas interpreted by this court in Booker. Id. Pittmanhas not been affected by the Supreme Court's decision in Bookerbecause the Court again preserved the Almendarez-Torresexception for prior convictions. See Booker,___ U.S. at ___, 125 S.Ct. at 758. And, although the Supreme Court recently called its future into question, the Almendarez-Torresexception for prior convictions still stands. Shepard v. United States,___ U.S. ___, 125 S.Ct. 1254, ___ L.Ed.2d ___, 2005 WL 516494 (U.S. March 7, 2005).
Schlifer attempts to distinguish his case by arguing that the district court's conclusion that he is a career offender entailed finding facts outside the "fact of a prior conviction," namely, whether his prior convictions are for crimes of violence and whether they are "related." But we have already rejected a similar argument in
United States v. Morris,
293 F.3d 1010
(7th Cir.2002). In
Morris,
a defendant who was sentenced under the Armed Career Criminal Act, 18 U.S.C. § 924(e), argued that his sentence was unconstitutional under
Apprendi
because the government did not prove beyond a reasonable doubt that his prior convictions had been committed on separate occasions as required by the statute. We rejected the argument, noting that there was no precedent for "parsing out the recidivism inquiry."
Id.
at 1012. Likewise, Schlifer cites no authority in support of his argument that, although "the fact of a prior conviction" may be found by a judge by the preponderance
[403 F.3d 853]
of the evidence, the factors that bear on that determination must be proved beyond a reasonable doubt. In this case, the district court did not engage in impermissible factfinding with respect to its determination that Schlifer was a career offender, and Schlifer's sentence accordingly does not violate the Sixth Amendment.
In his supplemental brief, however, Schlifer raises the nonfrivolous argument that the Supreme Court's remedial opinion in Bookerinvalidates his sentence even in the absence of a Sixth Amendment violation. In Justice Stevens's opinion in Booker,the Court extended its holding in Blakelyto the federal sentencing guidelines and held that the Sixth Amendment right to trial by jury is violated where a defendant's guidelines range is increased based on facts (other than a prior conviction) found by the judge without a jury or using a preponderance standard. Booker,___ U.S. at ___, 125 S.Ct. at 756. Second, the Court, in an opinion authored by Justice Breyer, severed from the authorizing statute the provision that called for the mandatory application of the Guidelines and the provision that established the appellate standard of review. Id.at 765. The Court thus crafted a system under which the district courts are obligated to consider the guidelines but are not bound by them. Id.at 767.
The remedial portion of the Court's decision, which invalidates the mandatory application of the guidelines and instead requires the courts to consult them in an advisory fashion, must be applied to all cases pending on direct review, even in the absence of a Sixth Amendment violation. See id.at 765. Thus in every pending appeal where the district court sentenced a defendant under the now-defunct mandatory guidelines scheme, error will have been committed. See id.at 768, 1769 (holding that parties in respondent Fanfan's case "may seek resentencing under the system set forth in [ Booker]" though "Fanfan's sentence d[id] not violate the Sixth Amendment"); United States v. Paladino,Nos. 03-2296 et al.,401 F.3d 471, 2005 WL 435430, at *7 (7th Cir. Feb.25, 2005) (finding Bookererror where a portion of defendant Velleff's sentence "was based on mandatory provisions of the sentencing guidelines"); see also, United States v. Crosby,397 F.3d 103, 114-15 (2d Cir.2005); United States v. Hughes,401 F.3d 540, 2005 WL 628224, at *4 (4th Cir. Mar.16, 2005); United States v. Labastida-Segura,396 F.3d 1140, 1142-43 (10th Cir.2005).
The existence of error, however, does not mean that every appeal must lead to resentencing. In
Booker,
the Court instructed that the "ordinary prudential doctrines" of plain error and harmless error should be applied in determining whether resentencing is necessary. ___ U.S. at ___, 125 S.Ct. at 769. Thus we must first determine whether Schlifer preserved his
Booker
claim and what standard of review applies to the claim.
See United States v. McDaniel,
398 F.3d 540
(6th Cir.2005). The doctrine of plain error applies when a defendant forfeits a ground in the district court but raises it on appeal.
[403 F.3d 854]
United States v. Pawlinski, 374 F.3d 536 , 540 (7th Cir.2004). Otherwise, the appellant is entitled to plenary review of a sentencing error.
This is not a plain error case, and our recent decision in Paladinois inapposite here. Schlifer was sentenced prior to the Supreme Court's opinion in Booker,but he objected to his sentence in the district court on Blakelygrounds. Schlifer also anticipated the possibility that the guidelines were severable. His objection was specific enough to preserve the argument he makes now about the mandatory character of his sentence because it was sufficient to alert "the court and opposing party to the specific grounds for the objection." United States v. Linwood,142 F.3d 418, 422 (7th Cir.1998). This is also the position recently taken by the Tenth Circuit, which held that an appellant who raised a Blakelyargument in the district court also preserved for appeal a Bookererror. See Labastida-Segura,396 F.3d at 1143. In contrast, the courts of appeal that have applied plain error analysis to a Bookerclaim have done so because no Sixth Amendment challenge was raised in the district court. E.g., Paladino,401 F.3d 471, 2005 WL 435430, at *7; Hughes,401 F.3d 540, 2005 WL 628224, at *5; United States v. Rodriguez,398 F.3d 1291, 1298 (11th Cir.2005).
Because, in effect, the district court's error amounts to a misapplication of the guidelines, Schlifer's sentence must be vacated unless the error was harmless. See United States v. Hollis,230 F.3d 955, 958 (7th Cir.2000); United States v. Jackson,32 F.3d 1101, 1109-10 (7th Cir.1994). When an error relates to the validity of a defendant's sentence, it is harmless only if it did not affect the district court's choice of sentence. United States v. Smith,332 F.3d 455, 460 (7th Cir.2003); Jackson,32 F.3d at 1109.
The government argues in its supplemental brief that any error in Schlifer's sentence was harmless because it did not affect the district court's choice of sentence. First, the government argues that the district court's decision to depart downward the equivalent of just three offense levels based on Schlifer's substantial assistance signals the court's unwillingness to exercise the discretion already available to it by further lowering Schlifer's sentence. This argument has some facial appeal, but it ignores the fact that a sentencing judge, prior to Booker,had the guidelines and the appellate standard of review in mind when fashioning a departure. A departure decision, even if "discretionary," was nevertheless informed by the guidelines and thus sheds little light on what a sentencing judge would have done knowing that the guidelines were advisory.
Moreover, although the size of the departure was within the court's discretion, see U.S.S.G. § 5K1.1, the government cites no examples of past cases in which this argument has been accepted as basis for concluding that a guidelines misapplication was harmless. Typically, we require a higher degree of certainty for such a conclusion. For example, we have noted that when a sentencing judge must choose between two sentencing ranges that overlap, and expressly acknowledges that it would impose the same sentence under either range, this court can be certain that an error in choosing the wrong range was harmless.
Jackson,
32 F.3d at 1110. But "there is no such certainty here."
See id.
Nor is this a case where the district court clearly stated that it wanted to impose the maximum available sentence,
see United States v. Benitez,
92 F.3d 528
, 539 (7th Cir.1996), or where the district court "erred on the high side but the sentence could not have been any lower because of a statutory minimum,"
see United States v. Giacometti
28 F.3d 698
, 704 (7th Cir.1994).
[403 F.3d 855]
Ultimately, this court would have to speculate that the district court's error in thinking itself bound by the guidelines did not affect the sentence.
The government next argues that the district court's rejection of Schlifer's motion for a downward departure under § 5K2.0 evinces its unwillingness to impose a lower sentence. This argument is unpersuasive because it appears that the district court simply did not agree that Schlifer had presented a permissible basis for departure under that guideline. In denying Schlifer's motion, the court determined that the circumstances of his case were not "outside the heartland." Given this determination, the district court did not have a solid basis to depart under § 5K2.0. Thus the court's denial of Schlifer's motion sheds no light on whether the court would have departed had Schlifer presented different grounds, or whether the court might have granted the very same motion had it known that Bookereffectively allows greater latitude in making departure decisions.
Finally, the government makes the undeveloped argument that the district court's acknowledgment of Schlifer's extensive criminal history reveals a disinclination to impose a lesser sentence. The government provides no support for this argument, and although the district court characterized Schlifer's criminal history as "horrendous," it did so in the context of explaining its decision to sentence him as a career offender. Moreover, this court has acknowledged that such comments are common at sentencing, and are not necessarily evidence that an error was harmless. See Jackson,32 F.3d at 1110. Thus, the most that can be inferred from the district court's statement is that Schlifer's criminal history warranted sentencing under § 4B1.1.
The government ultimately fails to meet its burden of demonstrating that, if the district court had known that the guidelines are advisory rather than mandatory, its choice of sentence would have been the same. While the result might be different under a plain error standard, where the defendant has the burden of demonstrating that his substantial rights were affected, in this case the error cannot fairly be deemed "harmless."
III. CONCLUSION
For the reasons stated above, we VACATE Schlifer's sentence and REMAND the case to the district court with instructions to resentence in light of Booker.
This opinion was circulated to the entire court before issuance. No member of the court in active service voted to hear the case en banc.
FootNotes
1. The Government would render the Guidelines advisory in "any case in which the Constitution prohibits" judicial factfinding. But it apparently would leave them as binding in all other cases. We agree with the first part of the Government's suggestion. However, we do not see how it is possible to leave the Guidelines as binding in other cases.... [W]e believe that Congress would not have authorized a mandatory system in some cases and a nonmandatory system in others, given the administrative complexities that such a system would create. Such a two-system proposal seems unlikely to further Congress' basic objective of promoting uniformity in sentencing. Id. at 768.
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Avoiding Seed Corn Maggots in Spring Melons - 2019
I was driving through the Yuma Valley last week and noticed several fields that had recently been planted with spring melons. I also noticed beds that had been listed for melon planting and saw a lot of broccoli residue in the beds. This reminded me of the threat of seed corn maggots on early planted melons, particularly in a wet winter like we’re having this season. Seed corn maggot is a pest that is best avoided. Seed corn maggots are always a concern for melon crops planted from Jan-Mar, and are most prevalent under cool, wet weather; ideal conditions for infestations. Seed corn maggots can cause significant stand reductions in melons and other large seeded crops (e.g., cotton, corn, safflower) due to the maggots feeding on germinating seed, roots and stems of young seedlings and transplants. If larvae populations are high in the soil, replanting parts or all of an infested field is often necessary. Not only is this an inconvenience to the grower, but replanting is expensive and can disrupt harvest schedules. Unfortunately, once maggots have been found infesting the soil during stand establishment, there is usually nothing you can do. Thus, avoidance of the problem is the most effective way of preventing stand reductions. First, weather plays a major role in determining the damage potential for seed corn maggot. Melon stands are more susceptible to seed corn maggot during wet, cool spring weather in which seed germination is slowed or delayed. These conditions give seed corn maggots a chance to develop in the soil and attack the seeds before they can emerge. However, I’ve also observed seed corn maggots take down direct seeded cantaloupe and transplanted watermelon stands established under warm, dry conditions when fly populations were high. Secondly, our cropping system plays a key role. Melon crops following produce are the most often attacked because seed corn maggot adults are attracted to freshly tilled soils with high levels of decomposing organic matter and will readily lay eggs in the soil. This includes heavy plant residue remaining after harvest of the previous lettuce or cole crop, as well as applications of composted manure prior to planting. Growers would be encouraged to delay planting melons into fields under these conditions. However, if growers decide to plant in these conditions, then it would be wise to use a preventative insecticide applied at planting to minimize the impact from seed corn maggot and give seedlings a fighting chance. A few alternatives are available that have shown activity against seed corn maggot and may be practical for their management in spring melons. For more information, visitSeed Corn Maggot in Spring Melons 2019.
To contact John Palumbo go to: [email protected]
Water and Food Security in the Desert Southwest
The difficulties we are experiencing with water in the west are the consequence of the worst megadrought in 1200 years, which is increasingly clear to be a process of aridification and climate change (Wheeler et al., 2022). These conditions are bearing down on desert agriculture in a very significant way. In the next week, the U.S. Bureau of Reclamation (BoR) is expected to announce the 2023 operational plan for the Colorado River and it will definitely involve reductions in water allocations. On 14 June 2022 BoR Commissioner Camille C. Touton described the need to achieve additional reductions on Colorado River allocations. The BoR has been engaging in discussions with the seven basin states that depend on the Colorado River to develop a plan for the reductions, and that decision will be announced in the next few days. As Commissioner Touton described, the BoR has the authority to “act unilaterally to protect the system, and we will protect the system.” (Bureau of Reclamation, 28 June 2022). Commissioner Touton stated that the seven basin states on the Colorado River must reduce allocations by 2 to 4 million acre-feet (MAF). The basic arithmetic on the Colorado River is as follows: 16.5 MAF is currently the allocated amount of water budgeted with 7.5 MAF allocated to both the upper and lower basins, plus 1.5 MAF allocated to Mexico: (7.5+7.5 MAF = 15 MAF U.S. + 1.5 MAF Mexico = 16.5 MAF total ) In the past two decades, the average annual flow of the Colorado River from 2000 - 2018 has been approximately 12.4 MAF , which is 16 % lower than the 1906-2017 average of 14.8 MAF/year . Thus, we can see where the 4 MAF differential is determined. A reduction of Colorado River water allocations from 16.5 MAF to 12 MAF represents a 27% reduction. That is in line with the climate and hydrological reality we are dealing with and a huge reduction for the Colorado River basin. So, while the good news is that we do have approximately 12 MAF coming down the river, the bad news is that it is almost 1/3 less than what has been allocated on the existing Colorado River water budget. To bring the Colorado River system into better balance will require some major changes. The valleys of the Colorado River watershed are tremendously valuable resources with alluvial soils that are young geologically, extremely fertile, and highly productive if sufficient water is provided. These are some of the richest agricultural areas in the western United States. For example, the lower Colorado River valley, particularly the valleys in the Yuma, Arizona and Imperial Valley, California areas, provide more than 90% of the leafy green vegetables (all types of lettuce, broccoli, cauliflower, etc.) for the U.S. and Canada every year from November through March. These valleys produce an abundance of other crops including high quality durum wheat production that supports the pasta industry, including most Italian pastas, and a seed production industry that provides high quality seed stocks regionally, nationally, and internationally. An extremely well developed and sophisticated infrastructure system is in place to direct and manage water to the fields for highly efficient and productive irrigation systems. The management of these systems requires a high level of specialized and well-developed expertise which is in place and operating in the rich and productive valleys of the lower Colorado River. Thus, the valleys of the Colorado River and the people on the ground in the field are managing some of the most productive farms in the U.S. and anywhere in the world. These are resources that we should value and protect for both water and food security that is both regionally and nationally significant. Analysis of the desert Southwest’s paleoclimate have shown a distinct susceptibility of the region to experience extraordinary megadroughts that can last for decades or even centuries (Baum, 2015; Stahle et al., 2000; and Acuna-Soto et al., 2002). For example, paleoclimate records show that a fifty-year drought struck the Southwest, Northern Mexico, and the Rocky Mountains between about AD 1540 and 1590. Three hundred years earlier, records reveal the Great Drought of AD 1267-1299. It is believed that this 32 year Great Drought period was at least partially responsible for the abandonment of concentrated Native American populations throughout the Southwest (Cook et al., 2007; Benson et al., 2007; and Cook et al., 2010). Paleoclimate records indicate that droughts of more than a century in length have hit this region in the past (Stine, 1994). The result of this overall situation is that we are reaching a crossroads in the development of a strategy to deal with the changing conditions in the west and immediate action is needed. All efforts that have been directed to deal with this issue in the past 20 years, although well-intended, have not been sufficient in addressing the problem, including the 2007 interim guidelines, the Intentionally Created Surplus program, the Drought Contingency Plan, and the 500+ Plan. The climate is changing much faster than our system of governance. Thus, we are facing an existential crisis for the desert Southwest that includes the interface between the agricultural and urban sectors of our society. It seems to be one of the classic cases of “If you are not at the table, you are probably on the menu.” In this case, it might be both. One of the difficulties with this overall situation is the past tendency to develop short-term responses to a situation that has long-term implications and needs. In general, people have a tendency in strategic management at all levels, from international relations, to national, state, and local governance towards “Strategic Narcissism”, which is the tendency to define challenges as we would like them to be while ignoring the agency that other entities have over our results. This term of strategic narcissism was first presented by Hans J. Morgenthau and he expanded on this theme in his 1948 book Politics Among Nations where he introduced the concept of political realism, presenting a realist view of power politics. He pointed out that strategic narcissism and the tendency to think idealistically and narrowly about the scope of the problem or challenge usually leads to narrow solutions and strategies, which commonly fail. In his 2020 book Battlegrounds: The Fight to Defend the Free World , H.R. McMaster reinforces Morgenthau’s point regarding the dangers of indulging in strategic narcissism and the corresponding tendency to artificially separate interconnected problem sets, which encourages short term and simplistic solutions to complex problems. He describes the common tendency to define and address a problem in a manner that allows us to develop a response that we favor. This is often based on wishful thinking and our own capacity for self-delusion with flawed assumptions rather than dealing with a realistic assessment of basic facts. While Morgenthau and McMaster are addressing strategic issues on the international scale, we are confronted with similar challenges of avoiding the indulgence in strategic narcissism in our efforts to develop effective strategies to manage our water resources in the desert Southwest, as exemplified in the Colorado River situation. It is important for us to recognize the legitimacy and importance of all involved components, current and future, including both urban and agricultural interests and understand that the decisions made today will have an impact on residents of the desert Southwest in the decades to come in all sectors. Thus, we need to be considerate of more than ourselves and the immediate needs and include the prospects for our children, grandchildren, and the unborn generations yet to come. Considering the basic facts associated with the current Southwestern megadrought and the realistic indications that we are dealing with increasing aridification of the climate through the process of climate change is a good example. We have consistently held onto the hope that the drought will end, and we will soon return to the climate and hydrological patterns of the mid-20 th century. Instead, it would be better to plan for the probable contingency that aridification is taking place and future generations in the desert Southwest will be forced to continue to deal with it. As the paleoclimate records show us, this is within the range of possibilities. A case of strategic narcissism is the belief and conviction that some people hold that commercial agriculture in the desert Southwest should be eliminated with the food and fiber production being replaced by distant and perhaps international sources or small farm local crop production operations. Placing future generations at the mercy of long-distance sources of food production is dangerous and it would be irresponsible to do at this time. These are rather simplistic and idealistic visions. For example, small scale local farming can serve as a nice food supplement to some communities, particularly in urban areas, but it is not going to replace the needs for large scale food and fiber production supporting 7.4 M Arizonans, 330 M people in the United States and nearly 8 B people on the planet today. These ideas run counter to good and practical strategic planning for water and food security for the desert Southwest. Admittedly, it is exceedingly difficult for humans to have the necessary discipline to avoid strategic narcissism and develop a better sense of empathy for strategic planning. As Jamil Zaki, a psychologist from Stanford University has pointed out, it is difficult for people to develop the necessary empathy because it runs counter to our basic nature and instincts (Zaki, 2019). Both time and distance diminish our capacity for empathy because “humans caring instincts are short sighted. Our ability to feel empathy about future development is limited because we tend not to feel for our future selves. It goes against our instincts to tackle problems that we have not yet been forced to confront.” As we plan and develop a functional strategy for future water and food security in the desert Southwest, it is realistic to consider that large urban areas will exist and continue to grow. Agriculture is essential to any society and that is certainly true for the large cities of the Southwest, present and future. In 2022 we should be very alert to the dangers of depending on long supply chains and the single points of failure in supply chains that can be devastating to the dependent populations. The current situation is an opportunity to strategically plan for the future of the desert Southwest in a manner that provides for both water and food security. Based on the agricultural capacities of the desert Southwest, Arizona could be self-sustaining, or very nearly so. Considering Arizona, New Mexico, and California collectively, the possibility of long-term agricultural sustainability is entirely possible. But sufficient water is required to support the agricultural systems necessary to support that population. I am confident that we can work through these challenges in a balanced and effective manner but “business as usual” will not be sufficient in addressing the demands of today. This is a complex situation environmentally, geographically, politically, economically, and socially. Compounding the current challenges is the fact that actions need to take place rather swiftly and here are many factors to consider simultaneously. It is important that we develop a consideration of the broad and long-term impacts of our decisions for all parties with critical issues such as the management of our water resources for both water and food security in the desert Southwest. This requires a conscious and concerted effort to do so and all parties taking Colorado River water should share in absorbing the changes that are coming, nobody should get a pass. It is possible to develop a balance of coexistence with agriculture and urban development with the water resources available in this region but it will not be easy. As stated in the old Greek proverb: “ Society grows great when old men plant trees whose shade they know they shall never sit in .” We can see the value of that line of thought that was true 3,000 years ago and also with what we are dealing with today. This is one of the great challenges of our time and I believe we can step up and deliver in a balanced and constructive manner. References: Acuna-Soto, R., D.W. Stahle, M.K. Cleaveland, and M.D. Therrell. 2002. Megadrought and Megadeath in16th Century Mexico. Historical Review 8(4): 360-362. Baum, R. 2015. Climate change and drought in the American Southwest. The Climate Institute. https://climate.org/effects-of-21st-century-climate-change-on-drought-disk-in-the-american-southwest/#:~:text=Drought%20is%20a%20common%20occurrence%20in%20the%20American,completely%20unprecedented%20within%20the%20past%2010%2C000%20years.%208 Benson, LV., M.S. Berry, E.A. Jolie, J.D. Spangler, and D.W. Stahle. 2007. Possible impacts of early-11th-, middle-12th-, and late-13th-century droughts on western Native Americans and the Mississippian Cahokians. Quaternary Science Reviews 26(3): 336-350. Bureau of Reclamation, 28 June 2022 https://www.usbr.gov/ColoradoRiverBasin/ Cook, E.R., R. Seager, M.A. Cane MA, D.W. Stahle. 2007. North American drought: Reconstructions, causes, and consequences. Earth Science Reviews 81(1): 93-134. Cook, E.R., R. Seager, R.R. Heim Jr., R.S. Vose, C. Herweijer, and C. Woodhouse C. 2010. Megadroughts in North America: placing IPCC projections of hydroclimatic change in a long-term paleoclimate context. Journal of Quaternary Science 25(1): 48-61. McMaster, H.R., 2020. Battlegrounds: The Fight to Defend the Free World. Harper Collins Publishers, New York, NY. Morgenthau, H.J. and K. Thompson. 1948. Politics Among Nations. New York: McGraw-Hill. (1985, 6th ed.). Stahle, D.W., E.R. Cook, M.K. Cleaveland, M.D. Therrell, D.M. Meko, H.D. Grissino-Mayer, E. Watson, and B.H. Luckman. 2000. Tree-ring Data Document 16th Century Megadrought Over North America. EOS 80(12): 121-125. Stine, S. 1994. Extreme and persistent drought in California and Patagonia during mediaeval time. Nature 369: 546-549. Wheeler, K.G, B. Udall, J. Wang, E. Kuhn, H. Salehabadi, and J.C. Schmidt. 2022. What will it take to stabilize the Colorado River? Science, 377 (6604) p. 373-375. • DOI: 10.1126/science.abo4452 Zaki, J. 2019. The War for Kindness: Building Empathy in a Fractured World. Crown Publishing Group (NY).
To contact Jeff Silvertooth go to: [email protected]
Botrytis rot is not considered a major problem in lettuce and we saw the disease in only couple of fields this growing season. However, it can cause significant damage/loss when the field conditions are favorable for the pathogen. Cool wet conditions are favorable for the pathogen. Symptoms include water-soaked, brownish-gray to brownish-orange, soft wet rot that occurs on the oldest leaves in contact with the soil. Old leaves are more susceptible than young leaves and the fungus can move into the healthy parts. Fuzzy gray growth can be observed in the disease area which is characteristic of the pathogen. In worse cases, the entire plant can collapse. Romaine cultivars, transplanted lettuce that are big and have leaves touching the soil are more susceptible.The pathogen: Botrytis cinereaBotrytis cinerea affects most vegetable and fruit crops, as well as a large number of shrubs, trees, flowers, and weeds. Outdoors Botrytis overwinters in the soil as mycelium on plant debris, and as black, hard, flat or irregular sclerotia in the soil and plant debris, or mixed with seed. The fungus is spread by anything that moves soil or plant debris, or transports sclerotia. The fungus requires free moisture (wet surfaces) for germination, and cool 60 to 77 F, damp weather with little wind for optimal infection, growth, sporulation, and spore release. Botrytis is also active at low temperatures, and can cause problems on vegetables stored for weeks or months at temperatures ranging from 32 to 50. Infection rarely occurs at temperatures above 77 F. Once infection occurs, the fungus grows over a range of 32 to 96 F.Masses of microscopic conidia (asexual spores) are produced on the surface of colonized tissues in tiny grape-like clusters (see picture). They are carried by humid air currents, splashing water, tools, and clothing, to healthy plants where they initiate new infections. Conidia usually do not penetrate living tissue directly, but rather infect through wounds, or by first colonizing dead tissues (old flower petals, dying foliage, etc.) then growing into the living parts of the plant.Disease management:1. Buy high-quality seed of recommended varieties. Treat the seed before planting.2. Practice clean cultivation. Plant in a light, well-drained, well-prepared, fertile seedbed at the time recommended for your area. If feasible, sterilize the seedbed soil before planting, preferably with heat. Steam all soil used for plantbeds at 180 F (81 C) for 30 minutes or 160 F (71 C) for one hour.3. Avoid heavy soils, heavy seeding, overcrowding, poor air circulation, planting too deep, over-fertilizing (especially with nitrogen), and wet mulches.4. Focus on healthy plant vigor. Do not over fertilize.5. Use drop or furrow irrigation instead of sprinklers. If sprinklers have to be used, irrigate morning or early afternoon giving enough time for foliage to dry.6. Apply recommended fungicides when conditions favor disease development. Make sure to rotate fungicide to avoid development of resistance.
Prefar (bensulide)
Prefar (bensulide) is an organophosphate herbicide that has been used for more than 50 years in Arizona for lettuce production. In fact, it is one of the standard herbicides used for this purpose.The University of Arizona Vegetable IPM Team conducted a Yuma County and Imperial Valley Survey evaluating a portion of the acres checked by Pest Control Advisors. The 2017 data indicated that in 58% of the lettuce acreage reported was treated with Prefar. Similarly, in the 2018 survey 52% received a Prefar application.This product performs well when incorporated with sprinkler irrigation at stand establishment. It also works best in course textured soil’s such as the ones found in Coachella Valley, California. One of the weeds controlled by Prefar is pigweed (Amaranthus palmeri), which was found to be resistant to glyphosate herbicide in Arizona by Dr. William B. McCloskey in 2012. Other weeds are purslane (Portulaca oleracea), goosefoot (Chenopodium murale),Lambquarter (Chenopodium album), and some species of grasses.The list of crops in which bensulide is used demonstrates the importance of this weed control tool for the agricultural industry.According to the 1080 Pesticide Use Reporting Database provided by the Arizona Pest Management Center the list of crops includes: Arugula, Bok choy, Broccoli, Brussel Sprouts, Cabbage, Cantaloupe, Cauliflower, Celery, Cilantro, Corn, Cress, Endive, Fennel, Mustard, Kale, Lettuce, Onion, Parsley, Squash, Swiss chard, and others.Please read the following contribution from Dr. Al Fournier on theEPA Notice- Petition to Revoke Organophosphate Tolerances: (includingBensulide).
Petition to Revoke Tolerances and Cancel Certain OP Uses: Comment Deadline Extended
Al Fournier, IPM Program Manager, Arizona Pest Management Center10 August 2022The EPA has extended its deadline for public comment on a Petition to Revoke Tolerances and Cancel Registrations for Certain Organophosphate Uses untilSeptember 25, 2022.The petitioners, including United Farm Workers, Earthjustice, and several other groups, request that the Agency revoke all tolerances and cancel all associated registrations for food uses of 15 listed OPs, and further requests that the Agency complete its registration review process for these chemicals no later than October 1, 2022. The pesticides are currently at various stages of review, and the proposed deadline does not align with EPA’s published schedule to complete scientific reviews.Among 15 Organophosphates named in the petition are 10 with reported uses in Arizona (bolded below). Those with known uses in lettuce and other produce include Bensulide (Prefar) and Acephate (Orthene).Acephate,Bensulide,Chlorethoxyfos, Chlorpyrifos-methyl,Diazinon,Dichlorvos,Dicrotophos, Dimethoate,Ethoprop,Malathion, Naled, Phorate,Phosmet,Terbufos, TribufosRead the full EPA Notice here:https://www.regulations.gov/document/EPA-HQ-OPP-2022-0490-0001To submit comments to the docket, use the following link:https://www.regulations.gov/commenton/EPA-HQ-OPP-2022-0490-0001To contribute to Arizona Pest Management Center comments, contact Al Fournier
Area wide Insect Trapping Network (February 23, 2022)
Results of pheromone and sticky trap catches can be viewed here. Area wide Insect Trapping Network VegIPM Update, Vol. 13, No. 4, Feb 23, 2022 Corn earworm : CEW moth counts remain low across all locations; average for this time of the season. Beet armyworm : Trap counts decreased in all locations, and below average for late-January. Cabbage looper: Cabbage looper trap counts remained low in all locations; below average for early February. Diamondback moth: Adult activity increased slightly in some locations, particularly fields where trap is adjacent to with nearby brassica seed crops. Overall, activity is below average for this time of year. Whitefly: Adult movement remained low in all locations consistent with previous seasons. Thrips: Thrips adult movement beginning to increase slightly in most locations. Activity a about average for mid-February. Aphids: Aphid movement increased in many locations, particularly in Yuma Valley. Trap captures about average for this time of year. Leafminers: Adult activity increased in most areas, below average for this time of season.
| https://acis.cals.arizona.edu/agricultural-ipm/vegetables/vegetable-ipm-updates/19?Insectpage=89&Trappingpage=25 |
Carboplatin and Paclitaxel and Taladegib in Gastroesophageal Junction Adenocarcinoma and Stage IB Esophageal Adenocarcinoma AJCC v7 and Stage II Esophageal Adenocarcinoma AJCC v7 - Clinical Trials Registry - ICH GCP
This phase IB/II trial studies the side effects of taladegib, paclitaxel, carboplatin, and external beam radiation therapy and to see how well they work in trea...
Taladegib, Paclitaxel, Carboplatin, and Radiation Therapy in Treating Patients With Localized Esophageal or Gastroesophageal Junction Cancer
A Phase 1B/2 Study of Taladegib in Combination With Weekly Paclitaxel, Carboplatin, and Radiation in Localized Adenocarcinoma of the Esophagus or Gastroesophageal Junction
Study Overview
Status
Terminated
Conditions
Gastroesophageal Junction Adenocarcinoma
Stage IB Esophageal Adenocarcinoma AJCC v7
Stage II Esophageal Adenocarcinoma AJCC v7
Stage IIA Esophageal Adenocarcinoma AJCC v7
Stage IIB Esophageal Adenocarcinoma AJCC v7
Stage IIIA Esophageal Adenocarcinoma AJCC v7
Stage IIIB Esophageal Adenocarcinoma AJCC v7
Intervention / Treatment
Other: Laboratory Biomarker Analysis
Drug: Carboplatin
Drug: Paclitaxel
Radiation: External Beam Radiation Therapy
Drug: Taladegib
Detailed Description
PRIMARY OBJECTIVES:
I. To evaluate the toxicity of taladegib administered orally daily concurrently with weekly paclitaxel, carboplatin and radiation therapy in patients with localized nuclear glioma-associated oncogene homolog (Gli-1) expressing adenocarcinoma of the esophagus or gastroesophageal junction.
(Phase IB) II.
To assess the rate of pathologic complete response (pathCR) when taladegib is administered orally daily concurrently with weekly paclitaxel, carboplatin, and radiation therapy in patients with localized nuclear Gli-1 expressing adenocarcinoma of the esophagus or gastroesophageal junction.
(Phase II)
SECONDARY OBJECTIVES:
I. To evaluate the toxicity of biochemoradiation in the phase II study.
II.
To assess additional biomarkers (hedgehog [Hh] related and Hh unrelated) in sequentially procured tissues (biopsies and resected specimens).
IV. Assess relapse-free survival and overall survival.
OUTLINE:
PHASE IB: Patients receive taladegib orally (PO) once daily (QD) on days 1-38, paclitaxel intravenously (IV) over 3 hours on the first radiation day of each week for 5 doses, carboplatin IV over 2 hours on the first radiation day of each week for 5 doses, and undergo external beam radiation therapy 5 days weekly on 28 consecutive weekdays for 5.5 weeks.
PHASE II: Patients are assigned to 1 of 2 steps.
STEP I: Patients receive taladegib PO for 7 days, followed by taladegib, paclitaxel, carboplatin, and external beam radiation therapy as in Phase IB.
STEP II: Patients receive taladegib, paclitaxel, carboplatin, and external beam radiation therapy as in Phase IB.
After completion of study treatment, patients are followed up at 3 months, every 3-6 months for 1 year, every 6 months for 2 years, and at years 4 and 5.
Study Type
Interventional
Enrollment (Actual)
7
Phase
Phase 2
Phase 1
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Locations
United States
Texas
Houston, Texas, United States, 77030
M D Anderson Cancer Center
Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
18 years and older (Adult, Older Adult)
Accepts Healthy Volunteers
No
Genders Eligible for Study
All
Description
Inclusion Criteria:
Histologically or cytologically confirmed adenocarcinoma of the esophagus or gastroesophageal junction (EAC)
Localized EAC and its baseline clinical stage determined as: T2-T3N0 or T1-3N positive (+); imaging studies suspicious for metastases must be followed with a negative biopsy before a patient can enter the study
Patients with malignant celiac nodes are eligible if the primary lesion is in the mid-thoracic or distal thoracic esophagus or it is involving the gastroesophageal junction
Tumor must have labeling index of >= 5% of the nuclear Gli-1 (integral biomarker) performed in the MD Anderson Cancer Center Clinical Laboratory Improvement Amendment (CLIA) laboratory for patient to be eligible in this trial (if enough archival tissue is not available to determine labeling index, patient must agree to a biopsy to be eligible for the study)
Tumor may not extend > 4 cm below the gastroesophageal junction
Eastern Cooperative Oncology Group (ECOG) performance status 0 or 1
All patients must be willing to provide research tumor tissue for biomarker studies at baseline, from archival tumor tissue or through endoscopy if sufficient archival tissue is not available; all patients must also allow biomarker studies on the tissue obtained through surgery to remove the primary cancer
Phase II only: patients volunteering for the Phase II part of the protocol must be willing to undergo a research endoscopy for tissue collection on day 8 (+/- 2 days) from the beginning of therapy
Absolute neutrophil count >= 1500/mm^3
Platelets greater >= 100,000/mm^3
Hemoglobin >= 8 g/dL
Serum creatinine =< 2 x upper limit of normal (ULN)
Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) =< 2.5 x ULN
Serum bilirubin =< 1.5 x ULN
Patient must be able to comprehend the approved consent document and have the willingness to sign it; the patient prior to enrollment and the administration of any protocol-specific therapy must sign the consent document
Willingness and ability to comply with study procedures and follow-up examinations
Must be considered medically fit for operation as determined by multidisciplinary evaluation
Males and females with reproductive potential must agree to use 2 forms of medically approved contraceptive precautions and for at least 6 months following the last dose of biochemoradiation; should a woman become pregnant or suspect she is pregnant while participating in this study, she should inform her treating physician immediately
Women of childbearing potential are defined as follows: having regular menstrual cycles; has amenorrhea, irregular menstrual cycles or using a contraceptive method that precludes withdrawal bleeding; have had a tubal ligation; women are considered not to be of childbearing potential for the following reasons: had hysterectomy and/or bilateral oophorectomy; post-menopausal defined by amenorrhea for at least 1 year in a woman > 45 years old
Females with childbearing potential must have a negative serum pregnancy test within 14 days prior to treatment start
Exclusion Criteria:
Baseline clinical stage of T1N0 or inoperable T4 (unequivocal organ involvement) are to be excluded
Unequivocal metastatic tumor at baseline
Tracheo-esophageal (TE) fistula or direct invasion into the tracheo-bronchial mucosa; a bronchoscopy (biopsy and cytology should be performed) is required to exclude TE fistula or tracheo-bronchial involvement in patients with a tumor located at < 26 cm from the incisors
Cervical esophageal cancer will not be entered in this study
Any prior chemotherapy, surgery, or radiotherapy for EAC
Prior mediastinal irradiation (for any reason)
Clinically significant ulcerative colitis, inflammatory bowel disease, or partial or complete small bowel obstruction are to be excluded
Malabsorption syndrome or other condition that would interfere with intestinal absorption are excluded
Pregnant or nursing females are to be excluded; breastfeeding should be discontinued if the mother is treated with taladegib
Presence of other significant cancer(s) or history of other significant cancer(s) within the last 3 years (patients who have been cancer-free for 3 years, or have a history of completely resected non-melanoma skin cancer or successfully treated in situ carcinoma of the cervix are eligible)
Known active viral or other chronic types hepatitides (hepatitis B, C) or cirrhosis
Uncontrolled concurrent illness including, but not limited to: serious uncontrolled infection, symptomatic congestive heart failure (CHF), unstable angina pectoris, cardiac arrhythmia that interfere with blood pressure, uncontrolled diabetes, or psychiatric illness/social situations that would limit compliance with the study requirements
Patients with uncontrolled hypocalcemia, hypomagnesemia, hyponatremia or hypokalemia defined as less than the lower limit of normal for the institution, despite adequate electrolyte supplementation
Patients who are receiving concurrent non-protocol anti-cancer therapy (chemotherapy, radiation therapy, surgery, immunotherapy, hormonal therapy, targeted therapy, biologic therapy, or tumor embolization) are to be excluded
Patients may not be receiving any other investigational agents
Patients with known hypersensitivity to taxanes or platinums are to be excluded
Patients taking medications with narrow therapeutic indices that are metabolized by cytochrome P450 (CYP450), including warfarin sodium (Coumadin) are ineligible; patients on strong cytochrome P450, family 3, subfamily A (CYP3A) inhibitors will also be excluded
Known human immunodeficiency virus (HIV)-positive patients on combination antiretroviral therapy are ineligible; in addition, these patients are at increased risk of lethal infections when treated with marrow-suppressive therapy
Any other conditions or circumstances that would, in the opinion of the investigator, make the patient unsuitable for participation in the study
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
Primary Purpose : Treatment
Allocation : Non-Randomized
Interventional Model : Parallel Assignment
Masking : None (Open Label)
2
Arms and Interventions
Participant Group / Arm Intervention / Treatment Experimental: Step I (taladegib, paclitaxel, carboplatin, and radiation) Patients receive taladegib PO for 7 days, followed by taladegib, paclitaxel, carboplatin, and external beam radiation therapy as in Phase IB. Other: Laboratory Biomarker Analysis Correlative studies Drug: Carboplatin Given IV Other Names: Blastocarb Carboplat Carboplatin Hexal Carboplatino Carboplatinum Carbosin Carbosol Carbotec CBDCA Displata Ercar JM-8 Nealorin Novoplatinum Paraplatin Paraplatin AQ Paraplatine Platinwas Ribocarbo Drug: Paclitaxel Given IV Other Names: Taxol Anzatax Asotax Bristaxol Praxel Taxol Konzentrat Radiation: External Beam Radiation Therapy Undergo external beam radiation therapy Other Names: EBRT Definitive Radiation Therapy External Beam Radiation External Beam Radiotherapy External Beam RT external radiation External Radiation Therapy external-beam radiation Radiation, External Beam Drug: Taladegib Given PO Other Names: Benzamide, 4-Fluoro-N-methyl-N-(1-(4-(1-methyl-1H-pyrazol-5-yl)-1-phthalazinyl)-4-piperidinyl)-2-(trifluoromethyl)- LY-2940680 LY2940680 Experimental: Step II (taladegib, paclitaxel, carboplatin, and radiation) Patients receive taladegib, paclitaxel, carboplatin, and external beam radiation therapy as in Phase IB. Other: Laboratory Biomarker Analysis Correlative studies Drug: Carboplatin Given IV Other Names: Blastocarb Carboplat Carboplatin Hexal Carboplatino Carboplatinum Carbosin Carbosol Carbotec CBDCA Displata Ercar JM-8 Nealorin Novoplatinum Paraplatin Paraplatin AQ Paraplatine Platinwas Ribocarbo Drug: Paclitaxel Given IV Other Names: Taxol Anzatax Asotax Bristaxol Praxel Taxol Konzentrat Radiation: External Beam Radiation Therapy Undergo external beam radiation therapy Other Names: EBRT Definitive Radiation Therapy External Beam Radiation External Beam Radiotherapy External Beam RT external radiation External Radiation Therapy external-beam radiation Radiation, External Beam Drug: Taladegib Given PO Other Names: Benzamide, 4-Fluoro-N-methyl-N-(1-(4-(1-methyl-1H-pyrazol-5-yl)-1-phthalazinyl)-4-piperidinyl)-2-(trifluoromethyl)- LY-2940680 LY2940680
What is the study measuring?
Primary Outcome Measures
Outcome Measure Measure Description Time Frame Safety of taladegib when given in combination with paclitaxel, carboplatin, and radiation therapy defined by dose-limiting toxicities (Phase IB) Time Frame: Up to 5 weeks The safety data will be summarized using frequencies and percentages by adverse event category, grade and attributions. Up to 5 weeks Pathologic complete response rate (Phase II) Time Frame: Up to 5 years A pathologic complete response (pathCR) rate of at least 35% (>= 40% is desirable) will be of interest.
The pathCR rate in each of the treatment step will be estimated, along with the 95% confidence interval. Up to 5 years
Secondary Outcome Measures
Outcome Measure Measure Description Time Frame Change in biomarker expression levels of primary and secondary resistance Time Frame: Baseline to the time of surgery A linear mixed effect model will be used to assess the change of biomarkers over time.
The outcome variable will be biomarker expression level and the covariates will include time, treatment step and time by treatment interaction.
The biomarker expression may be log-transformed prior to fit the model in order to satisfy the normality assumption.
Also, a logistic regression model will be used for the binary outcome of pathCR, using treatment step, baseline biomarker and the change of biomarker between baseline and at surgery as covariates. Baseline to the time of surgery Relapse-free survival Time Frame: Up to 5 years Kaplan-Meier method will be used to estimate the probabilities of relapse-free survival. Up to 5 years Overall survival Time Frame: Up to 5 years Kaplan-Meier method will be used to estimate the probabilities of overall survival. Up to 5 years
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
M.D. Anderson Cancer Center
Collaborators
National Cancer Institute (NCI)
Investigators
Principal Investigator: Jaffer A Ajani, M.D. Anderson Cancer Center
Publications and helpful links
The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.
Helpful Links
MD Anderson Cancer Center Website
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start (Actual)
March 7, 2017
Primary Completion (Actual)
January 7, 2022
Study Completion (Actual)
January 7, 2022
Study Registration Dates
First Submitted
August 19, 2015
First Submitted That Met QC Criteria
August 19, 2015
First Posted (Estimate)
August 21, 2015
Study Record Updates
Last Update Posted (Estimate)
January 16, 2023
Last Update Submitted That Met QC Criteria
January 13, 2023
Last Verified
January 1, 2023
Esophageal Diseases
Adenocarcinoma
Esophageal Neoplasms
Molecular Mechanisms of Pharmacological Action
Antineoplastic Agents
Tubulin Modulators
Antimitotic Agents
Mitosis Modulators
Antineoplastic Agents, Phytogenic
Carboplatin
Paclitaxel
Albumin-Bound Paclitaxel
Other Study ID Numbers
2014-0966 (M D Anderson Cancer Center)
NCI-2015-01554 (Registry Identifier: CTRP (Clinical Trial Reporting Program))
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Yes
Studies a U.S. FDA-regulated device product
No
This information was retrieved directly from the websiteclinicaltrials.govwithout any changes. If you have any requests to change, remove or update your study details, please [email protected]. As soon as a change is implemented onclinicaltrials.gov, this will be updated automatically on our website as well.
Clinical Trials on Gastroesophageal Junction Adenocarcinoma
NCT05836584
Not yet recruiting
NCT05802056
NCT05753306
NCT05733000
NCT05709574
NCT05705635
NCT05677490
| https://ichgcp.net/clinical-trials-registry/NCT02530437 |
Whirlpool W11427474A 30 Inch Freestanding Gas Range User Guide
Learn how to safely operate your Whirlpool W11427474A 30 Inch Freestanding Gas Range with these easy-to-follow instructions. Discover how to use the oven and range functions, including setting the temperature and adjusting the flame. Avoid common mistakes, such as using aluminum foil on the oven bottom, with our helpful tips.
Whirlpool W11427474A 30 Inch Freestanding Gas Range User Guide
Contents hide
1 Whirlpool W11427474A 30 Inch Freestanding Gas Range
2 OPERATING INSTRUCTIONS
3 Using Your Oven
4 POSITIONING RACKS AND BAKEWARE
5 BAKING COOKIES AND LAYER CAKES ON TWO RACKS
6 BURNER SIZE
7 OVEN VENT
8 OVEN LIGHT
9 Online Ordering Information
10 Documents / Resources
10.1 References
Whirlpool W11427474A 30 Inch Freestanding Gas Range
OPERATING INSTRUCTIONS
WARNING:
To reduce the risk of fire, electric shock, or injury to persons, read the IMPORTANT SAFETY INSTRUCTIONS, located in your appliance’s Owner’s Manual, before operating this appliance.
Using Your Oven
Step 1 . Select oven function
Step 2. Set the temperature
Step 3. Press Start
Step 4. Place food inside the oven once the set temperature is reached. Close the oven door.
Step 5. (Optional) Enter time to cook
Step 6. The Cancel button can be used to cancel the function during or after cook time.
NOTE:
For more detailed instructions on specific functions, see the online Control Guide.
Using Your Range
Before setting a control knob, place filled cookware on the grate. Do not operate a burner using empty cookware or without cookware on the grate. The flame should be adjusted so it does not extend beyond the edge of the pan.
NOTE:
Visually check that the burner has lit. If the burner does not ignite, listen for a clicking sound. If you do not hear the igniter click, turn the burner off. Check for a tripped circuit breaker or blown household fuse. Check that the control knob is pressed completely down on the valve shaft. If the spark igniter still does not operate, call a trained repair specialist.
To Set:
WARNING
Fire Hazard Do not let the burner flame extend beyond the edge of the pan. Turn off all controls when not cooking. Failure to follow these instructions can result in death or fire. Electric igniters automatically light the surface burners when the control knobs are turned to Ignite.
POWER FAILURE
In case of prolonged power failure, the surface burners can be lit manually. Hold a lit match near a burner and turn the knob counterclockwise to IGNITE. After the burner lights, turn the knob to set.
ALUMINUM FOIL
IMPORTANT:
To avoid permanent damage to the oven bottom finish, do not line the oven bottom with any type of foil or liner. For best cooking results, do not cover entire oven rack with foil because air must be able to move freely.
POSITIONING RACKS AND BAKEWARE
IMPORTANT:
To avoid permanent damage to the porcelain finish, do not place food or bakeware directly on the oven door or bottom.
Racks
Position racks before turning on the oven.
Do not position racks with bakeware on them.
Make sure racks are level.
To move a rack, pull it out to the stop position, raise the front edge, and then lift out. Use the following illustrations as a guide. For hamburger patties to have a well-seared exterior and a rare interior, use a flat rack in rack position 7. Preheat the oven for 5 minutes. Side 1 should cook for approximately 4 to 5 minutes. Side 2 should cook for approximately 41/2 to 51/2 minutes. Expect a moderate degree of smoke when broiling.
BAKING COOKIES AND LAYER CAKES ON TWO RACKS
Baking Layer Cakes
For best results when baking cakes on two racks, use the Bake function, a flat rack in rack position 5, and a flat rack in rack position 2. If you do not have two flat racks, use a Max Capacity Oven Rack in rack position 6. Place the cakes on the racks, as shown. Keep at least 3″ (7.6 cm) of space between the front of the racks and the front cakes.
Baking Cookies
For best results when baking cookies on two racks, use the Convection Bake function, a flat rack in rack position 5, and a flat rack in rack position 2. If you do not have two flat racks, use a flat rack in rack position 2 and a Max Capacity Oven Rack in rack position 6. If you do not have Convection Bake, use the standard Bake function.
BURNER SIZE
Select a burner that best fits your cookware. See the following illustration and chart.
OVEN VENT
The oven vent releases hot air and moisture from the oven, and should not be blocked or covered. Blocking or covering the oven vent will cause poor air circulation, affecting cooking and cleaning results. Do not set plastics, paper or other items that could melt or burn near the oven vent.
OVEN LIGHT
The oven light is a 40 W halogen bulb. Before replacing, make sure the oven and cooktop are cool and the control knobs are in the Off position.
To Replace
Disconnect power.
Turn the glass bulb cover in the back of the oven counterclockwise to remove.
Remove bulb from socket.
Replace bulb, using tissue or wearing cotton gloves to handle bulb. To avoid damage to or decreasing the life of the new bulb, do not touch bulb with bare fingers.
Replace bulb cover by turning clockwise.
Reconnect power.
IMPORTANT:
Do not use lamps rated higher than 40 W.
SABBATH MODE:
The Sabbath Mode sets the oven to remain on in a bake setting until disabled. For guidance on usage and a complete list of models with Sabbath Mode, visit
www.star-k.org
or contact us as per the information given below.
Online Ordering Information
For detailed installation instructions and maintenance information, winter storage, and transportation tips, please see the Owner’s Manual included with your machine. For information on any of the following items, a full cycle guide, detailed product dimensions, or for complete instructions for use and installation, please visit
https://www.whirlpool.com/owners
, or in Canada
https://www.whirlpool.ca/owners
. This may save you the cost of a service call.
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Paul Nash’s Geological Enigma | Article index | Articles | British Art Studies
An online, open-access and peer-reviewed academic journal for research on all aspects of British art, architecture and visual culture.
Paul Nash’s Geological Enigma
ArticlebyAnna Reid
Paul Nash, The coast at Kimmeridge, Dorset, circa 1935-1936, black and white negative, 8.9 × 12 cm. Tate Archive Collection (TGA 7050PH/947).
Digital image courtesy of Tate (CC-BY-NC-ND 3.0 Unported).
Abstract
This essay explores the
attunement of Nash’s work to pioneering geophysical research in England, connections which have not yet been fully recognized. In a context of the early-to-mid twentieth century, when geophysicists read the startling radioactivity of the land and worked mathematical equations to put a vastly ancient and sensational new age on the rocks of the earth, Nash’s landscape works, fraught with mathematical problems, equations, stones and bones, resonated afresh, beyond the confines of the Modern. Through these interests, I argue, Nash channelled and revitalized a British tradition of engagement with the aesthetics of the geological.
Fig. 1
).
1
This essay describes how, when read in the context of geological knowledge, the landscape work of Paul Nash exhibits a prescient realism and evinces experimentation amidst a new era of empirical research.
2
<here is a image db8e4e0a6c898061-89a60eef4506096b>
DOI Figure 1.
Paul Nash, Equivalents for the Megaliths, 1935, oil on canvas, 45.7 × 66 cm. Collection of Tate (T01251).Digital image courtesy of Tate (CC-BY-NC-ND 3.0 Unported).
Nash worked in a context of astounding geological discovery: that of a radioactive earth legible by mathematics—a new geological real. The attunement of Nash’s work to this discovery is under-recognized. This is partly owing to the concurrence of his work with the emergence of modernist critical thought in Britain, which exactly rejected the possibility of ontological description and its history in art. Critical thought of modernist origins has now been decentred by the engagement of artists with pressing matters of the geological real. Nash’s work, read as intense realism, offers a rich precedent to realisms of the twenty-first century. It guides the eye towards dynamic geological problems and curiosity.
An English Landscape Artist
Nash’s work tends to be described first as “English”.
3
I propose that the English concept of the land at play in the work has to do with universal new insight gained through geological discovery. From the perspective of a modernist critic in England, driven by the imperative to break with the immanent in pursuit of international critical dialogue, Nash’s refusal to relinquish the landscape appeared at best insular.
4
Yet the “English” adjective is invested in a way that does not contradict the modern reverence for the virtuosity of human perception above and beyond the immanent land.
The Age of the Earth
(
Fig. 2
)
.
It detailed mesmerizing earth processes: uranium halos, atoms sparking and bursting like rockets, flashing zinc sulphide, Beta and Gamma Rays, pitchblende glowing with light in the darkness, “Man putteth an end to the darkness and exploreth to the utmost limit the stones of darkness.”
5
Figure 2.
The Age of The Earth: An Introduction to Geological Ideas, Arthur Holmes (ed.) (London: Ernest Benn, 1927[1913]), pp. 92–93.
Digital image courtesy of Arthur Holmes / Ernst Benn.
Figure 3.
The Age of The Earth: An Introduction to Geological Ideas, Arthur Holmes (ed.) (London: Ernest Benn, 1927[1913]), pp. 59.
Digital image courtesy of Arthur Holmes / Ernst Benn.
Holmes proceeded to work with the physicist Frederick Soddy, who had discovered that elements exist in diverse isotopes. They worked together using mathematics to read complex sequences of radioactive decay from one isotope to another, occurring in diverse rock samples. From these legible sequences arose new “radio-metric” dating (
Fig. 3
). Holmes worked complex and elegant equations to put an age of 370 million years on a mineral in a Devonian Norwegian rock, astoundingly older than the extant estimated age of the earth at 100 million years.
6
Three editions of Holmes’s book gave vivid and accessible accounts of this new vision of an abundant land, vast in time. The 1927 edition was part of the
Benn Sixpenny Library
, which was aimed at a general audience. The new research was well known in the public domain. From 1929, the BBC published
The Listener
as a weekly magazine and it covered the new geological breakthroughs (Nash wrote art criticism and reviews for
The Listener
on a regular basis). The science section of the very first edition featured “Revolutionary Discoveries”, a text describing spontaneous radioactivity:
7
The artist’s own book collection includes a copy of
The Mysterious Universe
8
During the inter-war period, the science community was receptive to the concept of the land as being more complex, intricate, and legible than ever imagined—a land replete with new avenues for research. Amidst increasingly precise radiometric estimates at this time arose another equation which was solved: putting an age on the earth of 3 billion years.
9
A historian of geology, Martin Rudwick, has noted the universal implications, not only for the earth itself but also for the earth in relation to the sun, the solar system, and the cosmos.
10
He cites the geologist William Sollas, who remarked in 1921 that the geologist who before had been “bankrupt” in time, now finds himself suddenly transformed into “a capitalist with more millions in the bank than he knew how to dispose of.”
11
Modern Painters
(1843–1860), Ruskin urged artists to study geology. His interest in Turner was as a painter of vital new geological truth, and of
The Fall of the Tees
, he said: “With this drawing before him the geologist could give a lecture upon the whole system of aqueous erosion” (
Fig. 4
).
12
<here is a image 979d59466beee1f4-97d3051dc11d6991>
DOI Figure 4.
Joseph Mallord William Turner, Fall of the Tees, Yorkshire, 1825–26, watercolour over pencil on wove paper, 27.9 × 38 cm. Collection of Indianapolis Museum of Art at Newfields (1997.141).Digital image courtesy of Indianapolis Museum of Art at Newfields.
13
Going back further, to the seventeenth century, the footwork between poetic and scientific work on the geological landscape in the British context has been explored by the historian Stephen Gould, who foregrounds the role of Thomas Burnet’s 1681
Sacred Theory of the Earth
in instigating geological thought, to contradict “whiggish” accounts of geological history, which pit rational empiricism against the theological and poetic.
14
Unseen Landscapes
Throughout the British landscape tradition, there is an impetus to devise new strategies to visualize previously unknown or unseen dimensions of the land. This could be described as the geological impetus. Nash certainly took an active interest in mysterious physical phenomena.
15
In his contribution to the book
Unit One: The Modern Movement in English Architecture, Painting and Sculpture
, which presented the work of the artists’ group founded by Nash, he refers to his imaginative research in the “hidden” land.
16
He recalls the hidden land that is gleaned in the work of Turner, Blake’s ancient Britain, Albion, and the
renewed
task of the landscape artist. Nash’s endeavours have often been read as Blakean, as seeking the spirit of the land or place, the genius loci. In this, and in a recent neo-romantic reading, Nash’s hidden land is envisaged as a spiritual sphere and realm of the mind, theological, and connected to Christian Science’s “soaring rhetoric of spirit over the material world”.
17
A reading with geological context can pull Nash’s unseen land back to a material dimension, less emanating spirit of place and more as land that is literally emanating radioactivity.
In 1927, Holmes described a magnificent unseen earth, veined with radioactive minerals from Ceylon to St Ives, Katanga to the Mourne Mountains. He detailed the high-velocity ejections of electrically charged helium atoms that are Alpha “rays”, long and intricate patterns of transformations that can be traced, “each accompanied by an explosive liberation of energy”.
18
These revolutionary discoveries were described as “the processes going on in a garden”.
19
Nash’s
Unseen Landscape
too, as he describes in his May 1938 article of the same name for
Country Life
magazine, is a land of “stones, bones, empty fields … back gardens” alive with new intrigue and offering “endless possibilities of fresh adventure”
.
His is a view of land seething with processes of decay and transformation: petrified forests, bleached objects, blanched springs and branches, “mutilated by shafts of light”. It is not a residual landscape, but one with the “terrific animation” of the landscape of the white horse
,
flickering as the eye moves across it, traversed by the radiance of the sun and the moon, “beating down on glinting white”
20
(
Fig. 5
,
Fig. 6
,
Fig. 7
).
Figure 5.
Paul Nash, Unseen Landscapes, in Country Life, 21st May 1938, pp. 526–527.
Digital image courtesy of TI Media Limited.
Figure 6.
Paul Nash, Stone Forest, 1937, pencil, black chalk, and watercolour on paper, 58.7 × 40 cm. Collection of The Whitworth, University of Manchester (D.1950.10).
Digital image courtesy of University of Manchester.
Figure 7.
Paul Nash, Study for Landscape of Bleached Objects, 1934, watercolour and pencil on paper, 28.4 × 39.4 cm. Collection of The Daniel Katz Gallery, London.
Digital image courtesy of The Daniel Katz Gallery.
21
Nash’s hidden lands are “unseen merely because they are not perceived; only in that way can they be regarded as ‘invisible’.”
22
They are a materiality that is not visible to the unaided eye.
In 1926, Holmes described his research, citing Swinburne: “man can see through the years flowing round him, the law lying under the years”
23
(
Fig. 8
). A crucial observation of the new geological discovery was that radioactive decay takes place in minerals at rates that are constant throughout deep time. The discovery of an Earth emitting radioactivity was also a discovery of intricate and legible sequences and patterns. Holmes describes radium:
24
Nash’s interest in pattern has recently been described by Inga Fraser as a search for order, and in line with a mediumistic conception of the land as offering “a glimpse of another metaphysical reality”
.
25
Yet Nash’s work can also be read as dealing with the literal and immanent geological appearance of order and pattern. It appears to see, for the first time, a land infused with design of an intricacy quite beyond belief—an unseen material land, that in its immanent self radiates transcendence.
<here is a image efb29e5303a6660f-1bd5b46ed5b84611>
DOI Figure 8.
Arthur Holmes, Radium Uncovers New Clues to Earth’s Age, published in The New York Times, 6 June 1926, Sect IX, pp. 4f.
One of Nash’s natural science books,
The Worship of Nature
by James George Frazer, is a volume which from its opening pages contemplates atoms and electrons, “the imperceptible particles of matter”, with reference to works by Soddy and by the physicist William Bragg, whose 1912
Studies in Radioactivity
26
Nash made streams of photographs observing and visualizing sequences and patterns made “by design” and otherwise: the ploughed earth
,
a cobbled road, the rhythms of a dry stonewall, the surface of the sea (
Fig. 9
.
Fig. 10
,
Fig. 11
,
Fig. 12
). The photographs bestow these overlooked forms of the earth with new intrigue, signalling the discovery of long “invisible” processes. Nash’s preferred medium to capture these patterns is apposite: a chapter in Holmes’
The Age of the Earth
addressing radioactivity opens by describing the photographic plate and Henri Becquerel’s discovery of emanation. Holmes writes that, “uranium salts and minerals give out invisible rays which are capable of penetrating black paper and of revealing their existence by their effect on a photographic plate wrapped within it.”
27
Figure 9.
Paul Nash, The coast at Kimmeridge, Dorset, circa 1935-1936, black and white negative, 8.9 × 12 cm. Tate Archive Collection (TGA 7050PH/947).
Digital image courtesy of Tate (CC-BY-NC-ND 3.0 Unported).
Figure 10.
Paul Nash, Kimmeridge Bay (double exposure), unknown date, black and white negative, 8.2 × 12.1 cm. Tate Archive Collection (TGA 7050PH/950).
Digital image courtesy of Tate (CC-BY-NC-ND 3.0 Unported).
Figure 11.
Paul Nash, A stone wall, Worth Matravers, unknown date, black and white negative, 8.6 × 12.4 cm. Tate Archive Collection (TGA 7050PH/1234).
Digital image courtesy of Tate (CC-BY-NC-ND 3.0 Unported).
Figure 12.
Paul Nash, Wave breaking on Chesil Beach, Dorset, 1935, black and white negative, 8 × 12.5 cm. Tate Archive Collection (TGA 7050PH/369).
Digital image courtesy of Tate (CC-BY-NC-ND 3.0 Unported).
There is a darker aspect here too: in 1938, German scientists split the nucleus of a Uranium atom freeing enormous explosions of energy. The British and American collaboration,
The Manhattan Project
, worked to develop an atomic bomb and the spectre of this invention loomed in the public imagination. A 1939 letter to
The Times
speculated on the threat of “a death ray; some super-atomic bomb”.
28
One journalist described how the weapon, used by the enemy, “might destroy the whole world—even Germany!”
29
The very same discoveries that had animated the earth were pointing towards a “dreadful miracle” (Nash’s words) to which Nash alludes in his 1945
Flight of the Magnolia
.
30
On 7 August 1945,
The Times
described how scientists were harnessing the “basic power of the universe”, or to use Truman’s phrase, “the force from which the sun draws its power”. Viewed with this contemporary understanding of ubiquitous radiation in mind, a set of Nash’s 1940s landscapes—saturated as they are in colour and viscous rays—seem to evoke the legion processes of the radiating sun and land (
Fig. 13
,
Fig. 14
,
Fig. 15
).
<here is a image 43cd9390e6c0738c-82174e31c7db9e6f>
DOI
<here is a image 8101cb4d140dd51e-ce89e512af1fd1c8>
DOI
<here is a image 8def8438fd78192e-589f12e8391ae0e4>
DOI
The Real Object
The artist’s engagement with the rediscovered land and earth can be traced in his work with found objects. In 1936, Nash cited and reflected on a review of his sculpture
Found Object Interpreted
, exhibited that year as part of the
International Surrealist Exhibition
in London, which it described as, “an awkward object to have knocking around in the unconscious”. “From that little remark,” Nash retorted in
The Architectural Review
, “anyone might say to himself, oh, so that is what Mr Nash finds in his unconscious; whereas, actually, I found it on the Romney Marsh.”
31
Nash’s prosaic response is not only a joke, and I propose that it should be heard in its fullest geological sense: Nash’s found object and unconscious thoughts derive not from the individual psyche, but from the geological land.
André Breton described the surrealist object as deriving from dreams or the waking unconscious. He celebrated the capacity of such objects to unleash and vitalize powers of invention, and to “depreciate those objects of ‘usefulness’ which clutter the so called real world”.
32
In his 1937 essay, “The Crisis of the Object”, Breton describes the disruptive, perturbing potential of surreal objects in the problematic context of modern rationality and its “unprecedented desire to objectify”
.
He alludes to the “marvellous” quality of such disruption, derived from dream and the unconscious, as distinct from the marvellous impulse of romanticism, which he calls “the urge to coalesce the mind and the tangible world, which
led
to the inauguration of the rationalist era.”
33
Breton was interested in an experience of the marvellous that is not romantic, theological, and ontological, but rather one that is epistemological, deriving from the psyche and its irrational dimension as described by Freud. The subjective mind is the source of potential, transformation, and revolution as embodied in Breton’s object.
By contrast, Nash’s marvellous objects, his animate bleached stones, illuminated monoliths and minerals, his nests of the phoenix rising, derive from far beyond the limits of the subject and psyche (
Fig. 16
,
Fig. 17
). In the mid-1930s, Nash resided in Dorset, on the Jurassic coast of England, over an extended period and his experimental work with objects was exuberant. He collected stone, flint, driftwood, objects foremost derived from the processes of the land, which he handled, studied, posed, and documented. Dorset was a revelation for Nash, as presented in the artist’s 1936
Dorset: Shell Guide
, one of a series produced for motorists, which closely articulates his sense of the landscape as a geological and surrealist object. In it, he describes seeing “Charlbury at twilight—cut against the afterglow, as to experience an almost unnerving feeling of the latent force of the past.”
34
<here is a image 11d9e1202172a07c-c62f8c22dad28e7e>
DOI
<here is a image 3b9fc5ae705f1a4e-e76250dd35f34e3d>
DOI
Fig. 18
,
Fig. 19
,
Fig. 20
,
Fig. 21
,
Fig. 22
,
Fig. 23
). The
Dorset: Shell Guide
is replete with the fantastic natural forms of the Jurassic coast: the folded limestone strata of Stair Hole, the implausible land formations of Lulworth Cove, Durdle Door, and Chesil bank, which were in his words, “the result of a mystical judgement called the law of compensation”.
35
Figure 18.
Paul Nash, Dorset: Shell Guide, front cover, 1936. Tate Archive Collection (TGA/964/1/16).
Figure 19.
Paul Nash, Dorset: Shell Guide, p. 8, 1936. Tate Archive Collection (TGA/964/1/16).
Figure 20.
Paul Nash, Dorset: Shell Guide, p. 20, 1936. Tate Archive Collection (TGA/964/1/16).
Figure 21.
Paul Nash, Dorset: Shell Guide, p. 37, 1936. Tate Archive Collection (TGA/964/1/16).
Figure 22.
Paul Nash, Dorset: Shell Guide, p. 39, 1936. Tate Archive Collection (TGA/964/1/16).
Figure 23.
Paul Nash, Dorset: Shell Guide, back cover, 1936. Tate Archive Collection (TGA/964/1/16).
A new link, articulated by Sarah Fill, between the
Dorset: Shell Guide
and the materialism of Georges Bataille aids the task of interpreting it in a geological context.
36
Bataille, the “debaser” of Surrealism, produced the journal
Documents
from 1929–1930, and pursued an alternate trajectory to Bretonian Surrealism. In his view, Breton’s notion of human irrationality was idealizing and sublimated the base, perverse, and violent—a material irrationality into which he ventured.
37
Nash too was interested in this “underside”, a corrective to the bias of Bretonian Surrealism, and he was engaged with
Documents.
38
Documents
and the
Dorset: Shell Guide
have been described as sharing an anti-humanist sentiment. In the words of Sarah Fill, Nash’s guide made “the nation’s ancestors appear as primitive monsters”.
39
40
Dorset: Shell Guide
derives from the accident of encountering a scintillating geological real.
The new land was also understood as an active chronometer with regular and even rhythm—its minerals “timekeepers of the earth’. Nash opens his guide to the animate “face of Dorset” in metre, with an excerpt from Thomas Hardy’s
An August Midnight
:
A shaded lamp and a waving blind
And the beat of a clock from a distant floor:
On this scene enter—winged, horned and spined—
A longlegs, a moth, and a Dumbledore:
While ‘mid my page there idly stands
A Sleepy fly, that runs its hands …
Thus meet we five in this still place
At this point of time, at this point in space …
Nash’s May 1937 article for
Country Life
, titled “The Life of the Inanimate Object”, channels a history of perceiving the pulse of the land, citing the Psalms of David: “The mountains skipped like rams and the little hills like lambs”.
41
Mary Ann Doane describes the increasing reification and standardization of time during the early twentieth century, the “temporal demand” of modernity.
42
As this abstracted demand looms large and the contingency of the surrealist object is but an ephemeral release from it, Nash’s found object, alive with the beat of real time, derives from far beyond any such duality.
43
It is a vision that does not accord with the anthropocentric time of modernity, and exceeds the chance encounter. Nash’s marvellous is not ephemeral, conditioned by the subjective unconscious—it is infinite.
In grappling with this marvellous, Nash’s work is ontological enquiry and description, hand in hand with the geologist whose concerns and queries are shared. Nash’s
Equivalents for the Megaliths
Fig. 1
,
Fig. 24
).
<here is a image 92cfa48e2eae6f07-d5f22a97d3c77172> DOI Figure 24.
Paul Nash, Poised Objects, 1932, pencil, chalk, and watercolour on paper, 55.9 × 37.5 cm. Collection of St Anne’s College, Oxford.Digital image courtesy of The Principal and Fellows of St Anne’s College, Oxford | Photo: Keith Barnes.
The work indicates a vertiginous shift of dimensions, such that time and space are stretched, enlarged, flattened, transformed. The solid modern monoliths appear here from a high and scaled-back perspective as two-dimensional remains in the land, equivalent to the megaliths amidst a vast new timescale. The scene appears as if from some distant time or space, wherein modern art objects, human remains of mysterious ritual value, stud the land. Herein, the work not only poses as archaeological and geological material, it also hints at its own status being actual geological material; the abstraction of the work of art is construed as part of material geological reality.
What is the position of the human in this encounter? Does the archaeological nature of these megaliths imply a potential future without a human vantage point? The work is a captivating geological problem and mathematical hieroglyph. As does Nash’s oeuvre more broadly, it makes a virtue of the curiosity that sustains the adventure of the guessing mind:
44
The Flightless Bird
To conclude, I aim to solve one rich geological curiosity among many posed by Nash’s oeuvre. Nash’s
Nest of Wild Stones
and his 1937 written piece of the same name are characteristically evocative of the connections between stones, mathematical harmony, and deep time (
Fig. 25
). Nash says of the stones in question:
45
Another passage, in Nash’s “Unseen Landscapes”, illuminates the title of the work: he refers to “the nests of giant birds … scattered groups of fantastic nests … a sanctuary for Moas.”
46
The Moa is a giant flightless bird, extinct, that once roamed and dominated the forests of New Zealand.
Figure 25.
Paul Nash, The Nest of Wild Stones, 1937, watercolour and pencil on paper, 37.1 × 55 cm. Collection of Arts Council Collection, Southbank Centre (AC 30).
Digital image courtesy of Arts Council Collection.
Figure 26.
Moa Gizzard Stones, Collection of Thames Mineralogical Museum, Coromandel, New Zealand.
Elsewhere, in William Corliss’
Unknown Earth: A Handbook of Geological Enigmas
, a striking discovery of stones is described, with words from Professor Lee, of the Geological Survey, first published in
Science
, in 1924:
Fig. 26
).
The extraordinary discovery of the precious stones of the Moa captivated Lee, who remarks on:
the good judgment of these extinct birds in choosing jewel stones for use in their lapidary mills. By judicious selection of material, these first families among diamond cutters handed down lasting memorials to admiring posterity.
47
Nash’s “Nest of Wild Stones” too is marvellous geological enigma, legible stones, deciphered in the field, alive with mathematics and the turn of a conjuror’s hand.
In a context where geophysicists read the startling radioactivity of the land and worked mathematical equations to put a vastly ancient and sensational new age on the rocks of the earth, Nash’s landscape works, fraught with mathematical problems, equations, stones and bones, resonate afresh, beyond the confines of the Modern. Nash’s work poses as a geological problem, implicating the art works as vital geological remains and training the eye of the beholder to marvellous geological mystery. In describing and adventuring in a new geological consciousness, alongside empirical geology, Nash engages with an effable geological reality, channelling and revitalizing a British tradition. Nash’s landscapes are prescient of and suggestive to new modes of engagement in the current context of geological discovery, of a geological age of man, and the landscape now.
Acknowledgements
Footnotes
Paul Nash, “Contribution to Unit One”, in Andrew Causey (ed.), Paul Nash: Writings on Art(Oxford: Oxford University Press, 2000), 107–110.
1
I make this argument at greater length in Anna Reid, “The Nest of Wild Stones: Paul Nash’s Geological Realism”, Visual Culture in Britain19, no. 2 (2018): 189–215.
2
Emma Chambers, “Introduction”, in Emma Chambers (ed.), Paul Nash(London: Tate, 2016), 11.
3
Charles Harrison, “England’s Climate”, in Brian Allen (ed.), Studies in British Art: Towards a Modern Art World(London: Yale University Press, 1995), 207–223.
4
The Book of Job cited in Arthur Holmes, “The Radioactive Timekeepers of the Rocks”, in Arthur Holmes (ed.), The Age of The Earth: An Introduction to Geological Ideas(London: Ernest Benn, 1927 [1913]), 55–75.
5
Martin Rudwick, Earth’s Deep History: How It was Discovered and Why It Matters(Chicago, IL: University of Chicago Press, 2014), 235–241.
6
Oliver Lodge, “Revolutionary Discoveries”, The Listener, 16 January 1929, Science section, 11.
7
James Jeans, The Mysterious Universe(Cambridge: Cambridge University Press, 1930).
8
The American geochemist, Clair Patterson arrived at 4.5 billion years in 1953—this radiometric date still stands as the most accurate.
9
Rudwick, Earth’s Deep History, 235–241.
10
Words spoken by Sollas and recorded in: J.W.S. Rayleigh, William Sollas, J.W. Gregory, and Harold Jeffreys “The Age of the Earth”, Nature108, 13 October 1921, 217–218.
11
Rebecca Bedell, “The History of The Earth: Darwin, Geology and Landscape Art”, in Diana Donald and Jane Munro (eds), Endless Forms: Charles Darwin, Natural Science and the Visual Arts(London: Yale University Press, 2009), 49–77.
12
Noah Heringman, Romantic Rocks, Aesthetic Geology(Ithaca, NY: Cornell University Press, 2004), 94–137.
13
Stephen Jay Gould, Time’s Arrow Time’s Cycle: Myth and Metaphor in the Discovery of Geological Time(London: Harvard University Press, 1987), 4–15.
14
For example, of the books collected by Nash, The Universeby Félix Archimède Pouchet is an in depth guide to the principles of geology; The Atmosphereby Camille Flammarion is an illustrated exploration of such phenomena as sun halos, snow crystals, the refraction of light through raindrops or emanations of phosphoretted hydrogen gas, and an in-depth description of the geomorphic processes of the wind, atmospheric temperature, “water-clouds-rain” and thunderstorms; The Heavensby Amédée Guillemin details processes of tides, eclipses, gravity, and meteoric form; Nash arranged, illustrated, and retained a “Sun Calendar” for the year 1920.
15
Nash, “Contribution to Unit One”.
16
David Mellor, “A Spectral Modernity”, in Emma Chambers (ed.), Paul Nash(London: Tate, 2016), 23–33.
17
Holmes, “The Radioactive Timekeepers of the Rocks”.
18
Lodge, “Revolutionary Discoveries”.
19
Paul Nash, “Unseen Landscapes”, in Herbert Read (ed.), Outline, an Autobiography and Other Writings(London: Faber & Faber, 1949), 229–231.
20
Félix Archimède Pouchet, The Universe (or the Infinitely Great and the Infinitely Little)(London: Blackie and Son, 1885), see, for example, 3–38, 502–510, and 537.
21
Nash, “Unseen Landscapes”.
22
Arthur Holmes, “Radium Uncovers New Clues to Earth’s Age”, The New York Times, 6 June 1926.
23
Holmes, “The Radioactive Timekeepers of the Rocks”.
24
Inga Fraser, “‘From a Sheet of Paper to the Sky’: Pattern in the Work of Paul Nash”, in Emma Chambers (ed.), Paul Nash(London: Tate, 2016), 59–67.
25
James George Frazer, The Worship of Nature, Vol. 1 (London: Macmillan and Co, 1926).
26
Holmes, “The Radioactive Timekeepers of the Rocks”.
27
Anonymous (civilian), “The New Weapon”, The Times, 28 September 1939.
28
“That Dreadful Atom Bomb”, Press and Journal, 20 August 1943.
29
Paul Nash, “Aerial Flowers,” in Herbert Read (ed.), Outline, an Autobiography and Other Writings(London: Faber & Faber, 1949), 258–265.
30
Paul Nash, “The Object”, The Architectural Review(November 1936): 207–208.
31
André Breton, “The Crisis of the Object”, in Myfanwy Evans (ed.), The Painter’s Object(London: Gerald Howe, 1937), 275–280.
32
Breton, “The Crisis of the Object”.
33
Paul Nash, Dorset: Shell Guide(London: Architectural Press, 1936).
34
Nash, Dorset.
35
Sarah Fill, “Paul Nash Surrealism and Prehistoric Dorset”, in Emma Chambers (ed.), Paul Nash(London: Tate, 2016), 49–57.
36
Dawn Ades and Simon Baker (eds), Undercover Surrealism Georges Bataille and Documents(London: Haywood Gallery, 2006).
37
Sarah Fill describes how Bataille’s thought reached Nash via Edward Burra, in Sarah Fill, “Paul Nash Surrealism and Prehistoric Dorset”, 51.
38
Fill, “Paul Nash Surrealism and Prehistoric Dorset”.
39
Gould, Time’s Arrow, Time’s Cycle, 1–3.
40
Paul Nash, “The Life of the Inanimate Object”, in Andrew Causey (ed.), Paul Nash: Writings on Art(Oxford: Oxford University Press, 2000), 137–139.
41
Symptomatic is Frederick W. Taylor’s subjecting of the human body to temporal management, see Mary Anne Doane, The Emergence of Cinematic Time, Modernity, Contingency, the Archive(London: Harvard University Press, 2002), 2–11.
42
Nash, “Unseen Landscapes”.
43
Paul Nash, “The Nest of Wild Stones”, in Myfanwy Evans (ed.), The Painter’s Object(London: Gerald Howe, 1937), 38–40.
44
Nash, “The Nest of Wild Stones”.
45
Nash, “Unseen Landscapes”.
46
William R. Corliss, Unknown Earth: A Handbook of Geological Enigmas,(Glen Arm, MD: The Sourcebook Project, 1980), 474.
47
Bibliography
Ades, D. and Baker, S. (2006) Undercover Surrealism Georges Bataille and Documents. London: Haywood Gallery.
Anon. (1939) “The New Weapon”. The Times, 28 September.
Bedell, R. (2009) “The History of the Earth: Darwin, Geology and Landscape Art”. In Diana Donald and Jane Munro (eds), Endless Forms: Charles Darwin, Natural Science and the Visual Arts. London: Yale University Press, 49–77.
Breton, A. (1937) “The Crisis of the Object”. In Myfanwy Evans (ed.), The Painter’s Object. London: Gerald Howe, 275–280.
Causey, A. (ed.) (2000) Paul Nash: Writings on Art. Oxford: Oxford University Press.
Chambers, E. (ed.) (2016) Paul Nash. London: Tate Publishing.
Corliss, W.R. (1980) Unknown Earth: A Handbook of Geological Enigmas.Glen Arm, MD: The Sourcebook Project.
Doane, M.A. (2002) The Emergence of Cinematic Time, Modernity, Contingency, the Archive. London: Harvard University Press.
Evans, M. (ed.) (1937) The Painter’s Object. London: Gerald Howe.
Fill, S. (2016) “Paul Nash Surrealism and Prehistoric Dorset”. In Emma Chambers (ed.), Paul Nash.London: Tate, 49–57.
Fraser, I. (2016) “‘From a Sheet of Paper to the Sky’: Pattern in the Work of Paul Nash”. In Emma Chambers (ed.), Paul Nash. London: Tate, 59–67.
Gould, S.J. (1987) Time’s Arrow, Time’s Cycle: Myth and Metaphor in the Discovery of Geological Time. London: Harvard University Press.
Harrison, C. (1995) “England’s Climate”. In Brian Allen (ed.), Studies in British Art: Towards a Modern Art World. London: Yale University Press, 207–223.
Heringman, N. (2004) Romantic Rocks, Aesthetic Geology. Ithaca, NY: Cornell University Press.
Holmes, A. (1926) “Radium Uncovers New Clues to Earth’s Age”. The New York Times, 6 June.
Holmes, A. (1927 [1913]) The Age of the Earth: An Introduction to Geological Ideas. London: Ernest Benn.
Holmes, A. (1927 [1913]) “The Radioactive Timekeepers of the Rocks”. In Arthur Holmes (ed.), The Age of The Earth: An Introduction to Geological Ideas. London: Ernest Benn, 55–75.
Lodge, O. (1929) “Revolutionary Discoveries”. The Listener, 16 January.
Mellor, D. (2016) “A Spectral Modernity”. In Emma Chambers (ed.), Paul Nash. London: Tate, 23–33.
Nash, P. (1936) Dorset: Shell Guide. London: Architectural Press.
Nash, P. (1936) “The Object”. The Architectural Review(November): 207–208.
Nash, P. (1937) “The Nest of Wild Stones”. In Myfanwy Evans (ed.), The Painter’s Object. London: Gerald Howe, 38–40.
Nash, P. (1949) “Aerial Flowers”. In Herbert Read (ed.), Outline, an Autobiography and Other Writings. London: Faber & Faber, 258–265.
Nash, P. (1949) “Unseen Landscapes”. In Herbert Read (ed.), Outline, an Autobiography and Other Writings. London: Faber & Faber, 229–231.
Nash, P. (2000) “Contribution to Unit One”. In Andrew Causey (ed.), Paul Nash: Writings on Art. Oxford: Oxford University Press, 107–110.
Nash, P. (2000) “The Life of the Inanimate Object”. In Andrew Causey (ed.), Paul Nash: Writings on Art. Oxford: Oxford University Press, 137–139.
Press and Journal(1943) “That Dreadful Atom Bomb”, 20 August.
Rayleigh, J.W.S., Sollas, W., Gregory, J.W., and Jeffreys, H. (1921) “The Age of the Earth”. Nature108, 13 October.
Read, H. (ed.) (1949) Outline, an Autobiography and Other Writings. London: Faber & Faber.
Reid, A. (2018) “The Nest of Wild Stones: Paul Nash’s Geological Realism”. Visual Culture in Britain19, no. 2: 189–215.
Rudwick, M. (2014) Earth’s Deep History: How It was Discovered and Why It Matters. Chicago, IL: University of Chicago Press.
Shand, P.M. (1939) “Object and Landscape”. CountryLife, 3 June.
Selected books and items from the Paul Nash Collection
Flammarion, C. (1873) The Atmosphere.London: Sampson Low.
Frazer, J.G. (1926) The Worship of Nature, Vol. 1. London: Macmillan and Co.
Guillemin, A. (1883) The Heavens (an illustrated Handbook of Popular Astronomy).London: Richard Bentley & Son.
Jeans, J. (1930) The Mysterious Universe.Cambridge: Cambridge University Press.
Nash, P. (1920) The Sun Calendar For The Year 1920.London: The Sun Engraving Company.
Pouchet, F.A. (1885) The Universe (or the Infinitely Great and the Infinitely Little).London: Blackie and Son.
Imprint
Author
Anna Reid
Date
29 November 2018
Category
Article
Review status
Peer Reviewed (Double Blind)
Licence
CC BY-NC International 4.0
Downloads
PDF format
Article DOI
https://doi.org/10.17658/issn.2058-5462/issue-10/areid
Cite as
Anna Reid, "Paul Nash’s Geological Enigma", British Art Studies, Issue 10, https://doi.org/10.17658/issn.2058-5462/issue-10/areid
| https://www.britishartstudies.ac.uk/index/article-index/nash-geological-enigma/search/www.artspace.com/year/2015/article-category/cover-collaboration |
[A case of multiple sulfatase deficiency with fiber type disproportion]
Download Citation | [A case of multiple sulfatase deficiency with fiber type disproportion] | We describe a case of multiple sulfatase deficiency with fiber type disproportion. An 8-year-old girl had slow motor and mental deterioration... | Find, read and cite all the research you need on ResearchGate
[A case of multiple sulfatase deficiency with fiber type disproportion]
February 1984
No to hattatsu. Brain and development 16(3):205-9
Authors:
S Fujibayashi
K Wagatsuma
R Minami
Abstract
We describe a case of multiple sulfatase deficiency with fiber type disproportion. An 8-year-old girl had slow motor and mental deterioration since the age of 17 months. She had main clinical features characterized by contractures in all extremities, gargoyle face, ichthyosis, retinitis pigmentosa, and enlarged liver. Laboratory examinations showed elevated CSF protein and delayed nerve conduction velocity. Radiologic bone survey disclosed deformities similar to those of mucopolysaccharidosis. The activities of arylsulfatase A, B and C were markedly reduced in culture in skin fibroblastosis. The findings of biopsied sural nerve showed metachromatic granules in Schwann cell cytoplasma and segmental demyelination without onion-bulb formations. Electron microscopy showed tuff-stone bodies. Those findings coincided with those of the infantile form of metachromatic leukodystrophy. Muscle biopsy showed that type I fibers were predominant and the diameter of type I fibers was relatively smaller than that of type II fibers without other obvious histological findings. These findings coincided with the histopathology of congenital fiber type disproportion. The finding of fiber type disproportion is observed in various conditions such as experimental tenotomy and joint fixation. Our case had bilateral fixed knee joints. This condition might introduce fiber type disproportion. However, demyelination of peripheral nerves in multiple sulfatase deficiency might be a factor associated with fiber type disproportion. We suggest that the pathogenesis of fiber type disproportion in our case with multiple sulfatase deficiency is associated with various complex factors.
... Mutations in ACTA1 (Laing et al. 2004), SEPN1 (Clarke et al. 2006), TPM3 (Clarke et al. 2008), RYR1 (Wilmshurst et al. 2010), and more recently MYH7 (Ortolano et al. 2011) have also been identified in patients with FTD. To add to its nonspecific nature, this morphological finding has been reported in association with several inherited metabolic disorders including Pompe disease (Martin et al. 1976), multiple sulfatase deficiency
(Tachi et al. 1984)
, congenital lactic acidosis (Iso et al. 1993), metachromatic leukodystrophy (Krendel et al. 1994), carnitine palmitoyltransferase deficiency (Shintani et al. 1995), and Krabbe disease (Marjanovic et al. 1996). To our knowledge, FTD has never been described in patients with CDG. ...
Further Delineation of the Phenotype of Congenital Disorder of Glycosylation DPAGT1-CDG (CDG-Ij) Identified by Homozygosity Mapping
Jan 2012
Faiqa Imtiaz
Abeer Al-Mostafa
Zuhair Al-Hassnan
Congenital disorders of glycosylation (CDG) are an expanding group of genetic diseases affecting protein and lipid glycosylation. These disorders have a variable presentation and are individually rare. DPAGT1-CDG is a protein N-glycosylation disorder with epilepsy, development delay, severe hypotonia, and dysmorphy, reported in a single patient. Here we present the second family with DPAGT1-CDG identified through homozygosity mapping in a large consanguineous family with 18 affected infants. The patients had severe hypotonia, global developmental delay, seizures, and microcephaly but no dysmorphy. In the index case, the brain MRI revealed delayed myelination, and there was fiber type disproportion on muscle biopsy. Homozygosity mapping identified a large block of homozygosity on chromosome 11p15.5-q25 where two known CDG-I causing genes, ALG9 and DPAGT1, are located. Sequencing ALG9 did not reveal any mutations while analysis of DPAGT1 identified a novel homozygous mutation c.902G>A (p.R301H) in two affected infants. The disorder was fatal in all affected cases and mostly in early infancy.
A serial muscle biopsy study in a case of congenital fiber-type disproportion associated with progressive respiratory failure
Feb 1990
BRAIN DEV-JPN
Yoshihiko Mizuno
Kazuhiko Komiya
The muscle fiber diameter and distribution were studied in serial muscle biopsy specimens taken at the ages of 21 months and 8 years in a girl with congenital fiber type disproportion. The patient was floppy from birth and showed delayed motor development. Progressive respiratory failure developed from the age of 8, which required artificial respiration during the night. The mean diameters of type 1 fibers at the ages of 21 m and 8 y were 10 mu and 21 mu, and those of type 2 fibers 32 mu and 61 mu, respectively. Whereas most type 1 fibers were hypotrophic in both biopsy specimens, a small number of type 1 fibers (approximately 15%) were normal-sized or hypertrophic, measuring 50 to 90 mu, in the second biopsy specimen, which were thought to have arisen on the maturation of normal-sized or hypertrophic type 1 fibers measuring 15 to 35 mu in the first biopsy specimen. Excessive hypotrophy of type 1 fibers was considered to be responsible for the progressive respiratory failure due to weakness of the diaphragm. The pattern of type 1 fiber evolution from the first to the second biopsy specimen suggested that dysmaturation of spinal motoneurons innervating type 1 muscle fibers would be involved in the pathophysiology of the fiber type disproportion in this case.
Congenital fiber type disproportion myopathy in Lowe syndrome
Nov 1989
PEDIATR NEUROL
Jun Kohyama
Fumio Niimura
Koichiro Kawashima
Ikuya Nonaka
Two brothers with the typical clinical features of oculocerebro-renal syndrome of Lowe exhibited delays in developmental milestones, muscular weakness and hypotonia, and high serum creatine kinase activity. The biopsied muscle revealed selective type 1 fiber atrophy and mild type 1 fiber predominance, similar to that observed in congenital fiber type disproportion myopathy. The abnormal fiber type distribution may be responsible for the common finding of muscle hypotonia in this syndrome.
Association of Krabbe leukodystrophy and congenital fiber type disproportion
Aug 1996
PEDIATR NEUROL
B Marjanović
Dubravka Cvetković
S Dozić
Milena Djuric
Hypotonia and weakness developed in a 12-month-old boy whose psychomotor development had previously been normal. The muscle biopsy demonstrated a disparity in the mean diameters of type 1 and type 2 fibers and satisfied major histologic criteria for diagnosis of congenital fiber type disproportion (CFTD). However, deterioration of motor and mental function, which developed subsequently, strongly suggested progressive encephalopathy. Examination of leukocyte cerebral enzymes at 15 months of age revealed a complete lack of galactosylceramide-beta-galactosidase. Selective type 1 fiber atrophy with type 1 fiber predominance has been observed in various conditions, including Krabbe disease. We report an additional case of Krabbe leukodystrophy associated with CFTD. The finding on the molecular level will resolve the dilemma of whether CFTD is a congenital myopathy or whether these patterns of disproportion may result from a number of different processes that interfere with the maturation of the developing motor unit.
Congenital fiber type disproportion - 30 Years on
Nov 2003
Nigel F Clarke
Kathryn N North
Thirty years ago, M. H. Brooke coined the term "congenital fiber type disproportion" (CFTD) to describe 12 children who had clinical features of a congenital myopathy and relative type 1 fiber hypotrophy on muscle biopsy. It is now clear that this histological pattern can accompany a wide range of neurological disorders, leading to disillusionment with CFTD as a distinct nosological entity. To determine whether the CFTD has clinical utility as a diagnostic entity, we have reviewed the literature for cases of type 1 fiber hypotrophy and have used strict exclusion criteria to identify 67 cases of CFTD. Most patients presented at birth with weakness and hypotonia, had normal intelligence, and followed a static or improving clinical course. In 43% of families, more than 1 individual was affected. Failure to thrive was common and 25% of patients had contractures or spinal deformities. Bulbar weakness and ophthalmoplegia were less common and cardiac involvement was rare. Twenty-five percent followed a severe course and 10% had died at the time of reporting, all from respiratory failure. Ophthalmoplegia and facial and bulbar weakness were significantly associated with a poorer prognosis. The relatively homogeneous phenotype supports the retention of CFTD as a distinct diagnostic entity and familial occurrence suggests a genetic basis. Regarding the diagnosis of CFTD, we found no strong evidence that the minimum difference between type 1 and type 2 fiber sizes should be increased from 12% to 25%. We also list the other reported causes of relative type 1 fiber hypotrophy to aid their exclusion from CFTD.
| https://www.researchgate.net/publication/16728801_A_case_of_multiple_sulfatase_deficiency_with_fiber_type_disproportion |
The Oxford Oratory
A sanctuary in the midst of the city
The Oxford Oratory is a vibrant centre of Catholic life. Our church is open every day: join us for Mass, pop in for some quiet prayer, or come and discover more at one of our groups. Our historic church of St Aloysius has been a key feature in the lives of the city’s Catholics for 150 years, attracting people of all ages and from every walk of life. We use beauty to raise hearts and minds to God, faithful to the traditions of St Philip Neri and St John Henry Newman.
Two relics of his are displayed this month in our relic chapel, including a letter bearing his signature.
#oxfordoratory
Flos paradisi
Today we celebrate the great solemnity of the patron of our church: St Aloysius Gonzaga of the Society of Jesus. St Aloysius is, together with St Gabriel Possenti, patron of young people, students, and seminarians and thus was a natural choice as patron for our church in this university city. He is also the patron of our parish school and we entrust to his loving intercession all our children who are able to learn the love of God from his example. We have his shrine in the chapel of Our Lady of Oxford, his statue is there on the reredos, and his initials guide our eyes towards his heavenly home as we look up at the sanctuary ceiling. Our patrons are important — St Aloysius has been given to us in this parish by God, through his Church, to watch over us in a particular manner, to intercede for all those who live and worship here, and to encourage us in our own quest for holiness.
Born the eldest son of the Marquis of Castiglione, St Aloysius seemed destined for a life of political intrigue and secular affairs, but, as with St Ignatius before him, it was the lives of the saints that really captivated him and placed in his heart the desire to strive for something better. This was not some childish caprice; he had seen the reality of life at court with its violence, frivolity, and degradation of human dignity, and desired not only to turn his back on it, but to embrace with all his heart a life given wholly to God. He began in earnest, adopting severe penances and teaching the local children their catechism. Hearing about the missions of St Francis Xavier, he set his heart on becoming a Jesuit — much to the horror of his family.
Eventually, having not overcome family opposition but at least its concrete obstacles, and having renounced his rights of inheritance, he entered the Jesuit novitiate in Rome in 1585. He had much to learn and much to which to adapt himself, but whatever he had to do he simply did it with all his heart — trusting in the sure knowledge that God was at work. Would he have met St Philip in Rome? Concrete evidence is hard to find, though these two saints of Rome are often depicted in art. We know they had mutual friends and these no doubt would have told them of Rome’s Third Apostle and of the holy Jesuit novice. One can imagine St Aloysius on a novitiate walk popping in to the Chiesa Nuovato see Mister Father Philip whom all Rome spoke of and revered or of St Philip blessing a crowd of passing Jesuit novices and knowing the heart of one of them that would see them both in glory.
St Aloysius’ real work in Rome was that which St Philip had embarked upon at the beginning — the care of the sick and the destitute. When plague broke out he volunteered to go with the other novices to pick people off the streets, to wash them, to prepare them for the sacraments and care for their souls. At first, he admitted to his director St Robert Bellarmine, this revolted him, but he soon learnt to see the image of Christ in these people, and to love them, not only in caring for them, but in seeing Christ in them. Never one to enjoy good health, Aloysius himself fell ill of plague, and died at the age of 23 on 21 June 1591, just a few years before St Philip’s death.
When we look at images of St Aloysius we normally see a rather pale young man who looks like so many other sickly young saints, distinguished perhaps only by the great ruff that he wears about his neck. But he was more than that. He was a young man who bothered about God and thus about other people. He was not yet in his mid-twenties, when he had discovered that real freedom comes from serving God with all ones heart; that Christian love has to be lived in the real, strength-sapping, heart-breaking, service of others; that there is joy in taking people off the streets, washing them, bandaging their wounds and restoring them to the dignity that is theirs as children of God.
The image attached to these words is a depiction of St Aloysius in Milan in the Chiesa di Santa Maria presso San Satiro. The saint looks rather weak and malnourished, but what strength he has is used to hold up a man who is either dying or dead, with St Aloysius pressing the Cross to him and holding the man’s head up with his hands. The look on St Aloysius’ face is one, simply, of love — of love for God and neighbour, and of joy found in bringing the love of God to others. How much this young man, St Aloysius, still has left to teach us…
Heart of Jesus, all-holy! Fountain of all blessings, I adore thee, I love thee, and with a lively sorrow for my sins, I offer thee this poor heart of mine. Make me humble, patient, pure, and wholly obedient to thy will. Good Jesus, grant that I may live in thee and for thee. Protect me in the midst of danger; comfort me in my afflictions; give me health of body, assistance in my temporal needs, thy blessing on all that I do, and the grace of a holy death. Amen.
#oxfordoratory
A photo from Sunday’s Solemn Mass for Corpus Christi.
June Music
Sunday 4 JuneSolemn Mass 11:00The Most Holy TrinityKyrie MundyMissa Euge bone TyeLibera nos SheppardHonor, virtus et potestas Tallis
Sunday 11 JuneSolemn Mass 11:00Corpus ChristiMissa Pange lingua JosquinLauda Sion PalestrinaOculi omnium Byrd
Friday 16 JuneSolemn Mass 18:00The Most Sacred Heart of JesusMissa Dormendo un giorno GuerreroImproperium PalestrinaSancte Deus Tallis
Sunday 18 JuneSolemn Mass 11:0011th Sunday of the YearMissa Brevis in F Op.117 RheinbergerBenedicam Dominum VictoriaSalve Regina Poulenc
Wednesday 21 JuneSolemn Mass 18:00St Aloysius GonzagaMissa O quam gloriosum VictoriaJustitiae Domini A ScarlattiO bone Jesu Anchieta
Sunday 25 JuneSolemn Mass 11:0012th Sunday of the YearMissa Repleatur os meum PalestrinaPerfice gressus meos LassusHomo quidam fecit coenam magnam Mouton
Thursday 29 JuneSolemn Mass 18:00St Peter and St PaulMissa Petre ego pro te rogavi LoboPetre ego pro te rogavi GuerreroJanitor caeli Ortiz
The Sacred Heart
Love is a funny thing. Materialists will tell us that it is purely the result of a series of electro-chemical responses in the brain, and yet others will tell us that it is the result of fate, the conspiracy of the alignment of the planets or the times we find ourselves in. The heart has long been understood as the centre of a person, a place of knowledge as much as will. It makes us do unreasonable things like acts of unwarranted kindness and altruism and by the edge of its blade we can be hurt in ways that we just can’t speak about. And yet none of these express what love is in itself — only God does that.
On Friday we venerate the Heart of our Lord as the symbol of his human love in which God’s divine love is revealed to us. In most of the prayers to or the meditations on the Sacred Heart, even those very ancient prayers, the woundedness of our Lord’s heart comes to the fore. That heart pierced with a lance and bruised with outrages and blasphemies is a stark and realistic image of the extent to which Christ loves us. Christ, who is the image of the unseen God, the Icon of the Father, shows us precisely what God’s love for us looks like. And it looks like a heart pierced and bruised on account of our sins, yet burning with ardent love for you and for me. This divine love is not for softies.
The time when we celebrate this feast is very fitting. We have come to the end of the Church’s celebration of the mysteries of our redemption: the Passion, the Cross, the Resurrection, the Ascension, Pentecost, the Feast of the Blessed Trinity and Corpus Christi. But today we commemorate the divine-human love which motivated them all. In adoring the Sacred Heart, we adore the totality of Christ’s saving work — it represents the way in which God holds nothing back from us. And in order to share his divine life with us, he reaches down into the very depths of our life, even — and especially — where it is painful, difficult to speak of, hidden. By taking it all and joining it to himself, he scoops us up, he enables us to become like him. By sharing our life, and by sharing our pains, he heals us, he sanctifies us, and he strengthens us.
It is also true that his heart welcomes us precisely so that we might become like it. The whole thrust of our Christian life is that we might be conformed to our Saviour, that we might resemble him, and in this sense, in the life of faith, we should ask ourselves continually whether our heart resembles his. His Sacred Heart is both the example and the cause of our becoming like him. His love is attractive. The more we consider the love with which Jesus acted, and spoke and gave of himself for us, the more we can begin, by his grace, to imitate him — it is truly the school of Christian perfection.
And we begin in that school by prayer. When St John Henry Newman, our Cardinal, chose his motto, he looked to St Francis de Sales’ Treatise on the Love of God. The phrase he chose and paraphrased, Cor ad Cor loquiturrepresents for us the central mystery of the prayer that can begin to transform us. St Francis de Sales wrote:
Truly the chief exercise in mystical theology is to speak to God and to hear God speak in the bottom of the heart; and because this discourse passes in most secret aspirations and inspirations, we term it a silent conversing. Eyes speak to eyes, and heart to heart, and none understand what passes save those who speak.
We may be no great shakes at the spiritual life, or prayer, or we may feel that excelling in virtue is beyond us, but if we can in the simplest of ways open our poor heart to his Sacred Heart, and speak to him as to a friend, if we can entrust our lives to him and ask him devoutly and sincerely to shape us after the model of his Heart, then our Christian life will be all the more graced.
The Corpus Christi procession concluded with Benediction at the University Chaplaincy. #oxfordoratory
The procession finished at the University’s Catholic Chaplaincy. #oxfordoratory
The numbers caught the attention of the local media:
https://www.oxfordmail.co.uk/news/23582016.oxfords-catholic-congregations-take-part-corpus-christi-procession/
#oxfordoratory
Children scattered flower petals before the Blessed Sacrament all the way. #oxfordoratory
Our route now passes through the city in a straight line, taking us directly through the busiest shopping areas. #oxfordoratory
The canopy was carried by members of the University of Oxford wearing their academic dress. #oxfordoratory
Fr Robert Ombres OP preached a sermon. #oxfordoratory
We paused at Blackfriars. #oxfordoratory
We were joined by local clergy and religious orders as we processed through the streets to the Dominican Priory at Blackfriars. #oxfordoratory
The processions sets off… #oxfordoratory
We had record numbers for the procession this year. There wasn’t space in church for everyone at the beginning! There were more people outside too. #oxfordoratory
The beginning of our Corpus Christi procession last Sunday.#oxfordoratory
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The Oratory Prayer Book is now shipping internationally!
We’ve made it even easier to buy the Oratory Prayer Book from anywhere in the world.
And we’ve made it easier to order multiple copies too — in the UK and worldwide.
Order your copy here:https://tinyurl.com/opb-buy
If you have one, we’d love to hear what you think about it. Let us know in the comments, or tag a photo of your prayer book in the wild with #oratoryprayerbook
Thanks to @acatholicinoxford for the photo.
#oxfordoratory
Worship
What does it actually mean to worship God? In the New Testament, the word we most often translate as ‘worship’ doesn’t mean to reverence another in some abstract sense. It always involves some kind of bodily action. When we think about the magi visiting the Holy Family, we sometimes convey this motion by describing them — after they fall to their knees — as ‘doing homage’. But it’s actually that same word here we might translate elsewhere as ‘worship’. It’s just that we recognise the need to describe the bodily sign of their submission and adoration of the new born King with something that sounds a bit more physical.
The word we usually translate as ‘worship’ ( proskuneo) comes literally from a root meaning ‘to make yourself like a dog before the other person’. It originally meant prostrating yourself on the floor to show your humble submission before another. By the time of the New Testament, people wouldn’t necessarily have had the root of this word in mind whenever they used it,* but the word still carries with it the idea of doing something with your body to express your worship.
The feast of Corpus Christi is all about this kind of bodily worship. It’s tied to the fact that we are not pure spirits, but that we are human beings, body and soul. To worship God is not just a spiritual act. The right worship of God does not consist in simply having the right kinds of thoughts towards him. But the worship of God involves the humble submission of our entire human being, body and soul, before the God who is greater than all of us.
And ever since the Incarnation, we do this not just before an abstract spirit. Because, from the moment of the Incarnation, God really does have a human body, that we can worship, that we fall down on our knees before, like the magi and the Canaanite woman, and so many others in the Gospel who kneel down and worship Christ. When we worship God, we kneel before God who is present in the flesh, under the appearances of bread and wine, in our churches all over the world.
Corpus Christi is a joyful celebration of Christ’s presence among us, and it gives us an opportunity to think about how we respond to that gift. All this talk of kneeling and worship might not sound so joyful, but one of the great paradoxes of Christianity is that we find our greatest freedom in the humble service of God. Our greatest joy really should be found in finding ways to express this loving worship. So at least once a year, it is no bad thing to think about how we express with our own bodies that worship of God’s body, and what ways we can find to worship him even more perfectly.
This Sunday, we will carry Christ’s Body through the streets of our city. We have a chance to demonstrate to the world our love, our joyful service, our worship of him, through our presence. The procession leaves our church at 2:30pm. Make sure you are there.
But we should also think about the more ordinary things, like making sure we show that worship whenever we are in his presence. We should show through our behaviour in church that we believe him to be there: by genuflecting before him in the tabernacle of the church, and by keeping the church quiet and prayerful.
We show our worship above all by kneeling down before him — like all those people in the Gospel — for the moment of Holy Communion. And we allow the priest to place the Host on our tongues, so that we don’t handle unnecessarily what is holy and precious, and no particles of Our Lord’s Body are ever dropped or lost through carelessness.
We continue that worship in our prayers of thanksgiving after Communion and once the Mass has ended. We certainly never leave church during Communion. And we might think of ways of extending the time we spend with Christ present in the Blessed Sacrament: by attending Mass during the week sometimes, or visiting him during the times each week when his Body is exposed solemnly on the altar for Adoration, or even just by visiting an empty church, where he is waiting for us to show him our worship.
Our Lord is hidden there, waiting for us to come and visit him, and make our request to him. See how good he is! He is there in the Sacrament of his love, sighing and interceding incessantly with his Father for sinners. To what outrages does he not expose himself, that he may remain in the midst of us! He is there to console us; and therefore we ought often to visit him. How pleasing to him is the short quarter of an hour that we steal from our occupations, from something of no use, to come and pray to him, to visit him, to console him for all the outrages he receives! When he sees pure souls coming eagerly to him, he smiles upon them. They come with that simplicity which pleases him so much, to ask his pardon for all sinners, for the outrages of so many ungrateful men. What happiness do we not feel in the presence of God, when we find ourselves alone at his feet before the holy tabernacles! ‘Come, my soul, redouble thy fervour; thou art alone adoring thy God. His eyes rest upon thee alone.’
— St John Mary Vianney
* One exception is that I do think Christ had this root meaning in mind when he spoke to the Canaanite woman in Matthew 15:21–28. He wasn’t randomly insulting her by comparing her to a dog, but drawing attention to the fact that she was making herself like a dog before him — i.e. worshipping him — because she recognised him to be God. In other words, he was acknowledging her worship as proof of her faith and humility.
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Town Of Springfield v. Newton, 1205. - Vermont - Case Law - VLEX 889135547
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Town Of Springfield v. Newton, 1205.
Docket Nº No. 1205. Citation 50 A.2d 605 Case Date January 07, 1947 Court United States State Supreme Court of Vermont
50 A.2d 605
TOWN OF SPRINGFIELD v. NEWTON et al.
No. 1205.
Supreme Court of Vermont.
Jan. 7, 1947.
50 A.2d 606
Original prohibition proceeding by the Town of Springfield against Maurice A. Newton and others, County Road Commissioners for the County of Windsor, respondents, to restrain the respondents from enforcing an order made by them requiring the petitioner to make certain designated repairs on a bridge situated within limits of the petitioner, wherein Harry P. Fitch and others, citizens and taxpayers of the petitioner, intervened and filed an answer.
Issuance of writ of prohibition ordered.
50 A.2d 607
H. H. Blanchard, of Springfield, and Lawrence and O'Brien, of Rutland, for petitioner.
Clifton G. Parker, of Morrisville, for respondents.
Ernest F. Berry and Barber & Barber, all of Brattleboro, for intervenors.
Before MOULTON, C. J., and BUTTLES, STURTEVANT and JEFFORDS, JJ.
MOULTON, Chief Justice.
This is a petition for a writ of prohibition, by which it is sought to restrain the County Road Commissioners for the County of Windsor (hereinafter called the respondents) from enforcing an order made by them requiring the Town of Springfield, in that County, (hereinafter called the petitioner) to make certain designated repairs upon a bridge situated within the limits of the Town.
The writ is sought upon the ground that the bridge is not a public highway or a part of a public highway, never having been laid out under authority of law, or dedicated or accepted as such, and that therefore the respondents were without jurisdiction or authority to entertain or hear any complaint, or to make any legal or binding order upon the petitioner in connection therewith, or to take any steps for the enforcement of such order if the petitioner should fail to comply with it. Upon presentation of the petition to a Justice of this Court a stay of all proceedings respecting the matters alleged was granted pending that final disposition of the controversy.
50 A.2d 608
The respondents have filed an answer. Harry P. Fitch, Nora S. Fitch, Ervin C. Balch and Hugh H. Balch, all citizens and taxpayers of Springfield (hereinafter called the intervenors) who were the complainants to the respondents, have, upon their motion, been permitted to enter as parties respondent, and have filed an answer. The cause is before us upon the report a Commissioner, who has been appointed to find and report the facts in issue.
The proceedings which resulted in the order made by the respondents were those prescribed by statute. As provided by P.L. 4945 the intervenors gave notice of the insufficiency of the bridge and the nature of such insufficiency to the selectmen of the petitioner; and after a neglect by the petitioner to commence work upon the bridge for 36 hours, filed a complaint with the respondents, signed and sworn to, with security for costs. In accordance with P.L. 4946, 4947 and 4948 the respondents, after giving the required notice, heard the parties, examined the bridge, and filed their report that the public good required that certain specified repairs should be made thereon, allocating the sum of $500.00 for the purpose, with an order that the petitioner commence work upon them within a designated time. The hearing was held over the protest and objection by the petitioner that the respondents were without authority or jurisdiction in the matter, for the same reason as that set forth in the petition.
The petition alleges that unless prohibited by an order of this Court the respondents, in the event that the repairs shall not be made, will continue to exercise jurisdiction, will appoint an agent to expend the amount allocated by them, will file a certificate in the office of the County clerk of Windsor County, and cause a judgment for this sum to be entered against the petitioner and execution issued thereon, as provided by P.L. 4949 and 4950.
The function of a writ of prohibition is to prevent the unlawful assumption of jurisdiction by a tribunal either of the entire subject matter or of something collateral or incidental thereto, contrary to common law or statutory provisions. Leonard v. Willcox, 101 Vt. 195, 203, 142 A. 762 and cas.cit. The writ lies not only to courts eo nomine but also to inferior ministerial bodies possessing incidentally judicial powers, such as are known as quasi judicial functions. In re First Congressional District Election, 295 Pa. 1 , 144 A. 735 , 739, 43 Am.Jur.Tit. ‘Prohibition,’ p. 153, para. 14, and cas.cit. In the proceedings to order repairs upon defective highways and bridges under the sections of our Statutes above referred to the County Road Commissioners constitute such an inferior tribunal having certain quasi judicial power, and therefore the writ may issue against them to prevent an assumption of jurisdiction not conferred by law. Town of Shrewsbury v. Davis, 101 Vt. 181, 187, 142 A. 91 . In this case the status of the bridge in question as a public highway is the essential jurisdictional element. Town of Shrewsbury v. Davis, supra.
A highway, which term includes a bridge and its approaches (P.L. 13; Cook v. Town of Barton, 63 Vt. 566 , 568, 22 A. 663 ), is established either by regular statutory proceedings, or by dedication and acceptance. Hyde, Adm'r, v. Town of Jamaica, 27 Vt. 443, 454. In the case just cited it is intimated that the establishment may also be by prescription, but it is said in Gore v. Blanchard, 96 Vt. 234, 241, 118 A. 888 , 891, that: ‘Inasmuch as the public cannot take by grant, prescription, which presupposes a grant, in its strict sense, seems to have no application to highways.’ In the present case there is nothing to show that the bridge was ever laid out as a highway by the authority of statute; in fact, it appears that all the available surveys and records are silent upon the subject. But the legality of its establishment is not disproved by the absence of a record, for it may have acquired its status by dedication and acceptance, as the defendants and the intervenors claim to be the case in this instance. Judd v. Challoux, 114 Vt. 1, 3, 39 A.2d 357 ; Brown v. Town of Swanton, 69 Vt. 53 , 56, 37 A. 280 ; Page v. Town of Weathersfield, 13 Vt. 424, 429.
A dedication of a road as a highway is the setting apart of the land for public use, and may be either express or implied from the acts of the owner. It need not be evidenced by any writing or by any form of words, but may be shown by evidence of the
50 A.2d 609
owners' conduct, provided his intention, which is the essential element, clearly appears. Gore v. Blanchard, 96 Vt. 234, 239, 118 A. 888 ; Littlefield v. Hubbard, 124 Me. 299, 128 A. 285 , 287, 38 A.L.R. 1306. It is not, like a grant, to be presumed from length of time alone, but may, if the act of dedication be unequivocal, take place immediately. State v. Wilkinson, 2 Vt. 480, 486, 21 Am.Dec.560...
20 practice notes
Concerned Loved Ones and Lot Owners Ass'n of Beverly Hills Memorial Gardens v. Pence, CC993 United States Supreme Court of West Virginia July 21, 1989 ...S.W.2d 528, 528 (1953); Priolo v. City of Dallas, 257 S.W.2d 947, 952 (Tex.Civ.App.1953); Town of Springfield v. Newton, 115 Vt. 39, 44, 50 A.2d 605 , 609 (1947); Humphrey v. Krutz, 77 Wash. 152, 155, 137 P. 806, 807 (1913). See 11 E. McQuillin, The Law of Page 838 Municipal Corporations § 3......
Thompson v. Smith, 311 United States Vermont United States State Supreme Court of Vermont February 7, 1957 ...law and fact. Smith v. Vermont Marble Co., 99 Vt. 384, 395-396, 133 [119 Vt. 498] A. 355; Town of Springfield v. Newton, 115 Vt. 39, 47, 50 A.2d 605 . See also Rothfarb v. Camp Awanee, Inc., 116 Vt. 172, 176, 71 A.2d 569; Merchants Mutual Casualty Co. v. Izor, supra, 118 Vt. at page 443, 111......
Kirkland v. Kolodziej, 14–339. United States Vermont United States State Supreme Court of Vermont July 17, 2015 ...Town of Bethel v. Wellford, 2009 VT 100, ¶ 14, 186 Vt. 612, 987 A.2d 956 (mem.) (quoting Town of Springfield v. Newton, 115 Vt. 39, 47, 50 A.2d 605 , 610 (1947) ). We defer to the trial court's findings of fact if, viewed in a light most favorable to the prevailing party, they are not clearl......
Watson v. City of Albuquerque, 7774 United States New Mexico Supreme Court of New Mexico July 18, 1966 ...485; Board of Comm'rs of Jefferson County v. Warneke, 1929, 85 Colo. 388, 276 P. 671; Town of Springfield v. Newton, 1947, 115 Vt. 39, 50 A.2d 605 ; compare City of Carlsbad v. Neal, 1952, 56 N.M. 465, 245 P.2d 384; State ex rel. Shelton v. Board of Com'rs of Bernalillo County, 1945, 49 N.M.......
20 cases
Concerned Loved Ones and Lot Owners Ass'n of Beverly Hills Memorial Gardens v. Pence, No. CC993 United States Supreme Court of West Virginia July 21, 1989 ...S.W.2d 528, 528 (1953); Priolo v. City of Dallas, 257 S.W.2d 947, 952 (Tex.Civ.App.1953); Town of Springfield v. Newton, 115 Vt. 39, 44, 50 A.2d 605 , 609 (1947); Humphrey v. Krutz, 77 Wash. 152, 155, 137 P. 806, 807 (1913). See 11 E. McQuillin, The Law of Page 838 Municipal Corporations § 3......
Thompson v. Smith, No. 311 United States Vermont United States State Supreme Court of Vermont February 7, 1957 ...law and fact. Smith v. Vermont Marble Co., 99 Vt. 384, 395-396, 133 [119 Vt. 498] A. 355; Town of Springfield v. Newton, 115 Vt. 39, 47, 50 A.2d 605 . See also Rothfarb v. Camp Awanee, Inc., 116 Vt. 172, 176, 71 A.2d 569; Merchants Mutual Casualty Co. v. Izor, supra, 118 Vt. at page 443, 111......
Kirkland v. Kolodziej, No. 14–339. United States Vermont United States State Supreme Court of Vermont July 17, 2015 ...Town of Bethel v. Wellford, 2009 VT 100, ¶ 14, 186 Vt. 612, 987 A.2d 956 (mem.) (quoting Town of Springfield v. Newton, 115 Vt. 39, 47, 50 A.2d 605 , 610 (1947) ). We defer to the trial court's findings of fact if, viewed in a light most favorable to the prevailing party, they are not clearl......
Watson v. City of Albuquerque, No. 7774 United States New Mexico Supreme Court of New Mexico July 18, 1966 ...485; Board of Comm'rs of Jefferson County v. Warneke, 1929, 85 Colo. 388, 276 P. 671; Town of Springfield v. Newton, 1947, 115 Vt. 39, 50 A.2d 605 ; compare City of Carlsbad v. Neal, 1952, 56 N.M. 465, 245 P.2d 384; State ex rel. Shelton v. Board of Com'rs of Bernalillo County, 1945, 49 N.M.......
| https://case-law.vlex.com/vid/town-of-springfield-v-889135547 |
Wavefront-guided LASIK and Wavefront-optimized LASIK in Astigmatism and Myopia - Clinical Trials Registry - ICH GCP
The purpose of the study is to compare the results of LASIK surgery when using wavefront-guided excimer laser treatment compared to wavefront optimized excimer...
Wavefront-guided Versus Wavefront-optimized LASIK for Nearsightedness
The purpose of the study is to compare the results of LASIK surgery when using wavefront-guided excimer laser treatment compared to wavefront optimized excimer laser treatment in patients with nearsightedness with and without astigmatism
Study Overview
Status
Completed
Conditions
Astigmatism
Myopia
Intervention / Treatment
Procedure: Wavefront-guided LASIK
Procedure: Wavefront-optimized LASIK
Detailed Description
This is a research study comparing the outcomes of LASIK surgery for nearsightedness when using the two different excimer laser technologies.
Patients will have both eyes treated with the Alcon WaveLight Allegretto excimer laser.
You will be one of 150 sighted patients at Stanford to undergo treatment in this clinical research trial.
This will be a prospective, randomized, research study in which up to 300 consecutive eyes scheduled to undergo excimer laser in situ keratomileusis (LASIK) using one laser technology in the first eye and the second laser technology in the fellow eye for the correction of myopia (nearsightedness) with or without astigmatism will be enrolled.
The choice of which eye receives the wavefront guided technology and which eye receives the wavefront-optimized technology will be randomized prior to enrollment.
Randomization will be done according to a randomization schedule.
You will know which eye is being treated with which each technology.
The randomization will determine only whether your right or left eye is treated with the wavefront guided technology.
The other eye will be treated with wavefront-optimized laser technology.
You have a fifty percent chance of having your left eye treated with custom wavefront guided technology as your right eye.
Subjects will undergo bilateral (both eyes at once) LASIK treatments using the Alcon WaveLight Allegretto excimer laser.
All subjects will be followed for one year after the vision correction procedure.
Subjects scheduled to undergo LASIK for the correction of myopia (nearsightedness) with or without astigmatism will be screened for eligibility.
Eligible subjects will be examined preoperatively to establish a baseline for ocular condition (the general health and glasses prescription of the eyes).
Postoperatively, subjects will undergo an ophthalmic evaluation (complete eye examination) at regular intervals as specified in this protocol.
Retreatments (a second operation on the same eye for residual nearsightedness) will not be allowed during the first twelve months of this study.
If you elect to undergo a retreatment of your LASIK surgery prior to the 12-month post-operative visit, the retreated eye will be exited from the study as of the retreatment date.
Any significant new finding developed during the course of the research which may relate to the subject's willingness to continue participation will be provided to the subject or subject's representative in a timely manner.
Study Type
Observational
Enrollment (Actual)
36
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Locations
United States
California
Stanford University School of Medicine
Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
21 years and older (Adult, Older Adult)
Accepts Healthy Volunteers
No
Genders Eligible for Study
All
Sampling Method
Non-Probability Sample
Study Population
Subjects age 21 and older with healthy eyes.
Nearsightedness between -7.50 diopters and -7.00 diopters with or without astigmatism of up to 3.50 diopters.
Description
Inclusion Criteria:
Subjects age 21 and older with healthy eyes.
Nearsightedness between -7.50 diopters and -7.00 diopters with or without astigmatism of up to 3.50 diopters.
Exclusion Criteria:
Subjects under the age of 21.
Patients with excessively thin corneas.
Patients with topographic evidence of keratoconus.
Patients with autoimmune diseases.
Patients who are pregnant or nursing.
Patients must have similar levels of nearsightedness in each eye.
They can not be more than 3.0 diopter of difference between eyes.
Patients must have similar levels of astigmatism in each eye.
They can not have more than 4.0 diopters of difference in nearsightedness or astigmatism between their two eyes.
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
Observational Models : Case-Control
Time Perspectives : Prospective
What is the study measuring?
Primary Outcome Measures
Outcome Measure Time Frame Changes in best corrected visual acuity Time Frame: 12 months 12 months Changes in 5 and 25% contrast visual acuity Time Frame: 12 months 12 months Refractive predictability Time Frame: 12 months 12 months Uncorrected visual acuity Time Frame: 12 months 12 months
Secondary Outcome Measures
Outcome Measure Time Frame Changes in higher order aberrations Time Frame: 1 yr 1 yr Quality of vision measurement Time Frame: 1 yr 1 yr Topographic analysis Time Frame: 1 yr 1 yr
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Edward E. Manche
Publications and helpful links
The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.
General Publications
Sales CS, Manche EE. One-year outcomes from a prospective, randomized, eye-to-eye comparison of wavefront-guided and wavefront-optimized LASIK in myopes. Ophthalmology. 2013 Dec;120(12):2396-2402. doi: 10.1016/j.ophtha.2013.05.010. Epub 2013 Jun 15.
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start (Actual)
April 6, 2010
Primary Completion (Actual)
April 30, 2012
Study Completion (Actual)
April 30, 2012
Study Registration Dates
First Submitted
June 3, 2010
First Submitted That Met QC Criteria
June 4, 2010
First Posted (Estimate)
June 7, 2010
Study Record Updates
Last Update Posted (Actual)
December 8, 2021
Last Update Submitted That Met QC Criteria
November 24, 2021
Last Verified
November 1, 2021
More Information
Terms related to this study
Keywords
Wavefront-guided LASIK.
Wavefront-optimized LASIK.
Custom LASIK
Additional Relevant MeSH Terms
Eye Diseases
Refractive Errors
Astigmatism
Other Study ID Numbers
SU-05272010-6188
Stanford Protocol # 18692
This information was retrieved directly from the websiteclinicaltrials.govwithout any changes. If you have any requests to change, remove or update your study details, please [email protected]. As soon as a change is implemented onclinicaltrials.gov, this will be updated automatically on our website as well.
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Myopia
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Myopia
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A Comparison of Fellow Eyes Undergoing LASIK or PRK With a Wavefront-guided Excimer Laser Versus a Wavefront-optimized Excimer Laser
Astigmatism
Myopia
Hyperopia
NCT01454843
Completed
LASIK Using the Alcon Allegretto Wavefront-Guided Excimer Laser vs AMO Visx Wavefront-Guided Excimer Laser (LASIK)
Astigmatism
Myopia
Wavefront-guided Photorefractive Keratectomy (PRK) Versus Wavefront-guided Lasik for Myopia
Astigmatism
Myopia
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Completed
Evaluation of Visual Outcomes After Myopic LASIK
Astigmatism
Myopia
Myopic Astigmatism
NCT00366769
Completed
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Astigmatism
Myopia
Myopic Astigmatism
| https://ichgcp.net/clinical-trials-registry/NCT01138189 |
The 33-bus network results with load factor µ = 0.75. | Download Table
Download Table | The 33-bus network results with load factor µ = 0.75. from publication: A New Method for Distribution Network Reconfiguration Analysis under Different Load Demands | The strategies of distribution network reconfiguration are applicable for minimizing power loss and saving electrical energy in the distribution system. Network reconfiguration is usually represented by constant load demand so ignoring the variability of load demand causes... | Distributed Systems, Patterns and Switches | ResearchGate, the professional network for scientists.
The 33-bus network results with load factor µ = 0.75.
A New Method for Distribution Network Reconfiguration Analysis under Different Load Demands
The strategies of distribution network reconfiguration are applicable for minimizing power loss and saving electrical energy in the distribution system. Network reconfiguration is usually represented by constant load demand so ignoring the variability of load demand causes uncertainty and misleading results in the minimization of power loss. This p...
Context in source publication
Context 1
... are four levels of load demand starting from µ = 0.75 to µ = 1.25 with step changes of 12.5%. Tables 4-7 show the switch set (s07, s09, s14, s32, s37) had minimum active power loss compared with other methods at different load levels. Table 3 shows the results of Case 1 at µ = 1. ...
Optimal Allocation of Renewable Distributed Generation and Capacitor Banks in Distribution Systems using Salp Swarm Algorithm
Recent advances in power generation technologies using renewable energy resources, changes in utility
infrastructure and government policies tend to increase the interest in a renewable-based distributed generation units (DGs) in a
distribution system. To obtain reduced power loss, voltage deviation and improved bus voltage stability in distributio...
Citations
... On the other hand, a meta-heuristic methodology for network reconfiguration with demand variation is presented in
[20,
21], aiming to minimize network losses while observing the operating constraints of system voltages, currents, and the final topology. This methodology includes, among other things, particle swarm optimization and an improved coyote optimization algorithm. ...
Optimal Load Redistribution in Distribution Systems Using a Mixed-Integer Convex Model Based on Electrical Momentum
This paper addresses the problem concerning the efficient minimization of power losses in asymmetric distribution grids from the perspective of convex optimization. This research’s main objective is to propose an approximation optimization model to reduce the total power losses in a three-phase network using the concept of electrical momentum. To obtain a mixed-integer convex formulation, the voltage variables at each node are relaxed by assuming them to be equal to those at the substation bus. With this assumption, the power balance constraints are reduced to flow restrictions, allowing us to formulate a set of linear rules. The objective function is formulated as a strictly convex objective function by applying the concept of average electrical momentum, by representing the current flows in distribution lines as the active and reactive power variables. To solve the relaxed MIQC model, the GAMS software (Version 28.1.2) and its CPLEX, SBB, and XPRESS solvers are used. In order to validate the effectiveness of load redistribution in power loss minimization, the initial and final grid configurations are tested with the triangular-based power flow method for asymmetric distribution networks. Numerical results show that the proposed mixed-integer model allows for reductions of 24.34%, 18.64%, and 4.14% for the 8-, 15-, and 25-node test feeders, respectively, in comparison with the benchmark case. The sine–cosine algorithm and the black hole optimization method are also used for comparison, demonstrating the efficiency of the MIQC approach in minimizing the expected grid power losses for three-phase unbalanced networks.
... The network reconfiguration problem can be formulated as a mixed-integer nonlinear programming (MINLP), which addresses the nonlinear nature of power losses. Some linearization strategies have been proposed in the literature, such as the linearization of the power flow [7], the power losses [4], [8], or the demand
[9]
. This paper uses a linearization of the power flow based on a load model approximating the power-voltage relationship to propose a dynamic reconfiguration method for application in an active distribution system. ...
A Dynamic Reconfiguration Method based on a Deterministic Optimization Approach in Active Distribution Systems
This article proposes a method for dynamic distribution network reconfiguration (DDNR) with distributed generation for loss reduction. Advantages and conceptual principles of a deterministic optimization method are exposed, which allows the minimization of technical power losses in distribution systems based on a linear approximation of the loads. In this work is proposed the application of this approach for the modelling of distributed generation sources, obtaining a mathematical formulation that exploits mixed-integer nonlinear programming in solving the optimal reconfiguration problem. The DDNR method is implemented in an automatic tool integrating OpenDSS and GAMS software. IEEE69-Bus test system is considered to demonstrate the effectiveness of the technique. Dynamic results are obtained by implementing the optimal reconfiguration strategy, making the dynamic adjustments of the mathematical modelling in the face of variations in distributed generation and demand profiles. The results reveal schemes that range from one to twenty-four daily control actions.
... For this case, the whole Q loss increases from 302.26 kVAR to 428.9 kVAR, while the percentage increase of total Q loss is 41.90%. Optimal DG sizes are found as [71] 0.9706 0.9450 ITS [72] 0.9686 0.9420 SLR [73] 0.9684 0.9420 PSO
[68]
0.9556 0.9254 MPSO [68] 0.9684 0.9453 Proposed HHO 0.9843 0.9417 Figure 9(a) illustrates the bus voltage magnitude of 33-bus RDN with and without considering the deployment of two DGs for the autumn load. e bus voltage magnitude is upgraded from 0.87025 (per unit) to 0.89229 (per unit). ...
... For this case, the whole Q loss increases from 302.26 kVAR to 428.9 kVAR, while the percentage increase of total Q loss is 41.90%. Optimal DG sizes are found as [71] 0.9706 0.9450 ITS [72] 0.9686 0.9420 SLR [73] 0.9684 0.9420 PSO [68] 0.9556 0.9254 MPSO
[68]
0.9684 0.9453 Proposed HHO 0.9843 0.9417 Figure 9(a) illustrates the bus voltage magnitude of 33-bus RDN with and without considering the deployment of two DGs for the autumn load. e bus voltage magnitude is upgraded from 0.87025 (per unit) to 0.89229 (per unit). ...
... International Transactions on Electrical Energy Systems Loss Reduction (%) ACO-ABC [35] BA [36] HA [37] HGWO [38] EMA [29] SPEA2 [40] SSA [42] GSA-GAMS [31] GA [47] CSCA [78] QOCSOS [44] IHSA [51] PPA [72] Proposed HHO Algorithm vmin (per unit) PLOSS Reduction (%) Proposed HHO PPA [72] GA [77] PSO [77] GA/PSO [77] HSA
[68]
BFOA [79] ABC [68] SSA [42] WCA [82] HGWO [84] 1. Proposed HHO PPA [72] GA [77] PSO [77] GA/PSO [77] HSA [68] HSA [33] BFOA [79] BFOA [34] ABC [68] SSA [42] FWA [43] SFLA [43] SSA [42] WCA [82] WCA [82] HGWO [38] HGWO [84] 1. RDN, the ANOVA test has been carried out between fourteen (14) algorithms, while for IEEE 69-bus RDN, the test has been performed between twenty (20) algorithms. e value of F for both RDNs is less than the critical level. ...
8640423 (2)
... For this case, the whole Q loss increases from 302.26 kVAR to 428.9 kVAR, while the percentage increase of total Q loss is 41.90%. Optimal DG sizes are found as [71] 0.9706 0.9450 ITS [72] 0.9686 0.9420 SLR [73] 0.9684 0.9420 PSO
[68]
0.9556 0.9254 MPSO [68] 0.9684 0.9453 Proposed HHO 0.9843 0.9417 Figure 9(a) illustrates the bus voltage magnitude of 33-bus RDN with and without considering the deployment of two DGs for the autumn load. e bus voltage magnitude is upgraded from 0.87025 (per unit) to 0.89229 (per unit). ...
... For this case, the whole Q loss increases from 302.26 kVAR to 428.9 kVAR, while the percentage increase of total Q loss is 41.90%. Optimal DG sizes are found as [71] 0.9706 0.9450 ITS [72] 0.9686 0.9420 SLR [73] 0.9684 0.9420 PSO [68] 0.9556 0.9254 MPSO
[68]
0.9684 0.9453 Proposed HHO 0.9843 0.9417 Figure 9(a) illustrates the bus voltage magnitude of 33-bus RDN with and without considering the deployment of two DGs for the autumn load. e bus voltage magnitude is upgraded from 0.87025 (per unit) to 0.89229 (per unit). ...
... International Transactions on Electrical Energy Systems Loss Reduction (%) ACO-ABC [35] BA [36] HA [37] HGWO [38] EMA [29] SPEA2 [40] SSA [42] GSA-GAMS [31] GA [47] CSCA [78] QOCSOS [44] IHSA [51] PPA [72] Proposed HHO Algorithm vmin (per unit) PLOSS Reduction (%) Proposed HHO PPA [72] GA [77] PSO [77] GA/PSO [77] HSA
[68]
BFOA [79] ABC [68] SSA [42] WCA [82] HGWO [84] 1. Proposed HHO PPA [72] GA [77] PSO [77] GA/PSO [77] HSA [68] HSA [33] BFOA [79] BFOA [34] ABC [68] SSA [42] FWA [43] SFLA [43] SSA [42] WCA [82] WCA [82] HGWO [38] HGWO [84] 1. RDN, the ANOVA test has been carried out between fourteen (14) algorithms, while for IEEE 69-bus RDN, the test has been performed between twenty (20) algorithms. e value of F for both RDNs is less than the critical level. ...
Optimal Placement and Sizing Problem for Power Loss Minimization and Voltage Profile Improvement of Distribution Networks under Seasonal Loads Using Harris Hawks Optimizer
Abdul Khalique Junejo
Improving efficiency with sustainable radial distribution networks (RDNs) is challenging for larger systems and small grid-connected RDNs. In this paper, the optimal placement of DGs with the Harris hawks optimizer (HHO) under seasonal load demands is proposed to simultaneously reduce total active and reactive power losses and minimize bus voltage drops with the consideration of operational constraints of RDNs. HHO is a newly inspired metaheuristic optimization algorithm primarily based on the Harris hawks’ intelligent behaviors during the chasing of the prey. Furthermore, the authors have investigated four stages of DGs. The first stage involves the optimal allocation of one DG. The second stage includes an investigation with two DGs, the third stage considers three DGs, and the fourth stage investigates the integration of four DGs. The effectiveness of the applied HHO is validated on IEEE 33 and 69 bus RDNs, and results are analyzed by comparing with the standard optimization methods. The Big-O test is also executed for statistical analysis with standard algorithms. The simulation results reveal the better performance of the applied HHO under different circumstances than other algorithms. Furthermore, the total active and reactive power losses and bus voltage drops are improved by adding more DGs into IEEE 33 and 69 bus RDNs.
... The method included constraints on node voltages, feeder currents and radiality of the network.
8
The PSO was applied in solving the NWR problem with a goal of lowering the APL. The method adapted a tree algorithm controlling the solution improvisation process with a view of enhancing the exploration during search with reduced computations. ...
Modified rainfall optimization based method for solving distributed generation placement and reconfiguration problems in distribution networks
This article formulates the distribution generation placement and the network reconfiguration problems of distribution networks (DNs) as a composite multi-objective optimization problem by normalizing and combining the objective functions, and suggests a new rainfall optimization (RFO) based method for solving the developed problem. The RFO, a metaheuristic optimization algorithm that models the behavior of raindrops falling down from a hill towards sea, has certain drawbacks such as removal of inactive raindrops that weakens the search process, and the possibility of choosing the same raindrop as inactive throughout the iterative process. This article also introduces modifications in the RFO for overcoming its drawbacks before adopting it in the proposed method. It considers two scenarios with seven test cases for simulation study, and compares the results of two standard DNs with existing methods for exhibiting the superior performances in respect of final solution, robustness, voltage profile, and average execution time of the proposed method.
... A method combining small population PSO and dynamic neighborhood PSO with Pareto optimization was proposed to improve the performance of ship power system fault reconfiguration in Wang et al. [25]. A modified PSO was proposed with a gradually decreasing inertia factor, and a learning factor consisting of a normalized random number
[26]
. Results show that the algorithm improves the performance of the distribution network reconfiguration. ...
A fault reconfiguration strategy based on adjustable space operator discrete state transition algorithm for ship microgrid system
Tengfei Zhang
Saifeng Huang
As an independent power supply network, when the ship ring microgrid system (SRMS) fails or is damaged, the power-loss load can be reasonably distributed to other power sources through the control switch, thereby improving the reliability of the power grid. We consider the maximum power load, minimum switching action and generator efficiency as the reconfiguration goals. In order to complete the reconfiguration quickly, we present an optimization strategy based on an adjustable space operator (ASO) and the discrete state transition algorithm (DSTA), the ASODSTA. The main idea of DSTA is to use four spatial geometric operators to find the optimal solution. The optimization is completed by combining the operators with the sigmoid function, and an ASO is proposed as the variable of the sigmoid function. The spatial distribution of the candidate solutions is more widespread through the unification of the four operators. The introduction of the sigmoid function and the ASO improves the quality of the global optimal solution and shortens the running time of the algorithm. The simulation results show that the proposed method can solve the SRMS reconfiguration problem faster and more effectively by comparing with the algorithms EO, WOA, GWO and BPSO in the references.
... [117]. In this context, SGs analysis and optimization was extended to consider time-dependent loads in a wide energy-based assessment
[118]
. Furthermore, the growth of EDN electronic automation is performing for the DNO the possibility of switching from one to another configuration more easily than in the past. ...
Pitch Angle Control of the PMSG Wind Turbine
The applications of wind generation progress are faster than any other renewable energy. During this rapid development of the wind power, the majority of the wind turbines has been operated with diverse generators. One way to generate an efficient power is to control the pitch angle of the wind turbine. This paper aims at studying the pith angle and turbine management control strategy with Permanent Magnet Synchronous Generator-based different conditions. This research has investigated a model of the PMSG Wind Turbine Pitch Angle Control technique. Three different controllers namely: no controller, PI and PID control techniques are compared. On the other hand, the PID parameters have been adjusted. A PI/ PID pitch angle controller is studied in this paper to ensure the stability of mechanical torque and response of wind power. The model is implemented in MATLAB/SIMULINK software to investigate the outlined concept and control strategy. The simulation with PID controller shows good result when comparing with the others cases of study, in terms of the advanced stability of the parameters.
... The DN distributes the power from the substation to various consumers using distribution lines and distribution transformers (DTRs). In designing a DN of a power grid, the line length should be short because a long line means more technical power losses due to the high current at a low voltage level
[7]
. However, in some rural areas, the three-phase DTRs supply the consumers through long distribution lines due to the long distances between consumers. ...
[7,
20]. The line reconfiguration method improves the voltage profile at both the LV and MV sides of the DN. ...
... The discussed technologies presented in the literature and their technical/economic gaps are also clarified in Table 1. [17,18] Line reconfiguration The need for an active network and real-time communications
[7,
20] Injecting the reactive power via FACTS High initial cost [22,23] Using solid-state transformers Low efficiency, more harmonics [24,26] Restructuring the cross-section area of LV conductors Low voltage improvement at the tail end [9] Converting LV system to MV system The presented studies did not consider the economic feasibility [27,28] ...
Voltage Profile Enhancement and Power Loss Reduction with Economic Feasibility Using Small Capacity Distribution Transformers
Firas M. F. Flaih
... These research goals that can be satisfied by network reconfiguration are the decrease of power loss and enhancing the voltage profile, taking into account limitations and dissimilar scenarios of load variations. The objective function used to calculate the smallest value of the overall active power losses is illustrated in Eq. (6)
[13]
. (6) Where : control variable vector; : tie switch state; switch. ...
... A constant load model may be defined as a polynomial load representing the power relationship to voltage magnitude and frequency [19]. As shown in Eq. (12) and
(13)
, the general structure of a load model comprising of actual and reactive power reliance on voltage and frequency is: ...
Analysis of Distribution System Reconfiguration under Different Load Demand in AL-KUT City by using PSO Algorithm
... Al-Mahroqi, 2012).The network reconfiguration method is one such method that is proven to be effective and reliable (Napis, Khatib, Hassan, & Sulaima, 2018). The distribution network reconfiguration and re-settlement is a complex combinational work that contains the optimization process; aimed at finding a radial operating structure and minimizes the system power loss while satisfying operating constraints
(Flaih et al., 2017;
Rao, Ravindra, Satish, & Narasimham, 2012). With the advent of highly capable computers,a requirement of high computing power and complex decision-making process (Shilpa Kalambe, 2013) for network reconfiguration can now be easily fulfilled. ...
Performance Enhancement of Radial Distribution System via Network Reconfiguration: A Case Study of Urban City in Nepal
Increasing unplanned energy demand has led to network congestion, increased power losses and poor voltage profile. To decrease these adverse effects of an unmanaged power system, distribution network reconfiguration provides an effective solution. This paper deals with improving the power losses and poor voltage profile of the Phulchowk Distribution and Consumer Services (DCS) via the implementation of an optimum reconfiguration approach using Genetic Algorithm (GA). The developed algorithm is firstly put into work on the IEEE 33 bus system to improve its voltage profile and the poor power losses. The effectiveness of the developed system is validated as it reduced the voltage drop by 5.66% and the power loss by 25.96%. The algorithm is further implemented on Pulchowk DCS. Without overhauling the entire network, a better reconfiguration of the present network is provided which can be realized with the reconfiguration or allocation of tie-switches and sectionalizing switches within the network.After reconfiguring the system in different individual cases, optimum network reconfiguration is selected that improved the voltage profile and the active and reactive power losses when compared to the base case scenario.
| https://www.researchgate.net/figure/The-33-bus-network-results-with-load-factor-075_tbl2_315934493 |
Remarks at a Meeting on Women in Health Care | The American Presidency Project
Remarks at a Meeting on Women in Health Care
The President.Well, thank you very much. I appreciate you being here. It's a great honor, very great honor. I want to thank Vice President Pence, Secretary Tom Price, and Administrator Seema Verma—who's done an incredible job, by the way—for all of the time and energy they've put into repairing and replacing Obamacare ahead of tomorrow's crucial vote. Big vote tomorrow in the House.
I want to especially thank Seema, the Administrator of the Centers for Medicare and Medicaid Services—a wonderful job she's doing and definitely a complex job, but you have it under control, right—[ laughter]—for hosting this very important meeting to discuss the vital role women play in health care and the hardships inflicted on them by the Obamacare catastrophe. It's been bad.
Administrator Seema Verma is playing the leading role for us in helping us to repeal and replace Obamacare. The doctors, nurses, and health care professionals here today represent the millions of women—millions and millions—who play a vital and indispensable role in Americans' health care. Unfortunately, Obamacare is making their lives so much more difficult, as we all know, and putting enormous barriers in the way of helping patients who we are going to help. We're going to get this thing done. We're going to get it figured out. It's a tough situation our country has been put in. It's not easy.
Women doctors and health care leaders have changed the face of health care in America, saving and improving countless American lives. In 1965, only 9 percent of accepted medical school applicants were women—9 percent. Last year, nearly 50 percent of newly accepted applicants were women. Congratulations. Good job. It's a good job. Thirty-eight percent of physicians and surgeons are women, and that number will continue to grow. That's a big victory for our society, big victory for America.
I want to also thank all of the women nurses and health care aides for their incredible service and dedication to our country. What you do is remarkable. Unfortunately, Obamacare is making it much harder for all of the doctors, nurses, and health care professionals—men and women alike—to do their job. As insurers flee Obamacare's broken marketplace—and it is broken, it's broken badly; the insurance companies are fleeing—millions of patients can no longer access the health care professionals the know and trust. That was "keep your doctor, keep your plan"—didn't work out that way. You don't get your doctor; you don't get your plan.
So that is one of the more vital reasons why we must repeal Obamacare. It's one of the reasons why we're here today.
So with that, I want to turn it over to Administrator Verma, and we'll start a meeting.
Centers for Medicare and Medicaid Services Administrator Seema Verma.Thank you.
The President.Thank you very much. You could probably do it and stay for this little while, and then, we'll clear out the room and talk, okay?
Administrator Verma.Sounds great.
The President.Go ahead. Administrator Verma.Well, thank you, Mr. President.
The President.Thank you.
Administrator Verma.Appreciate it. This gentleman has been very supportive as I started my position at CMS, and I am very appreciative to be a part of this great health care team.
The President.Thank you.
Administrator Verma.And thanks to all the women that came today. It's great to see so many strong, professional women that are on the frontlines of healthcare. So thanks again for coming today.
Obamacare has just been a broken promise. Instead of meaningful health care, we have higher costs, less choices, and more mandates. Right now we have the Government that's making decisions about our health care, not patients and not doctors. As a mother and as a woman, the most important thing about my health care is being able to pick out the doctor that I feel comfortable with, but unfortunately, with Obamacare, we have less choices.
And I think the other thing that concerns me is hearing from providers. Many providers are faced with dealing with regulations and mandates instead of focusing on high-quality care and spending time with their patients. They are forced to deal with regulations.
And I came to DC because I was so concerned about the direction our health care was going in because of Obamacare. I want to be a part of the solution. I'm very excited about the American Health Care Act, if there's a vote on that tomorrow. I think this is an opportunity for us to finally get rid of Obamacare and move towards a system that's going to drive costs down, give Americans more choices, and put patients and doctors in control of their health care.
So once again, thank you for coming today. And I look forward to hearing all the stories. Thank you.
The President.Thank you very much.
NOTE: The President spoke at 11:24 a.m. in the Roosevelt Room at the White House. In his remarks, he referred to Secretary of Health and Human Services Thomas E. Price. Also participating in the meeting were National Economic Council Director Gary D. Cohn; State Sens. Donna Campbell and Dawn Buckingham of Texas; Steffany Williams, chairwoman, Novant Health Professional Nurses Council; Lina Varela-Gonzalez, director of nursing, Novant Health Presbyterian Medical Center Emergency Department; and Parmis Khatibi, anticoagulation/antithrombotic and tobacco treatment specialist, University of California—Irvine Medical Center.
Donald J. Trump, Remarks at a Meeting on Women in Health Care Online by Gerhard Peters and John T. Woolley, The American Presidency Project https://www.presidency.ucsb.edu/node/326450
Filed Under
Categories
Presidential
Spoken Addresses and Remarks
Location
Washington, DC
| https://www.presidency.ucsb.edu/documents/remarks-meeting-women-health-care |
(PDF) UNIVERSITAS CATHOLICA RU MBEROK Ž O
PDF | This article discusses the importance of ethical aspects in the work of social services/personal assistants with regard to the applicability of... | Find, read and cite all the research you need on ResearchGate
September 2020
Authors:
Lukáš Stárek
Univerzita Jana Amose Komenského Praha
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References (54)
Abstract
This article discusses the importance of ethical aspects in the
work of social services/personal assistants with regard to the applicability
of the Ethical model for decision making.
Main purpose of the text is research of the influence of social
service workers, especially personal assistents with ethical code. How is
ethical code useable while dealing with ethical dilemmas in relation to
the performance of this profession. Further we search for familliarity
with Ethical model for decision making between those assistents.
In their almost daily routine, personal assistents are facing
particular ethical questions. Their realization, searching for answers and
wondering about the questions in general requires neccesary care and
time. It leads to the importance and influence of the Ethics that might
be possibly flouted.
Reflection of ethical aspects may contribute to improvment
of provided social services, more precisely to professionalism of the
profession or strengthening professional competencies.
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S T U D I A S C I E N T I F I C A F A C U L T A T I S P A E D A G O G I C A E
/ / 3 2020
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ISSN 1336-2232
9 7 7 1 3 3 6 2 2 3 0 0 5 6 0
KATOLÍCKA UNIVERZITA V RUŽOMBERKU
STUDIA SCIENTIFICA
FACULTATIS PAEDAGOGICAE
UNIVERSITAS CATHOLICA RUŽOMBEROK
Ružomberok 2020
STUDIA SCIENTIFICA FACULTATIS PAED
AGOGIC AE
UNIVERSITAS CATHOLIC A RUŽOMBEROK
Vedecký recenzovaný časopis
Číslo 3, jún
2020, ročník 19.
Vychádza 5 -
krát do roka.
Šéfredaktor:
doc. PaedDr. Tomáš Jablonský
, PhD. –
Catholic University in Ružomberok
(Slovakia)
Medzinárodná redakčná rada:
prof. PaedDr. Pavel Doulík
, PhD. – J.
E. Purkyně University in Ústí nad Labem (Czech Republic)
prof. PhDr. Ingrid Emmerová
, PhD. – Catholic University in Ružomberok (Slovakia)
doc. PaedDr. PhDr. Miroslav Gejdoš
, PhD. – Catholic University in Ružomberok (Slovakia)
doc. PhDr. Ladislav Horňák
, PhD . – The University of Prešov (Slovakia)
prof. PhDr. Jolana Hroncová
, CSc. –
Matej Bel University in Banská Bystrica (Slovakia)
prof. PaedDr. Anna Hudecová
, PhD. –
Catholic University in Ružomberok (Slovakia)
prof. dr hab. Stanislaw Juszczyk
, PhD. – Catholic University in Ružomberok (Slovakia)
doc. PaedDr. Barbora Kováčová
, PhD. – Catholic University in Ružomberok (Slovakia)
doc. PhDr. Vladimír Klein
, PhD. –
Catholic Universi ty in Ružomberok (Slovakia)
prof. PaedDr. Milan Ligoš
, CSc. – Catholic University in Ružomberok (Slovakia)
dr hab. Piotr Mazur – Pa ństwowa Wyższa Szkoła Zawodowa in Chełmie (Poland)
prof. Pradeep Kumar Misra
, PhD. –
Chaudhary Charan Singh University (India)
prof. Bart McGettrick –
Liverpool Hope University (United Kingdom)
prof. dr hab. Marian Nowak –
Catholic University of Lublin (Poland)
prof. PhDr. Erich Petlák
, CSc. – Catholic University in Ružomberok (Slovakia)
prof. PhDr. Mária Pisoňová
, PhD. –
Constantine the Philosopher University in Nitra (Slovakia)
prof. PhDr. Mária Potočárová
, PhD. –
Comenius University in Bratislava (Slovakia)
prof. dr. Gabriella Pusztai –
University of Debrecen (Hungary)
prof. PhDr. Karel Rýdl
, CSc. –
University of Pardubice (Czech Republic)
doc. PhDr. Albín Škoviera
, PhD. –
University of Pardubice (Czech Republic)
prof. Juan Carlos Torre Puente –
Universidad Pontificia Comillas Madrid (Spain)
prof. PaedDr. Milan Valenta
, PhD. – Palacký University Olomouc (Czech Republic)
prof. PhDr. Miron Zelina
, DrSc. – DTI University in Dubnica nad Váhom (Slovakia)
Za jazykovú a štylistickú úroveň príspevkov zodpovedajú ich autori.
Výkonný redaktor :
PaedDr. Ján Gera, PhD.
Obálka:
doc. akad. mal. Pavol Rusko, ArtD.
EV 4416/11
Katolícka univerzita v Ružomberku
© VERBUM –
vydavateľstvo Katolíckej univerzity v Ružomberku
Hrabovská cesta 5512/1A, 034 01 Ružomberok
IČO: 37 -801-279
ISSN 1336-2232
Obsah
Predhovor
Ján Gera ........................................................................................................ 5
Motivace frekventantů celoživotního vzděláván
í pro
výkon
učitelské profese
Kamil Janiš ml., Kamil Janiš st. ................................................................... 7
Oblasť environmentálnej výchovy u det
í školského veku
Mária Šoltésová, Lucia Dimunová ............................................................. 18
Míra významnosti pastorace mládeže v postupu
jící sekularizaci
české společnosti
René Strouhal ............................................................................................. 23
Príčiny školského podvádzania
Gabriela Gabrhelová, Dáša Porubčanová ................................................... 34
Etický model rozhodování se jako pro
fesní nástroj
Lukáš Stárek ............................................................................................... 42
Tri piliere kvalitatívnej transformácie výučby
materinského jazyka I.
(Rámcové východiská)
Milan Ligoš ................................................................................................ 58
Fröbelova teória hry a jej relevancia pre súč
asné vzdelávanie detí
mladšieho školského veku
Miroslav Gejdoš, Ivana Prachárová ........................................................... 73
Inštitucionálna príprava a vzdelávanie učit
eliek v
Košiciach
do roku 1938
Miroslava Gallová ...................................................................................... 83
Zmeny a reformy slovinského vzdelávaci
eho systému od roku 1991
po súčasnosť
Alexandra Punčová .................................................................................. 102
Kooperatívne učenie ako prostriedok napĺňania
filozofie
inkluzívnej edukácie
Zdenka Zastková ...................................................................................... 108
Recenzie
........................................................................................................ 114
Contents
Preface
Ján Gera ........................................................................................................ 6
Motivation of Lifelong Learning Trainees for
the Teaching Profession
Kamil Janiš ml., Kamil Janiš st. ................................................................... 7
The Area of Environmental Education o
f Children of School Age
Mária Šoltésová, Lucia Dimunová ............................................................. 18
The Importance of Youth Pastoral Work
in the Progressive
Secularization of Czech Society
René Strouhal ............................................................................................. 23
Causes of School Cheating
Gabriela Gabrhelová, Dáša Porubčanová ................................................... 34
Ethical Model for Decision Making as a
Professional Tool
Lukáš Stárek ............................................................................................... 42
Three Pillars of Qualitative Transformat
ion of Teaching of Mother
Tongue I. (Framework Starting Points)
Milan Ligoš ................................................................................................ 58
Froebel's Theory of Play and its Relevance
for the Teaching
of Children of Younger School Age
Mirosla v Gejdoš, Ivana Prachárová ........................................................... 73
Institutional Training and Education of Wo
men Teachers in Košice
by 1938
Miroslava Gallová ...................................................................................... 83
Changes and Reforms of the Slovenian Education S
ystem from 1991
to the Present
Alexandra Punčová .................................................................................. 102
Cooperative Learning as a Means of Achieving
the Philosophy
of Inclusive Education
Zdenka Zastková ...................................................................................... 108
Critiques
....................................................................................................... 114
STUDIA SCIENTIFICA FACULTATIS PAEDAGOGI CAE
UNIVERSITAS CATHOLICA RUŽOMBEROK 2020, č. 3
5
Pr edhovor
Tret
ie tohtor
očné čís
lo vedec
kého čas
opisu „S
tudia Sci
entific
a Facult
atis
Paedagogicae Universitas Catholica Ružomberok“ ponúka pestrú paletu štúdií
na relevantné pedagogické témy.
Kam
il Janiš ml.
a Kam
il Janiš st.
sa zaobera
jú motivá
ciou frek
venta
ntov
celoživotného
vzdelávania
pre
výkon
učiteľskej
profesie.
Mária
Šoltésová
a Lucia Dimunová približujú výsledky prieskumu, ktorý realizovali v rámci
environmentálnej
výchovy
u
žiakov
druhého
stupňa
základnej
šk
oly.
René
Strouhal
sa
venuje
miere
v ýznamnosti pastorácie mládeže v postupujúcej
sekularizácii
českej
spoločnosti . O príčinách
školského
podvádzania
píšu
Gabriela
Gabrhelov
á a Dáša Porubč
anová. Luk
áš Stárek pojed
náva o dôlež
itosti
etických
aspektov
v
práci
pracovníkov
v
sociálnych
službách
s
ohľadom
na
využiteľnosť
Etického
modelu
rozhodovania sa.
Milan
Ligoš
približuje
rámcové východiská
kvalitatívnej
transform
ácie
výučby
materinského jazyka
v
európskom
v
zdelávacom
priestore.
Miroslav
Gejdoš
a I vana Prachárová
prezentujú analýzu teórie hry proponovanú významným nemeckým klasickým
pedagógom
Friedrichom
Fröbelom
a
dokumentujú
jej
prínos
pre
súčasné
primárne
vzdelávanie. Miroslav
a
Gallová
predstavuje
vzdelávanie
dievčat
a žien a ich prípravu na povolanie učiteľky na viacerých učiteľských ústavoch
v K ošicia ch do rok u 1938. A lexan dra Pun čová sa sú streďu je na zm eny a ref ormy
slovinského
vzdelávacieho
systému
za
posledných
30
rokov,
respektíve od
osam
ostat
nenia k
rajiny
po s
účasno
sť. Zd
enka Z
astkov
á spája
inkl
uzívnu
eduká
ciu
s kooperatívnym učením.
PaedDr. Ján Gera , PhD.
Gera, J .:
Preface
6
Pr eface
Th e t hird issue of th e sci entifi c jou rnal “ Studia Scie ntific a Fac ultati s
Paedagogicae Universitas Catholica Ružomberok” of this year brings a varied
palette of studies on relevant pedagogical topics.
Kam
il
Ja
niš
Jr.
a
nd
K
amil
Janiš
Sr.
deal
with
motivat
ion
of
l
ifelong
lear
ning
at
tendan
ts
for
th
e
teachi
ng
prof
ession
. Mária Šoltésová and
Lucia
Dimunová
introduce
the
results
of
the
research
they
implemented
within
environmental education of second ary school pupils. René Strouhal deals with
the impor
tance of pastoral care
of youth in the time of advanc
ing secularizati
on
of the Czech society. T
he causes of school cheating are discussed by Gabriela
Gabrhelová and Dáša Porubčanová. Lukáš Stá
rek
writes about the importance
of
ethical
aspects
in
the
work
of
social
services
workers
with
regard
to
usability of
the Ethical model for
decision making. Milan Ligoš
describes the
framework
starting
points
of
the
q
ualitative
transformation
of
teaching
the
mother
t ongue in European educational b ackground. Miroslav Gejdoš and
Ivana
Prachárová
present
the
analyses
of
the
game
theory
proposed
by
the
disting
uished classical Germ
an pedagogue Friedrich Fröbe
l
and
they
do
cument
its contribut
ion to
the curre
nt
pri
mary educa tion. Mirosla va Gallová introduces
education
of
girls
and
w
omen
and
their
trai
ning
for
teaching
profession
at
several teaching institutions in Košice since 1938. Alexandra Punčová focus
es
on
the
changes
and
reform
s
of
Slovenian
educational
system
in
the
last
30
years,
or
in
other
wo
rds –
since
country
independence
up
to
present
day.
Zdenka Zastková conjoins inclusive education w
ith cooperative learning.
PaedDr. Ján Gera , PhD.
STUDIA SCIENTIFICA FACULTATIS PAEDAGOGI CAE
UNIVERSITAS CATHOLICA RUŽOMBEROK 2020, č. 3
7
Motivace frekventan tů celoživotního vzděláván í
pro výkon učitelské profese
Motivation of Lifelong Learning Traine
es
for the Teaching Profession
Kamil Janiš ml.,
Kamil Janiš st.
Abstract
The lack
of teachers
is one
of the
factors t
hat threatens t
he functioning
of
education.
The
paper
deals
w
ith
the
presentation
of
data
obtained
from
the
trainees
of
the
lifelong
learning
course,
which
will
enable
them to meet
the qualification requirements for
the teaching profession.
The
aim of
our paper
is
to describe
and d
iscuss the
data that
describes
the motives of respondents leading to the subject.
Keywords: Teacher. Qualification. Study. Mo tivation.
Úvod
Česká
republ
ika
se
v
současné
době
potýk
á
a
v
blízké
budoucnosti
stále
potýkat
bude,
a
to
mnohem
závažněji, s nedost
atkem
učitelů
obecně
a učitelů s konkrétními předm ětovými aprobacemi. Chybějící počet učitelů se
pohybuje
v řádech jednotek tisíc. Významným faktorem, který umožňuje
velmi
negativní
predikci
daného
stavu
je
relativně
vy
soký
věkový
průměr
učitelů,
kdy
více
než
polovina
učitelů
je
starších
45
let
( Statistická ročenka
MŠMT [online]; Hlavní výstupy z Mimořádného šetření ke stavu zajištění
výuky učiteli v MŠ, ZŠ, SŠ a VOŠ [online]).
Ministerstvo
školství, mládeže
a
tělovýchovy
(dále j
en „MŠMT“)
se
tuto situaci s naží změnit tím, že uv olňuje nebo uvolníme podmínky pro uznání
kvalifikace
pro
učitele,
po
siluje
výuku
na
pedagogických
fakultách
jistými
bonifikacemi
(navýšením
rozpočtu),
zvyšováním platu
učitelů.
Tyto
všechny
podmínk
y jsou tedy někter
ými považová
ny jako
motivač
ní pro to, aby vstoupi
li
do školského systému.
V našem příspěvku jsme se zam ěřili na zjišťování důvodů, které vedli
vybranou
skupinu
jedinců
k tomu, aby si
doplnili
pedagogické
vzdělání
a splnili tak kvalifikační podmínky dané z ákonem. Domníváme se, že důvody,
které
k
takovému kroku
jedince
vedou se
následně
projevu
jí
v praxi a v jeho
kvalitě
výuky.
Cílem
našeho
příspěvku
je
popsat
a
diskutovat
zjištěná
data
popisující motivy respondentů vedoucí k
vý
konu učitelské profese.
Janiš ml., K.,
Janiš st., K.:
Motivace frekventantů celoživotního vzdělávání pro výkon učitelské profese
8
Metodologie výzkumu a její limity
Výzkumný
vzorek
byl
tvořen
frekventanty
kurzu
celoživotního
vzděláv
ání, jehož úspěšn
é dokončení vede ke spln
ění zákonných kva
lifikačních
předpok
ladů pro
v
ýkon učitelské profese na střední škole.
Celk
em se
výz
kumu
zúčastnilo
268
respondentů,
z nic
hž
254
bylo
žen
a
14
mužů.
Z tohot o
genderového nepoměru (který sice
odpov
ídá r
ozložení
ve školách základních)
nebyly
odpovědi
porovnávány
mezi
jednotlivým
i
pohlavím
i,
ale
na
základě
věkových
skupin.
Všichni
respondenti
měli
magisterské
vysokoškolské
(neučitelské)
vzdělávání,
popř.
jej
dokončovali
společně
s
daným
kurzem
celoživotního vzdělávání (dále jen CŽV)
.
V dotaz níku bylo vy užito škály Lik ertova typu . Respondenti odpovídali
na 5 stupňové škále (6. možnost byla „neuvažoval/a jsem o tom“), zda je
dané
t vrzení motivovalo k tomu, aby se stali učitelem /učitelkami.
K vy hodno cení a interp retaci dat by lo využit o tzv. znamén kové schém a.
V tabulkách č. 3 až 14 je v jednotlivých polích tabulky vždy nej výše uvedena
pozo
rovan
á
č
etnost
,
v
z
ávorc
e
po
d ní
vý
sledek z- skóre a pod výsl edkem z - sk óre
jsou
uvedena
znaménka z
něj
vyplývající. Tabulky
č. 1
a 2
jsou interpretační
pro vypočtené hodnoty z - skóre.
Z konstrukce jednotlivých otázek a jejich znění vyplývá, že jsme
nevyužili
celkovou
„šíři“ různorodých
motivů,
které
mohou
vést
jednotlivce
k tomu, aby se stal učitelem. Záměrně jsme vynechali otázky, které směřují na
smysluplnost učitelské profese,
jejího významu ve spol
ečnosti, touhu člověka
pozitivně
působit
na
mladé
lidi
apod.
Důvodem
nebylo,
že
bychom
takové
„motivy“
nepovažovali
za
významné,
v
některých
případech
naopak“,
ale
chtěli jsme se zaměřit na „motivy“ nižší. Tato skutečnost vyplynulo z
aktuální
situace
v České republice (viz výše), kdy j e učitelů všeobecně nedostatek,
zvyšuje se
jejich
věkový
průměr (srov.
Skopalová,
Janiš ml.,
2017) a
snahou
ústředních
orgánů (MŠMT)
je
přilákat do
škol
(všech
stupňů) právě
jedince,
kte
ří nevyst
udoval
i
u
čitelsk
é studijn
í program
y a
v
s
oučasn
é
d
obě tedy nes
plňují
zákonné podmínky pro výkon dané profese. Předpokládáme tedy, ž e motivace
těchto jedinců z
počátku vychází či vy
cházela z
nižších pohnutek.
Dalším
limitem
je
skutečnost,
že
volbu
povolání
mohou
ovlivnit
i faktory, které jsme v rámci našich proměnných nezachytili. Dále pak j sou
naše
výsledky
limitovány
celkovou
četností
respondentů,
kte
rou
rozhodně
nelze
pov
ažovat
za
nízkou,
ale
u
více
t
abulek
a
ve
více
polích
tabulky
je
četnost
příliš
nízká na
to,
abychom
mohli,
sice
platný, výsledek
významněji
generalizovat.
Analýza výsledky
Jednotlivé
výsledky
je
vždy
nutné
posuzo vat a hodnotit v kontextu
charakteristiky cílové skupiny.
STUDIA SCIENTIFICA FACULTATIS PAEDAGOGI CAE
UNIVERSITAS CATHOLICA RUŽOMBEROK 2020, č. 3
9
Tab. č. 1: Hodnota z -
skóre s
přiřazením znaménk
a
ZNAMÉNKO
INTERVAL
0
-1,96 < z
< 1,96
+
1,96 ≤ z < 2,58
+ +
2,58 ≤ z < 3,30
+ + +
3,30 ≤ z
-
-2,58 < z ≤
-1,96
- -
-3,30 < z ≤
-2,58
- - -
-3,30 > z
(Chráska, 2007, s. 75)
Tab. č. 2: I
nterpretace znaménkového schématu
ZNAMÉNKO
INTERPRETACE
0
Mezi
pozorovanou
a
očekávanou
četností
není
statisticky
významný
rozdíl.
+
Pozorovaná
četnost je
významně větší
než
četnost očekávaná
na
hladině
významnosti 0,05.
+ +
Pozorovaná
četnost je
významně větší
než
četnost očekávaná
na
hladině
významnosti 0,01.
+ + +
Pozorovaná
četnost je
významně větší
než
četnost očekávaná
na
hladině
významnosti 0,001.
-
Pozorovaná četnost
je významně menší než
četnost očekávaná na hladině
významnosti 0,05.
- -
Pozorovaná četnost
je významně menší než četnost
očekávaná na hladině
významnosti 0,01.
- - -
Pozorovaná četnost
je významně menší než četnost
očekávaná na hladině
významnosti 0,001.
(Chráska, 2007, s. 76)
Janiš ml., K.,
Janiš st., K.:
Motivace frekventantů celoživotního vzdělávání pro výkon učitelské profese
10
Tab. č. 3:
Chtěl/a jsem být vždy učitelem/uč
itelkou
věk
Rozhodně
ano
Spíše
ano
Tak
napůl
Spíše ne
Rozhodně
ne
Neuvažoval/a
jsem o tom
CELKEM
do 24
0
(-1,781)
0
1
(-1,808)
0
14
(5,092)
+ + +
4
(-0,345)
0
2
(-1,321)
0
2
(-0,397)
0
23
25 -
30
9
(1,061)
0
13
(0,770)
0
15
(1,063)
0
12
(-0,033)
0
11
(-0,156)
0
0
(-3,122)
- -
60
31 -
45
11
(-0,862)
0
25
(1,090)
0
17
(-2,079)
-
22
(-0,545)
0
23
(0,171)
0
17
(1,480)
0
118
46 -
65
10
(1,119)
0
10
(-0,821)
0
8
(-1,934)
0
16
(0,879)
0
12
(-0,270)
0
11
(1,566)
0
67
CELKEM
30
49
54
54
51
30
268 S vědomím, že nikdo z dotazovaných nemá vystudovaný studijní
program
učitelství,
tak
není
překvapující,
že
v
tab.
č.
3
převažuje
jakási
nerozhodnost
a
odpovědi,
které
signalizují,
že
dotazovaní
nechtěl
i
bý
t
v
ždy
učiteli a učitelkam
i.
Z
ajímavé jsou rozdíly v
jednotliv
ých věkových skupinách,
kdy
skupiny
mladší
jsou
spíše
nerozhodnější.
Signifikantní
je
to
zejména
u nejmladší věkové skupiny.
Tab. č. 4:
Bylo to velké přání mých rodičů
věk
Rozhodně
ano
Spíše
ano
Tak
napůl
Spíše ne
Rozhodně
ne
Neuvažoval
jsem o tom
CELKEM
do 24
0
(-0,935)
0
1
(-0,907)
0
3
(0,495)
0
7
(0,968)
0
9
(-0,346)
0
3
(0,171)
0
23
25 -
30
4
(1,615)
0
7
(0,584)
0
7
(0,465)
0
18
(1,606)
0
17
(-2,526)
-
7
(-0,074)
0
60
31 -
45
3
(-0,658)
0
10
(-0,602)
0
11
(-0,363)
0
23
(-1,009)
0
54
(0,947)
0
17
(1,104)
0
118
46 -
65
2
(-0,196)
0
8
(0,715)
0
6
(-0,352)
0
12
(-1,015)
0
34
(1,569)
0
5
(-1,305)
0
67
CELKEM
9
26
27
60
114
32
268 Vliv rodičů na budoucí povolání dětí je nepopiratelný, a to vliv přímý
i
nepřímý.
Není
výjimkou,
že
v
rodinách
existuje
i
určitá
učitelská
tradice.
Z výsledků z - skóre je zřejmé, že v celé tabulce (až na jednu výjimku)
neexistují
žádné
statisticky
významné
rozdíly
v
rámci
jednotlivých
skupin.
Z celkových četností ve sloupcích vyplývá, že rodina, resp. ze strany rodičů
nebylo
žádné
velké
přán
í,
aby
se
respondenti
stali
také
učiteli.
Opět
tuto
skutečnost
lze přisoudit
tomu,
že mají
vystudované
jiné obory
a
dál e nebylo
zjišťováno, jakou profesi vykonávají jejich
rodiče.
STUDIA SCIENTIFICA FACULTATIS PAEDAGOGI CAE
UNIVERSITAS CATHOLICA RUŽOMBEROK 2020, č. 3
11
Tab. č. 5 :
Studovat učitelství mi připadalo jednodu
ché
věk
Rozhodně
ano
Spíše
ano
Tak
napůl
Spíše ne
Rozhodně
ne
Neuvažoval
jsem o tom
CELKEM
do 24
0
(-1,221)
0
3
(-0,410)
0
4
(0,775)
0
7
(1,701)
0
5
(-1,038)
0
4
(0,030)
0
23
25 -
30
5
(1,047)
0
16
(2,545)
+
9
(0,719)
0
12
(0,569)
0
14
(-1,518)
0
4
(-2,448)
-
60
31 -
45
10
(1,818)
0
14
(-1,654)
0
15
(0,176)
0
17
(-1,195)
0
28
(-2,383)
-
34
(4,486)
+ + +
118
46 -
65
0
(-2,301)
0
10
(-0,288)
0
5
(-1,395)
0
11
(-0,278)
0
37
(4,866)
+ + +
4
(-2,806)
- -
67
CELKEM
15
43
33
47
84
46
268 U této otázky jejichž výsledky jsou uvedeny v tab. č. 5 musíme uznat,
že
m
ohla
vzbuzovat tzv.
sociální žádoucnost
odpovědi. Učitelstvím je
v
dané
otázce
myšlen
předmětný
kurz
C
ŽV.
Za
zajímavá
považujeme
u
vybrané
tabulky
dat
ve
dvou
polích,
a
to
že
nestarší
věková
skupina
rozhodně
nepovažuje
studium za
jednoduché.
To
lze
vysvětlit
nejen tí
m
,
že
získávané
informace a celkový průběh studia považuje za obtížný, ale
i tím, že jakékoliv
studium
považuje
za
obtížné,
a
to
na
z
ákladě
proměny
kognitivních
funkcí,
i když docilita je celoživotní. Druhým zajímavým výsledkem je, že významná
část druhé nejstarší věková skupiny nad daný
m nepřemýšlela.
Konstat
ujeme, že je
po
zitivní, že respondenti
spíš
e
nep
ovažují studium
za jednoduché. V
opačn
ém
případě by to
vedlo k
devalvaci samotné učitelské
profese.
Uvedené
konstatování
je
nut
né
konfrontovat
s
první
větou
našeho
komentáře k
dané tabulce.
Tab. č. 6 :
Být učitelem/učitelkou mi připadalo
jednoduché
věk
Rozhodně
ano
Spíše
ano
Tak
napůl
Spíše ne
Rozhodně
ne
Neuvažoval
jsem o tom
CELKEM
do 24
0
(-1,221)
0
3
(0,294)
0
3
(0,566)
0
6
(1,013)
0
7
(-0,018)
0
4
(-0,842)
0
23
25 -
30
5
(1,047)
0
9
(1,061)
0
5
(-0,406)
0
18
(2,665)
+ +
18
(-0,114)
0
5
(-3,325)
- - -
60
31 -
45
8
(0,747)
0
11
(-0,862)
0
13
(0,645)
0
15
(-2,093)
-
38
(0,506)
0
33
(1,125)
0
118
46 -
65
2
(-1,074)
0
7
(-0,224)
0
5
(-0,715)
0
10
(-0,821)
0
19
(-0,459)
0
24
(2,456)
+
67
CELKEM
15
30
26
49
82
66
268
Janiš ml., K.,
Janiš st., K.:
Motivace frekventantů celoživotního vzdělávání pro výkon učitelské profese
12
Výsledky v
tab.
č.
6
do
jisté
míry
kopírují
výsledky
v t abulce
předchozí.
Otázka však
neměla
a nemá
plnit
funkci zjišťování
tzv.
lži -
skóre.
Byla zařazena z
důvodu, že „představu“ o náročnosti studia si zpravidla každý
nedokáže
představit,
popř.
má
danou
„představu“
zprostředk
ovanou.
Avšak
s rolí učitele, jeho chováním, přístupem se setká (až na naprosté výjimky
způsobené
ně
jakým
zdravotním
postižením)
každý
z
nás.
V
průběhu
školní
docházky se setkáváme s
různými ty
py učitelů.
Z celkových výsledků je potěšující, že většině nepřipadá být učitelem
jako
jednoduché.
Tento
závěr
však
musíme
opět
konfrontovat
s
posledně
uvedeným odstavcem u tab. č. 5.
Tab. č. 7 :
Tak trochu z „nouze cnost“ (naskytla se
šance)
věk
Rozhodně
ano
Spíše
ano
Tak
napůl
Spíše ne
Rozhodně
ne
Neuvaž oval
jsem o tom
CELKEM
do 24
0
(-0,988)
0
5
(1,364)
0
5
(0,959)
0
4
(2,013)
+
7
(-2,228)
-
2
(-0,046)
0
23
25 -
30
0
(-1,731)
0
6
(-0,710)
0
10
(0,430)
0
7
(1,568)
0
36
(1,301)
0
1
(-2,244)
-
60
31 -
45
9
(2,985)
+ +
10
(-1,838)
0
11
(-2,283)
-
6
(-1,134)
0
65
(0,719)
0
17
(2,772)
+ +
118
46 -
65
1
(-1,116)
0
13
(1,907)
0
14
(1,584)
0
2
(-1,512)
0
33
(-0,636)
0
4
(-0,988)
0
67
CELKEM
10
34
40
19
141
24
268 U učitelské prof ese je při výkonu pro fese relativně poznat nezájem
o práci a její vykonávání jen
z nutnosti obživy. Kraus (2014) mj. uvádí
negativní typy pedagogů
a zmiňuje typ
tzv. lhostejného, který vykonává svou
profesi jen z důvodu, že nějakou práci m ít musí.
Z tab. č. 7 vyplývá , ž e sice v ětšina učitelů svou práci vyk onává nikoliv
z nouze
cnosti,
ale
z jiného důvodu, ale v ýznamná část naopak. Statis ticky
významné
rozdíly
v
jednotlivých
polích
j
sou
u
četností,
kde
se
setkáváme
spíše
s
rozdílem v
řádu
jednotek. Zajímavá
je zejména
kategorie nejmladších
učitelů,
jejichž četnost
i jsou relativně pra
videlně rozlož
eny. To nelze považ
ovat
za pozitivní signál do jejich budoucího pedag
ogického působení.
STUDIA SCIENTIFICA FACULTATIS PAEDAGOGI CAE
UNIVERSITAS CATHOLICA RUŽOMBEROK 2020, č. 3
13
Tab. č. 8 :
O učitele je všude zájem
věk
Rozhodně
ano
Spíše
ano
Tak
napůl
Spíše ne
Rozhodně
ne
Neuvažoval
jsem o tom
CELKEM
do 24
2
(-1,922)
0
8
(0,289)
0
5
(0,151)
0
3
(1,625)
0
2
(0,089)
0
3
(0,883)
0
23
25 -
30
11
(-1,422)
0
22
(0,862)
0
21
(3,152)
+ +
3
(-0,228)
0
3
(-1,028)
0
0
(-2,629)
- -
60
31 -
45
39
(2,562)
+
29
(-2,337)
-
22
(-0,675)
0
7
(0,212)
0
13
(1,485)
0
8
(-0,756)
0
118
46 -
65
16
(-0,324)
0
27
(1,662)
0
7
(-2,358)
-
2
(-1,074)
0
4
(-0,771)
0
11
(2,827)
+ +
67
CELKEM
68
86
55
15
22
22
268 Otázka u tab. č. 8 byla do jisté míry podobná otázce p ředešlé, ale
přesto z
jejího znění cítíme, že takový motiv je
pozitivnější, než výše uvedená
z nouze cnost. Není, zde však dominance v k ategorické odpovědi rozhodně
ano nebo rozhodně ne. V jednotlivých polích tabulky byly zazna m enány
statisticky
významné
rozdíly
mezi
pozorovanou
a
očekávanou
četností.
Z výsledků si můžeme klást otázku, proč j e druhá nejmladší kategorie
„nerozhodná“. Jednoznačnou odpověď
jsme nenalezli.
Tab. č. 9 :
Učitelé mají velkou prestiž ve spol
ečnosti
věk
Rozhodně
ano
Spíše
ano
Tak
napůl
Spíše ne
Rozhodně
ne
Neuvažoval
jsem o tom
CELKEM
do 24
1
(-0,706)
0
4
(0,521)
0
6
(-0,333)
0
6
(-0,046)
0
5
(0,296)
0
1
(0,402)
0
23
25 -
30
5
(0,040)
0
13
(2,004)
+
15
(-0,794)
0
20
(1,363)
0
6
(-2,091)
-
1
(-0,681)
0
60
31 -
45
8
(-0,756)
0
9
(-2,601)
- -
34
(-0,093)
0
33
(0,485)
0
28
(1,588)
0
6
(1,792)
0
118
46 -
65
8
(1,285)
0
11
(0,716)
0
23
(1,087)
0
12
(-1,838)
0
13
(0)
0
0
(-1,658)
0
67
CELKEM
22
37
78
71
52
8
268 Každý z nás chce vykonávat ve svém životě zaměstnání, které je
společno
stí uznávané
. Domníváme se, že toto by mě
lo být i jedním z určujících
motivů pro to, když se někdo rozhodně stát se učitele
m. Z
tab. č.
9 vyplývá, že
sami
respondenti se
nedomnívají,
že
by
učitelská profese
byla
vnímána
jako
prestiž
ní.
St
atisticky význam
né
roz
díly se
opě
t
v
té
to
tabu
lce objevují v polích,
kde jsou rozdíly mezi pozorovanou a oček
ávanou četností v
rámci jednotek.
Janiš ml., K.,
Janiš st., K.:
Motivace frekventantů celoživotního vzdělávání pro výkon učitelské profese
14
Tab. č. 10 :
Učitelům se neustále zvyšují platy
věk
Rozhodně
ano
Spíše
ano
Tak
napůl
Spíše ne
Rozhodně
ne
Neuvažoval
jsem o tom
CELKEM
do 24
2
(-1,166)
0
4
(-0,683)
0
6
(0,039)
0
7
(1,517)
0
2
(-0,046)
0
2
(0,577)
0
23
25 -
30
9
(-0,587)
0
15
(0,389)
0
16
(0,185)
0
12
(0,303)
0
4
(-0,705)
0
4
(0,258)
0
60
31 -
45
25
(1,393)
0
30
(0,788)
0
30
(-0,107)
0
16
(-1,900)
0
10
(-0,244)
0
7
(-0,023)
0
118
46 -
65
11
(-1,762)
0
13
(-0,836)
0
17
(-0,081)
0
15
(0,905)
0
8
(0,988)
0
3
(-0,595)
0
67
CELKEM
47
62
69
50
24
16
268 Výběr profese je přirozeně ovlivněn i určitými benefity , které přináší.
Jedním
z
nich
je
určitá
jistota
v
růstu
platu,
která
j
e
dána
nejenom
dle
platných
tabulek
založených
na
započítaných letech,
ale
i
tím,
že
platy
jsou
pravidelně
zvyšovány.
Z
tab.
č. 10
vyplývá,
že
tato
skutečnost
je
pro
respondenty
motivační
či
alespoň
částečně.
V
tabulce
nebyly
zaznamenány
žádné statisticky významné rozdíly.
Tab. č. 11 :
Poměrně krátká denní pracovní doba
věk
Rozhodně
ano
Spíše
ano
Tak
napůl
Spíše ne
Rozhodně
ne
Neuvaž oval
jsem o tom
CELKEM
do 24
4
(-0,803)
0
5
(-0,659)
0
6
(0,445)
0
5
(1,439)
0
2
(-0,397)
0
1
(0,715)
0
23
25 -
30
14
(-0,189)
0
13
(-1,169)
0
18
(1,606)
0
10
(1,165)
0
4
(-1,263)
0
1
(-0,340)
0
60
31 -
45
37
(2,406)
+
38
(1,491)
0
21
(-1,599)
0
8
(-2,445)
-
11
(-0,862)
0
3
(0,298)
0
118
46 -
65
10
(-2,057)
-
18
(-0,158)
0
15
(0)
0
10
(0,751)
0
13
(2,461)
+
1
(-0,477)
0
67
CELKEM
65
74
60
33
30
6
268 Dalším benefitem , který spíše vnímán laickou veřejností, je relativně
krátká
denní
pracovní
doba.
Tato
představa
však
může
být
zkreslující
a nereflektující přípravu učitelů, tvorbu didaktických materiálů a dalších
pomůcek (tedy
nepřímou pedagogickou činnost), které
pravidelně aktualizují.
Záleží
tedy
na
přístupu
pedagoga.
Z
tab.
č.
11
plyne,
že
se
jedná
o
m otiv,
který
v
íce
než
polov
ina
dotazovaných
považovala
za
významný
pro
volnu
jejich profes
e.
Z
ajímavá skutečnost
je ta, že těch, kteří nad daným neuvažoval
i
je nejméně (společně s
tab. č. 12).
STUDIA SCIENTIFICA FACULTATIS PAEDAGOGI CAE
UNIVERSITAS CATHOLICA RUŽOMBEROK 2020, č. 3
15
Tab. č. 12 :
Dva měsíce prázdnin a samé vo
lno
věk
Rozhodně
ano
Spíše
ano
Tak
napůl
Spíše ne
Rozhodně
ne
Neuvažoval
jsem o tom
CELKEM
do 24
5
(-1,001)
0
4
(-0,763)
0
7
(0,723)
0
4
(1,061)
0
2
(0,089)
0
1
(0,920)
0
23
25 -
30
16
(-0,818)
0
14
(-0,113)
0
16
(0,495)
0
4
(-1,176)
0
9
(2,175)
+
1
(-0,129)
0
60
31 -
45
44
(1,984)
+
32
(1,103)
0
28
(-0,177)
0
12
(-0,304)
0
0
(-4,342)
- - -
2
(0,183)
0
118
46 -
65
18
(-0,839)
0
14
(-0,662)
0
14
(-0,741)
0
9
(0,795)
0
11
(2,827)
+ +
1
(-0,261)
0
67
CELKEM
83
64
65
29
22
5
268 V tab. č. 12 jsou uvedeny výsledky odpovědí na otázku, který laická
veřejnost
vnímá
jako
ten
ne
jvětší
benefit
učitelsk
é
profese,
a
který
je
často
prezentován v
kontextu požadavků učitelů. Na
zvýšení platů. Ve smyslu: „Co
by ještě ch
těli, vždyť ma
jí furt prázdn
iny.“ Z výs ledků vidíme, že opět převaž ují
možnosti
odpovědí,
ze
kterých
lz
e
určit,
že
daná
skutečnost
je
významným
faktorem.
U
věkové
skupiny 31
až
45
let
se
jedná
o
dominantní
faktor,
což
potvrzuje nulová četnost a výsledek z -
skóre u m
ožnosti rozhodně ne .
Tab. č. 13 :
Konečně mne bude někdo poslouchat
věk
Rozhodně
ano
Spíše
ano
Tak
napůl
Spíše ne
Rozhodně
ne
Neuvažoval
jsem o tom
CELKEM
do 24
0
(-0,435)
0
3
(1,763)
0
3
(-0,363)
0
6
(0,957)
0
6
(-2,665)
- -
5
(2,863)
+ +
23
25 -
30
0
(-0,762)
0
3
(-0,088)
0
6
(-1,372)
0
16
(1,808)
0
33
(0,421)
0
2
(-1,287)
0
60
31 -
45
2
(1,600)
0
5
(-0,644)
0
15
(-1,182)
0
24
(0,627)
0
67
(1,212)
0
4
(-2,093)
-
118
46 -
65
0
(-0,820)
0
3
(-0,317)
0
17
(2,522)
+
4
(-3,078)
- -
35
(-0,071)
0
8
(1,786)
0
67
CELKEM
2
14
42
50
141
19
268 Danou otázku v tab. č. 13 jsme nezařadili z důvodu, že bychom chtěli
respondenty
nějak
pobavit,
ale
z
v
lastní
praxe
víme,
že
existuje
určitá
část
učitelů,
kteří
svou
profesi
vykonávají
z
důvodu,
že
mají
publikum
(žáky),
kteří
je
poslouchají.
Tímto
si
však
kompenzují
určitý
nedostatek
ve
svém
občanském
životě.
Potěšující
je,
že
většina
dotazovaných
tuto
skutečnost
nevnímala
jako
motiv.
Ale
zanedbatelná
není
ani
skupina
nerozhodných
respondentů.
Statisticky
významné
rozdíly
jsou
o
pět
v
polích,
kde
se
jedná
o rozdíly v řádech jednotek.
Janiš ml., K.,
Janiš st., K.:
Motivace frekventantů celoživotního vzdělávání pro výkon učitelské profese
16
Tab. č. 14 :
Přesvědčil mne můj učitel/ka
věk
Rozhodně
ano
Spíše
ano
Tak
napůl
Spíše ne
Rozhodně
ne
Neuvažoval
jsem o tom
CELKEM
do 24
0
(-1,038)
0
2
(1,161)
0
2
(-0,109)
0
5
(2,595)
+ +
12
(-1,383)
0
2
(-0,109)
0
23
25 -
30
5
(1,874)
0
2
(-0,342)
0
12
(3,226)
+ +
4
(-0,383)
0
35
(-1,287)
0
2
(-1,812)
0
60
31 -
45
6
(0,717)
0
7
(1,338)
0
7
(-1,696)
0
7
(-1,029)
0
76
(-0,272)
0
15
(1,689)
0
118
46 -
65
0
(-1,955)
0
0
(-1,955)
0
4
(-1,091)
0
5
(-0,131)
0
52
(2,445)
+
6
(-0,121)
0
67
CELKEM
11
11
25
21
175
25
268 Na úplný závěr našeho dotazníku jsme zařadili otázku, která přinesla
nejjednoznačnější odpověď a vyjádření respondentů. Uvedené
vý
sledky
v tab.
č.
14.
je
nutné
interpretovat
v
kontextu
charakteristik
cílové
skupiny.
Z dat
vyplývá,
že
čím
starší
věková
skupina,
tím
jsou
méně
ovlivněny
svým
učitelem.
Vzhledem
k
tomu,
že
ani
jeden
dotazovaný
nemá
vystudovaný
magisterský
učitelský
obor,
je
zjevné,
že
se
původně
jeho
myšlenky
na
budoucí
profesi
ubíraly
jiným
směrem.
Mladší
respondenti
tak
mají
více
v paměti svého učitele.
Závěr
Z výsledků vyplývá, že jedněmi z nejsilnějších motivů pro výkon
učitelsk
é profese jsou jisté benefity
, které přináší. Mezi jednot
livými věkovým
i
skupinami
a
ani
uvnitř
nich
nebyly
zaznamenány
přílišné
a
časté
statisticky
významné rozdíly.
V našem výzkumu jsme se nezaměřili na celé spektrum různých
motivů, ale
jak jsme již
předznam
enali
v
první části
příspěvk
u,
tak na motivy
nižší úrovně. Z
námi zjištěných dat pro praxi
plyne následující:
Zvyšovat prestiž učitelské profese tak, aby možnost ji vykonávat byla
sama
o sobě motivující. Tuto skutečnost lze zajistit efektivnější
komunikací
mezi
rodinou
a
školou.
Zaváděním
inovativních
metod
a prvků učení aj. Nesmíme zapom ínat, že učitele hodnotí rodiče.
Prezentovat široké veřejnosti sk utečnou náplň učitelské profese tak,
aby
byla vnímána
každá
její
součást tedy
nejen
přímá,
ale i
nepřímá
pedagogická
či
nnost.
K
tomuto
lze
opět
využít
široké
spektrum
komunikačních kanálů (sociální sítě, webové s
tránky apod.).
Na základě četnosti zastoupení věkových skupin, tak motivovat mladé
lidi
k tomu, aby se vydali na učitelskou kariéru, a to systémem
podpory
z
ačínajících učit
elů, uvádějícím
i učiteli, metodic
kou podporou
v praxi apod.
STUDIA SCIENTIFICA FACULTATIS PAEDAGOGI CAE
UNIVERSITAS CATHOLICA RUŽOMBEROK 2020, č. 3
17
Z několik výše uvedený ch bodů vyplývá, že se do jisté míry j edná
o marketing a o činnosti, které je relativně jednoduché naplňovat, alespoň to
tak
lze
vnímat.
Z
výzkumu
Janiše
ml.
a
Skopalové
(2017)
mj.
vyplývá,
že
jedny z nejčastějších problematických situací ve škole jsou problémy s rodiči
žáků
nikoliv
se
žáky
samotnými.
Je
tedy
důležité
neustále
hledat
cesty,
jak
naplňovat
nám
i
uvedený
bod
první,
i
když
chápeme,
že
se
mnohdy
j
edná
o Sisyfovskou práci.
Bibliografie
Hlavní výstupy z Mimořádného šetření ke s
tavu zajištění výuky učiteli v MŠ,
ZŠ, SŠ a VOŠ . [online][cit. 20. 3. 2020] . Dostupné z :
<http://www.msmt.cz/file/50371/>
CHRÁ
SKA , Mirosl av. Me tody p edago gického výzk umu: zá klady kvant itativ ního
výzkumu . Praha: Grada, 2007. ISBN 978-80-247-1369-4.
KRAUS, Blahoslav. Základy sociální pedagogiky . Vyd. 2. Praha: Portál,
2014. ISBN 978-80-262-0643-9.
SKOPALOVÁ , Jitka a
JANIŠ , Kamil. Profesní připravenos t učitelů
základních škol v oblasti řešení rizikového cho
vání a možnosti jeho
prevence v Moravskoslezském kraji. I, Pedagog
ické aspekty . Opava:
Slezská univerzita v Opavě, Fakulta veřejný
ch politik, 2017.
ISBN 978-80-7510-235-5.
Statistická ročenka MŠMT. [online][cit. 21. 3. 2020 ]. Dostupné z:
<http://toiler.uiv.cz/rocenka/rocenka.as
p>
Mgr. Kamil Janiš, Ph.D.
Katedra tělesné výchovy a sportu
Univerzita Hradec Králové ,
Pedagogická fakulta
U Pivovarské Flošny 296/3, Hradec Králové, Česká re
publika
[email protected]
D oc. PhDr. et PaedDr. Kamil Janiš, CSc.
Ústav pedagogických a psychologických v
ěd
Slezská univerzita v Opavě , Fakulta
veřejných po
litik v Opavě
Bezručovo nám. 14, 746 01 Opava, Česká repub
lika
[email protected]
Šoltésová, M., Dimunová, L.:
Oblasť environmentálnej výchovy u detí školského veku
18
Oblasť environmentálnej výchovy u detí šk olského veku
The Area of Environmental Education of Chi ldren
of School Age
Mária Šoltésová, Lucia Dimunová
Abstract
The
aim
of the
paper
is
to
present the
results
of
the
research
we have
carried
out within
the e
nvironmental education
of p
upils of
the seco
nd
stage
of
primary
school.
We
focused
on
information
in
the
field
of
wast
e
so
rting,
ele
ctrosmo
g
an
d
th
e
u
se of
in
formati
on and communic
ation
equi
pment. The
f
indings
of the survey
sh
ow that pup
ils are kept
u
p- to
-date
on topics related to environmental education.
Keywords: Enviromenal education. Electrosmog . Gender. Waste separation.
Úvod
Problematika
env
ironmentálnej
výc hovy v
súvislosti
s
čoraz
v
äčším
vply
vom člove
ka na jeho životn
é prostre
die predst
avuje jedn
u
z najak tuálne jších
tém
súčasnosti. Jej
význam podči
ark
uje
aj
fakt, že
environmentálna
vý
chova
je
prierezovou
témou
v
rámci
štátneho
vzdelávacieho
programu
(Fryková,
2012).
O životnom prostredí môžeme rozprávať ako o
komplexnom
mnoho-
zložkovom
systéme,
ktorý
je
vytv
orený
a
určený
fyzikálnym,
chemickým,
biologi
ckým a
sociálnym prostre
dím, v
ktorom človek žije a
realizuje kultúr
ne,
soci
álne,
mater
iálne
a
biolo
gické
potre
by (Urm
inská
, 2010
). V
ži
votnom
pros
tredí
sa stretáv
ame s
veľkým
množstvom fyz
ikálnych fak
torov, ktoré môž
u pozitívne
no v ko nečnom dôsled ku aj negatív ne ovplyvňov ať kvalitu ž ivota. Envir onmen -
tálna výchova
na druhom stupni
základných škôl je
prierezová téma,
ktorá sa
prelína
najmä s
biológiou,
chémiou a
geografiou.
Na formovaní
environmen -
tálneho poved
omia žiakov sa
po
dieľajú aj spoločensko -
v
edné predmety, najmä
občianska a etická výchova, slovenský jazyk a literatúra. Cieľom environmen -
táln
ej vých
ovy
je pr
ispieť
k rozvo ju osobn osti žia ka tak, ab y v obl asti ved omostí ,
zručností
a
schopností
nadobudol
schopnosť
chápať,
analyzovať
a
hodnotiť
vzťahy medzi čl
ovek
om
a
jeho životným prostredím.
Tieto zručnosti získa na
základe
poznania
zákonov,
ktorými
sa
riadi
život
na
Zemi,
pochopením
súvislosti
medzi vývojom
ľudskej
populácie a
vzťahom
k
prostrediu.
Taktiež
chápaním
súvislostí
medzi
globálnymi
a
lokálnymi
problémami
a
najmä
vlastnej zodpovednosti vo vzťahu k prostrediu (MŽP SR, 2015). Cieľom
STUDIA SCIENTIFICA FACULTATIS PAEDAGOGI CAE
UNIVERSITAS CATHOLICA RUŽOMBEROK 2020, č. 3
19
environmentálnej
výchovy
j
e
aj
komplexný
prístup
k
environmentálnym
problémom
s prihliadnutím
na
Listinu
základných práv
a
slobôd,
v ktorej
sa
okrem iného
píše, že
každý človek
má právo
na priaznivé
životné prostredie,
má pr
ávo na vč
asné a úpl
né inform
ácie
o
stave živ
otného
prostr
edia a p rírodn ých
zdr
ojov,
pričom
nikto
nesmie
pri v
ýkone
svojic
h práv
ohroz
ovať a
ni poš
kodzov
ať
životné
prostredie,
prírodné
zdroje,
druhové
bohatstvo
prírody
a
kultúrne
pamiatky
nad
mieru
ustanovenú
zákonom.
Tieto
základné
e
tické
a
morálne
pri ncípy je potrebné systematicky rozv íjať aj u žiakov na základnej škole.
Rezortná
koncepcia environmentálnej
výchovy,
vzdelávania
a osvety
do rok
u 2025 (M
ŽP SR) up
riamuj
e pozor
nosť na t
ri pilier
e určen
é na zvyš
ovanie
environmentálneho
povedomia:
environmentálnu
výchovu,
environmentálne
vzdelávanie
a osvetu. V
rámci
stanovených
priorít
sa
zameriava
na
environ -
mentálne rizikové faktory
v
jednotlivých odvetviach. Eliminácia environmen -
tálnych
rizikových
faktorov je jedn
ou z
nosnýc
h tém environm
entálnej výc
hovy
u žiakov základných škôl.
V duchu tejto myšlienky sme sa rozhodli realizovať
prieskum.
Jeho hlavným cieľom bolo z istiť, ak é ma jú deti školského veku
informácie
o
možných
environmentálnych
rizikových
faktoroch.
Zamerali
sme
sa na
informácie
z oblasti trie
denia odpadu,
elektrosmogu
a využívania
informačno - komunikačných zariadení (m obilov, počítačov, smartfónov).
Metodika
Súbor tvorili deti navštevujúce druhý stupeň základnej školy. Celkovo
sa
do
prieskumu
zapojilo
146
žiakov
– 69 (47 %) chlapcov a 77 (53 %)
dievčat
vo
veku
12 -
15
rok
ov.
Metódou
zberu
údajo
v
bol
dotazník
vlas
tnej
konštrukcie. Zber dát sa
realizoval v
januári a
februári 2020 v
košickom kraji.
Na
spracovanie
údajov
sme
využili
deskriptívnu
a
i
ndukt
ívnu
štatistiku
(Pearsonov chí - kvadrát test na hladine výz namnosti α = 0.05).
Výsledky
Triedením
odpadov
šetríme
primárne
zdroje
surovín
a
vytvárame
predpoklad pre
zabezpečenie
proce
su
recyklácie odpadov.
V oblasti t riedeni a
odpadu
sme sa
zamerali na
informovanosť o správnej separácií plastov, skla
a papiera do farebne označených kontajnerov. Z počtu 146 opýtaných žiakov
priradilo
správne
plastový
odpad
k
farbe
kontajneru
n
=
113
(77,4
%)
detí,
sklo
n =
100 (68,5
%) detí
a
papier
n =
116
(79,5 %)
detí. V
tabuľke
č.
1 sú
uveden
é
od
povede na základe pohlavia. Zisťov
ali sme
a
j,
či existu
je štatisticky
významný
rozdiel
medzi
i
nformov
anosťou
a
pohlav
ím.
Chí -
kvadrát
testom
neboli zistene signifikantné rozdiely.
Šoltésová, M., Dimunová, L.:
Oblasť environmentálnej výchovy u detí školského veku
20
Tabuľka č. 1 : Informovanosť žiakov o separácii odpadov (n = 146)
Separácia
materiálu
chlapci
dievčatá
správna
odpoveď
n (%)
nesprávna
odpoveď
n (%)
správna
odpoveď
n (%)
nesprávna
odpoveď
n (%)
χ 2
p
plast
51 (73,9)
18 (26,1)
62 (80,5)
15 (19,5)
0,429
0,225
sklo
44 (63,8)
25 (36,2)
56 (72,7)
21 (27,3)
0,286
0,162
papier
54 (78,3)
15 (21,7)
62 (80,5)
15(19,5)
0,838
0,447
χ 2 - Chí - kvadrát test (p < 0.05) Elektrosmog alebo „znečistenie elektrinou“ predstavuje elektro -
magnetické
vlnenie,
ktoré
je
um
elo
vyrobené
človek
om.
Možno
ho
merať
a vyhodnocovať prostredníctvom špeciálnych meracích zariadení. Zvýšená
hladina
elektrosmo
gu má dopad
na naše z
dravie. Info
rmovanosť
detí o
význam
e
slova elektrosmog sm e zisťovali v ďalšej otázk e. Medzi elektromagnetické
vlnenie,
ktoré
sa
stáva súčasťou
každodenného
života
u
deti
školského
veku
môžeme
zaradiť
okrem
iného
aj
tablety,
notebooky,
mobilné
telefóny
a počítače. Pojem elektros mog je pre viaceré deti nez námy, o čom svedčí
odpoveď
„neviem“
od
49
(33,6
%)
žiakov
.
Správnu
odpoveď,
že
sa
j
edn
á
o znečisťovanie pro
stredia elektrinou uviedlo len 78 (5 3,3 %) žiakov.
Fenoménom
súčasne
doby
je
využívanie
technológii
vo
zvýšenom
množstve
najmä
u
detí.
Ďalšou
otázkou
sme
zisťovali koľko času de nne
venujú
žiaci
práci s
telefónom
a počítačom . Podrobné údaje sú uvedené
v tabuľke č. 2. Údaje poukazujú, že na počítači trávia viac času chlapci ako
dievčatá.
Zaujímavým
zistením
bolo, že
pri
používaní mobilného
telefónu to
bolo
naopak. Pri
mobilno
m
tele fóne, a to viac ako 60 minút, trávia viac času
dievčatá
n
=
45
(58,4 %) ako chlapci n = 35 (50,7 %). Sledovali sme aj
signifikantnú
závislosť
medzi
pohlaviami.
Zistili
sme
signifikantný
rozdiel
v dĺžke trávenia času s počítačom, a
to
v neprospech
chlapcov (p
<
0,05).
V dĺžke používania mobilu počas dňa sme signifikantné interpohlavné
rozdiely nezistili (p ˃ 0,05).
Tabuľka č. 2 : Čas žiakov strávený na počítač i a telefóne počas dňa (n = 146)
Čas denne/
počítač
0 minút
n (%)
> 30 min
n (%)
30 -60 min
n (%)
> 60 min
n (%)
neviem
n (%)
χ 2
p
Chlapci
11 (15,9)
10 (14,5)
19 (27,5)
23 (33,3)
6 (8,8)
20,748
,000
Dievčatá
30 (38,9)
21 (27,3)
14 (18,2)
8 (10,4)
4 (5,2)
Spolu
41 (28,1)
31 (21,2)
33 (22,6)
31 (21,2)
10 (6,9)
Čas denne/
mobil
Chlapci
3 (4,3)
9 (13)
19 (27,5)
35 (50,7)
3 (4,3)
2,662
,616
Dievčatá
1 (1,3)
6 (7,8)
21 (27,3)
45 (58,4)
4 (5,2)
Spolu
4 (2,7)
15 (10,3)
40 (27,4)
80 (54,8)
7 (4,8)
χ 2 - Chí - kvadrát test (p < 0.05)
STUDIA SCIENTIFICA FACULTATIS PAEDAGOGI CAE
UNIVERSITAS CATHOLICA RUŽOMBEROK 2020, č. 3
21
Problematike mobilných telefónov sme sa venovali hlbšie, nakoľko sú
známe
negatívne
účinky
najmä
na
psychické
zdravie.
Našim
záujmom
bolo
zistiť,
či
žiaci používajú telefón, aby som sa cítili lepšie
,
keď
im
je
nanič.
Podľa
nášho
prieskum
u
až
64
(43,8
%) ži
akov
sa
nevie
vyjadriť,
či využíva
telefón
na
zlepšenie
psychického
stavu,
čo
považujeme
za
vysoké
číslo.
V rámci rodových rozdielov sme zistili signifikantný rozdiel v neprospech
chla
pcov,
vy
počíta
ná hodno
ta chí = 10,7
84; p = 0,013 (p
< 0,
05). Naš
e
v
ýsled ky
sa odlišujú
od výsledkov štúdie HBSC (2019)
realizovanej na Slovensku, kde
chlapci a dievčatá uvádzali v rovnakej miere, že používajú svoj telefón, aby sa
cítili
lepšie,
keď
im
je
na
nič.
Tento
rozdiel
je
možné
vysvetliť
lokálnym
rozdielom
ale
súčasne
aj
naznačuje,
že
je
po
trebnú
tento
fenomén
naďalej
sledovať. Na
základe výsledkov považujeme využívanie
mobilných telefónov
za rizikový faktor, ktorému je potrebné venov
ať pozornosť.
Záver
Enviromentálna
výchova
vedie
žiakov
ku
komplexnému
pochopeniu
vzájomného vzťahu
človeka
k
životném
u
prostrediu. Dôležitosť
environmen -
tálnej
výchovy
na
základných
školách
je
bezpochybne
opodstatnená.
Náš
prieskum
poukazuje na
nie
veľmi
dostatočnú i
nfo
rmovanosť
u
detí
v proble-
matike triedenia odpadu. Znepokojujúcim je aj čas, ktorý trávia deti na mobile
a po čítači . Výsledk y ďalej pou kazujú , že je veľmi dôl ežité ži akom inte nzívne jšie
priblíži
ť
prob
lematiku elektros
mogu a
poukázať na jeho
dôs
ledky. Máme zato,
že environmentálna výchova vytvára
tento priestor a prijatie
informácií deťmi
môže pozitívne ovplyvniť aj rodičov.
Bibliografia
HBSC. Sociálne determinanty zdrav
ia školákov. vyd. Úrad verejného
zdravotníctva SR, 2019. 203 s. ISBN 978 -80- 7159-242-6.
FRYKOVÁ, E. Environmentálna výchov
a v
edukačnom procese. Bratislava:
Metodick
o- pedagog ické centrum , 2012. 6 4 s. ISBN 9 78 - 80 - 8052 - 441 - 8.
MŽP SR –
Ministerstvo životného prostredia S
lovenskej republiky a jeho
rezortné organizácie. Rezortná koncepci
a environmentálnej výchovy,
vzdelávania a
osvety do roku 2025. vyd. MŽ
P SR, 2015. 35 s.
URMINS
KÁ, J. 2010.
Potenciáln
y vplyv vy
braného g
eochemickéh
o prostredia
na zdravotný stav detskej populácie v
oblasti žiarsk
ej kotliny. 1. vyd.
Nitra: Slovenská poľnohospodárska univerzita Ni tra. 69 s.
ISBN 978-80-552-0399-7.
Šoltésová, M., Dimunová, L.:
Oblasť environmentálnej výchovy u detí školského veku
22
Ing. Bc. Mária Šoltésová
Vysoká škola zdravotníctva a
sociálnej práce sv
. Alžbety
Detašované pracovisko bl. Sáry Salkaháziov
ej Rožňava
Kósu Schoppera 22, 048 01 Rožňava
[email protected]
Doc. PhDr. Lucia Dimunová, PhD .
Ústav ošetrovateľstva
Univerzita Pavla Jozefa Šafárika v
Košiciach, Lek
árska fakulta
Tr. SNP č. 1,
040 22 Košice
[email protected]
STUDIA SCIENTIFICA FACULTATIS PAEDAGOGI CAE
UNIVERSITAS CATHOLICA RUŽOMBEROK 2020, č. 3
23
Míra významnosti pastorace mládeže
v postupující sekularizaci česk
é společnosti
The Importance of Youth Pastoral Wor
k
in the Progressive Secularization of Czech Soc
iety
René Strouhal
Abstract
The younger
generations are classified
as a hope
for the future
in many
fields.
In
the
pastoral
work
of
the
Church,
the
formation
of
young
Christians
is
borne
by
its
relevance.
Both
the
solid
statistical
data
of
soci
ologists
of religion
and our resear
ch have contri
buted to the dis
cussion
of such an accent by the
auth
ority of the
Chu
rch. Shifting the experience
of faith
from quantity
to inner
quality and an
adequate offer
of pastoral
activiti
es for young p
eople are becomin
g new starting
points.
Keywords: Youth. Pastoral care. Privatizat ion of faith. Secularization.
Specialized surveys.
A ntropologické konsekvence a otázky relevantnos ti pastorace mládeže
Každá nová mladá
ge
nerace je nadějí pro budoucnost
1
nejen z hlediska
biologického
či
z
hlediska
kulturní
antropologie
nebo
evoluční
psy
chologie,
ale i
z pozic etických a spirituálních, vede se i nezřídka manipuluje k různým
budoucím hodnotám a je akcentována
její edukace a vůbec formace.
Z antropologického hlediska subkultury mládeže percipujeme jako
velk
é skupin
y mladý
ch (dosp
ívajíc
ích) lidí
, kteří
m
ají spol
ečného
něco (pr
oblém,
zájem, zvyk),
co je
odlišuje od
členů ostatních
sociálních skupin,
vztahují ke
specifickým
způsobům
chování,
vykazují
silný sklon
k
určitým hodnotovým
preferencím, akceptování či zavrhování určitých nor
em a životních stylů.
2
1
Srov. BENEDIKT XVI . Spe salvi , článek 25.
2
Srov. THORNTON, S., s. 1 – 7.
Strouhal, R.:
Míra významnosti pastorace mládeže
v postupující sekularizaci české společnosti
24
Konkrétněji je
charakterizuje styl jako
hudba, tanec,
oblečení, úprava
těla
apod.,
čemuž
členové
subkultur
přikládají
specifický
význam
a
který
současně
tímto
vyhraněním
determinuje
hranice
vůči
jiným
subkulturám
a uskupením vně subkultury
3
. Jejich styl je vyjádřen následujícími prv
ky:
1) image – vzhled, tj. oblečení, účes, různé doplňky, tetování;
2) vystupo vání – tvoř ené výrazem tváře, sty lem chůze a postojem t ěla;
3) argot – speciální slovní zásoba a způsob, jakým je pronášena.
4
V rámci specifické péče o věřící , která se nazývá
pojmem past
orace
5
,
je
na
formaci
mládeže
rovněž
kladen
velký
důraz, a to dokonce au toritou
církve. Je však otázkou, zda je vůbec relevantní. Všeobecně a v jisté
nezávislosti na
aktivity
církve ji
lze hodnotit
z
pozice
sociologie náboženství
na
základě
pevných
statistických
dat
kvantitativního
výzkumu
vyjadřující
zájem mládeže o spiritualitu:
‒ Extrémně malá identifikace české populace a zejména české mládeže
s církvem
i vyvolává zdán
í, jako by se otázka spirit
uality české m
ládeže
vůbec
netýkala.
Tento
dojem
je
ještě
umocněn
společenským
pově -
domím,
v
němž
člověk,
který
se
veřejně
zajímá
o
duchovní
život,
vybočuje z
většinově žitých norem.
‒ Pochybnost o relevanci tématu spi rituality je v současném českém
prostředí
způsobena
zejména
trojím
zjednodušením
,
které
je
v
naší
společnosti velmi rozšířené:
1) nereflektované automatické ztotožnění spirituality s křesťan
-
stvím,
2) ztotožnění víry v Boha s příslušností k něk teré církvi, zejména
k církvi katolické,
3) ztotož nění obsahu křesťansk é ví ry se zjedn odušenou formu lací
některých dogmat.
‒ Podle výzkumu spirituality mládeže:
33% se deklarovalo jako ateisté (nevěří v žádného Boha),
3
Srov. KOLÁ ŘOVÁ , M., Hudební subkultury mládeže v současné ČR – postsubkulturní či
postsocialistické? , s. 233.
4
Srov. BRAKE , M., Comparative Youth Culture, s. 224.
5 V iEncyklopedii.cz se uvádí, že slovo pastýř pochází z latinského slova pastor. V Bibli se tak
obrazně
nazývají králové
a představení,
přičem
ž
nejvyšším pastýřem
je
Bůh
a Ježíš
je dobrý
pastýř, jen
ž dává
život za
své
stádo. Rozšířením
pak byl
tento
výraz vztažen
na
biskupy jako
před
staven
é
k
řesťan
ských společen
ství. Srov. htt p://ww w.ienc ykloped ie.cz/ pastyr /. V Teo logick ém
slovníku
Karla Rahnera
se dočteme,
že pastýř
a stádo
jsou v
Izraeli a
v No
vém
zákoně běžné
a důležité obrazy , jež popisují vztah Boha k jeho lidu jako osobní, star ostlivý a záchranný.
Dnes
je
tento
obraz těžko
použitelný, pro
tože výrazem
„stádo“ bývá
označována tupá,
shora
řízená
masa. V
katolické
církvi se
pod pojmem
pastorace
rozumí
péče
a doprovázení
lidí ve
víře a v prožívání celého života. Srov. RAHNER, K., Teologický slovník , s. 236.
STUDIA SCIENTIFICA FACULTATIS PAEDAGOGI CAE
UNIVERSITAS CATHOLICA RUŽOMBEROK 2020, č. 3
25
29% se zařadilo do sk upiny „je nerozhodný, agnostik, neví,
zda je Bůh, nepatří k žádné náboženské skupině“,
26% se označilo jako věřící (8% jako praktikující, 18% jako
nepraktikující).
‒ Nábože nství tedy před stavuje kladno u hodnotu minim álně pro ¼ mladé
populace v ČR, téměř každý třetí nemá v
této otázce jasno a zbytek se
k této otá zce staví buď lhostejně nebo odm ítavě. Jednoznačn é je pouze
to, že většina mládeže se k žádné círk
vi přímo nehlásí.
‒ Důležitým j evem j e takzvaná sekulární religiozita, tedy hledání
transcendentního rozměru v běžném
životě:
‒ K duchovním skutečnostem evidovaným ve výzkumné popul aci
mládeže se řadí hledání přátelství, lásky
a sounáležitosti.
6
Církev
proklamuje,
že
je
důl
ežité
věnovat
se
mládeži
ze
všech
sociálních
oblastí,
to
znamená
středoškolákům,
vysokoškolákům,
učňům,
pracujícím
i
nezaměstnaným.
Je
důležité,
aby
kněží
a
další
zodpovědní
za
pastoraci mládeže
měli čas
na osobní
setkání s
mladými
lidmi. J
ejí pastorace
mládeže
má
být
záležitostí celé
církve
a
jejím
úkolem
je
pomáhat
mladému
člověku klást si otázky a napomáhat m
u nacházet na ně správné odpovědi.
7
Církev
m
á
být
pro
mladé
lidi
domovem,
kde
se
m
ladý
člověk
cítí
přijat i přes svou odlišnost a často i kritičnost a kde cítí být m
ezi svými.
8
S tím
kolerují
její
snahy
o
budování
i
nterní
sociální
struktury:
mladí
potřebují
zázemí,
ve
kterém
se
budou
cítit
pochopeni
a
př
ijati,
a
kde
se
ve
svých
postojích
budou
navzájem
povzbuzovat.
9 Nabízí zázemí a zároveň hájí
formační
axiom,
že
sami
mladí
lidé
musí
být
z
apojeni
jako
aktivní
činitelé
života církve.
10
Afirmace Plenárního sněmu
Čeští
a
moravští
biskupové 5.
č
ervence
1997
na
Velehradě
vyhlásili
Plenární
sněm
katolické
církve v České republice
11
.
Dle
jeho
reflexe
se
situace mládeže v české společnosti rapidně změnila, a to zejména v oblasti
demografické,
sociální,
kulturní
a
náboženské.
Známé
sociální
ten dence,
6
Srov.
EUROPEAN
COMMISSION. Eu robarometer public opinion in the Eu ropean union ,
s. 101 – 255.
7
Srov. S EKCE PRO MLÁDEŽ ČESKÉ BISKUPSKÉ KONFERE NCE , Pastorační plán sekce
pro mládež ČBK , s. 14 – 15.
8 Srov. tamtéž, s. 16.
9
Srov. Závěry 17. konferenc e o mláde ži Sekce pro mládež České biskupské konf erence , dostupné
z: https://cbk.blob.core.windows.net/cms/CirkevOld/015696.pdf
10
Srov. JAN PAVEL II., Christifideles laici , článek 46.
11 Sněm se chronologicky členil na několik fá zí a vytvořil osm sněmovních komisí, které po
dva roky
zpracovávaly stanovená témata
ze života a
poslání křesťanů v
církvi v naší
zemi i ve
světě a byly v trvalém kontaktu mezi sebou i s vedením sněmu.
Strouhal, R.:
Míra významnosti pastorace mládeže
v postupující sekularizaci české společnosti
26
jakými jsou
nárůst násilných trestných činů pác
haný
ch
dětmi a dospívajícími,
jsou
pro
církev
velkou
pastorační
výzvou.
Jen
malá
část
mladých
lidí
je
oslovena pastoračními aktivitami církv
e. Tvoří ji:
1) mladí lidé v církvi plně socializovaní a k ní loajální,
2) ti, kdo své místo v církvi teprve začínají n acházet,
3) i ti, kdo využívají služeb církve bez ohledu na vlastní náboženské
přesvědčení.
Z povahy svého věku mladí křesťané mají mnohdy spoustu výhrad
vůči
praxi
nebo
nauce
církve.
Tuto
kritičnost,
ačkoli
je
někdy
podána
provokativní
formou,
nelze
pouze
odmítat,
je
ji
potřeba
rovněž
chápat
jako
příležitost
k
dialogu
a
k
zamýšlení
se
nad
naší
past
orační
praxí.
To
klade
nároky
na schopnost kněží,
jáhnů i dalších pastorační
ch
pra
covníků partnersk
y
doprovázet
a
moudře poradit,
lidsky
a
pravdivě přiblížit
evangelium.
Církev
tak
s otevřeností může nabídnout dom ov, aniž by uspíšila proces konverze.
Prot
o mají být mlad
í
l
idé akcept
ováni ve far
ních spol
ečenstv
ích s porozu
měním
,
podporováni
ve
svý
ch
dobrých
snahách,
k j
ejichž
realizac
i
nejsou
dost
silní,
a přitom konfrontováni s jednoznačnými postoji v oblasti víry i m orálky, které
nejsou podávány moralizujícím nebo odsuz
ujícím způsobem.
Faktor náboženských specifik České repub
liky
Relaci
mezi
náboženstvím
a
společností
ozřejmuje
již
Durkheim
ve své teorii, podle níž je náboženství klíčovým faktorem pro pochopení
základn
ích sociologický
ch otázek: jak se vytváří a udržuje integrita společ
nosti
nebo jaký je vztah jedince k
ní ( „náboženství je jednotný systém víry a praktik
vztahujících se k
posvátným věcem“ ).
12
N áboženské chování je efektivní zjišťovat nejen skrze návštěvnost
bohoslužeb
13
,
kladením
otázek
o víře
v B oha, ale i dotazováním se např. na
člověka převyšující skutečnosti či informace o
religiozitě z
celorepublikov
ého
sčítání
lidu,
domů
a
bytů.
14 A konečně využít je možné také data z příle -
žitostných
či opakovaných
sociologických průzkumů
státních
či soukromých
institucí (Institut pro výzkum veřejného mínění IVVM,
Středisko empirických
výzkumů STEM, aj. ).
12
Srov. VÁCLAVÍK,
D., Náboženství a moderní česká společnost,
s. 10 –
11.
13 Ve všech dosavadních výzkumech návštěvnosti bohoslužeb v různých evropských zemích je
v zásadě zachováno následující pořadí zemí: země s vysokou účastí (Irsko, Polsko, Portugalsko,
Slov
ensko)
a na opačné m k onci země s ní zkou účast í. Srov. VÁVRA M., Jak zji š ťovat návš těvnos t
bohoslužeb? Problémy s
měřením náboženského fenoménu .
14 Nábo ženské vy znání bylo v rám ci SLDB zjišťo váno od vz niku Českos lovensk a/Česk é republik y
v letech 1921, 1930, 1950, 1991, 2001 a 2011. Údaje o náboženském vyznání obyvatel ze
SLDB j sou využívá ny zejména pro formulování dlouhodobé koncepce uspořádání vztahu mezi
státem
a církv
emi a náboženskými spol
ečnostmi i pro vyhodno
cování nábožensk
é svobody v ČR.
Využívají je také jednotlivé církve a náboženské sp
olečnostii nevládní organizace, sociologická
a vědecká pracoviště apod.
STUDIA SCIENTIFICA FACULTATIS PAEDAGOGI CAE
UNIVERSITAS CATHOLICA RUŽOMBEROK 2020, č. 3
27
Religiozita
může
být
studována
na
pozadí
obe
cných
společenských
hodnoto
vých orientací (např.
výz
nam duchovních strán
ek života v hodnotovém
žebříčk
u
jedin
ců).
Da
lším možným výzkumem je zjišťování místa náboženst
ví
v osobním životě jednotlivců.
15
Religioz ita měřená otázkou na víru v Boha vykazovala v počátku
druhého
tisíciletí vcelku
stabilní výsledky
(zhruba jedna
třetina
populace ČR
je
věřící,
50
%
je
ateistů
a
jedna
p
ětina
nemá
v
této
otázce
jasno).
K
víře
v Boha se hlásí tém ěř polovina osob starších 60 let, v ostatních věkových
skupinách se
podíl věřících
pohybu
je
mezi jednou
pětinou a j
ednou čtvrtinou
věřících.
16
Naše
společnost je
tvořena
zhruba
půl na
půl
bezvěrci a
religiózními
lidmi
(pevnou
víru
v
Boha
a
silné
náboženské
přesvědčení
v
šak
deklaruje
pouze necelá
pětina z nich).
Do náboženského
života se řadí
i mnoho
dalších
činností
kultovního
i
mimokultovního
charakteru
(modlení,
svěcení
nábo -
ženských svátků, vyznávání nábožensk ých symbolů, přednášková, výchovná
i propagandistická činnost – úča st na náboženské výchově, di skuse o nábo -
ženství, studium náboženské
literatury
aj.). Součástí náboženského chování je
rovněž znalost
a vyznávání náboženské etik
y a hodnot.
Důležitou
součást
náboženského
přesvědčení a
vz
tahu
k
náboženství
představuje vědomí o k
onečnosti lidského ž
ivota, a to i v případě necírkevních
forem.
17 Vědomí vlastní smrtelnosti má vliv na náboženské i nenáboženské
postoje většiny
lidí, obojí
se odráží
v
jejich konkrétním „zacházení
se smrtí“,
pohřebních
obřadech
(či
j
ejich
absenci).
P ostoj
e
české
společnosti
jsou
v tomto ohledu světovým unikátem. V našem národě je výskyt církevních
pohřbů i kremací velmi nízký .
18
Při
interpretaci
výsledků
výzkumů
r
eligiozity
se
musí
postupovat
obezřetně,
neboť
individuální
víru
člověka
je
nesnadné
jednoznačně
převést
do forma
lizovaného jazy
ka empirický
ch výzkumů, ne
ní možné vždy posti
hnout
rozdílná
osobní
pojetí
víry
a
pro
zjišťování
religiozity
má
velký
význam
15 Generační přenos vztahu k náboženství (přenos rodinnou tradicí) je dle výzkumů STEM
velmi
silný.
Podle
některýc
h
výzkumů až
75
% nábožensky
založených lidí
pochází
z rodin,
kde nábož
enství bylo důle
žitou součástí
hodnotové orie
ntace. Srov. HABERL
OVÁ, V., Problé my
empirického zkoumání religiozity v
české společnosti, [2011: online].
16
Srov. HA BERLOVÁ, V., Problémy empirického zkoumání religiozity v české společnosti,
[2011: online].
17 Někteří autoři se domnívají, že právě smrt je jednou z hlavních příčin vzniku náboženství,
res
p. jednou z je ho hlavníc h fu nkcí je právě „vy rovnáv ání se smrtí“ . Na př. dle brits kého sociá lního
antropolo
ga Bronislawa Mal
inowského je smrt nejdůl
ežitějším prame
nem náboženství.
Am
erický
sociolog
ná
boženství Thomas
O´De
a
vy
mezil mezi svými šesti základní
mi funkcemi náboženst
ví
také
„ú
těchu a podpo
ru při akcepta
ci smrti a přísl
ib posmrtn
é
ex
istenc
e“. Srov.
NEŠ
POROVÁ, O. ,
Existenciální dimenze současné církevní zbožnosti, s. 39-40.
18
V ČR je podíl kre mací (tedy pohřbů žehem v krematoriích) na všech uskutečně ných pohřbech
75,9 % (rok 2000), což je zdaleka nejvy
šší podíl v
Evropě. Srov. NEŠPOR , Z. , VÁCLAVÍK , D.,
Příručka sociologie náboženství, s. 180.
Strouhal, R.:
Míra významnosti pastorace mládeže
v postupující sekularizaci české společnosti
28
odlišení víry v „osobního“ Boha od pojetí boha jako universální
síly, která
řídí
a organizuje svět.
19
Mají - li lidé odpovědět na otázku, ke kterém u vyznání se hlásí, jejich
odpo
věď na výzku
mnou otáz
ku může být moti
vována
ce
lou řadou
s
ubjekti
vních
faktorů
a
ateistická
sebedeklarace
ještě
nemusí
znamenat
odmítání
transcen -
dentna (např. může jít o
demonstrat ivní odpor vůči církvím). Počet lidí, kteří
se
nepovažují
za
členy
církví,
ale v
„něco“
věří,
daleko
převyšuje
počet
oficiálních věřících i
ateistů u nás (v některých
případech může jít o
polovinu
až
dvě
t
řetiny
české
populace).
20 Můžeme se v ní setkat s ji stou formou
religioz
ity zejména pros
třednictvím alte
rnativní, detr
adicionaliz
ované a privátní
podoby náboženství.
21
S ociologové náboženství se dom nívají, že historický vývoj národa
s v elkou pravd ěpodo bností vytv ořil skrytý po tenciá l k je ho výrazn é sek ulariz aci,
která s
e významně
projevila
až v
obdob
í státního ate
ismu v le tech 1948- 1989.
22
V evropských zemích včetně té české přetrvává navzdory j ejich
sekularizovanému
charakteru
vcelku
vysoká
v
íra
v
nadpřirozeno
č
i
alespoň
podmínk
y
pr
o
ni, ale jedná se spíše o
k
vazinábože
nské představy, názory
nebo
činnosti,
které
stojí
mimo
oficiální
církevní
věrouku,
proto
je
označujeme
generálně termínem alternativní religioz
ita.
23
Většina výzkumů religiozity v ČR byla dosud
zam
ěřena na
její menší,
tj. institucionalizovaný segment (příslušnost k cír kv i, návštěvnost bohoslužeb
aj.).
Analyzováním
religiózních
jevů v
českém národě
v
celé
jejich šíři
(tedy
i mimocírkevních) se v ČR (kromě několika výzkumů z
90.
let
20.
stol.)
v prvn ím desetiletí tohoto tisíc iletí zabýv al zejména vý zkum Detradi cionalizace
a i
ndividual
izace
náboženství v
České
republice (DI N 2006), jehož výsledky,
doplněné
o informace z
obdobných
výzkumů,
např. Mezinárodní program
19 Např . z výzkumu ST EM, prová děného tímto způs obem, vyš el podíl ne věřícíc h v naší spo lečnos ti
na zhruba jednu pětinu populace a 43 % lidí uvedlo víru v nějakou duchovní či životní sílu.
20 Údaje o „klasické“ (oficiál ní, institucionalizo vané) religiozitě tedy stále méně a mé ně odrážejí
náboženskou situaci současné moderní společnosti.
21 Individualizovaná a detradicionalizované religiozita v ČR je často omezena na úzké rodinné
či
přátelskékruhy,
na
nejrůznější
spirituální
společenství
nebo
na
„náboženský
konzum“
jednotlivců (ten
se projevuje např.velkým
zájmem o duchovní
a terapeutickou literaturu,
různé
formy spirituálního
rozvoje osobnosti
či
magickénebo okultní
praktiky a
horoskopy). Z to
hoto
pohledu je česká společnost daleko méně nenábo
ženská, než se naprvní pohled jeví či než sama
sebe
nazírá
(spirituální
zájmy
přitom často
ovlivňují
i
sociální jednání,
spotřebu i
celou
řadu
dalších oblastí lidského života a jednání).
22 Jak je patrné z údajů SLDB z let 1921, 1930 a 1950, byl v této dob ě stabilní p očet věřících
(92,82
%,
92,19 % a 93,90 %) a (z dnešního pohledu) re lativně nízký podíl lidí bez vyz nání
(7,16 %, 7,8 % a 5,84 %). S
LDB z roku 1991 však již generuje pouze 43,9 % věřících a 39,9 %
lidí bez
vyznání a SLDB z
roku
2001 dokonce pouze
32,2 % věřících
a 59 % lidí
bez vyznání.
Srov. LUŽNÝ, D., NAVRÁTILO VÁ
,
J., Náboženství a sekularizace v České republice
[2011:
online].
23 Současná hnutí tohoto typu navaz ují na v Evropě bohatou historickou tradici alternativní
religiozity (od gnosticismu, přes hermetismus, neoplatonismus až
k okultismu).
STUDIA SCIENTIFICA FACULTATIS PAEDAGOGI CAE
UNIVERSITAS CATHOLICA RUŽOMBEROK 2020, č. 3
29
sociální
ho
výzk
umu (I SSP – In ternational Social Survey Program , 1992- 2005)
či Evropská studie hodnot (EVS – European Value Survey , 1999), nabízí
konkrétnější
obraz
o
alternativních
formách
r eligioz ity v ČR. V roce 2007
se také opakoval výzkum Religio zita v reformovaný ch zemích východo(stře -
do)evropských z roku 1997 (AUFBR 2007) . Ze závěrů těchto šetření vyplývá,
že ačkoliv Češi neprojevují velký zájem o
tradiční církevní religiozitu, je mez
i
nimi značně rozšířena víra v
nadpřirozené jevy. Výzkumy potvrdily, že trendy
na poli religiozity
z 90.
let 20.
stole tí, které potvrdil také cenzus z
roku 2001
a 2011
(SLDB),
v české společnosti pokračují a současně je pokračujícím
jevem intenzita odcírkevnění. Česká společnost více než za sekulární b y se
dala označit za necírkevní .
24
Zpětná vazba výzkumného šetření
K optim álnímu monitorování a analyzování co nejpravdivější míry
a formy
religiozity
v České republice není možné pracovat jen na základě
SLDB, sociologických výzkumů či údajů jednotlivých náboženských sdružení
a církví, ale je nutné využít také specializované průzk umy, jež poskytují dle
závěrů soci
olog
ů
náboženství nejbohatší
materiál ke
studiu současného
stavu
religiozity.
Tvrzení o
relevantnosti zaměření se na
pastorační péči o mládež
jsme
se snažili konfirm
ovat alespoň nějakým výzkumným
šetřen
ím. Byly sta noveny
výzkumné
metody
s
ohledem
na
zmíněnou
intenci
předmětu
zkoumání
a formulování cílů, kterých mělo být dosaženo. Náš výzkum je charakte
-
rizován užitím
techniky dotazníku
a
následný
m
použitím matematicko -statis-
tické procedury.
Bylo
užito
dotazník
ového
šetření,
komparační
metody
a
Likertovy
škály,
přičemž
u
posledně
uvedené
m
etody
škálování
(vytváření
škál)
byl
o
významné, že
pomocí této
metody lze
zachytit určité
náboženské kvalitativní
jevy v kvantitativní podobě a dobře inform
uje o míře stupně souhlasu či.
Jako
zkoumaná
populace
byli
vybráni
respondenti,
kteří
praktiku
jí
křesťanskou
víru,
a
to
z
řad
laiků
a
duchovních
z
různých
druhů
farností:
tradičních
většinových
(většina
obyvatel
obce
se
cítí
být
součástí
farnosti),
menšinových
(
kostel
je
plný,
farnost
živá,
ale
zasahuje
to
jen
menšinu
obyvatel
obce)
a
vymírajících
nebo
již
prakticky
neexistujících
(nemůžeme
reálně očekávat její vnitřní regeneraci).
Výběr byl zamýšlen
a realizován lokálně ze všech
regiónů naší vlasti,
věkově
od
nejmladších
s plnol
etostí
po
seniory,
muži
i
ženy
.
C
elkem
se
do
výzkumu zapojilo 72 respondentů.
24
K alternativní religiozitě inklinují na základě zjištěných údajů lidé mladší a také ti, kteří dříve
dle vlastního
tvrzení sice navštěvovali bohoslužby,
ale ne příliš často.
Srov. HAMPLOVÁ, D.,
Čemu Češi věří: dimenze soudobé české religiozity, s. 709-711.
Strouhal, R.:
Míra významnosti pastorace mládeže
v postupující sekularizaci české společnosti
30
Tabulka 1: Respondenti dle pohlaví v pro
centech
Muži
Ženy
Věřící laici
50
50
Kněží
100
-
Celkem
69
31
Tabulka 2: Respondenti dle vzdělání v p
rocentech
Základní
Vyučen/a
Maturita
Vysokoškolské
Věřící laici
-
-
18
82
Kněží
-
-
-
100
Celkem
0
0
11
89
Tabulka 3: Respondenti dle typu farnosti v proc
entech
Farnost tradiční
Farnost menšinová
Farnost vymírající
Věřící laici
18
82
-
Kněží
3,6
78,6
17,8
Celkem
12,5
80,6
6,9
Graf 1: Akcentace oblastí evangelizace a pastorace
Na
sedmi
st
upňov
é
škále
významnosti
pastorační
péče
o
m
ládež
u věříc ích laiků zaujímá prv ní místo s hod notou 6,8 Liker tovy stupnice, u kněží
se
nachází na
třetím místě
s hodnotou 5,5 Likertovy
škály
po
pastoraci rodin
a pastoraci nemocných.
Její
vysoké
hodnocení
v
míře
významnosti
svědčí
o relevantnosti
akcenta
ce shora uved
eného typu p
astorační péče
církve a rov
něž z
pozic
e kněží,
kteří
jsou
primárním
i
činiteli
komplexní
pastorace, lze
vnímat
nutnost
jejího
zakotvení v
širším prostoru rodiny jako z
ákladní buňky
církve a společnosti.
STUDIA SCIENTIFICA FACULTATIS PAEDAGOGI CAE
UNIVERSITAS CATHOLICA RUŽOMBEROK 2020, č. 3
31
Zralá reflexe víry jako východiska
Fokusu
jeme – li směrem k pastorac i mládeže, lz e konstatov at, že v Česk é
republic
e
je celkov
ě
zaz
namenán pokles zájmu o náboženské
skupi
ny. Nejvíce
je tomu
u skupiny v r ozm ezí 15 – 18 let, jež se výrazně posunuje k prioritám
konzumní
společnosti,
a
to
jak
svou
hodnotovou
stupnicí,
tak
způsobem
života. Na
oblast náboženství
se v
současné době
nejvíce orientují mladí
lidé
ve
v
ěku
kolem
20
let.
Jako
iniciující
fak
tor
zde
může
být
potřeba
hledán
í
smyslu
života a
bytí
i osobní
existencionální krize.
I
zde byl
však
diagnosti -
ková
n posun z
ájmu k vn
itřní a ne
organiz
ované
spiritu
alitě.
Tím se rov
něž otev
írá
nový
a
netradiční
prostor
pro
oslovení
mladý
ch
lidí
z
hlediska
duchovního
rozměru člověka.
25
Za tohoto předpokladu
by pastorace mládeže měla pokračovat nikoliv
množe
ním akcí,
ale
přede
vším jejich zkvalitněn
ím a
hledán
ím nových přístupů
ve stávající
ch aktivitách.
26 Může doko nce recipročně pomáha t vy tvářet v církvi
pros
tor k věd
oměji pro
žívan
é spiritu
alitě,
která ze
své podst
aty nab
ídne odp
ovědi
hledajícím , aby i pastorace ostatních skupin byla více expanzivní a
otev
řená .
27
Vždyť fo
rmovaný mladý
věřící v
dnešní
m světě veřejné
diskuze a
při
používání
moderních forem sdělovacích prostředků přispívá k utváření veřejného mínění
ve společnosti i církvi a osvojuje si schopnost rozeznávat různé podoby
manipulací a propagandy a
formovat si svá stanov
iska a
hodnotové soudy.
Pastorační
možnosti
formace
mladých
jsou
pak
různé:
duchovní
prog
ramy a boh osluž by, život v mo dliteb ních skupi nách, syste matick é p rogram y
rozhovorů
nad
Biblí
a o
víře,
duchovní
poradenství
a
doprovázení
pro
české
i zahraniční studenty, duchovní cvičení a obnovy, pomoc při duchovním
r ozlišování, přípravy k přijetí svátostí, kulturní, hudební a umělecké tvůrč í
aktivi
ty, poutě a sportovní č innosti, vz dělávací a diskusní poř ady a před nášky.
28
Plodem a stěžejním měřítkem kvality pastorace mládež
e se takto stává
předávání
konkrétní odpovědno sti za
živé
slavení liturgie,
solidní
vzdělávání
ve víře, misijní nasazení, moudrost v rozlišování povolání, diakonický rozměr
i schopnost spolupodílet se
na fungování nutného zázemí farností a podobně.
I proto je akcenta
ce formace mládež
e v
pastoračním
ús
ilí církve a nejen v jejím
konání relevantní.
25
Srov. SAK, P., Proměny české mládeže
, s. 131 –
145.
26 Česká biskupská konference schválila pod číslem ČBK 45 - XVII – 5 - c „Pastorační plán
Sekce
pro
mládež
ČBK“ : h ttps://cbk.blob.core.windows.net/cm s/ContentItems/297_00297/21 -
pastoracni-plan.pdf
27
Srov. FRANTIŠEK , Evangelii gaudium , článek 31.
28
Srov. ČESKÁ BISKUPSKÁ KONF ERENCE , Koncep ce vysoko školské pastorace v České
republice , článek 13.
Strouhal, R.:
Míra významnosti pastorace mládeže
v postupující sekularizaci české společnosti
32
Bibliografie
BENEDIKT XVI. Spe salvi, O křesťanské nadě ji . Encyklika. Přeložil Prokop
Brož. 1. vyd. Praha: Paulínky, 2008. 63 s. I
SBN 978 -80-86949-41-3.
BRAKE, Mike. Comparative Youth Culture
. 1. vy d. Londýn: Routledge,
1990. 238 s. ISBN 13-978-0415051088.
ČESKÁ BISKUPSKÁ KONF ERENCE. Koncepce v ysokoškolské pastorace
v České republice . Praha: ČBK, 2017. Pro vnitřní po třebu. ISBN
neuvedeno.
FRANTIŠEK. Evangelii gaudium . Apoštolská e xhort ace o hlásání evangelia
v současném světě. Přeložil Milan Glaser. 1. v yd. Praha: Paulínky,
2014. 83 s. ISBN 978-80-7450-118-0.
EUROPEAN COMMISSION. Eurobarometer pub lic opinion in the European
union . 1. vyd. Brusel: Directorate-General Press and Communication,
2002. ISBN neuvedeno.
HABERLOVÁ, Věra. Problémy empirického z koumání religiozity v české
společnosti. In: <http://www.stem.cz/clanek /406> [2011: online]
HAMPLOVÁ, D ana. Čemu Češi věří: dimenze so udobé české religiozity.
In: Sociologický časopis,
4/2008: 703-723.
iEncyklopedie.cz [online]. Praha: 2007 [cit. 2012-
03- 31]. Dostupné z:
http://www.iencyklopedie.cz/pastyr/.
JAN PAVEL II., Christifideles laici . O povolání a pos lání laiků v církvi a ve
světě. Posynodní list. Překladatel neuveden. 1. vy
d. Praha: Zvon, 1990.
69 s. ISBN 80-7113-162-8.
KOLÁŘOVÁ , Marta. Hudební subkultury mlá deže v současné ČR –
postsubkulturní či postsocialistické? In DA NIEL , Ondřej, KAVKA,
Tomáš, MACHEK
, Jakub. Populární kultura v čes kém prostoru ,
s. 323 –
248. 1. vyd. Praha: Karolinum, 2013. 328
s.
ISBN 978-80-246-2192-0.
LUŽNÝ, Dušan, NAVRÁTILOVÁ , Jolana. Nábo ženství a sekularizace
v České republice. In: <http://snem.cirkev.cz/downlo ad/Luzny.htm>
[online]
NEŠPOR, Zdeněk. Ústřední vývojové trendy so učasné české religiozity. In:
Jaká víra? Současná česká religiozita/spir
itualita z
pohledu kvalitativní
sociologie náboženství. Sociologické studie 5/2004. Praha: 21 -37.
NEŠPOROVÁ, Olga. Existenciální dimenze souč asné církevní zbožnosti.
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86429-92-2.
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[online]. Praha: 2002 [cit. 2012-03-31], s. 14- 15. Dostupné z:
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tems/297_00297/21-
pastoracni-plan.pdf.
THORNTON, Sarah. General Introduction
. I
n GELDER, Ken, THORNTON,
Sarah. The subcultures reader
, s. 1 –
7. 1. vyd. London:
Routledge,
1997. 599 s. ISBN 0415127270.
VÁCLAVÍK, David. Náboženství a moderní čes ká společnost. 1. vyd. Praha:
Grada, 2010. 243 s. ISBN 978-80-247-2468-3.
VÁVRA, Martin. Jak zjišťovat návštěvnost bohos lužeb? Problémy s měřením
náboženského fenoménu . In
Naše společnost 7/ 1, s. 32 – 39. Praha :
Centrum pro výzkum veřejného mínění, S
ociologický ústav AV ČR,
2009. ISSN 1214-438X.
PhDr. Mgr. René Strouhal
Římskokatolická farnost Moutnice
Moutnice 248, 664 55 Moutnice
[email protected]
Gabrhelová, G., Porubčanová, D.:
Príčiny školského podvádzania
34
Príčiny školského podvádzania
Causes of School Cheating
Gabriela Gabrhelová, Dáša Porubčanová
Abstract
The article analyzes the theoretical
basis of the issue of school cheating.
It
clarifies
the
phenomenon
of
school
cheating
in
connection
with
scientif
ic
know
ledge and
result
s
of renowned experts on an
int
ernational
scale with an
emphasis on ethical-moral,
socio-psychological and peda
-
gogi
cal-did
actic as
pects in
the educa
tional c
ondition
s of seco
ndary sch
ools.
The co
ntribution was process
ed within the
solution of
the grant
project
KEGA
no.
001DTI-4/2018
Cheating
in
the
schools
as
a
problematic
aspect of
evaluating the
results of
the educational
process in
secondary
sc hools.
Keywords: Cheating. Education. School. Teach er. Teen-student.
Úvod
Pri
analýze
domácich i
zahraničných
zdrojov
vo
vzťahu k
skúmaniu
príčin, (dô
vodov, motív
ov) školského podv
ádzania žiakov
, nachádzame viac
eré
spolupôsobiace
aspekty
negatívnych
tendencii
správania
žiakov.
Vrbová,
Stuchlíková,
(2012)
uvádzajú,
že
podvádzanie
sa
st
alo
všade
prítomným
problémom
školského vzdelávania
na
všetkých
jeho úrovniach.
Na
vedeckej
úrovni
sa
danej problematike
venujú
mnohí
slovenskí i
zahraniční
odborníci
(Ciz
ek, 2 003 ; Panákov á, 2011; D avis, Dri nan, Gal lant, 200 9; Bajtoš , Honzík ová,
2019) a ďalší.
Pri
vym
edzení
pojmu školské podvádzanie
sa stretávame
s viacerými
neja
snosťa
mi. Pr
esne p
ojem ch
arakt
erizov
ať je p
roblem
atick
é. Pod
ľa odbo
rníkov
,
podvádzanie
v
škole
identifikujú
tri
znaky.
Je
to
porušovanie
stanovených
školských pravidiel, prinášanie výhody voči
ostatným spolužiakom a zníženie
spoľahlivosti
a
presnosti
pedagogického
hodnotenia
(
Cizek
,
2003;
Mareš,
2005, s. 312).
Detekc
ia príčin škols
kého podvádz
ania je v odbor
nej literatúre a výsku -
moch najčastejšie charakterizovaná v dvoch rovinách. Prvá rovina sa prepája
s osobnostnými predispozíciami žiakov . Druhú rovinu tvoria situačné a kon-
textuálné faktory, ako prediktory podvádzania. V týchto súvislostiach budeme
analyzovať príčiny školského podvádzania.
STUDIA SCIENTIFICA FACULTATIS PAEDAGOGI CAE
UNIVERSITAS CATHOLICA RUŽOMBEROK 2020, č. 3
35
Osobnostné
predispozície žiaka a ko príčina školského podvádzania
Axiolog
ickým prístupom
k problé
mu podvádzania
sa zaobe
ral Kolberg
(1976).
Skúmal väzby
medzi
podvádzaním a
autonómnym
morálnym rozho -
dovaním, ktoré
sa, v súvislosti
s rozvojom abstraktného
myslenia, formuje až
po jeden
astom rok
u života. Vek
ová skupi
na pätnásťro
čných sa p
otom nachádz
a,
podľa autora,
niekde medzi druhým a
tretím
štádiom morálneho usudzovania.
Heidbrink, (1997) uvádza, že
je to na rozhraní
m
edzi
predkonvenčný
m a kon-
venčným stupňom. Druhé štádium je prepojené s účelovým myslením (konám
tak, a
by sa mi vrát
ilo, čo som
poskytol), n
azývané aj,
ako orientáci
a na odmen u.
Tretie š
tádium, zho
da s
ostatným
i –
je skôr vý
počtom určit
ých cností, o
rientácia
na
normy jednej
alebo
niek
oľkých
referenčných
skupín. Správne
je to,
čo
za
sprá
vne považ
ujú ostatn
í. Štúdie o vplyv
e
ro
vesník
ov na početno
sť podvádz
ania
pritom preukázali silnú pozitívnu koreláciu medzi pozorovaným podvádzaním
u
spolu žiakov a v lastným podvádzaním (McCabe, Trevio, 1993). Výskum
nie
je ale
možné obmedzovať
len
na väzbu
medzi podvádzaním
a
morálnym
výv
inom ž
iakov,
aj ke
ď ide
nespor
ne o
dôleži
tú imp
likáciu
neče
stného
správ
ania.
Říčan,
(2010)
opisuje
výskum
detskej
poctivosti,
ktorý
v
roku
1928
uskuto
čnili Hartshon a May.
Deti boli v laboratórny
ch podmienka
ch podrobené
niekoľkým
skúškam,
kde
im
bolo
nenápadne
umožnené
podvádzať.
Všetko
bolo
dôsledne
sledované,
avšak
deti
o
tom
nevedeli.
Výskum
nepotvrdil
pôvodn
é
očak
ávania, ktoré
m
ali
potv
rdiť
exi
stenciu poctivosti,
ako všeobecne
j
vla
stnost
i. Bola tu len
m
alá prav
depodo
bnosť od
hadu, či die
ťa, ktor
é podvád
zalo
v
jednej
situácii,
bude
podvádzať
aj
v
situácii
inej.
Z
toho
vychádza,
že
existujú ľudia poctiví a nečestní, ale nedá sa presne odpovedať, či je správanie
viac ovplyvnené osobnosťou, alebo danou situác
iou Lind, 2009).
Vývinové
r
ozdie
ly
medzi
žiakmi
sú
dôsledkom
ich
rozdielnych
kognitívnych
schopností
a
odlišných
sociálnych
štruktúr,
s
ktorými
žiaci
v edukačnom kontexte interagujú. Pozornosť analýzy prí čin školského
podvádzania primárne zacieľujeme na obdobie ado
lescencie.
Psychologický
prístup
odhaľovania
príčin,
objasňuje
nazeranie
na
štruktúru
osobnos
ti.
Stredoškolák,
adolescen
t
bio -psycho-
sociálne
vyzriev
a.
Dochádza k
výraznému
vývinu intelektu.
Vytvárajú sa
optimálne podmienky
pre
efektívne
učenie
sa,
rozvíja
sa
preferovaný
učebný
štýl.
Význam
nadobúda
sociálne
učenie
všetkých
stupňov.
Rôzne
vý
skumy
zamerané
na
osobnostné
rysy
adolescentov
potvrdzujú,
že
dnešná
mladá
generácia
sa
podstatn
e odlišuje o
d svojich pr
edchodcov.
Osobnostné
charakterist
iky súčasne
j
mládeže podľa
Slavíka (2012)
definujú: otvorenosť,
kritickosť, prílišné
seba -
vedomie, asertívnosť, dobrá znalosť cudzích jazykov, zručnosť v práci s infor-
mač
no - kom unikač nými t echnol ógiami , slob oda, n esamost atnosť a zod povedn osť.
Veľk
ý
v
ýznam
v
obd
obí
dospie
vania
má
vzť
ah
k
s
poluži
akom,
vrstovník
om.
Silný
vzťah k
jedincom i
k
skupinám, veľká
potreba
kontak
tu
s
vrstovníkmi,
snah
a neo
dlišov
ať sa,
byť v
skupi
ne obľ
úbený
a uzn
ávaný,
je úst
redným
motív
om
dospiev
ania stredoš
kolskej m
ládeže. Pri v
zdelávaní m
ládeže sa v
enuje špeciá
lna
Gabrhelová, G., Porubčanová, D.:
Príčiny školského podvádzania
36
pozornosť psychickým predpokladom, predovšetkým schopnostiam a nadaniu
pre určitú činnosť.
Z hľadiska budúceho smerovania edukácie sa v pedagogike čoraz viac
pozo
rnosť up
riamuje
na budovan
ie kompe
tencii žia
ka pre živo
t. Nezane
dbateľ
né
sú tiež emočné determin
anty a
soc
ializačné aspekt
y,
k
toré prispievajú k poch o-
peniu často kladených otázok. Čo, alebo čomu, a ako sa m á stredoš kolák učiť,
aby z ískal uvedené kompetencie?
Príčiny
podvádzania
z
hľadiska
osobnostných
faktorov,
sú
podľa
Zelinu (2018) spájané so
schopnosťou sociálne
j a psychickej regulácie.
Člov
eka a jeho pôsobe
nie v
so
ciálne
j
sk
upine
,
v spo
ločnost
i
ov
plyvň
uje
široká
šk
ála
parametrov
ľudského
života,
životných
podm
ienok
(Balogová,
2018). Sociáln
a
reg
ulácia osobnosti je utváraná
soci
álnymi normami,
zákonm
i,
zvyklo
sťami,
ku
ltúrou,
form
ovaná j
e výchovou,
spoločensk
o -
kultúrnym
systé -
mom a médiami.
Psychická
regulácia
je
spojená s
vedomím,
svedomím
vedomosťami
a inteligenciou, schopnosťami, citmi, hodnotam i a skúsenosťami.
Školsk
é podvádzanie
môže mať súvi
s so sociálnym
učením. Výsk
umný
tím Millera (2007) prezentoval významné výsledky skúmania príčin správania
osobnosti, s
označením ako „vnímaná osobná účinnosť“,
alebo tiež
vedomie
vlastnej
účinnosti.
Z
pohľadu
autorov
ide
o
presvedčenie
jedinca
o
jeho
schopnosti realizovať aktivity k dosiahnutiu požadovaných výsledkov v škole.
Žiaci so
schopnosťou sebariadenia viac
veria svojim schopnostiam
dosiahnuť
ciele.
Vo
väčš
ej
miere
dokážu
čeliť
nárokom
na
učenie
a
preverovanie
ich
vedomostí v
škole. Z výskumu
tiež vzišli
zistenia, že žiaci,
ktorí pochybovali
o
zvládnutí
zadanej
úlohy
,
pravdepodobnejšie
zvolili
podvádzanie
(Miller at
al., 2007).
Tieto závery pot vrdil aj výskumný tím Murdocka, Haleho a Webera
(2001).
V
ich
výskumnej
štúdii
sa
rovnako
pot
vrd
ilo,
že
príčinou
vyššej
pravdepodobnosti
podvádz
ania
bola
nižšia
osobná účinnosť.
Autori
vyslov
ili
názor,
že
prí
činou
nižšej
osobnej
účinnosti,
je
strac
h
z
neúspechu.
Ten
pravde
podobnosť podvádz
ania zvyšuje. Strach z neúspechu je zároveň viazaný
na úroveň sebavedomia žiaka
a tá sa
odví
ja
od výchovných vplyvov v rodine.
Z uvedenéh
o vyplýva, že pri hľadan
í príčin školskéh
o podvádzania ide o mu lti-
faktoriá lny jav.
Vplyvy rodiny ako príčina podvádzania žiaka v škole
Primárnym prostredím,
ktoré zásadným
spôsobom ovplyvňuje
rozvoj
psychiky
a
hodnotovú
orientáciu
dieťaťa
je
rodina.
Poskytuje
základné
skúsenosti,
ktoré
dieťaťu
sprostredkujú
pohľad
na
s
vet
určitým
spôsobom.
Významne sa
podieľa na
rozvoji pocitov
sebaistoty a
sebadôvery, na
ktorých
záleží
ďalš
ie uplatnenie dieťať
a
v
živ
ote. Potreba pozitív
neho prijatia je silným
prvkom
formovania
charak
teru
jedinca
a
výrazne
ovplyvňuje
interpretáciu
STUDIA SCIENTIFICA FACULTATIS PAEDAGOGI CAE
UNIVERSITAS CATHOLICA RUŽOMBEROK 2020, č. 3
37
správania
rodičov.
Má
dosah
na
ďalšie
konanie
jedinca v
budúcnosti
(Pasternáková,
Krásna,
2015).
Okrem
biologických
dispozícií,
úroveň
kognitívnych schopností, ktoré sú geneticky už v organizme žiaka definované,
na
rozvo
j
jeho
poznávacích
schopnosti
a
ich
výkon
v
škole
vplýva
postoj
rodičov k škole, k vzdelaniu k hodnotám
všeobecne.
Rodinné prostredie for
m
uje
kompetencie a uvažovanie dieťaťa
v jeho
smerovaní pre budúcnosť.
Význam určitých kompetencií rodičia z
dôrazňujú viacerými spôsobmi:
verbálnou proklamáciou,
svojim vl astným správaním,
hodnotením dieťaťa,
odmenami a t restam i, ktorými si formuje svoj morálny charakter
a buduje si sebavedomie (Vágnerová, 2001).
Práve
rodičia
môžu
byť
príčinou,
prečo
ich
dieťa
volí
stratégie
podvádzania
pred
stratégiami
efektívneho
učenia.
Voľba
k
podvádz
aniu
m
á
dve podoby:
1. Únik žiaka pred záťažovou situáciou a stresom, z reakcii rodičov na
nedostatočné
výsledky v
škole:
Vplyv
prísn
ej
vý
chovy,
trestan
ie
rodičov
za
zlý
prospech,
vzbudí u
dieťaťa
už
v
období
mladšieho
školského
veku,
potrebu
hľadať
možnosti,
ako
tejto
situácii
predísť.
Nakoľko
dosahovanie
dobrých
vý
sledkov
si
vyžaduje
viac
času
k
plneniu
úloh
a
osvojovaniu
s i
nového
učiva,
dieťa
–
žiak
sa
snaží
si
vypom
ôcť
inou
než
legálnou
cestou.
Štýl výchovy
ovp
lyvňuje rozhodov
acie procesy mladého človek
a, ich
vply
vom
si vy
tvára sv
oj morál
ny kódex
. Rodič
ia pred
stavujú
význam
ný prvok
formov
ania
osobnosti žiaka aj v uvedenej oblasti.
2. Následok nenaplnených očakávaní rodičov, učiteľov na výkon
žiaka:
Slavík,
(1999)
zistil,
že
u
školopovinných
jedincov
vzniká
úzkostný
strach
z
toho,
aby
neurobili chybu, ktorá by viedla k výčitkám učiteľov,
príp
adne k smút
ku rodičo
v. Nejde o podv
ádzan
ie z dôvodu pos
tihu ale z d ôvodu
obáv
nenaplnenia očakávaní.
Aby
žiak predišiel
nenaplneniu
očakávaní, volí
stratégiu
podvádzania.
S
uvedeným
javom
sa
prepája
následne
schopnosť
(ne) zvládať záťažové situ ácie v živote, čo vedie u adolescentov k ča stém u
zlyhaniu, nezáujem o
život, plány a ciele
do budúcnosti (Barnová, Tamášová,
Krásna, 2019).
Súčasný nelichotivý
postoj spoločnosti
ku
škole, k
profesii učiteľa
je
jedn
ou z ď
alších
príčin
podvá
dzani
a. Krit
ickos
ť adol
escento
v ku šk
ole a učite ľom
je
následok vývinových
zmien jedincov,
a zároveň
jej
podmienenosť prepája
so sociáln
ymi vplyvm
i. Kritika a nerešpe
ktovanie prav
idiel v škole často
svedčí
o
nedostatočnej
identifikácii
so
školou.
Vzťah
ku
škole,
s
ktorou
sa
jedinec
nestotožňuje,
môže mať
charakter
povrchnej
akceptácie, úplnej
ľahostajnosti
alebo dokonca
odporu (Vágnerová, 2005).
Ďalej autorka vo
svojom výskume
zistila,
že
existujú
zásadné
rozdiely
medzi
žiakmi
odborného
vzdelávania
(3 - ročný ch uče bných odborov ) a žiak mi štu dijných odborov (4 - roč. odborný ch
Gabrhelová, G., Porubčanová, D.:
Príčiny školského podvádzania
38
škôl
a
žiakov
gymnázií ). Postavenie žiakov („
učňov“)
bolo
výsledkami
z výskumu spojené s nižšou sociálnou prestížou. Žiaci učebných odborov,
preto zväčša
bývajú menej konformní,
odmietajú alebo
ignoru
jú
autoritatívne
pôso
benia
ško
ly a
ve
ľmi často nie sú so svojo
u profesi
jnou rolou
id
entifi
kovan
í.
Naproti tom
u žiaci 4 -
ročných študi
jných odborov býv
ajú so svojím postaven
ím
identifikovaní
vo
väčšej
miere,
a
preto
tiež
bývajú
sociálne
konform
nejší.
K tejto
konformi te žiakov môže prispievať
jednak
tlak
zo
strany
rodiny
a vedom ie, že strata roly stredošk oláka, by viedla k znížen iu ich spoločenskéh o
statusu a bolo by ohrozené ich budúce postavenie. V súvislosti so vzťahom ku
škole, Vágnerová (2005) výsledkami skúmania potvrdila, že motivácia stredo -
školákov (prevažne
žiakov
učebných odborov)
je veľmi
nízka.
Výnimk
ou
sú
iba
žiaci, ktorí
majú v
úmysle pokračovať
v štúdiu
na
vysokej škole.
Ostatní
žiaci
po
príchode
na
strednú
školu
motiváciu
strácajú.
Vedia,
že
na
v
ýkon
zv olenej profesie im postačí školu absolvovať a na výsledkoch im až tak
nezáleží.
Väčšine
žiakov
stačí
udržať
si
iba
taký
prospech,
aby
boli
sami
s výsledkami spokojní a nevyvolávali konflik tné situácie s rodičmi a učiteľmi.
Výv
inové hľadisk
o,
je
spoje
né
s hľadis
kom
m
otivač
ným
a výučbo vým.
Stredoškolák podvádza buď preto, že nevie, ako sa efek
tívne učiť, alebo preto,
že nechce
do učenia investovať čas. Žiaci,
ktorí si plánujú svoj
čas na učenie,
menej
často
vol
ia
podvádzanie
ako
tí, ktorí
si
nechávajú
učenie na
poslednú
chvíľu
(Miller
et
al.,
2007).
Adolescenti
formujú
svoju
identitu,
nachádzajú
v zložitom období, už nie sú deťmi, ale t iež stále nie sú dospelými. Sú medzi
nimi veľké individuálne aj typologick
é rozdiely.
Školské podvádzanie ako pedagog icko-dida ktický aspekt
Z
kontextuálnej
roviny,
predstavuje
šk
olské
podvádzanie
nežiaduci
zásah
do vyučovac
ieho procesu
, pričom sk
resľuje reáln
u úroveň
nadobudnutý
ch
vedomostí,
zručností
a
kompetencií
žiakov.
Žiaci,
ktorí
si
uvedom
ujú,
že
môžu
dosiahnuť
dobrý
prospech
aj
použitím
nedovolených
metód,
strácajú
motivá
ciu osvojiť si uči
vo. Jednou z príč
in, prečo žiac
i podvádzajú
je negatívne
vnímanie
alebo
uberanie
významnosti
j
ednotlivým
predmetom.
Inak
sa
pripravujú na predmet, ktorý považujú za dôležitý z hľadiska ďalšieho
vzdelávania, alebo
neskoršieho uplatnenia, a
inak sa
pripravu
jú
na nedôležitý
učebný
predmet.
Predmety,
ktoré
považujú
za
menej
dôležité
odsúvajú.
Ex istuje predpoklad, že žiaci sa v prípade predmetov s menšou náročnosťou,
uchýlia k podvádzaniu.
Žiaci,
ktorí
sa
učia
pre
známky
,
nie
kvôli
vedomostiam,
pociťujú
silnejšiu
motiváciu
podvádzať,
najm
ä
ak
nie
sú
schopní
učivo
si
osvojiť.
Niekedy
aj
náročnosť
učiva
a
obsah
učiva
rôznych
predmetov
môže
byť
spúšťačom
podvádzania
v
škole.
Zo
spom
enutých
motívov,
rôznych
zahra -
ničnýc
h výskumov, kt
oré identifik
ovali príčiny
školského pod
vádzania, exis
tuje
jeden zásadný. Je ním dôvod byť čo najlepšie k
lasifikovaný (Ci zka, 2003).
STUDIA SCIENTIFICA FACULTATIS PAEDAGOGI CAE
UNIVERSITAS CATHOLICA RUŽOMBEROK 2020, č. 3
39
Výchovná
funkcia
hodnotenia
v
škole
nielenže
neprisp
ieva
k nado-
budnutiu
správnych
hodnôt
žiaka,
naopak
dáva
mu
dôvod
myslieť
si,
že
podvádzanie
je
regulárny
spôsob
ako
sa
dopracovať
k
cieľu.
Žiaci
často
hľadajú
cesty
najmenšieho
odporu,
snažia
sa
dosiahnuť
maximum
pri
minimálnom
množstve
času
a
úsilia.
Preto
nevnímajú
školské
podvádzanie
ako problém, ale skôr ako odôvodnenú stratég
iu pre zisk lepších známok.
Uveden
á príčina je často spojená s benevolen
tným prístupom zo strany
učiteľa.
Jeho
nevšímavosť, či
jednoduchosť
podvádzať
je
pre
žiakov
tichým
súhlasom k podvádzaniu.
Záver
Mladá gener
ácia nepripisuje
v
ážnosť školském
u
po
dvádzaniu. Ign
oruje
autorské
práva
rôznych
prác
vedome,
či
nevedome.
Nie
len
s
tredoškolská
mládež si myslí, že všetko, čo je na internete patrí všetkým, pričom si
neuv
edomu
jú, že kradnú
, podvádza
jú, klamú
.
Sm
e svedkam
i nárastu
nef
érové
ho
dosahovania
výsledkov
v
škole,
pokles
spoločenského
vnímania
hodnoty
vzdelania, a tiež pokles kvality vyučov ania.
Z uvedeného
kontextu riešenej problematiky si
dovoľujeme tvrdiť, že
školsk
é
po
dvádzanie nie je len záležitosťo
u
a pochy
bením žiaka. Vnímam
e
ho,
ako
súhrn mnohých
činiteľov. Viac
eré nami
realizované pilotné
či
priebežné
skúmania v
rámci projektu odhalili
kor
elácie
medzi problémovými aspektami
edukácie
a
školským
podvádz
aním.
K
významným
problémovým
aspektom
zaraďujeme
klímu
šk
oly,
klímu
triedy
a
nerešpektovanie
prav
idiel
v
škole
(Hanuliaková,
Porubčanová,
2018),
spôsob
výučby
a
vnímanie
procesu
hodnotenia
žiakom
(Bajtoš,
Honzíkov
á,
2019;
Bajtoš,
Hanu
liaková,
2019),
význam
nosť predmetov
vo vzde
lávaní (Gabrhelo
vá, Hasajová, 2019
; Hasajová,
2019), ale i
nuda v škole je jednou
z príčin kedy žiaci podvádzajú, len
tak pre
zábavu, našepkávajú, opisujú a skúšajú či si
ich konanie učiteľ všimn e.
Potreba byť uznávaným, byť
„niekto“ devalvuje potrebu byť múdry
m
a
dobrým človekom.
Chceme
veriť,
že v
zanietených
učiteľoch
je stále
veľa
pozitívnych stimulov, viesť žiaka k rozvoju potencialít pre život. Odporúčame
v edukácii žiakov na všetkých stupňoch vzdelávania viac pozornosti smerov
ať
k rozvíjaniu ľudských kvalít, tvorivému, prirodz
enému a spontánnemu učeniu.
V
pr
íprave
učiteľov
dôraz
klásť
na
m
orálny
status
a
v
prípade
hodnotenia
využívať formatívne hodnotenie a rešpektov
ať osobnosť žiaka.
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ese cheaters? Characteristics of
academically dishonest students. In: Anderman, E.M.;
Murdock, T.B.
Psychology of academic cheating. London: Academ
ic, 2007. s. 9-32.
McCA
BE, D
. L.,
TREVIÑ
O, L.
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: Hono
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and
other contextual influences. Journal od Higher Ed
ucation, 1993, 64 (5),
s. 522-538.
MURDO
CK, T. B.,HA
LE, N. M.,W
EBER, J. M.
2001. Pre
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among Early Adolescents: Academ
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Contemporary Educational Psychology
, 2001, 26, s. 96-115.
KOHLBERG, L. 1976. Moral stages and m
oralisation. In: Lickona, T. Moral
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, Holt-Rinehart, Sauders, Wilson,
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LIND, G. 2009. Moral ist lehrbar. München: O
ldenbourg Schulbuchverlag,
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PANÁKOVÁ, M. 2011. Fenomén podv
ádění ve školách. Faktory ovlivňující
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Príspevok
bol
spracovaný
v
rámci
riešenia
grantového
projektu
KEGA
č. 001DTI- 4/2018 Školské podvádzanie ako prob lémový aspekt hodnotenia
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vzdelávacieho procesu na
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porubcanova@
dti.sk
Stárek, L.:
Etický model rozhodování se jako profesní nástroj
42
Etický model rozhodování se jak
o profesní nástroj
Ethical Model for Decision Making as a Profe
ssional T ool
Lukáš Stárek
Abstract
This
article
discusses
the
importance
of
ethical
aspects
in
the
work of social
services/personal
assistants with regar
d to the applicability
of the Ethical model for decision making.
Main
purpose
of
the
text
is
research
of
the
influence
of
social
service workers, especially personal assistents with ethical c
ode. How is
ethic al co de useable while dealing with ethical dilemmas in relatio n to
the
performance
of
this
profession.
Further
w
e
search
for
familliarity
with Ethical model for decision making between th
ose assistents.
In
their
almost
daily
routine,
personal
assistents
are
facing
particular ethical questions. Their
realization, searching for answers and
wondering
about
the
questions
in
general
requires
n
eccesar
y care
and
time.
It leads
to
the
importance
and influence
of
the
Ethics
that might
be possibly flouted.
Reflection
of
et
hical
aspects
may
contribute
to
improvment
of provided social s ervices, more precisely to professionalism of the
profession or strengthening professional competencies.
Keywords: Ethical dilemma. Ethical model for d ecision making. Ethical
code. Personal assistance.
Vymezení a vhled do problematiky
Co
j
e
a
co
není
etické
pro
pracovníka
v
sociálních
službách
j
e
v několika případech možné osvětlit i v rámci společenského úkolu sociáln í
práce.
Společenský
úkol
sociální
práce
vytváří
rámec
poskytující
smysl
p rofesního jednání. Tím je dáno pochopení sociální práce a zároveň i to, co po
ní
už
ivatelé
sociálních
služeb
a
jiní
mohou
vyžadovat.
Pracovník
dosahuje
toho, že
se lidé
ve vzájemném působení
se svým
okolím
lépe rozvíjejí,
podle
vlastní
přirozenosti,
potřeb
a
názorů.
Ilustrací
vztahu
m
ezi
etikou
a
úkolem
sociální
práce
se
můž
e
týkat
důvěrností
a
utajení
informací,
které pracovník
v sociálních službách získává od uživ atelů.
Sociální
práce sama
sebe chápe
jako
profesi poskytování
pomoci, ke
které
patří
vztah
založený
na
důvěře.
Pro
to
není
náhoda,
že
v
profesním
kodexu zaujímá
důležité místo důvěrnost
a utajení.
Aby
bylo možno
morálně
STUDIA SCIENTIFICA FACULTATIS PAEDAGOGI CAE
UNIVERSITAS CATHOLICA RUŽOMBEROK 2020, č. 3
43
přijatelně
působit,
j
e
potřebné
rozlišovat
následující
aspekty,
které
jsou
určující pro zmapování etiky a její přijatelno
st:
hodnoty, normy, morálka;
rozhodnutí se – řešení problému;
profesní etika;
osobnost a postoje. (Haterd van de et. al, 2000)
Etický kodex jako nástroj pro výkon pracovn
íků v
sociálních službách
Správný a
kvalitní
výkon profese
v
sociálních službách,
to j
e zásada,
která
vymezuje
pros
tor
ve
vztahu
uživatele služby
a
pracovníka
v
sociálních
službách. Zásady vycházejí z etického kodexu dané org
anizace, primárně však
z Et ickéh o kodexu so ciální ho pracov níka Čes ké repub liky, pr ameníc í z Všeob ec -
né dekl
arace lid
ských prá
v, z Listiny
z
ákladn
ích práv a svobo
d České repu
bliky
,
ze
zákona č.
108/2006 Sb.,
o soci
álních službách
a navazuje
na zásady
etiky
sociální práce definované Mezinárodní federací sociá
lní práce.
Etický
kodex je
jedním z
prvků
charakteru dané
profese a
určuje
tak
profesní
hodnoty
a
normy.
Kodexem
se
udává
směr
chování
pracovníka
a kladou se tak nároky na jeho chování a jednání. Kodex určuje prostor
i způsob jednání, které zároveň ukotvuje a usm ěrňuje.
„Etický
kodex vyjadř
uje poslání pr
ofese, zabe
zpečuje vede
ní a inspirac i
členům,
vytváří a
udržuje
profesní i
dentitu
,
zdůrazňuje
status profese,
slouží
jako
měřítko
pro
hodnoce
ní
aktuální
praxe,
chrání
klienty
před
zneužitím
úřední moci a zanedbá
ním péče, poskytuje souhr
nná poučení v
oblasti
et
ických
dilema
t a chrání pr
ofesi před
vnějším u
směrňováním
.“ (Nečasov
á, 2010, s
. 93)
Etika
není
jen
kodex,
dispozice
a
záměr,
ale
jsou
to
lidé,
které
můžeme
oslovit
prostřednictvím
jejich
činnosti
nebo
nečinnosti.
Nejenom
pracovníci
v
sociálních
službách
jsou
zatížení
morálním
úkolem
péče,
za
který
nesou
odpovědnost.
Toto
zdůrazňování
odpovědnosti
probíhá
nejen
v rámci toho, co organizace nebo instituce po pracovníkovi požaduje, ale i ve
v ztahu k hodnotám a normám, které lidé dodržují. Tak má také každý
představu o tom, co je dobré, správné a proto
hodné následování.
Kodex
nemívá
závaznost
právního
charakteru,
ovšem
některé
organizace mohou mít možnost výkon profese konkrétního pracovníka n
ebo
instituce komentovat
a ovlivnit. Smyslem
kodexu je ochrana
uživatele služby
a pracovníka
v
sociálních službách tím,
že se určí
hranice. Důsledné osvojení
si profesního
éto
su a
ho
dnot má svůj praktický význam
i
pro osob
u pracovníka
v
sociálních službách,
jelikož
napomůže k
občasnému
zamyšlení
se
nad tím,
jak člověk sám pohlíží na hodnoty, bez který
ch se daná profese neobejde.
Kodex
je
platný
pro
dané
členy
profesní
skupiny.
Je
důležité,
aby
profesní
skupina
učinila
své
profesní
hodnoty
a
normy
transparen
tními
a vysvětlila je. K tomu slouží kodex. Kodex t ím určuje směr profesního
Stárek, L.:
Etický model rozhodování se jako profesní nástroj
44
jednání. Aby
pracovník mohl
v
praxi řešit
nejen etická
dilemata, měl by
tedy
znát svůj vlastní kodex a umět jej aplik
ovat.
Uživatelé
služeb
i
společnost
by
si
měli
nárokovat,
aby
pracovníci
jednali profesionálně.
Hodnoty
a
normy,
které
jsou
obsaženy
v
kodexu,
jsou
proměnné
a závisí na socio - kulturním postavení dané spo lečnosti.
Vytvoření
kodexu
je
cílevědomý
proces,
jehož
hlavním
obecným
cílem
je
předcházení
nebo
minimalizování
projevů
neetického
chování.
Hlavní důvody,
proč dochází k
podporování etických kodexů jsou
následující
(Levy, 1992):
kod ex zabez pečuj e vede ní a ins piraci svým č lenům a stává se prův odcem
etické praxe;
kodex podporuje profesní chování a chrání uživatele služby před
nekvalitní péčí;
kodex pracuje s hodno tovými kritérii dané profese v návaznosti na
společenský rámec;
kodex podporuje a utváří identitu profes e. Etický kodex má čtyři důležité obecné funkce, které znázorňuje
následující obrázek.
Zdroj: Rolný, 1998, s. 30.
STUDIA SCIENTIFICA FACULTATIS PAEDAGOGI CAE
UNIVERSITAS CATHOLICA RUŽOMBEROK 2020, č. 3
45
Etické problémy –
etická dilemata
Člověk
se
někdy
dostává
do
si
tuace,
a
to
nejen
v
profesním
životě,
kdy s
tojí př
ed vol
bou mez
i dvěma
řešení
mi. Něk
teré p
roblémy
nás nu
tí, aby
chom
zvážili
situaci a
rozhodli se,
hovoříme o
tzv. di
lematech. U
těc hto dilemat je
často
zapojeno
více
osob
(skupin).
Základem
je
vědomí
vlastních
hodnot,
norem
a
zájmů, na
kterých
je
založeno
etické jednání.
V
rámci
výzkumného
šetření
je
etické jednání
vnímáno
jako
jednání,
které je
v
souladu
s
Etickým
kodexem Společnosti
sociálních pracovník
ů České republiky (2006).
„Řecké
slov
o problema
označuje
diskutabilní,
složité
situace,
které
vyžadují
řešení.
Etické
problémy
mají
alespoň
jedno
správné
řešení
nebo
jednu možnost správného řešení. Rozhodování v některých situacích může být
těžké,
složité nebo pro
blematické,
ale pokud existu
je správné řeš
ení, nemůžem
e
hovo
řit o dil
ematu.
Naproti
tomu řeck
ý výraz
dilema oz
načuje
dvojak
ý argum
ent
(dyo – dvě) v konfliktních složitých situacích. Všeobecně potom dilematem
rozumím
e
vý
běr
m
ezi
dvěma nebo více nechtěným
i
možn
ostmi.“ (Mátel et al.,
2010, s. 110)
Každodenní
praxe
se
zabývá
etickými
otázkami,
kdy
dilemata
často
nabý
vají for
my konf
liktů,
otázek
lo
ajality
nebo uč
inění vol
by. V
rá
mci zac
házení
s těmito dilematy j e důležité sledovat ja k společenský úkol sociální práce , tak
způsob
vztahu mez
i pracovník
em v sociáln
ích službác
h a uživate
lem služby.
Diskuse,
která
se vede
o
etických
problémech
či dilematech
(Banks,
Janoušková,
Nedělníkov
á,
Úlehla)
je
p
ro
pracovníky
v
sociálních
služ
bách
důležitá,
a
to
zejména
v
oblasti
orientace
v
nejednoznačných
kauzách.
Na
jejich
rozhodnu
tí
jsou uživatelé
služby závislí.
Pro některé
pracovníky řešení
etických
dilemat
může
být
jen
otázkou
dodržování
pevně
stanovených
pravide
l. Jiní pracovníc
i mohou situaci vní
mat jako etický
problém – pracovn ík
ví, jak by měl rozhodnout, ale je to pro ně
j složité.
Etický
kodex
Společnosti
sociálních
pracovníků
České
republiky
(2006)
se
mimo
jiné
zaměřuje na
takzvané
etické
problémové
okruhy,
které
nastiňují
specifika
sociální
práce
v
různých
oblastech.
Je
dná
se
o
práci
s jednotlivcem, rodinou, skupinou či organizací, kde působí jak sociální
pracovník, tak pracovník v sociálních službá
ch.
Etické
problém
ové
okruhy nastiňují
problematiku, s
níž se
pracovník
může
setkat,
a
nabádá
ho
k
využití
všech
zákonných
možností,
které
m
á.
Především
k
využití
informací
a
m
etod
práce,
které
může
využívat
v
rámci
profese.
Jedná
se
o
víceméně
ucelený
postup
při
řešení
etický
ch
problém
ů,
kde je zřejmé, že důležité jsou konz
ultace s odborníky a ko legy.
Základ
ní etické problém
ové okruhy, které vy
cházejí z Etického
kodexu
sociálních
pracovníků
České
republiky
(2006),
jsme
upravili
a
specifikovali
přímo
na
pracovníky
v
sociálních
služ
bách.
Konkrétně
jde
o
tyto
zák
ladní
okruhy:
V jakých případech by měl pracovník vstoupit či zasáhnout do života
občana, potencionálního uživatele služby
.
Stárek, L.:
Etický model rozhodování se jako profesní nástroj
46
Správné vyhodnocení míry pomoci, k terá by vedla uživatele služ by
k lepší kvalitě živ ota či změn ě jeho posto jů. Míra pom oci je každ odenní
otázkou.
Kdy nastane správný čas pro ukončení/přerušen í služby.
Další problémové okruhy:
střet zájmu uživatele služby a pracovník a;
konflikt mezi uživatelem služby a dalším spoluobčanem;
konflikt mezi institucí, organizací a už ivatelem služby;
střet zájmu uživatele služby a majoritní společnost i;
konflikt mezi zaměstnavatelem a osobn ím asistentem. Pracovník v sociálních službách nabízí pomoc a kontrolu zároveň.
V návaznosti na tyto dvě funkce sociální práce si má pracovník vy jasnit etické
důsledk
y své role vůči uživatelům
sociálních služe
b. (Etický kodex Spo
lečnosti
sociálních pracovníků České republiky
, 2006)
„Etické
problémy
mohou
vznikat
v
situacích,
když
pracovník
má
přijmout
rozhodnutí,
se
kterým
není
osobně
ztotožněný.
Nemůže
uživateli
služby
poskytnout
pomoc,
službu
z
důvodu
nesplnění
stanovených
kritérií
státem
anebo
organizací
poskytujících
sociální pomoc. Pokud ani jedno
z možných způsobů řešení nelze označit za “dobré“, výběr je rozporuplný
a konečné rozhodnutí má být “menším zlem“ anebo “menším utrpením“.
Riziko
se
zvyšuje
tím,
že
rozhodnutí
můž
e
být
vnímané
i
jako
(negativní)
precedens.
Jakékoliv
rozhodnut
í
může
přinést
kromě
nežádoucích
důsledků
i pocity viny, lítost a výčitky s vědom í, se kterými se ten, kdo dělá rozhodnutí,
musí vyrovnat.“ (Janigová, 2008, s. 48)
Oblastí
v
so
ciální
práci,
kde
mohou
vznikat
etická
dilemata,
střety
zájm
ů, je nespo
čet. Můž
eme sem zař
adit kon
flikty
m
ezi zaměs
tnanc
i organiz
ace,
ale také
kon
flikty
mez
i
s
amotným
i
už
ivate
li
s
lužby.
Dále
pa
k
st
řet osobno
stních
hodn
ot s hodnot
ami organ
izace. Nem
alý vliv na pro
blema
tiku etiky
rozhodov
ání
mají ho
dnoty a z
ájmy skupin o
byvatelstv
a v rámci k
omunity neb
o společnost
i.
Etické problémy a dilemata mohou být následkem konfliktních situací
v práci pracovníků v sociálních službách. Podle podnětů z praxe autorky
Ba nks (2010), uvádíme časté příčiny těchto p roblémů:
nedostatek zkušeností a znalostí pracovníka, který se může projevit
v řešení náročnějších situací;
nejasné informace o roli osobního asistenta;
nedůvěryhodnost ve vztahu mezi koleg y;
přehlížení komplexnosti celé situace, kdy je pracovník zaměřen pouze
na jednotlivosti. Nejspor nější oblast í etiky u pom áhajících prof esí je podle B anks (2010)
konflikt mezi etickými hodnotami a prin
cipy.
STUDIA SCIENTIFICA FACULTATIS PAEDAGOGI CAE
UNIVERSITAS CATHOLICA RUŽOMBEROK 2020, č. 3
47
Postupy při řešení etických problémů
Etic
ký kodex Spo
lečnos
ti sociáln
ích pracov
níků Česk
é republi
ky (2006)
nabádá, jak řešit etické problémy. Jedná se o
tato doporučení:
Hlavním právem pracovníka je diskuse, nejen se svým i kolegy, ale
i s uživateli, kterých se problém týk á.
Závažné etické problémy jsou řešeny v rámci Společnosti sociálních
pracovníků České republiky.
Společnost sociálních pracovníků České republiky může kodex
přizpůsobit pro oblast terénní sociální práce, kde jsou etické problémy
komplikované i závažné. Etický model rozhodování se se skládá z několika otáz ek. Jejich
zodpovězení by
nakonec mělo vytvořit
eticky
odpovědné rozhodnutí. Pomocí
tohoto
modelu se
pracovníci v
sociálních
službách
naučí pracovat
s
etickým
i
dilematy a kromě toho mohou zpětně hodnotit
svá rozhodnutí. Pak lze hovořit
o péči -
službě, která je smysluplně posky
tována.
V
praxi se
stává,
že jsou
etické
otázky opomíjeny.
Pracovníci bývají
stále častěji
vyzýváni k
tomu, aby se
k nim
stavěli věcně
a efektivně.
Hov
oří
se o vz
růstajícím
“taylorismu
péče“ = běž
ící pás v zem
i blaha. To by znamena lo
rychlejší
dosahování
výsledků,
méně
rozhovorů
a
na
výkon
péče
průměrně
méně
minut.
Standardizace
a
práce
s protoko
ly
mají
zvýšit
účinnost
práce
a mno ho zá ležitostí je pečlivě zapiso váno pomocí vyvinutý ch systémů. (Haterd
van de et al., 2000)
Ani
pom
ocí Etického modelu rozhodování se
není
reálné
vytvoření
určitého
v
zorce,
plného
údajů,
které
nás
zavedou
k
jednoznačném
u
řešení.
Jestliže vycházíme
z principu,
že etika
je proces,
nikoliv řešení
samo o sobě,
stávají
se
východiskem
otázky,
které
se
snaží
identifikovat
podstatu
daného
etického
problému.
Samostatným
bodem
eti
ckého
rozhodování
je
logická
analýza problému v návaznosti na řešení ce
lé situace.
Etický
model
rozhodování
se je spíše nástrojem, který nám usnadní
řešení dilemat bez přímého návodu ke k
onkrétnímu rozhodnutí.
Je
potřebné
si
uvědomit,
že
potenciální
uživatel
služby
se
obrací
na
instituci
za
j
istým
účelem,
potřebou
pomoci
či
podpory,
a
přichází
tedy
s problémem nebos břemenem. Nestačí pouze potenciálního uživatele služby
vy slechnout a nechat vypovídat. Pracovník se vyjadřuje k tomu, o čem
potenciální uživatel služby hovoří.
Při
k
aždé
činnosti,
kterou
osobní
asistent
provádí,
se
bude
zabývat
(ne)vědomou otázkou:
„Je to možné, nebo ne?“ Dalším autorem, který se kromě Haterd van de (2000) snaží o zdůraz -
nění system
atického přístu
pu v procesu řešení dilema
tických situací, je Ream
er
(2006).
Stárek, L.:
Etický model rozhodování se jako profesní nástroj
48
Navrhl
systematický
postup
pomoci
pracovníkům,
kteří
se
dostanou
do
dilematické
či
eticky
problematické
situace,
ve
které
je
potřebné
se
rozhodnout.
Tento přístup je tvořen sedmi následujícím
i body:
1) identifikace etického problému, dilematu vyskytujícího se v konfliktu,
včetně hodnot a povinností sociální prác
e;
2) identif ikace jednotli vců, skupin neb o organizací, kterých se bude etic ké
rozhodnutí pravděpodobně týkat;
3) zamyšlení se nad potencionálními přínosy a riziky konání pro všechny
zúčastněné; zároveň můžeme určit více v
ariant řešení;
4) důkladné prozkoumání výhod a nevýhod k aždé z variant řešení s ohle-
dem na:
etický kodex a platnou le gislativu,
etické teorie, principy a směry,
praktické teorie a principy sociální práce,
osobní hodnoty v četně kultu ry, nábožen ství a etick ých hodnot;
5) konzultace s kolegy a příslušným i odborníky;
6) zajištění dokumentace k celému procesu rozhodování;
7)
monitorov ání, zhodnocování a dokumentace rozhodnutí. Z výše uvedených modelů tedy plyne, že jedním z úkolů profesionála
je
umět
řešit
a
rozhodnou
t
se
v
situacích,
které
můžeme
vyhodnotit
jako
problem
atické či eticky dilematick
é. Et ický model rozhodování se (viz kapitola
níž
e) nebo Sy stemat ický pos tup řeš ení etic kých di lemat nen í zaruč eným náv odem
ke správnému výsledku rozhodnutí, ale spíše by nám
měl pomoci a tím ulehčit
práci,
jež
s
sebou
přináší nemálo
náročných
situací.
Podíl
má
také
osobnost
pracovníka, jeho zkušenosti a vědomosti. Zkušení pracovníci by
měli předávat
své
poznatk
y
nově začínajícím
a pokusit
se eliminovat
chyby, kterých
se tito
nezkušení pracovníci mohou dopustit na už
ivatelích služeb.
Význam etické ot
ázk
y
pak narůstá společně
s profesionalizací. Etické
přístupy
jsou
součástí
etických
principů
a
hodnot
celé
společnosti
a
každý
odborník stojí před volbou a měl by
nést za tuto volbu odpovědnost.
Etický model rozhodování se – Rob Sentse
Model
je sestaven
ze
čtyř základních
pilířů,
které
mají napomoci
při
řešení
ne
jen
etických
dilemat.
Prvním
bodem
je
v
ytyčení
samotných
faktů
a stanovení osob, které na nich mají zájem. Navazujícím, druhým bode m, je
popsání
regulace
chování
a
následků
s
tím
spojených.
První
dvě
otázky
uvedeného
m
odelu
jsou
určeny
zejména
k tomu,
aby mohla
být
situace nebo
dilema
co
nejobjektivněji
popsáno.
Následu
jící
body
(to
jest
III.
a
IV.)
jsou
propojené,
a
jelikož
mají
za
úkol
vybrat
správné
řešení
a
následně
vést
STUDIA SCIENTIFICA FACULTATIS PAEDAGOGI CAE
UNIVERSITAS CATHOLICA RUŽOMBEROK 2020, č. 3
49
k rozhodnutí, vybízejí osobního asistenta, aby chován í kvalifikoval za použití
několika kritérií.
I. Jaká jsou fakta a kdo jsou ti, kteří na nich ma
jí zájem? (cui bono)
Je důležité, aby osobní asistent inventarizoval veškerá relevantní fakta
týkající
se
problémové
situace,
která
má
být
vyřešena.
Snaha
o
co
nej -
objektivnější
pop
is
situace -
dilematu
a
využít
pro
to
vý
stižných
vět
a
slov.
Nesmí
dojít
k
převládání
emocí,
jelikož
b
y
umožnily
přijmutí
jen
určité
představy
nebo
pohledu
člověka.
J
e
důležité
si
všimnout
lidí
(skupin)
neb
o
institucí,
které
jsou
účastné
a
mají
zájem
na
dané
problémové
situaci.
V případě, že se nám podaří splnit tato požadovaná kritéria, můžeme
přistoupit k dalšímu kroku.
II. Jaké jsou možné regulace chování a jaké j
sou jejich následky?
Pohled pracovníka má být
realistický, ale zároveň kreativní.
Využív
at
vědomého přístupu k uživateli služby a vytvořit si tak co nejvíce úhlů pohledu
na
j
eho
chování
a
vyhodnocování
následků,
kdyby
dané
chování
bylo
vykonáno.
Přitom
se
vžívat
do
argumentů,
úvah
a
zájmů
lidí,
kteří
jsou
účastni problému. Přemýšlet navíc o tom, jaké
by to mohlo mít dopady na lidi
nebo
na organizaci.
Nakonec bude
nutné
zjistit, do
jaké
míry osobní
asistent
může splnit původní otázku služby osobní as
istence.
III. Vyzkoušení různých možností řešení a je
jich následky
Vyzkoušení
různých
možností
řešen
í
a
jejich
následky
na
základě
těchto otázek:
Je to legální?
Jsou zváženy všechny zájmy?
Je to možné uskutečnit?
Každé
řešení
a
jeho
následky
je
nutné
posoudit
v
rámci
morální
správnosti, zodpovězení výše zmíněných otázek. Tyto otázky zde více
rozvedeme:
Je to legální?
Zde
je
nutné
posoudit
legalitu
různých
možností
řešení
a
jejich
následků. Jsou volbou určitého řešení ohrož
eny stávající zákony nebo pravidla
platná
buď
v
rámci
společnosti,
nebo
vlastní
organizace?
Hranice,
v
rámci
kterých
bude
možné
rozhodnutí
odůvodnit,
udáv
ají
tak
referenční
rámec
či
kontrolní
bod. Překročení
těchto
hranic je
v rá
mci platné
kultury
společnosti
a organizace dovoleno pouze imaginárně. Tento referenční rámec je hlavně
vytvářen zákony či zákonodárstvím
.
Stárek, L.:
Etický model rozhodování se jako profesní nástroj
50
Jsou zváženy veškeré zájmy?
Jsou- li zváženy veškeré zájmy, použ ijeme následujících pomocných otázek:
Je rozhodnutí mezi osobními záj m y a zájmy organizace ospravedlni -
telné?
Je to ospravedlni telné pro všechny zúčastněné, jak z krátkodobého,
tak z dlouhodobého hlediska?
Jsou vol bou určitého řeš ení rovnom ěrně rozdělen y pozitivní a neg ativní
následky mezi různými zainteresovaným
i stranami?
Je možné uskutečnění?
U
této
otázky
osobní
asistent
posuzuje
každou
formu
péče
podle
svých
osobních
hodnot
a
norem.
Posouzení
může
proběhnout
na
základě
následujících otázek:
Byl bych hrdý na zvolené řešení?
Jak bych se cítil, kdyby moje rodina by la informovaná o této volbě?
Kdyby ch byl nejd ůležitějším účastníkem (nikoliv os obním asistentem),
jak bych se pak cítil, kdyby bylo zv
oleno toto řešení?
IV. Možnost rozhodnutí se
Pokud
je
zvoleno
řešení, mělo
by
být
přijato.
Člověk
si
klade
různé
druhy ot
ázek v návazno
sti na informac
e,
prohlášení
nebo pomoc. Jed
na z těchto
otázek
by se měla týkat smyslu
a
vý
znamu existence
, jedná se tedy o ex istenční
otázky.
Zde st
ojí centrálně
vztah
mezi
JÁ
a
TY
ve vztahu
ke
zvážení
dobra
a zla. (Sentse, 2010)
Výzkum
V rámci výzkumného cíle jsme zjišťovali využitelnosti Etického
modelu rozhodování
se v
každodenní praxi
pracovníků v
sociálních službách,
konkrétně osobních asistentů, j
enž jsou konfrontováni s
konk
rétními
etickým
i
otázkami. Jejich
uvědomění si,
hledání odpovědí na
tyto otázky a
přemýšlení
o
nich,
však
vyžaduje
potřebnou
péči
a
čas.
V
rámci
výzkumu
jsme
se
též
zaměřili
na
obeznámenost
s
etickým
kodexem,
který
by
měl
určovat
směr
profesního
jednání.
Aby
pracovník
mohl
v
praxi
řešit
nejen
etická
dilemata,
měl by tedy znát svůj vlastní kodex a umět je
j aplikovat.
Součástí
výzkum
u
byla
realizace pracovního setkání – workshopu ,
kde
byl pracovníkům
osobní
asistenc
e
představen
Etický model
rozhodování
se,
včetně
detailního
prakticistního
postupu,
jak
jej
využít
v
rámci
své
každodenní práce, včetně konkrétních situací/okamžiků s kterými se mohou
set kat p ři výkonu svého povolání. Se tkání trvalo cca 180 m inut, za účasti
všech
respondentů, kteří
byli zapojeni
do
výzkumu. Od
realizace
workshopu
STUDIA SCIENTIFICA FACULTATIS PAEDAGOGI CAE
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51
a prvního rozhovoru uplynula doba 4 měsíců. Důvodem byla možnost
aplikovatelnosti
získaných
poznatků
do
praxe,
s
možností
využití
odborné
konzultace.
Příprava a průběh rozhovoru
Jako pomocný
scénář pro
vedení rozhovorů jsme
využili připravenou
strukturu
vztahující
se
k
tématu,
jenž
pramenila
z
obecných
t
em
atických
okruhů. Témata rozhovorů vycházela ze z
aměření celého výzkumu.
Jak
využív
ají
osobní
asistenti
mohou
pracovat
s
Etickým
modelem
rozhodování
se?
Jak
uplatňují
etický
kodex
při
řešení
etických
dilemat?
Na
některé
okolnosti
(konkrétní
postupy,
e
tická
dilemata,
popis
krizové
nebo
náročné
situace
při
výkonu
povolání)
j
sm
e
se
více
vybavili
dalšími,
podrobnějšími otázkami.
Uvědomovali jsme si
riziko, skryté v tom, že
rozhovor s pevně danou
a připravenou
strukturou otázek by
mohl být
poněkud zkreslující.
Tudíž
byly
použity okruhové otázky, které jsme dále modifikovali dle průběhu rozhovoru
s jednotlivými respondenty. Pro některé respondenty bylo však potřebné
dotazy
přizpůsobit,
tak
aby
jim
osobní
asistenti
byli
schopni
porozumět
a orientovat se v tématu a jeho závažnosti.
Celkem proběhlo pět
polo
strukturovaných rozhovorů , respondenti
vyslovili
souhlas
s
provedením
rozhovoru
a
s
následným
využitím
pro
interpretaci získaných údajů. Nikdo z oslovených osobních asistentů neodmítl
prosbu o rozhovor pro výzkumné účely.
Pro
zaznamenávání
celého
interview
jsme
využili
diktafon.
Každý
z respondentů byl obez námen s využitím této technik y a nikdo proti tomu nic
nenamítal.
V
případě,
že
by
některý
z
respondentů
nesouhlasil
s
využitím
diktafonu,
byla
připravena
varianta
zaznamenávání
odpovědí
respondentů
písemně během rozhovoru. Interview probíhalo v prostorách kanceláře, kterou
pracovníci
znají. Byla
jim nabídnuta
možnost
provedení interview
v kavárně
či
na místě, kde
by se
oni sami
cítili příjemně.
Nikdo z
dotazovaný
c
h takové
nabídky
nevy
užil. Setkání vždy probíhala bez přítomn
osti
tř
etích osob, kterých
se to
ne
týkalo. Vytvoře
ní
ot
evřených kontak
tů
byl
o
zp
rvu
u všech
respo
ndentů
navozeno obecnými
otázkami k
tématu, clem
bylo získání
důvěry. Vytvoření
přátelské
atmosféry,
být
taktní
a
projevit
přiměřený
zájem
o
výpovědi
respond
enta
pom
ohlo
k d osažení uvolněného rozhovoru. V průběhu rozhovor u
jsme dbali
na to,
aby nebyla
použita slova,
kterým by
respondent nerozuměl.
Otázky
byly formul
ovány neutrálně tak, aby
ned
ošlo
k naznačová ní oček ávané
odpovědi.
Měli
jsme
snahu
klást
stručné
otázky,
pokud
možno
v
holých
větách.
Byla
volena
strategická
metoda,
kdy
otázky
začínaly
u
obecn
ějších
problémů/okruhů t
ém
at
a
následně se
zaměřovaly
na zcela
konkrétní
témata.
Úkolem tazatele b
ylo, aby při všech
interview byly kladeny otázky standardi -
zovaně, se
stejný
m akcentem.
Nebyla opomenuta analýza reakcí
respondentů
,
Stárek, L.:
Etický model rozhodování se jako profesní nástroj
52
jejich
chování
a
také
neverbálního
vyjadřování
během
rozhovoru
– pohyby
těla,
gesta,
pohyby
obličeje,
mimika,
úsměv,
smích,
pohledy
očí.
Všech
pět
rozhovorů
proběhlo
bez
žádné
nenadálé
č
i
trapné
situace,
k
terá
by
mohla
narušit důvěru mezi respondentem a tazatelem. Všech pět vybraných osobních
asistentů
projev
ilo
maximální
v
střícnost,
ale
tak
é
zájem
o
téma.
Průměrná
časová dotace každého rozhovoru trvala cca 45 m
inut.
Charakteristika
respondentů , cílová skupina respondentů nebyla
nikterak omez ena pohlavím, věkem, barvou ple ti, náboženským vyznáním,
dosaže
ným vzděláním
nebo délko
u působení v pracovní poz ici osobní asis tent –
prac ovník v sociálních službách.
Abych
om
mohl
i
zodp
ovědět výzkumné otázky, získali jsme informace
od určité
skupiny lidí.
Jedná se
o pracovníky, kteří
jsou zařazeni
do pracovní
pozice
“pracovník
v sociálních
službách
–
osobní
asistent“
a
vyk
onávají
tak
terénní službu osobní asistence.
Výzkumný
vzorek
je
tedy
tvořen
pracovníky
ze
služeb
osobní
asistence, a to dvou neziskových organizací, k teré p rimárně nabízejí služby
osobní asistence.
Organizace jsou rozdílné.
Především v
tom, že jedna
z nich
nabízí
služby
nejen
v
Praze,
ale
také
v
dalších
krajích
České
republiky.
Posláním
této organiza
ce je snaha o maxim
ální možné zapoje
ní svých uživa
telů
do jejich přirozené sociální sítě a společnosti. Druhá organizace je jiná,
pokud
jde o působnost. Své služby nabízí v Praze a občas také ve Středočeském kraji
a
má omezenou kapacitu
na
40 uživatelů sl
užby
.
Posláním této
organizace je
podpořit sociální začlenění dětí se zdravotním
postižením.
Tabulka 1: Přehled osobních asistentů, s
nimiž
byl proveden rozhovor
STUDIA SCIENTIFICA FACULTATIS PAEDAGOGI CAE
UNIVERSITAS CATHOLICA RUŽOMBEROK 2020, č. 3
53
Výzkumné zjištění
Etický
model
rozhodování
byl
prezentován
jako
další
z
možných
nástrojů,
v
součinnosti s
etickým
kodexem,
tak aby
bylo
patrné,
že záměrem
není
tvrzení
,
že by
osobní asistenti
vykonávali svou
práci dobře
nebo špatně.
Primárním
cílem
je
v
yužitelnost
nástroje,
který
může
upozornit
a
podpořit
vazbu mezi
etikou
a každodenní činností
pracovníků. Primárně
z workshopu,
který se
zaměřoval na
prezentaci Etického
modelu rozhodování
se, je
patrné,
že pracovní
ci
př
ijímají nové informac
i
s
ak
tivním zapojením
. Jejich zpracová ní
a aplikovatelnost v praxi je pak náročnější.
Celkem
4
respondenti,
za
zmiňovaný
časový
úsek
–
tj.
nejméně
4
měsíců,
se
snažili
v
praxi
uplatnit
Etický
model
rozhodování
se.
Stěžejní
oblastí, která byla pro všechny responden ty, kteří využili Modelu, náročná
a ne vž dy naplněna, po dstata nabídk y „všech“ mož ných variant ře šení. Primár ní
situace,
kdy
pracovníci
využili
Modelu,
byly
ve
vztahu
pracovník
a klient.
Další
problémovou
oblastí
byla
podstata
možnosti
rozhodnou
se,
a
to
ze
st rany uživatele služby. Tendence pracovník ů by la založena na komunikaci
s uživ atelem služby , na společné diskusi, ale t endence k r ozhodnutí či f inálnímu
výsledku přicházela ze strany pracovník
a.
Z rozhovorů vyplynula skutečnost, že obeznám
ení s etickým kod exem
dané
organizace proběhlo,
ale bylo
spíše
na formální
bázi. Respondentka
R1
poukazuje
na
skutečnost,
že
prioritou
pro
pracovníka
je
vždy
pracovní
smlouva.
Přílohám
,
které
jsou
přikládány
k
e
smlouvě,
kde
je
právě
etický
kodex dané organizace, dále pak c
íle a poslání organizace atd., není věnována
taková
míra
pozornosti,
jaká
by
měla
být.
Z
rozhovoru
s
respondentkou
R1
vyplývá, že teoretická
a praktická znalost etického
ko
dexu
je minimální. Tato
skutečnost
je
způsobena
především
přístupem
zaměstnavatelů
v
otázkách
seznámení
nově
nastoupeného
osobního
a sistenta se samotnou smlouvou
a etickým kodexem a dalšími dokumenty, které jsou „pouze“ přílohou.
Rozhovor
s
respondentkou
R1
poukázal
na
skutečnost,
jak
jsou
křehké
hranice
mezi
uživatelem
služby
a
osobním
asistentem,
které
mohou
být
narušeny
jakoukoliv
„maličkostí“,
která
se
pak
následně
stává
etickým
dilematem.
Dilematem
nejen
pro
osobního
asistenta,
ale
i
pro
uživatele
služby.
Důležitost
znalosti
a
praktick
ého
využití
kodexu
se
tedy
jeví
jako
potřebná,
aby
bylo možné
některým etickým
dilematům př
edcházet. Morální
rozpor
se může
objevovat
v každodenních
činnostech a
situacích,
které
tvoří
pracovní
náplň
osobního
as
istenta.
Prvek
výskytu
morálního
rozporu
je
patrný, ale osobní nastavení aktérů –
osobních as
istentů již tak zřetelný není.
Z
rozhovoru
bylo
zjištěno,
že
převážná
část
respondentů
(4
osobní
asistenti)
přistupují
k
oblasti
předávání
informací
o
uživateli
služby
vůči
někomu
dalšímu
zodpovědně.
Můžeme
se
jen
domnívat,
jaké
faktory
tuto
skutečnost
tvoří,
zda
jde
o
osobní
nastavení
as
istenta,
který
si
na
základě
vlastní
zkušenosti
uvědomuje
důležitost
a
citlivost
získaných
údajů,
nebo
o znalost práv uživatele služby a osobního asistenta, kdy citlivost s osobními
Stárek, L.:
Etický model rozhodování se jako profesní nástroj
54
údaji
je prioritou.
Roli má
zajisté
i etický
kodex a
jeho
znalost. Z
rozhovorů
vyplynula
skutečnost,
že
citlivost
ve
vztahu
k
osobním
údajům
není
pro
prac
ovník
a pouhý
m práz
dným po
jmem.
Z rozho
vorů,
předev
ším s re
spond
entkou
číslo 1, bylo
patrné pozastaven
í se u
smý
šlení výkonu práce a etick
ého jednání.
V praxi se setkáv
áme se situacemi, které nazý
váme nebo je řadíme do etický
ch
dilemat. Je patrné, že respondenti mají povědomí o existenci etického kodexu.
Problematickou oblastí
zůstává efektivní
použite
lnost
etického kodexu
a jeho
propojení na každodenní výkon povolání.
Analýzy
roz
hovorů poukazuj
í,
ž
e
oso
bní asistenti jsou žádá
ni o
služ
by,
které nejsou
vym
ezeny
ve smlouvě s
uživatelem
služby. Hlavním faktorem je
měnící
se
zdrav
otní
stav
uživatelů
služby
.
Služby
–
úkony,
které
uživatel
služby
požaduje,
jsou
různé
a
někdy
mohou
být
pro
osobního
asistenta
překvapující.
Tato
skutečnost
se
následně
může
projevit
i
vznikem
etického
dilematu:
ač
osobní asistent
zná
náplň
své práce,
na
druhé
straně je
uživatel
služby, který se obrací s prosbou
o pomoc. Z rozh ovoru s respondentem R3 je
patrné,
že
osobní
asistence
je
někdy
úzce
propojena
se
vznikem
přátelství
s uživatelem služby. Vymezení se v rámci nead ekvátních požadavků je v takto
nastavených vztazích složitější. Otázkou může být, zda právě přátelské vztahy
m ezi osobními asistenty a uživateli služby mohou minimalizovat etická
dilemata.
Etické jednání je potřebné vnímat nejen ze strany pracovníků, ale také
ze
strany
uživatelů
služby.
Přibývá
více
situací,
kdy
se
uživatelé
služby
nechovají adekvátně
a jejich
ataky směřují
právě na
osobní asistenty.
Osobní
asistent
je
člověk,
který
by
v
rámci
své
profesionality
měl
zvládat
takto
náročné situace, ač se jedná o okamž
iky psychicky náročné.
Z rozh ovorů je patrn é, ž e se u uživatelů služby setkávám e s či nnostmi,
které
jim
šk
odí.
Okolnosti,
které
to
způsobují,
jsou
různé
–
ať
už
se
jedná
o alkohol, nedodržování pitného režimu nebo nezdravé stravování. Osobní
asistenti
by
měli
být
připraveni
na
takové
si
tuace/
okamžiky
a
vědět,
jak
postupovat.
Nejen
vedoucí
pracovník,
ale
p rá
vě
i
etický
kodex
je
jednou
z možných variant, jak se nad věcí zamyslet a začít hledat řešení a správný
postup.
Pestrost
etických
dilemat
v
každodenní
praxi
osobních
asistentů
se
potvrdila.
Znalost a
podstata
etického kodexu
není
úplně nulová,
ale
zvolen í
řešení nebo posto
je k
dané situaci s vazbou na etický
kod
ex se zde nepotvrdila.
Jedná
se
o
subjektivní
pohled
pracovníků,
kteří
jsou
v
přímém
kontaktu
s uživatelem. Nutno podotknout, že uživatelé sociálních služeb mají plné
právo rozhodovat o svém životě
a nesou zodpov
ědnost za tato rozhodnutí.
Jednou
z
hlavních
myšlenek,
která
vychází
z
Etického
kodexu
Společnosti sociálních pracovníků České republiky (2006), je vzájemná
podpora
a
možnost
pomoci,
kter
ou
můžeme
očekávat
od
kolegů.
Prvotním
krokem
j
sou
právě
kladné
vztahy
na
pracovišti,
kterým
napomáháme
především tím,
že respektujeme znalosti
a zkušenosti nej
en svých kolegů, al
e
i ostatn ích odborník ů. Respondent i, s kterými byl proveden rozhov or, potvrzují,
že sdílení informací je
pro kvalitní péči o uživatele služby nezbytné a
v tomto
STUDIA SCIENTIFICA FACULTATIS PAEDAGOGI CAE
UNIVERSITAS CATHOLICA RUŽOMBEROK 2020, č. 3
55
ohledu
nezáleží
na
délce
praxe
a
ani
na
úrovni
vzdělání.
Z
uvedených
informací lze
vyvodit, že osobní asistenti
užívají pro přenos informací nejvíce
telefon
nebo
e- mail. Tato skutečnost je dán a rychlostí přenosu informací
v návaznosti na nutnost rychlého reagování v rámci služby osobní asistence.
Respondenti
v
oblasti
přenosu
informací
nepoukázali
na
možnost
etických
dilemat.
Přínosem je
však
skutečnost, že
dochází
k setkáním
mimo
pracovní
dobu,
což
může
pozitivně
ovlivňovat
vztahy
na
pracovišti
a
vypovídá
to
i o atmosféře v organizaci a také o kultuře organizace. Organizace, které
nabízejí
služby
osobní
asistence,
jsou
tvořeny
týmem
spolupracovníků,
a
to
klade
velký
důraz
na
spolupráci.
Jedním
z
úskalí,
k
terá
by
měla
týmová
spolupráce
překonat, je
právě
špatná komunikace
a
nesdílen
í
informací
nebo
jejich
špatný přenos.
Proto je
nezbytné, aby
zaměstnanci
uměli komunikovat
a sdílet informace nejen s uživateli služby , ale také vzájemně mezi sebou.
Při rozhov
orech byla většin
a (4 respondenti)
ve vnímání společen
ského
uznání
na stupních leh
ce nadprům
ěrného společ
enské uznán
í; vyšší spole
čenské
uznání
a
vysoké
společen
ské
uznání.
Respondent
R3
výstižně
popsal,
jak
uznání
vnímá
nejen
on
sá
m,
ale
i
jeho
okolí.
Důležitým
prvkem
je,
jak
je
povolání
osobního
asistenta
prezentováno
a
jak
jej
prezentuje
především
samotný pracovník vůči okolí.
Závěrem
V kaž dém pov olání s e prolín á osobn ost jedi nce a jeh o post oj k mor álním
hodnotám a k morálce. Z toho plyne, že morální povinností osobního asistenta
je
zůstat
stále
se
učícím
profesionálem,
účastnit
se
vzdělávání
a
školení
v uznaných školicích střed iscích, s ledovat odbornou literaturu, k onzultovat
s kolegy, učit se z minulých případů, sdílet znalosti a pracovat na schopnosti
tvoření
morálního
úsudku.
Přemýšlení
a
diskutování
o
etických
otázkách
v osob ní asi stenci, nepřichá zí sam o o sobě. Krom ě času je předev ším nez bytná
vstřícnost, empatie, ale také jistá míra discip
líny.
Ač
nechceme
hodnotit
etický
kodex
organizace
či
Etický
model
rozhodování
se, tak
je patrná
positivní
reakce ze
strany pracovníků.
Otázkou
dále zůstává jejich odborné vedení, a zjišťování refl exe na okolnosti v
kterých
chtěli
či se
snažili uplatňovat
dva stěžejní
nástroje, kterým
byl věnován
výše
uvedený
t
ext.
Problematickou
oblastí
zůstává
tedy
efektivní
použitelnost
etického kodexu
a Etického modelu
rozhodování se
ve vztahu k
propojení na
každodenní
výkon
povolání
dané
profese.
Morální
orientace
osobních
asistentů
–
pracov
níků
v
sociálních
službách
je
v
klíčové
pozici
v
oblasti
vzniku
a násled
ného zpracován
í
eti
ckého dilematu.
Po
ukazujeme na potřebn
ost
hlubší
orientace
v
samotné
profesi
za
stá l
ého
podporování
zájmu
o
vztah
k uživateli služby i k organizaci.
Zjištěn
í plynoucí pro prax
i jsou patrná v
sam
otném základu
pr
ofesiona -
lity sociální pedagogiky či so ciální práce. Jestliže podporujeme myšlenku
profesionalizace,
tak
je
nedílnou
součástí
tohoto
procesu
etika
a
profesní
Stárek, L.:
Etický model rozhodování se jako profesní nástroj
56
etika.
Výzkum poukazuje
na
realistické využívání
zejména
etických kodexů.
Otázka se
tedy vztahuje k
formě,
nastavení a obsahu
těchto dokumentů, které
jsou
v současné době nedílnou součástí profese, ale jsou velice povrchně
poja ty. Plynoucím dopo ručením je tedy zohledňovat pro fesní profil daných
pracovníků,
k
dy
nejsou
jen
sociálními
pracovníky
,
sociálními
pedagog
y
či
pracovníky
v
sociálních
službách,
ale
stávají
se
z
nich
odborníci
na
danou
oblast
s ohledem na zaměření pomoci a podpory určité cílové skupiny (děti,
seni
oři, oso
by s
post
ižením
at
d.) či urči
té oblast
i (sociá
lní práce
v
e zdravot
nictv
í,
školství
atd.). Je
tedy nutná
modifikace a
specifikace oblasti
etiky s ohledem
na profesní zaměření pracovníka či specializace
na cílovou skupinu. Následně
pak
může
daný
pracovník
lépe
identifikovat
možná
úskalí
nejen
ve
vztahu
k práci jako takové, ale i k sobě samotnému.
Etika
profe
sního
života
by
měla
korespondovat
s
etikou
celkového
života.
Je
nezby
tné
vážit
si
osobní
kvality
a
morálního
stanoviska
každého
spolupracovníka.
Kromě
kodifikovaných
pravidel
a
e
tických
z
ásad,
které
je
nutno
dodrž
ovat,
je pro
profesi sociální
práce důležité
a nepostradatelné,
aby
pracovník měl vysokou úroveň mravních a osobních hodnot. Etika je nedílnou
součástí osobní asistence.
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besluitvormingsmodel
SPOLEČ
NOST SOCIÁL
NÍCH PRACO
VNÍKŮ ČR. Etický kodex S polečnost i
sociálních pracovníků ČR [online]. [cit. 20. 04. 2019 ]. Dostupné z:
http://s
ocialniprac
ovnici.cz/
public/uploa
d/image/et
icky_kodex
_sspcr.pdf
STÁREK, L., 2015. Etika v práci osobních asis tentů . Praha. Disertační práce,
Pedagogická fakulta, obor studia: Speciální p
edagogika. ID práce
100098.
ÚLEHLA, I., 2005. Umění pomáhat: učebnice me tod sociální praxe. Praha:
Sociologické nakladatelství. ISBN 978 -80-86429- 36-6.
Zákon č. 108/2006 Sb., o sociálních službách. I
n : Sbírka zákonů České
republiky . 14. 03. 2018. ISSN 1211- 1244. Dostupné z :
https://www.zakonyprolidi.cz/cs/2006-108
Mgr. Lukáš Stárek, Ph.D., MBA
Katedra speciální pedagogiky
Univerzita Jana Amose Komensk
ého Praha
Roháčova 1148/63, 130 00 Praha 3
[email protected]
Ligoš, M.:
Tri piliere kvalitatívnej transformácie výučby materinského jazyka I. (Rámcové východiská)
58
Tri piliere kvalitatívnej transformáci
e výučby
materinského jazyka I. (Rámcové východisk
á)
Three Pillars of Qualitative Transform
ation of Teaching
of Mother Tongue I. (Framework
Starting Points)
Milan Ligoš
Abstract
The
article
explains
the
framework
starting
points
of
the
qualitative
trans
format
ion
of
teachi
ng
of the
mot
her
ton
gue
in
Europe
an
edu
cationa
l
background. Based
on the
opening of wider
context of
the dynamics of
socio-cul
tural conditions, the author points to
the
area of new challenges
and dimensions of teaching o
f the mother tongue on the level o
f general
starting
points in
the
intentions of
integrated
profiling of
graduates
for
the 21 st
century. He moves from general to specific, targe
ted teaching of
the mother
tongue, acknowledging the
creation of curricular
documents
as well as
highlig
hting the
progr
essive tendencies of
the most successful
school
system
in the
w
orld.
General
principles
and
target
attributes of
the
European
education
policy
lead
to
s
pec
ification
of
the
expected
competences of school
graduates, which are specifically
reflected in the
area of the educational programme for teaching of the mother
tongue.
Keywords: Education. Teaching. Mother tong ue. Competence. Curriculum.
Project of the teaching subject.
Úvod
Aktu
álnos
ť
kval
itatív
nej
tr
ansfo
rmácie
vyuč
ovania
mater
inské
ho
jaz
yka
v stredoeurópskom geopo
litickom
priestore
po
r. 1989 vidím v
kontexte
histo rických spoločensko
- kultúrnych zmien v integrácii postsocialistických
krajín
do
vyspelého
európsk
eho
sveta.
V
syntetick
ej
podobe
som
sa
tým
to
otázkam
venoval
v
štúdii
Współczesność
i
przyszłość
nauczania
języka
ojczy
stego
w środkowoeu
ropejskiej przestrzen
i
kszta
łcenia
(z uwzględn
ieniem
języ
ka słow ackieg o, czesk iego, niem ieckie go i p olskieg o), ktorá ak tuálne (2 020)
vyšla v Poľsku
1
. Z nej vyberám niektoré relevantné myšlienky do úvodu pred
-
kladan
ého príspevku.
Ak
o už naznačuje jeho názov
, ťažiskovo potom
pr
iblížim
1 Odkazy na zdroje vo východiskách k predkladanému príspevku sa nachádzajú v tejto štúdii.
STUDIA SCIENTIFICA FACULTATIS PAEDAGOGI CAE
UNIVERSITAS CATHOLICA RUŽOMBEROK 2020, č. 3
59
tri
základné
piliere
alebo
nosníky
kvalitatívnej
zmeny
výučby
materinského
jazyka z pozície súčasnosti s roztvorením problematiky do budúcnosti.
V uv edene j štúdii som sa z aobera l najm ä pohľa dom na is tú kom patibi litu
školstv
a stredoeuróp
skych postso
cialistick
ých krajín so v
zdelávacím
pr iestorom
Európy
i
vy
spelým školstv
om sveta s
konkretiz
áciou a aktualizácio
u na
vý
učbu
materinského
(vyučovacieho)
jazyka
v
kontinuu
súčasnosti
a
budúcnosti.
Na
najvšeobecnejšej úrovni je súčasná európska vzdelávacia koncepcia postavená
na
štyroch
strategických
c
ieľový
ch
pilieroch,
a
to:
učiť
sa
žiť,
učiť,
konať
a spolupracovať. Z nich sa odvíjajú cieľové zámery druhej úrovne v
podobe
8
nosnýc
h
kom
petencií, ktoré Európ
sky parlament a
Rada Európ
y (2006/962/ES)
stanovili
ako
rozhodujúce
a
strategické
pre
v zdel
ávanie
občanov
Európy
v 21. storočí. Ide o tieto ťažisk ové kompetencie: komunikácia v materinskom
jazyku (ďalej aj
MJ ) a
komunikácia v cudzích
jazykoch, matematická a príro -
dovedná
kompetencia,
kompetencia
v
oblasti
informačno -
komunikačných
technológií,
kultúrna kompetencia,
kompetencia
učiť sa
ako
sa
učiť, kompe -
tencia riešiť problémy , osobnostná, sociálna a občianska kompetencia. Tieto
kompetencie
tvoria
podlož
ie
pre
stanovenie
cieľov
tretej úrovne,
a to jednak
v obla sti kľúčový ch nadpredm etových kompetenc ií a jednak základných
osobnostných kompetencií. Pre
výučbu materinských jazykov nadpredmetové
kľú
čové kompet
encie sú orient
ované prim
árne na oblasť získ
avania
kog
nitívn
ej,
komunikačnej, personálnej, sociálnej a
kultúrnej kompetencie. So zreteľom na
osobn ostné dimenzie je pre vzdelávanie nosný tvorivo
- humanistický model,
ktorý
zohľadňuje
rozvíjanie
hlavných
sfér
osobnosti
žiaka
kognitívneho
a nonkognitívneho charakteru, ktoré sa vzťahujú na: kognitívnu, emocion álnu,
motiva
čnú, sociálnu, axioolog
ickú, kreatívnu a spirituálno - duchovnú dimenz iu.
Tento
model
poznáme
pod
akronymom
KEMSAKS
(pozri
bližšie
Zelina,
2011;
Ligoš,
2003;
Lig
oš
et
al.
2011).
Na
báze
týchto
cieľov
ých
úrov
ní
sa
potom
odvíjajú
v
národných
vzdelávacích
programoch
základné
vzdelávacie
oblasti
a kurikulá jednotlivých vzdelávacích odborov a učebných predmetov.
V rámci kurikúl sú stanovené špecifické predmetové kompetencie v
postupnej
konkretizácii
k
čiastkovým
predmetovým
kompetenciám
až
po
jednotlivé
deskrip
tory, t. j.
elementárne
jednotky c
ieľ ovo-
obsa
hového zam
erania učebn
ého
predmetu
ako
náplň
al
ebo
k
onkrétne
učivo.
Tento
strategický
postup
vidím
ako
presýp
acie ho
diny č
i spoje
né nád
oby, k
eď v
pr
ojektov
aní uč
ebného
predm
etu
pracujeme s
otázkou „presýpania“, t.
j. postupného zužovania
a konkreti
zácie
zámerov
vzdelávace
j politiky ku
elementárny
m jednotkám
vzdelávania (t
émam,
deskriptorom,
cieľom,
obsahu,
metódam
a
pod.),
realizáciou
ktorých
m
áme
v ka ždode nnej a neop akova teľnej pedag ogick ej praxi mať na z reteli rev erzibi lný
postup
„presýpania“,
t.
j.
dosahovanie
č
oraz
širších
cieľov
vzdelávania
c
ez
jednotlivé stupne
zámerov až
po štyri základné
méty, resp.
strategické piliere
moderného európskeho vzdelávania.
Vo
výučbe
jazykov
bol
EK
najskôr
v r.
1996
prijatý
Spoločný
európsky
referenčný
rámec pre jazyky (SERR) a
následne
aj
Európsky
indikátor
jazyk
ových
kompetencií,
podľa ktorého
si štáty
na
národnej úrovni
Ligoš, M.:
Tri piliere kvalitatívnej transformácie výučby materinského jazyka I. (Rámcové východiská)
60
rozpracovali istý štandard ovládania
cudzích jazykov na šiestich referenčných
úrovniach.
V
praxi sa
potvrdili
špecifiká osvojovania
si
materinského j
azy
ka
v kont
exte socio- ku ltúrnej komu nikácie, preto v EÚ do popredia vy stúpil zámer
pripraviť aj SERR
pre vyučovanie materinských jazykov. V
tejto
súvislost
i
sa
v roko
ch 2005- 2006 kon ali reprezentatív ne konferenc ie v Štrasburg u a Krakove
k vypra covaniu štandardizácie úrovní ovládania MJ, avšak tento projekt zatiaľ
zostal v rámci EÚ ne dokončený.
2
V r. 201 6 vyšla v anglickej mu tácii publik ácia
Teaching of
Nati
onal
Languag
es
in the V4
Countrie
s
(Vyučovanie národných
jazykov
v krajinách Vyšehrádskej štvorky), v ktorej sa celkove potvrdila istá
podobnosť
v
spoloč
enskom
vývoji i v
teórii
a
praxi
vyučov
ania
materinského
jazy
ka. V tý chto post social istický ch štáto ch stredn ej Európy je p ríznač ný príklo n
ku integrovanej koncepcii jazykovo- komunikačnej a
lite rárne j komunikácie so
záž
itkovým
, konštr
uktivi
stickým
a holist ickým prí stupom k rozvíja niu osob nosti.
žiaka.
Avšak
analy
zujúc silné a
slabé stránky národný
ch
edu
kačných systémov
autori
publikácie
zhodne
konštatujú
istú
diskrepanciu
medzi
požiadavkami
didak tickej teórie a deklarovanými zámermi v pedagogických dokum entoch
a reálnou štátnou vzdelávacou politikou s markantným negatívnym dopadom
na š
kolskú
prax.
Je to v zhode s moji mi skú senosť ami a zisteni ami, p odľa k torýc h
na
viacerých miestach
publikačných výstupov
konštatujem túto
tendenciu vo
vyuč
ovaní
sloven
činy vý
razne od
Februá
ra 1948
v
Česko
sloven
sku. I
šlo o z námy
rozpor
medzi deklarovanými
cieľmi, často
i
propagandisticky pr
edkladaným
i
zámermi
ústredných
orgánov
v
programových
vyhláseniach,
zákonoch
a i .
dokumentov
na j
ednej strane
a koncepciou
i obsahovou náplňou spracovania
východiskových
podkladov,
najmä
však
v
kolízii
s
reálnou
praxou
na
strane
druhej.
Podľa
cit.
príspevku
(Ligoš,
2020)
súčasnú
koncepciu
vy
učovania
slov
enčiny
ch
arakte
rizujem
e
ak
o
vy
ústen
ie
p
rogres
ívnych hist
orický
ch tendenc
ií
v kontexte nových výziev moderného európskeho vzdelávania, ktoré v genéze
post
upne sme
rovali k vyv
ažovan
iu jazyko
vo -
sys
témove
j (aj slohov
o - syst émovej ,
literárn
o - systém ovej) a kognitív no - komunik ačnej (aj kultú rn o- literárne j) výcho -
vy,
a to
v integrácii smerom ku holistickému poňatiu v intenciách rozvíjania
istých
kompetencií
a
scho
pností
žiaka.
V
tomto
zmysle
súčasnú
koncepciu
vyučovania slovenčiny
chápem
e
predovšetkým ako integračnú
komunikačno -
- kognit ívnu a zá žitkovú (poz ri najmä Liptákov á et al., 2015, s. 12; Ligoš, 2019 ,
s. 170). V pod state to znamená, že vy chádzajúc z na jnovších pozna tkov lingvo -
didaktiky a pedagogicko-psychologicke
j i odborovo-didaktickej vednej oblasti
modernú
koncepciu
vyučovania
materinského
jazyka
vidíme
na
podloží
ťažisk
ových
všeobecn
odidaktický
ch
a lingvistic ko- literárno vedných princ ípov,
vrátane
princípov
rečovo -
komunikačnej
ontogenézy
žiaka,
smerujúce
od
2 Na Slo vensku bol dokončený projekt KEGA (č, 3/2245/04) Štandardizácia úrovní ovládania
slovensk
ého jazyka s
výst
upom v
r. 2008, ktorý
koordinovala FF UCM v T rnave so zodpoved nou
riešiteľkou E. Nemcovou.
STUDIA SCIENTIFICA FACULTATIS PAEDAGOGI CAE
UNIVERSITAS CATHOLICA RUŽOMBEROK 2020, č. 3
61
kognitívneho
(konceptuálneho)
kurikula
cez
transform
áciu
ku
didaktickému
projekt u uče bného predmetu (didaktickému systému, modelu) a na tejto báze
sa
približujeme
k
projektovaniu
edukačnej
praxe
či
jej
realizácii,
t. j. ku
realizovanému a
dosiahnutému kurikulu (porov. Lipták
ová et al., 2015, s. 33
–
35). Hlavný problém pri aplikácii u vedene j koncepci e v praxi vyvstáva v tom,
že
v
centrálnych
pedagogických
dokumentoch
v
intenciách
jej
postupnej
konkre
tizácie, t. j. na úrovni Štátneho vzd
elávacieho prog
ramu (ŠVP) a vzdelá -
vacích štandardov na vyučovanie
slovenského jazyka a
literatúry (VŠ na SJL)
ich
spracovanie
„sklzáva“
do
podoby
tradičného
teoreticko -
akademického
programu,
v ktorom reálne do po predia vystupuje sy stém, štruk túra, po jmy,
faktuálne,
prípadne
i
k
onceptuálne znalosti a absentuje kontext v
reláciá
ch
s očak ávaným zvládnutím jazykovo - k omunikačný ch kom petencií, s rozvíjaním
vyšších
k
ognitívnych
funkcii,
kritického
my
slenia,
riešenia
komunikačných
situácií a pod. s
métou profilácie integráln
ej osobnosti žiaka.
Do východísk a úv odu zaradím ešte niekoľko vybraných m yšlienok
z medzinárodných meraní najlepších škôl vo svete z ostatného obdobia (pozri
podrobnejšie
Ligoš,
2020,
3.
časť).
Metriky
v
medzinárodný
ch
kontextoch
a komparáciách sa výraznejšie dostávali do popre
dia
v 2. polovici minulého
storočia
najmä
v
rámci
UNESCO
a OCED,
ktoré
boli
zamerané
primárne
na meranie dosahovania funkčnej gramotnosti s preferovaním čitateľskej
gramotnosti
a vôbec čitateľskej kultúrnej gramotnosti žiakov primárneho
a nižšieho sekundárneho vzdelávania, u
15- ročných sa testovanie orientovalo
i na matematickú a prírodovednú gramotnosť, pri čom postupne pribúdajú
i pa ramet re sociál no - kul túrnej ko mpete ncie, tím ovej prác e či kritic kého mys lenia
a hodnotenia (testovanie PIRLS,
TIMSS, PISA a i. ). Inou oblasťou je metrika
Prog
ramu medz
ináro
dného hod
noten
ia kompete
ncie dosp
elých (PI
AAC) OEC
D.
V ostatnom období sú aktuálne i otázky zvládnutia cudzích jazykov (podľa
SERR EÚ jazyk
ový pas, jazykov
é portfólio, v
US
A štandardizov
ané testy ACT
zamera
né n a predpoklady v o blasti angličti ny, matematik y, čítania a prírod ných
vied, nehovoriac o problematike merania rankingov VŠ) alebo úrovne telesnej
kultúry a zdatnosti. Do tohto okruhu by sme mohli zaradiť i
tradičné talentov
é
a iné pre dpoklady u chádzačov o štúdium, r esp. o isté fu nkčné miest a a pracovné
pozície,
ale
to
je
už
oblasť
mim
o
záujmu
tohto
príspevku.
Vráťme
sa
teda
k rezortu školstva.
Sloven
sko
s os tatnými stredoeurópsk ymi po stsocialistic kými kr ajinami
sa
po
r.
2000
na
úrovni
regionálneho
školstva
z
apája
v
etablovanej
metrike
PISA
v rámci OCED a r elevantnú výpovednú hodnotu má i
zostavovanie
rebríčka
najvyspelejšieho
školstva
vo
sv
ete,
napr.
známe
výstupy
Top
40
krajín s
najlepšími školami, zverejnené na portáloch britskej vysielacej stanice
BBC.
Pr i tomto probléme sa bližšie pristavím nižšie v prvom tematickom
okruhu tohto
textu. Na úvod tu
len spomeniem, že
podľa posledného merania
v r. 2018 (pozri zverejnené výsledky PISA, 9.12.2019, dostupné online na:
https://www.nucem.sk/dl/4628/Priloha_vysledky
_kra-jin_PISA_2018.pdf)
SR
sa zo 79 krajín v
čitateľskej gramotnosti umiestnila pod priemerným
výkonom
Ligoš, M.:
Tri piliere kvalitatívnej transformácie výučby materinského jazyka I. (Rámcové východiská)
62
(skóre 458),
v tejto kategórii aj Maďarsk o (sk óre 476), s priemerný m výkonom
ČR, avšak v
prvej desiatke bolo Poľsko (na
10. mieste so skóre 512 za takým i
krajinami,
ako
B-S-J- Z (Čína), Singapur, M akao (Čína), Honk ong, Kanada,
Fínsko,
Írsko
a
Južná
Kórea.
Pod
priemernými
výsledkami
sa
Slovensko
umiestnilo i v prírodovednej gramotnosti, pričom v
matematickej kompetencii
malo lepšie
výsledky o
jednu
kategóriu (na priemernej
úrovni), pričom
ČR si
udržala
v
matematic
kej i prírodov
ednej oblasti
nadprieme
rné výsledky a Poľsku
patr
ilo 10
. mies
to nie
len v č itateľs kej, a le aj m atemat ickej g ramot nosti, 11. m iesto
obsadilo
v obla sti pr írodovedný ch komp etencií. Podľa m erania PISA v r . 2018
je ešte relevantný prinajmenšom údaj, že rizikovú skupinu
tvorí 31, 4
% našich
žiakov.
Ide
najmä
o
žiakov,
ktorí
navštevujú
nematuritné
odbory
stredných
škôl
a
základné
školy.
S uvedeným i
výsledkami
evidentne
koreluje
takisto
spomenut ý rebríček či ranking najvyspelejšieho školstva sveta (v ostatných
rokoch
najmä
obľúbený
Top
40
krajín).
V
tomto
kontexte
je
prinajmenšom
zaujímavý
a
inšpiratívny
príklad
školstva
Poľska
po
r.
1989.
Totiž,
k
ým
do
r. 2006 v medzinárodných meraniach výraz ne zaostávalo i za k rajinami ako
ČR, Maďarsko a Slovensko, testovania PISA v
r. 2014
alebo 2018 preukázali,
že poľské školstvo
sa zaradilo ako 4.
najlepšie v
Európe a
10. na
svete. Podľa
výsledkov
v
komparácii
40
vybraných
krajín
„vyšiel
ako
najlepší
systém
n a
svete v Južnej Kórei, za ktorou nasledujú Japonsko, Singapur a Honkong. Až
za nimi
sa umiestnil viacročný líder
Fínsko a po ňom
na 6. mieste,
ako druhý
najlepší systém
vzdelávania v
Európe V
B. 10. miesto
opäť patrilo
Poľsku, za
ním
na 11.
pozícii
Dánsku, 11. Nem ecku, 13. Rusku a 14. boli USA. Medzi
najlepšími sa ocitlo aj Česko (20. miesto) a
Maďarsko (22. m
iesto). Slovensko
skončilo na
27. pozícií.
Okrem Fínska
a VB sa teda do prvej desiatky dostali
aj
Poliaci,
ktorí
predbehli
krajiny
ako
Nemeck
o,
Rakúsko,
Dánsko
a USA
(pozri Ligo
š, 2020). I
keď k
nadužívan
iu
m
etrík môžeme zaujať kritick
ý postoj
(pozri
nižšie,
ad
1), ako
vidieť
z
uvedených
výsledkov, hodno
sa
zamyslieť,
na
čom
je
založený
dlhodobejší
úspech školstva
niektorých
krajín,
resp.
pre
náš
stredoeurópsky
vzdelávací
priestor
postsocialistických
štátov
je
určite
relevantná
otázka, preč
o sa
stalo
Poľsko
po
r.
2010 takým
svetovým
lídrom
v školstve.
Opierajúc
sa
o
moju
najnovšiu
monografiu
(Ligoš,
2019)
a
štúdiu
(Ligoš
,
20
20) v
predkladan
ých dvoch štúdiách ťažis
kovo načrtnem tri zákla
dné
piliere kvalitatív
nej
transfor
mácie
slo
venského regionálneho školstva s ilustra-
tívnou
konkretizáciou
vyučovania
materinského
jazyka,
osobitne
slovenčiny
so zreteľom na isté výhľady do budúcnosti.
1. p
ilier.
Rámc
ov é ko ntexty vyučo vania vyuč ov acieho (mate rinské ho) j azyka
Do rám
cových
k
ontext
ov zaraďu
jem spolo
čensk
o -
polit
ické, ek
onomick
é
a kultúrno - vzdelávacie prostredie širšieho, t. j. v našom prípade najmä európ
-
skeho, slovenského i lokálneho charakteru. Patrí tu problematika vzdelávacej
STUDIA SCIENTIFICA FACULTATIS PAEDAGOGI CAE
UNIVERSITAS CATHOLICA RUŽOMBEROK 2020, č. 3
63
politiky,
jazykovej
kultúry
a
komunikácie
na
rôznej
úrovni,
ktorá
vytvára
podl
ožie pr
e konkr
étnu rea
lizác
iu výcho
vno -
vz
deláva
cieho pô
soben
ia v uče bnom
predmete MJL (SJL) prostredníctvom každodennej náplne
učiteľa slovenčiny.
Ako
som naznačil vyššie v úvode, pre jazykovo - komunikačné vzdelávanie
máme
v
súčasnosti
vytvorené
základné
piliere
a
rámcové
cieľové
atribúty
prof
ilácie
občana E
Ú s
očaká
vaným
i kľúčov
ými komp
etenci
ami pre 21
. storoč
ie.
Kým
pre
cudzie
jazyky
ciele
a
náplň
sú
jasne
vymedzené
východiskovým
dokumentom SERR,
vo
vyučovacích, resp.
materinských jazykov
bude
treba
dopracovať analogický strategický
materiál v
podobe Spoločného
európ
skeho
referenčného
rámca
pre
vy
učovanie
(osvojovanie
si)
materinských
jazyk
ov
(SERR/MJ).
Určité
kroky
v
tomto
smere
boli
už
vykonané
(pozri
vyššie
v úvod e), avšak užit očné by bolo vy pracovať is té stupne ovlá dania a použ ívania
materinských
jazykov
v
podobe
rámcových
štandardov,
čo
je
špecifické
pre
rodn é, resp. materinské jazyky v úzkom prepojení na komunikačnú a kultúrnu
kompetenciu človeka v
reláciách
s komplexným integrovaným rozvojom jeho
osobnosti.
V prvej etape by postačilo okrem istých štandardizácií úrovní
ovládania
MJ
uvažovať
o
dosiahnutí
portfólia
(podobne
ako
v CJ). V tomto
zmysle by išlo o
iné východiskové úrovne, súvisiace s
prirodzeným
osvojením
si
MJ
a komunikácie, na čo by sa vzťahovali aj ďalšie úrovne až po
štandardizácie
z
hľadiska
vykonávania
rôznych
spoločenských
a
pracovných
pozícií,
napr. špecifikácie
pri povolaní
učiteľa,
herc
a,
politika,
lekára, kňaza,
obchodníka,
manažéra
a
pod.,
na
čo
by
sa
vzťahovali
isté
predpoklady,
požiadavky
a
očakávania
pri
z
vládnutí
šta
ndardných
rečovo -
k
omunikačných
situácií z
hľadiska dynamiky života.
V kontexte vzdelávacích rámcov vyučovania sl ove nčiny problém
vidím v spoločensko -
politickej klíme a v
reálnom nastav
ení vzdelávania v SR.
Dlhodobo
som
totiž
svedkom
síce
moderných,
progresív nych a kultúrno -
humanistických zámerov
v
programových dokumentoch
centrálnych štátnych
orgánov
, t.
j.
vý
konnej moci i
parlamen
tnej demokracie,
avš
ak na
báz
e
vlast
nej
empírie
sa presvie
dčam o
tom, že
zväč
ša
ide
iba o
deklará
cie alebo
pr
opagáciu
nových
cieľ
ov
v
ro
zpore so
sk
utočnosťou v
každo
dennej praxi. Dá
sa p ovedať,
že
vzdelávanie
(aj
celoživotné)
sa
má
st
ať
relevantnou,
resp.
ťažiskovou
záležitosťou
celej spoločnosti.
Vzájomné prepojenie
sa
potom participačným
subsidiárnym efektom prejaví na priaznivej
spoločens
kej
klím
e
a v
dôstojnom
živote pre
všetký
ch
občanov. V tomt
o zmysle
vystupuje do popredia problém
absencie
kľúčových legislatívnych
a
pedagogických
dokumentov po
r.
1989,
ktoré
by
kontinuálne
a
strategicky
nasmerovali
slovenské
školstvo
dopredu
v kompatibilite s vyspelými krajinami sveta, resp. i
v našom stredoeurópskom
vzdelávacom priestore.
Tu totiž
zaostávam
e
aj za
štátmi V4.
Ako som vyššie
naznačil, v
súlade
s
novým školským
zákonom
č. 245/2008
Z.z. a
posledným
Národným
programom
výchovy
a
vzdelávania
na
r.
2018
–
2027
(dostupné
na:
https://www.slov-lex.sk/pravne-
predpisy/SK/ZZ/
2008/245/,
https://www.
mine
du.sk
/data/
att/13
285.pd
f)
do
teraz platn
é
dok
umenty centr
álneho
cha
rakter
u,
najmä ŠVP
a
VŠ predmetov, konk
rétne pre SJL všetký
ch stupňov regio
nálneho
Ligoš, M.:
Tri piliere kvalitatívnej transformácie výučby materinského jazyka I. (Rámcové východiská)
64
vzdelávania sú neadekvátne, ťažkopádne, neprehľadne a
neinštruktívne konci -
pované
a
bude
treba
ich
nanovo
prepracovať
v
konfrontácii
s dokumentm i
vyspelých
krajín
(pozri
nižšie,
ad
2).
Problém
začína
už
tým,
že
v
ŠVP
pre
jednotl
ivé
stupn
e
vzde
lávania
prí
liš
zlož
ito,
širok
o
a kom plikovane vymedzuje
základný
cieľ
výc hovy a
vzdelávania.
Takto
sú
všeobecné
ciele
a profil
abso
lventa
predl
ožené n
a pribli
žne jed
nej str
ane tex
tu (poz
ri napr
. ŠVP IS
CED 2,
dostupn
é na: http://ww w.statpedu.s k/files/art icles/doku menty/inov ovany-statny -
vzdelav
aci-program
/svp_nsv_
6_2_2015.p
df,
s. 4 –
5).
Na porovnani
e
v kra
jine
top
školstva
Singapur
hlavný
cieľ
majú
jednoducho
a
výstižne
stanovený
takto:
Spolo
čnosť
chce,
aby
absolvent
školy
bol
angažovaný
občan,
dobrý
pracov
ník a
sebavedomá osoba, ktorá sa vie učiť. Vo
všet
kých najúspešnejš
ích
vzd elávac ích p rogram och sveta sa v p odstat e najč astejš ie pr ezent uje po žiadav ka
sebavedomia a sebaobrazu, sebariadenia, tvorivosti, angažovanosti a
informo-
vanosti (porov. Feřtek, 2015, s. 32). Ako vidieť, tieto ci eľové atribúty sa
približujú k
základným pilierom vzdelávacieho priestoru Európy (pozri vyššie
v úvode).
Okrem
rámcov
ých spoločensko - kultúrnych kontex tov a celkovej klímy
v krajin e sa mi ponú ka otázka, v čom spočív a tendenčný alebo dlhodo bý úspech
niektorých
vzdelávacích
systémov
vo
svete.
V porovnan
í
so
Slovenskom
je
totiž profit príznačný i
pre také blízke krajiny ako Poľsko alebo
ČR, príkladné
však m
ôžu byť i
Fíns
ko, Nemeck
o alebo Dánsk
o a
Estónsk
o (pozri Lig
oš, 2020,
s. 103 – 105). V Poľsku pre kvalitatívnu zmenu určite výpovedne hovoria
ambiciózne
radikálne reformy
po roku
1989,
z
ktorých sa
ako najvýraznejšie
vnímajú reformy
v rokoch 1999 a 2007.
3
Podobne
ako v našej tradícii od čias
1. štátneho školského zákona Ratio edukationis (1777, 1806) z
obdobia
vládnutia
Márie T
erézie (pozri
podrobnejšie
Ligoš,
2019,
1. kap.) o 6-
ročne
j
základnej
škole a
najúspešnejšie
vzdelávacie
systém
y
sveta
(najmä východo -
ázijské
krajiny,
ale
i
Poľsko
a
i.)
sa
vyznačujú
prevažujúcim
modelom
štruktúry regionálnych škôl 6 -3-3/4, t. j. po 6-
ročnej základnej škole nasleduj e
prechod
ný j
ed
notný 3 -
ročný typ nižšej školy, ktorý zvyčajne končí závere
čnou
skú
škou s
funk
ciou istej pote
nciáln
ej
di
ferenc
iácie v
ďa
lšom štúdi
u. V Nemeck u
(alebo
v Rakúsku) majú tradične 4 - ročnú základnú školu, po ktorej už podľa
dosiahnutých
výsledkov
žiaci
môžu
pokračovať
na
3 -
4
typoch
nižšieho
sekundárneho vzdelávania v otvorenom zmysle, t. j. ide o
skoršiu vzdelávaciu
diferenciáciu,
pričom
je
tu
špecifi cky rozvin
utý
duálny
systém
vzdelávania
v podmienkach stavovských organizácii a
firiem
v úzkej previazanosti
s dôstojným statusom remeselníka v
krajine.
3 Treba však poznamenať, že aktuálne podľa ustanovenia Zákona o vzdelávaní z r. 2016 a tzv.
deklara
tívneho uznesenia vlády sa
od septembr
a
2019 končí v
Poľsku reformný model štruktúry
národného školstva. V
podstate sa sp
iatočnícky
vracia do centralistických kontúr pred rok 1989
a jeho ďalší vývoj je otázny a neistý.
STUDIA SCIENTIFICA FACULTATIS PAEDAGOGI CAE
UNIVERSITAS CATHOLICA RUŽOMBEROK 2020, č. 3
65
Porovnávajúc najvyspelejšie školy sveta sa
ako zaujímavý
ukázal fakt
o t
om
,
že na
výsledkoch relevantným spôsobom
naparticipujú také
premenné
ako j
e dĺžka
povinnej školskej
dochádzky či
rozsah
denného/ročného pobytu
žiaka v
ško
le (známe najmä vo
východo
ázijských krajin
ách), takisto frekv
encia
testovania, zdroje financovania alebo oblasť jednotného vs. diverzifikovaného
kurikula.
V súvislosti s
metrikami
a testovaním sa potvrdzuje Colemanova
správa z r. 1966, dobovo objednaná admin istratívnou pr ezidenta USA Joh nsona
v rámci projektu „Rovné vzdělávací příležitosti“, v ktorej konštatoval, že
„vý
stupy ško
l závise
jí na vstupe
ch: výko
ny stude
ntů kore
lují těsn
ě se sociál
ními,
ekonomickými a
vzdělávacími
výsledky jejich
rodičů“
(Muller, 2020,
s.
88).
Tieto
závery
v zhode s
mojou
empíriou
i
vlastným
bádaním
jednoznačne
v ostatnom období potvrdzujú viaceré medzinárodné merania (pozri vyššie).
Podľa
správy
PISA
z
r.
2019
sa
dokonca
ukazuje,
že
zo
všetkých
porovná -
vaných
krajín
má
rodinný
pôvod
(a
rodinné
zázemie)
na
výsledky
žiakov
najväčší
vplyv
na
Slovensku,
na
čo
sa
ešte
príz
načne
vzť
ahuje
zistenie,
že
žiaci
z najchu
dobnejších
slovenských
rodín
majú
v
značnej
miere
horšie
výsledky ako ich relatívne podobne chudobní vrs
tovníci v zahraničí. Prakticky
to
znamená
záver,
že
rozd
iely
vo
výsledkoch
vzdelávania
nemožno
celkom
„ve
skutečnosti
lepším
vzděláním
odstranit
–
a
že
důvody
přesahují
rámec
škol“ (ibid., s. 88). V
tejto súvislosti je už inou o
tázkou problematika chápania
pojm
u
„me
ranie“
a
ďal
ších oblastí
,
ako
testo
vanie,
evalv
ácia a diag nostik ovanie
v komplexnom zmysle (pozri ďalej, ad 2). Okrem spomenutého soc iálno -
-e konomického a kultúrneho zázemia rodiny žiaka v danom prostredí medzi
najzávažnejšími
faktormi
úspešnosti
školských
výstupov
sa
ukázali
tieto:
„zainteresovanosť
(záležitosť)
celej
spoločnosti,
kvalitní
učitelia
a ich
spoločenský status, štruktúra vzdelávacieho systému, progresívna koncepcia
a adekvátne pedagogické dokumenty (v ostatných rokoch sa presadzuje
viacúrovňové
kurikulum,
prinajmenšom
určené
štátom
a
školou,
povinné
a nepov inné a pod.), kvalita výchovy a výučby, komple xný a holistický prístup
k žiakovi“ (Ligoš, 2020, s.
105).
V ďalšej č asti upriamim pozornosť na dva
z tý chto rozhod ujúcich deter minan toch ak o o pi lieroc h kval itatív nej tra nsform ácie
výchovno - vzdelávacieho procesu v MJ.
2. pilier. Projekt učebného predmetu (kur
ikulum) a problematika
modelovania, plánovania, riadenia, realiz
ácie a diagnostikovania
výchovno - vzdelávacieho procesu.
4
S rámcovým kontextom je v prieniku prepojená prob lematika projektu
učebného
predmetu
a
realizácie
procesu
ako
komplexnej
tvorivej
ľudskej
činnosti
v
intenciách
holistického
rozvíjania
integrovanej
osobnosti
žiaka.
4 Doko nčenie 2. piliera a 3. pilie r priblí žim v ďal šej štúd ii s pred poklado m publik ovania v period iku
Studia scientifica fakultatis pedagogicae r. 2021.
Ligoš, M.:
Tri piliere kvalitatívnej transformácie výučby materinského jazyka I. (Rámcové východiská)
66
Do projektu zaraďujem všetky podklady, resp. dokumenty kurikula v podobe
konc
epcie
,
mo
delova
nia, plánov
ania,
ria
denia a
pr
ípravy
na konk
rétnu real
izáciu
výchov
no - vzdeláva cieho pro cesu. V na šich vý skumoch som tomut o fenomén u
prisúdil
status
základného
objektívneho
a
relatívne
statického
motiv
ačného
činiteľa
(porov. v
prácach
Ligoš, 1999,
2003, Ligoš
et
al., 2011
a i.). Projekt
učebného predmetu
vnímam na
horizontálnej i
vertikálnej
úrovni, a to j ednak
n a centrálnej v rámci štátu a jednak na lokálnej (školskej) úrovni i úrovni
učiteľa
slovenčiny,
na
dru
hej
strane
v
istom
hierarchickom
rozvrstvení
od
najširších
rám
cov
až
po
konkrétnu
p
rípravu
na
vyučovanie
učiteľa
aj
jeho
realizáciu,
vrátane
diagnostikovan ia, hodnotenia, sebareflexie a modelovania
ďalšej činnosti. Aspoň stručne priblížim
jednotlivé polohy tohto faktora.
Na
úrovni
širších
kontextov
by
sa
projekt
mal
koncipovať
v
rámci
zámerov medzinárodného
spoločenstva, čo
pre nás
znamená, ako
som
vyššie
p oukáz al, na báze vzdelávacej poli tiky EÚ a SR. Na úrovni štátu ide o národný
program
výchovy
a
vzdelávania
(najnovší
z r. 2018) a
ŠVP
(inovovaný
v r.
2015), vrátane vzdelávacích štandardov učebný ch predmetov a ostatných
centrálnych
pedagogický
ch
dokumentov,
ku
ktorým
patria
najmä
rámcový
učebný
plán,
metodické
pokyny
na
hodnotenie
a
klasifikáciu,
štandardné
testy,
ako
nepovinné
aj
uč
ebnice,
metodické
prí
ručky,
cvičebnice,
pracovné
zošity a pod. V
kontexte školy projekt
učebného predmetu je
koncipovaný na
po dloží školského vzdelávacieho programu (ŠkVP), tem atických vý chovno -
- vzdelávacích plánov učiteľa a jeho prípravy na vyučovania, pričom do tohto
okruhu
implic
itne
a p rierezovo patrí i odborná pedag ogicko - didak tická kompe -
tencia učiteľa, materiálno -technick á vybavenosť školy, zariadenie, učebné
pomôck
y,
vých
ovno -
vzdelá
vacia sila
ped
agogického
kolekt
ívu i socio- kultúrn e
prostredie
školy,
jej
riadenie
a
osobitne
rodinné
zázemie
žiakov.
Ako
sa
uvedené rozmery prejavujú vo vertikálny
ch priezoroch?
Na
prvom
mies te kurikulum, resp. projekt učebného predmetu musí
zohľadňovať
východiská,
piliere
a
princípy
vzdelávania
medzinárodného
vzdelávacieho
priestoru
v
intenciách
očakávanej
profilácie
občana
daného
spoločenstva
v
istom
zoskupení
(EÚ).
Na
tieto
širšie
kontexty
nadväzuje
kurikulum prinajmenšom v
trojstupňovom
rozlíšení, a
to najskôr konceptuálne
kurikulum, ktoré
predstavuje kognitívny
model učebného pr
edm
etu
v podobe
odborného
podložia
z
hľadiska
didaktickej
komunikácie
(pozri
pod
robnejšie
Liptáková
et
al.,
2015, s. 33 –
35,
Ligoš,
2014,
2015,
2016).
V zhode
s Liptákovou
(op.
cit.,
s. 35) uvádzam, že pre teóriu a prax vyučovania
materinského
jazyka
sú
pri
koncipovaní
konceptuálneho
kurikula
relevan
tné
jednak
princípy
z
hľadiska
jazykovedno -
literárnovednej
oblasti
(princípy
súvisiace
so
stavbou,
vývinom
a
fungovaním jazyka, s
recepciou,
analýzou
a interpretáciou literárneho textu a
s proces om rečovej ontogenézy žiakov)
a pedagogicko- psychologickej oblasti (zo všeobecnodidaktických princípov
najmä
princípy korelujúce s
vytváraním
optimálnych
podmienok vyučovania
a
zohľadňujúce
reálne
uč
ebné
m
ožnosti
ž
iakov).
Z
konceptuálneho
kurik
ula
sa odvíja
didaktický systém v
podobe ďalšej
konkretizácie projektu učebného
STUDIA SCIENTIFICA FACULTATIS PAEDAGOGI CAE
UNIVERSITAS CATHOLICA RUŽOMBEROK 2020, č. 3
67
predmetu. Na tejto úrovni na
základe špecifických princípov vyučovania MJL
(pozri
Svobodová
2000,
Ligoš,
2005,
2009a,
2009b,
2009c,
Obert,
1992,
2003,
Liptáková
et
al.,
2015
a
i.)
sú
stanovené
ciele,
obsah,
organizácia
a riaden
ie, proces a hodnote
nie v učebnom predme te. V podstate ide o rámco vé
centráln
e kurikulum pre SJ L, t. j. o ŠVP, VŠ, učebné plá ny, vstupné a vý stupné
štandardné
testy,
metodické
pokyny
na
klasifikáciu,
v
ktorých
sa
implicitne
a prierezovo majú uplatniť špecifické princípy koncepcie učebného predmetu.
Tretiu
úroveň
kurikula
predstavuje
edukačný
systém,
„t.
j.
konkretizácia
projektovaných
kurikulárnych
vstupov
a
výstupov
a
plánovaného
procesu
vyučov
ania
v školských dokume ntoch, v učebných materiálo v a v o vyuč ovacej
praxi“
(L
iptáková
et
al.,
2015,
s.
33).
Ide
teda
o
modelovanie,
plánovanie,
realizác iu a zavŕš enie výchovn o - vzdelávac ieho procesu v škole s hod noteným,
dosiahnutým
výstupom.
Ako
vidieť,
táto
úroveň
z
ahŕňa
zložitú
komplexnú
a reálnu oblasť výchovno - vzdelávacieho pôsobenia učiteľa slovenčiny
v konkrétnej
praxi,
v rámci ktorej sa ukáže jeho erudícia, pripravenosť,
kompetencia
a špecifická participácie na integrovane j profilácii absolventa
školy.
A v
tejto súvislosti
môžu
vyvstávať do
popredia
viaceré problémy,
na
ktoré výberovo ďalej poukážem z
hľadisk
a zámeru tohto príspevku.
Jeden
z hlavných problémov vidí
m
v spracovaní konceptuálneho
a didak tického kuriku la na ce ntrálnej úrovni . Na ten to problém som v ostat nom
období
poukázal
v niektorých publikačných výstupoch (poz ri Ligoš, 2015,
2016)
na
báze
komparácie
vzdelávacích
programov
v
blí
zk
om
zahraničí.
Dôležité
je,
aby
ŠVP
a
VŠ
boli
pre
riadenie
učebného
predmetu
v
škole
rámcové, stručné,
prehľadné, zrozumiteľné a
inštrukt
ívne
na jednej
strane, na
strane
druhej,
aby
zahŕňa
li
nielen
ciele
a
obsah
(pričom
je
vhodné
spájať
cieľovo - obsahovú kategór iu v podobe vzdelávacieho štandardu), ale i proces,
riadenie a najmä diagnostikovanie. Na úrovni cieľovo - obsahového zamerania
je
nevyhnutné prejsť
od teoreticko -
akademického
chápania ku
kompetenčno -
pojmovému, r
esp. vhodnejšie
ku
kompetenčno -
zážitkovému prístupu
vzdelá -
vacieho štandardu, v ktorom teor etick é poznatky (pojmy, fakty, pri ncípy,
štruktúry
a
pod.)
majú
status
odborného
podložia
(opory)
pre
získavanie
očakávaných kompetencií žiaka
v
učebnom predmete. V
tejto súvislosti
sa mi
žiada
zdôrazniť,
že
do
učiva, res
p. učebného
obsahu
nepatria
iba
vedomosti
alebo
zručnosti,
ale
i
metódy,
postupy,
stratégie,
procesy,
návyky,
hodnoty,
postoje,
záujmy,
schopnosti
a
požadov
ané
kom
petencie.
V
novom
poňatí
sú
východiskovou
didaktickou
kategóriou
ciele
ako
zámery
a
lebo
výstupy,
z ktorých sa odvíja obsah učebného predmetu, lebo ciele sú o niečom, t.
j.
organicky
ukazujú
i
na
učebný
obsah
(učivo),
ktorý
sa
nemôže
tradične
orientovať
iba
na
vedomosti
a
zručnosti,
ale
i
na
vyššie
úrovne
rozvoja
osobnosti
žiaka.
Preto
v
nových
pedagogický
ch
dokumentoch
sa
uvádzajú
nielen
faktuálne
a
k
onceptuálne
znalosti,
ale
i
procesuálne
a metakognitívne
s dimenziami prinajmenšom 6 úrovní kognitívneho procesu: zapamätať si,
rozumieť,
aplikov
ať,
analyzovať,
hodnotiť
a
tvoriť
(pozri
Liptáková, 2012,
s. 24 a i.). Podľa mojich analýz a zistení ŠVP a VŠ na vyučovanie SJL treba
Ligoš, M.:
Tri piliere kvalitatívnej transformácie výučby materinského jazyka I. (Rámcové východiská)
68
nanovo spracovať z
hľadiska koncepcie, formátu, štruktúry, takisto a
j rozsahu,
zrozumiteľnosti
a
inštruktívnosti
pre
tvorbu
učebných
textov
a
edukačné
kurikulum.
Napr.
v týchto platných dokumentoch úplne absentuje oblasť
modelových
úloh,
konkretizácie
cieľových
zámerov
smerom
ku
čiastkov
ým
cieľom v
podobe deskriptorov, nehovoriac
už o
procese, hodnotení a diagnos-
tikovaní.
Pristavím
sa
pri
závaž
nej
a v
teórii,
ale
najmä v
praxi
podceňovanej,
zna
čne reduk
ovane
j oblast
i diagno
stikov
ania. To
tiž je roz
diel med
zi hodn
otením
,
klasifikáciou, evalváciou, metrikami a
diagnostikovaním. Rozdiel
treba vidieť
i medzi diagnostikovaním a diagnostikou. Podľa P. Gavoru (Kožuchová et al.,
2011, s. 10, 11, 12): „Pedagogická diagnostik
a je vedná disciplína zaoberajúca
sa
t
eóriou
diagnostického
procesu...
Od
diagnostiky
musíme
odlišovať
pedagogickú
evalváciu
(resp.
jej
činnosť
–
pedagogické
evalvovanie)...
Diagnostikovanie
(diagnostická
činnosť)
na
rozdiel
od
diagnostiky...
je
zisťovanie,
analyzovanie
a
hodnotenie
úrovne
rozvoja
žiaka
(žiakov,
triedy)
ako
objektu
a subjektu výchovného a vzdelávacieho pôsobenia“. V
zhode
s m ojím názoro m te nto autor uvádz a (op. cit., s. 12 – 19 ), ž e sú časné konc epcie
diag
nostik
ovani
a smerujú ku zí
skania kom
plexn
ejšej a
kon
zisten
tnejše
j diagnóz
y
žiaka,
učiteľa,
šk
oly,
kontextu
či
rodinné
ho
prostredia,
pričom
vyz
dvihuje
skutočnosť
medzinárodného
merania
(metrík),
ako
PIRLS,
PISA
alebo
TIMSS, ktoré predstavujú skôr evalváciu ako
diagnostik
ovanie. V
tejto relácii
je dôležité, že diagnostikovanie sa vzťahuje na permanentný proces pôsobenia
učiteľa,
t. j.
ako
princíp a
neoddeliteľnú,
organickú
súčasť výchovno - vzdelá -
vac
ieho proces
u, a to od vs tupnéh o d iagnost ikova nia cez p riebež né (format ívne)
až
po výstupné,
záverečné alebo
sumatívne di
agnos
tikovanie
žiakov. T
akist
o
nejde
iba
o
diag
nostikovanie
ale
i o sebadiagnostikovanie (učiteľa, žiaka,
žiakov) a
t
iež o
diagnostikovanie
rodinného prostredia.
Treba brať
do
úvahy,
že
učiteľ
nemôž
e
plánovať,
organizovať, riadiť
výchovno -
vzdelávací
proces,
ak by nepoznával žiaka a nediagnostikoval ho a
celý proces svojho pôsobenia,
pričom
hodnotenie
je
istou
výstupnou
zložkou
tejto
činnosti.
A
následne
i vstupnou kategóriou. V uvedenej súvislosti si načim položiť otázku, čo by
učiteľ mal
diagnostikovať v
intenciách
posilňovania komplexnosti. Podľa
cit.
Gavoru (op.
cit., s.
14) ide širokú
škálu vlastností, prejavov
a
sfér žiaka,
a to:
kognitívnu
oblasť
(pozornosť,
pamäť,
vedomosti,
zručnost i a schopnosti),
tvorivosť, afektívne vlastnosti (postoje, motívy, hodnoty, záujmy), osobnostné
vlastnosti (sebapoňatie
a
sebaoceňovanie
),
behaviorálne vlastnosti (správanie,
usilovnosť, vytrvalosť,
svedomitosť), klímu
triedy (sociálne
vzťahy v triede),
ta kisto psychosomatickú k ondíciu žiaka (zdravotný stav, práceschopnosť či
únavu).
Na
tomto
mieste
vyzdvihujem,
že
tejto
problem
atike
zo
všeobecno -
didaktického
hľadiska
sa
P.
Gavora
venoval
podrobne
v
monografii
Akí
sú
moji žiaci? Pedagogická diagnostika žiak a (1999).
Prirodzene,
na
podloží
týchto
rámcov
sa
nám
ďalej
otvára
oblasť
špecifík
diagnostik
ovania
v jaz ykovo- komu nikačnom, slo hovo - komu nikačnom
a literárno - komunikačnom vzdelávaní v
materinskom
jazyku.
Ako
vieme,
STUDIA SCIENTIFICA FACULTATIS PAEDAGOGI CAE
UNIVERSITAS CATHOLICA RUŽOMBEROK 2020, č. 3
69
tradične sa
tu hodnotia najmä kognitívne
rozmery
,
a
to primárne
zam
erané
na
vedomosti
a zručnosti, čiastočne i na ústny a písomný prejav (orientovaný
skôr na pro
dukt ako na proces)
, analyticko - interpretačn ú činnosť, tiež intuitívne
klímu
triedy,
tvorivosť,
motiváciu,
postoje
alebo
hodnoty
a
pod.
Dôležité
je
podčiarknuť,
že
táto
problematika
je
z
načne
podcenená
a
málo
prebádaná.
Táto
oblasť bude
určite
aj jednou
z
výziev
a
vízií kvalitatívnej
transformácie
jednak
pedagogicko- didaktickej teórie, jednak, a
to
v dlhodobom
horizonte,
v r eálnej výc hovno - vzdel ávacej pra xi. Prikl áňam sa k náz oru, že treba zo hľadni ť
špecifiká
pri
novom
kompetentnom
prístupe
diagnostikovania
žiakov
vo
vyučovaní
slovenčiny
ako
materinského
jazyka.
V
tejto
relácii
odporúčam
prijať
aspo
ň v
rámcovom
zmysle
akceptácie
špecifík
diagnostikovania,
ako
ich
predstavila
Z.
Hirschnerová
v
cit.
pub
likácii
Kožuchovej
et
al.
(2011,
s. 2
6 – 51). Totiž z ohľad ňuje no vú kog nitívn o - komu nikačn ú zážit kovú k oncepc iu
vyučovania
slovenčiny
v
intenciách
in
tegrovaného
rozvoja
osobnosti
žiaka
(pozri Ligoš v
štúdii, 2021).
Záver
V príspevku som rámco
vo načrtol všeobecné východiská kvalitatívnej
transformácie vyučovania
materinského jazyka v
širšom
kontexte európskeho
vzdelávacieho
priestoru.
V
rozsiahlejšej
úvodnej
časti
som
predstavil
hlavné
tendenci
e
v
ývoja školstva vo vybraný
ch krajinách stredne
j
Euró
py so
z
reteľom
na
parametre
na
jlepších
škôl
vo
svete
v
ostatnom
období
jednak
z
pozície
postavenia
tohto
rezortu
v spoločnosti a jednak na podloží medzinárodných
mera
ní zis
ťovani
a výsl
edkov v
ýchov
no -
vzde
lávac
ieho p
rocesu.
Na tom
to zák
lade
štúdia ponú
ka pohľad do dvoch pilier
ov kvalitatív
nej transformác
ie vyučovania
materinského
jazyka
v
postupnej
konkretizácii
a
hierarchii
od
rámcových
cieľových
zámerov
moderného e
urópskeho
vzdelávania
pre
21.
storočie
v post upnej k onkretizáci i cez kognitív ne a o sobnostné dimenzie až po kľú čové
a z ákladn é predm etové kompet encie v yučov ania m aterins kého ja zyka. V 2. pil ieri
otváram
problematiku
projektu a riade nia výchovno - vzdelávacieho procesu
vo výučbe materinského jazyka na v
šeobecnej úrovni v komplexnom zmysle.
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rzyszłość nauczania
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eni kształcenia
(z uwzględnieniem języka słowack iego, czesk iego, niemieckiego
i polskiego). In: Beskydské dědictví. Svazek č. VI . Ed. L. Hampl.
Łodygowi ce : Beskidzki Instyytut Nauk o Cz lowieku, 2020, s. 93 – 114.
ISBN 978-83-62092-76-5.
MULLER, J. Z. 2020. Tyranie metrik.
Praha : Aca
demia, 2020.
ISBN 978-80-200-3074-0.
Národný program výchovy a vzdelávania na r. 2018 – 2027. Národný
program rozvoja výchovy a vzdelávania. Kvalitn
é a dostupné vzdelanie
pre Slovensko. [online]. Bratislava: MŠVVaŠ SR, 20 18. Dostupné na:
https://www.minedu.sk/data/att/13285.pdf [cit. 2019-
10-06].
OBERT, Viliam – SULÍK, Ivan. 1992. Nové pohľad y na vyučovanie
slovenskej literatúry v súčasnej škole. Bratislav a : ÚÚVU, 1992.
OBERT, Viliam. 2003. Rozvíjanie literárnej kultúry žiakov. Bratislava :
Poľana, 2003.
PIENIᾼŽEK, M. – ŠTĚPÁNEK , S. (Eds.) 2016. Teac hing of National
Languages in the V 4 Countries. Praha: PdF UK, 2016.
ISBN 978-80-7290-913-1.
SVOBODOVÁ, J. 2000. Jazyk
ová specifika školské komunikace a
výuka
mateřstiny. Spisy Ostravské univerzity
, 2000, 133. Ostrava: OU, 2000.
ISBN 80-7042-175-4.
Štátny vzdelávací program. [online]. Bratislava, MŠ VVaŠ, SR, 2008, 2011,
2015. [online]. Dostupné na: http://www.m inedu.sk/8387-sk/statne-
vzdelavacie-programy/; http://www.statpedu.sk
/sk/svp/inovovany-
statny-vzdelavaci-program/.
Štátny vzdelávací program ŠVP ISCED 2, dostupné na :
http://www.statpedu.sk/files/articles/dokum
enty/inovovany-statny-
vzdelavaci-program/svp_nsv_6_2_2015.pdf.
Vzdelávací štandard zo slovenského jazyka a
literatúry –
nižšie sekundárne
vzdelávanie . [online]. Dostupn é na:
http://www.statpedu.sk/files/articles/dokum
enty/inovovany-statny-
vzdelavaci-program/sjl_nsv_2014.pdf.
Ligoš, M.:
Tri piliere kvalitatívnej transformácie výučby materinského jazyka I. (Rámcové východiská)
72
Vzdeláv
ací štandard
Slovenský
jazyk a lit
eratúra –
g
ymnázium s
o štvorročný
m
a päťročným vzdelávacím programom . [online]. D ostupné na:
http://www.statpedu.sk/sk/svp/inovovany-
statny-vzdelavaci-
program/inovovany-svp-gymnazia- so
-
stvorrocnym-patrocnym-
vzdelavacim-programom/jazyk-komunik
acia/slovensky_jazyk_
a_literatura_g_4_5_r_novy.pdf.
PISA 20
18 na Slove
nsku. Čita
teľská, mat
ematická a p
rírodovedn
á gramotnos
ť.
[online]. Dostupné na: https://www.nucem.sk /dl/4628/
Priloha_vysledky_krajin_PISA_2018.pdf.
Zákon o
výchove a
vzdelávaní
(školský zák
on) a o zm
ene a dopln
ení niektor
ých
zákonov. [online]. Dostupné na: https://www.v edatechnika.sk/SK/
VedaATechnikaVSR/Legislatva/245_2008_sk
olsky_zakon.pdf.
ZELINA, M.2011. Stratégie a metódy rozvoja osobno sti dieťaťa. 3. doplnené
vydanie. Bratislava: Iris, 2011. ISB
N 978-80-89256-60-0.
P rof. PaedDr. Milan Ligoš, CSc.
Katedra slovenského jazyka a literatúry
Katolícka univerzita v Ružomberku ,
Filozofická f
akulta
Hrabovská cesta 1, 034 01 Ružomberok
[email protected]
STUDIA SCIENTIFICA FACULTATIS PAEDAGOGI CAE
UNIVERSITAS CATHOLICA RUŽOMBEROK 2020, č. 3
73
Fröbelova teória hry a jej relevancia p
re súčasné
vzdelávanie detí mladšieho školsk
ého veku
Froebel's Theory of Play and i ts
Relevance for
the Teaching of Children of Younger School A
ge
Miroslav Gejdoš, Ivana Prachárová
Abstract
The
study
presents
an
analysis
of
the
theory
of
play
promoted
by
famous
German
classical
teacher
Friedrich
Froebel
an
d
documents its
contribution
to
contemporary
primary
educat
ion.
It
deals
with
the
description
of
the
quintessence
of
Froebel's
theory
of
e
ducation
of
children
of
younger
school
age
and
interprets
current,
inspiratio
nal
ideas,
their
impulsiveness
and
relevance
for
the
development
of
cognition
of children.
It
points
to an
analogy
between
the ped
agogical
writings Ed
ucation of Ma
n, representing
the methodology
of education
of children and constructivis
t
theo
ry
of learning
and educati
on, opposing
trans
missiv
e,
m
echanic
al, memory learn
ing. It provides
prim
ary educati
on
teachers
with a
perspective
on
how
to plan
a
learning
process
to meet
the
needs of
each child
by u
sing a
game of
stimulating
self-expression
and subse
quent learning
, empowering the
world and fin
ding a place in
it.
Keywords: Primary Education. Friedrich F roebel. Theory of the play. Play as
a method.
Úvod
Avantg
ardné, dnešný svet
spr
evádzajúce inovácie
zaprí
činené rýchlym
rozv
ojom ved
y a tech niky zasa hujú aj do oblasti šk olstva . Parale lne s pro speri tou
sa prakticky neustále hľadajú aj nové spôsoby výučby, ktoré by mali dôkladne
zabezpečiť
kvalitný
rozvoj
poznávacích
procesov
detí
mladšieho
školského
veku. Moderný
spôsob výučby
vyž
aduje
aj od
dnešných učiteľov primárneho
vzdelávania,
aby
rozvíjali
komplexne
žiakovu
osobnosť,
jeho
osobnostné,
kognitívne,
psychomotorické
i
afektívne
črty
najmä
takými
vyučovacími
stratégiami
či
metódami, ktoré
sú
prínosné
primárne
pre
žiakov a
podporujú
trvácnosť vedomostí.
Samotná relevantnosť tohto
stupňa vzdelávania spočí va
v jeho zameraní na objavovanie základov každej vednej oblasti, kreujúce
konštitutívne
poznatky
ako
platf
ormu
pre
nadväzujúce
vzdelávanie
i
budúci
život v spoločnosti.
Gejdoš, M., Prachárová, I.:
Fröbelova teória hry a jej relevancia pre súčasné vzdelávanie detí mladšieho školského veku
74
V pedagogickej literatúre sa však stretávame s konštatovaniami, že
dnešná edukačná
prax veľmi sporo
akceptuje progresívne formy
vzdelávania.
V tejto kontinuite tak vyzdvihujeme dejiny šk olstva a pedagogiky, ktoré sú
a stále budú podnetne inšpiratívnym odkazom i cestou vedúcou k
pochopeniu
vých
odísk
účinne
j výchov
y a
vzd
elávan
ia. Tém
ou štúd
ie nie je le
n retro
spekt
ívny
návrat
do
minulosti,
kedy
prekvitala
Fröbelova
pedagogická
činnosť,
ale
poskytuje vo vzťahu k
jeho fundamentálnym zásadám vzdelávania
vý
hľadovú
perspektívu.
Zatiaľ čo
je
nemecký
klasický pedagóg
celosvetovo
známy ako
autor konc epcie predškolsk ej výchovy , jeho gnómická teória vzdelávania detí
mladšieho školského veku prostredníctvom
hry je veľmi málo inšpiratívna pre
jej aplikáciu pre súčasné prim
árne vzdelávanie.
Témou štúdie
je tak polemizovať
tradičnému vzdelávaniu obnovením
výzvy hry ako účinného strategického prostr
iedku edukácie, ktorý je zrkadlom
budúceho
života
detí i
jedinečným
prostriedkom
intelektuálneho, sociálneho,
emocionálneho
a
fyzického
r
ozv
oja
sebadisciplíny
i
sociálneho
správania
1
.
Východiskovým a
primárnym
prameňom pre
spracovanie štúdie
bolo pre
nás
Fröbelove
dielo „O výcho ve človek a“, ktoré ako spomína Cipro
2
si
dodn
es
zachováva
nemalú
pedagogickú
hodnotu
pr
e
svoj
rešpekt
k prirodzenej
aktivite
dieťaťa
a
cenné
psycholog
ické
rady
vzchádzajúce
zo
starostlivého
pozorov
ania
die
ťaťa. Ako
lapi
dárne konštatuje Quick
3 „všetky najlepš ie smer y
novodobého
myslenia
v pedagogike ako vede vrcholia v
tom,
čo
povedal
a urobil Fröbel“ , pre to i zámerom štúdie je vyzdvihnúť atemporálnu platnosť
Fröbelovho
pedagogického
odkazu
zachovaného
v
podobe
hry
pre
inovačné
vyučovacie
stratégie
orientované
na
hodnotné
rozvíjanie
poznávania
detí
mladšieho
školského
veku
a
poskytnúť
tak
súčasným
učiteľom
možný
východiskový bod pre modifikáciu prvk ov v prístupe k vzdelávaniu.
Formulácia cieľa
štúdie, charakteristika metód
a
teoretické východiská
Korporatívne
s
vyššie
ilustrovanou
intenciou
sme
si
determinovali
hlavný
cieľ
štúdie,
ktorým
je „analyzovať a zhodnotiť prínos myšlienok
Friedricha
Fröbela
pre
primárne
vzdelávanie“ . Vychádzajúc z hlavného
zamerania štúdie sme indikovali aj čias
tkové ciele:
Interp retovať Fr öbelove ide y o hre v k ontexte prim árneho vz delávania.
Zdôvodniť relevantnosť jeho pedagog ickej teórie hry pre súčasnosť.
Eminentnou
metódou
v
našej
historicko -
vedeck
ej
štúdii
bola
metóda
priama,
prostredníctvom
ktorej
sm
e
získavali
fakty
z
pôvodného
prameňa.
1 FRÖBEL, F.: Education of Man. New York : A. Lovell & Company, 1885. p. 30 – 31.
2
CIPRO, M.: Průvodce dějinami výchovy
. Praha : Panorama, 1984. s. 297.
3
QUICK, R. H.: Vychovávatelští reformátoři. P raha : Ján Laichter na Král. Vinohradech, 1897.
s. 315.
STUDIA SCIENTIFICA FACULTATIS PAEDAGOGI CAE
UNIVERSITAS CATHOLICA RUŽOMBEROK 2020, č. 3
75
K získavaniu i spracovaniu údajov sme ďalej využili literárno - historickú
metódu
a opierali sa aj o
ďalšie.
Explikáciu
starších j
avov pomocou
nových
nám umožnilo
využitie progresívnej metódy, v neposlednom rade didakticko-
- metodická metóda nám umožnila transformovať Fröbelove pedagogické
náhľady
pre súčasné vzd
elávanie. K
sp
racovaniu úda
jov, dôklad
nej interpretác
ii
a zver ejneniu výsledkov z bádania sme využili kvalitatívnu metódu, metódu
analýzy.
Pri
spracovaní
štúdie
nám
teoretické
východiská
poskytli
literárne
zdroje
pu
blikované
u
nás
i v
zahraničí.
Primárnym
prameňom
pre
nás
bolo
Fröbelo
ve dielo O vých ove človeka . Se ku ndárne zdr oje súvisiace s Fröbelovým i
pedagogicko- filozofickými náhľadmi i teóriou hry pre nás boli diela od
autorov
E.
Opravilová, V.
Štverák,
O.
Chlup,
M.
Cipro.
J.
L. Hughes,
S.
S.
Ravi,
E. Provenzo,
P.
Bowlby.
Záverom podotýkame,
že
získané
inform
ácie
boli
korektne
rozobrané,
podrobne
a
kriticky
analyzované
k
interpretácii
a vyvodeniu záverov.
Pedagogicko- filozofické náhľady Friedricha Fröbe la
Friedrich
Fröbel
založil
v
roku
1817
svoj
prvý
ústav
pre
výchovu
a vzdelávanie detí v
meste
K
eilhau,
v ktorom
z úročil vo svojej vlastnej
pedagogickej
praxi
imanentné
skúsenosti
z
detstva,
poz
orovania
prírody
či
okolitého
sveta, poznatky
i
vedomosti
zo
štúdií, výchovnej
činnosti
i pobytu
v Pestalozziho ústave v Yverdone. Prečo to spomíname je skutočnosť, že
svoju
filozoficko- pedagogickú prezentác iu prístupu a metód uplatňovaných
vo
Všeobecnom
nemeckom
výchovnom
ústave
stelesnil
do
diela
s titulom
O výcho ve človeka. V obdo bí klasicko - idealisticke j epochy v Nemeck u zastával
Fröbel
významnú
úlohu
práve
tým,
že
vydal
svoj
hlavný
spis,
v ktorom
predstavuje
svoje
myšlienky
o
výchov
e
vychádzajúce
z
jeho
idealistického
náz
oru a
komp
lexnéh
o
pr
ístupu
,
ke
dy z
Boha,
ako
pod
staty všet
kého stvor
eného
odôvodňuje
kvintesenciu
výchovy,
sprevádzajúcu
dieťa
cez
štádiá
vývinu
k cieľu, t.
j. zhode ako u J. A. Komenského k životu v Bohu. Vzťah Fröbela ku
Komenskému
vyjadrujú
predovšetkým
i
ch
jednotné
názory
na
ponímanie
človek
a, dôležitosť
strategicke
j výchovy i
nu
tnosť rodinne
j výchovy. Na
rozdiel
od
neho
sa
však
Fröbel
zamýšľal
nad
tým,
ak o v
praxi
posky
tnúť
rodine
možnosť
i
vzdelávacie
prostriedky
pre
výchovu
na
podklade
názornosti
a sústavy detských hier a disparátne sa zameral na reform u celého vzdelávania
ľudskej bytosti
4
.
Neodmysliteľnou pre
zaujatie
miesta človeka
v
spoločnosti a svete je
v kongruencii s Komenského „autopraxiou“
i u neho „samočinnosť“ dieťaťa
4 OPRAVILOVÁ, E. – ŠTVERÁK, V. : Friedrich Fröbel. O výchově člověka. Praha : Státn í
pedagogické nakladatelství, n. p., 1982. s. 26
Gejdoš, M., Prachárová, I.:
Fröbelova teória hry a jej relevancia pre súčasné vzdelávanie detí mladšieho školského veku
76
využívajúce
hru,
ktorá
je
jedinou
zárukou
dosiahnutia
svojho
sebaurčenia.
Zdôraznenie i
m
anentnej
aktivity
dieťaťa či
považovanie hry
za
najdôleži
tejší
výchovný
i
vzdelávací
princíp
Chlup
5
osobitne
vyzdvihuje
a vyslovuje
sa,
že
práve
vo
Fröbelovej
koncepcii
je
plne
rozvinutý
Komenského
princíp
poznávania
– ratio – or atio – operatio, v novom poradí operatio – ratio –
oratio. V metodike školy vychádza tak od činnosti a každé poznanie vzchádza
z činnosti, v
aktivite,
t. j.
hre,
z ktorej
sa
buduje
predstava
a názor a
na
obe
plynule nadväzuje
rozvoj myslenia a
reči. A
práve z
tejto
premisy sa odvíjajú
následné segmenty predkladanej štúdie, ktoré ď
alej podrobne explikujeme.
Hra a te ória hry v ponímaní Fröbela
O výchove človeka ak o repreze ntujúce dielo filozofickej prezentácie
princípov
a
metód
uplatňovaných
vo
Fröbelovom
ústave
zachytáva,
že
v edukačnej praxi sa metodicky orientoval na rozvoj síl dieťaťa mladšieho
školského
veku
v tr och rovinách: sily, vním ania, myslenia. Z didaktického
hľadiska
práve
hrou
a
činnostným
zameraním
vzdelávania
prechádzal
vo
vyuč
ovaní
kontin
uálne o
d jedno
duché
ho k
zlo
žitému
, od zná
meho k neznám emu,
v neposlednom r ade od názoru k pojmu. Svojím prístupom k
podstate
hry
sa
v spise
vyslovoval ak
o o najčistejše j tvorbe človek a a súčasne ak o o prostriedk u
spodobňujúcom celý budúci život
6
.
Ako je
ďalej známe z
odbornej literatúry, hra
sprevádza a
je súčasťou
ontogenézy
človeka,
r
esp.
zo
života
sa
nevytráca,
ale
m odifikuje svoj
charakter.
Túto
jedinečnú
a
zároveň
špecifickú
vlastnosť
hry
spozoroval
Fröbel
a
preto
hlavnou
funkciu
hry
detí
mladšieho
školského
veku
prestáva
byť
exetri
orizá
cia –
vy
jadren
ie vn
útra vo
n, ale
prech
ádza sa
k
úče
lu inte
rioriz
ácie,
t. j. hra v tom to období napomáha deťom zmocňovať sa sveta. Ako sa ďalej
expertízne
vyjadruje
Hughes
7
,
Fröbel
zasvätil
svoj
život
práci
a
štúd
iu
dieťaťa,
pričom
kládol
dôraz
na
jeho
vlastné
sily,
poskytol
mu
priestor
a pomáhal v sebavz delávaní a jeho prirodzený ch sc hopnostiam a mož nostiam
boli prispôsobené všetky vzdelávacie metódy. Radikálne sa snažil zm
eniť rolu
a postav enie učiteľa a n a vlastné, dieťa ťom konštruo vané poznávan ie v zmyslu-
plnej hre. Práve na
činnost
né hľadisko kládol
dôraz viac, ako ktorýkoľvek iný
významný pedagóg v
dejinách pedagog
iky a školstva.
Hra,
predovšetkým
ako
edukačný
činiteľ
a
najvyšší
stupeň
rozvoja
a poznávania dieťaťa mladšieho školského veku okrem rozvoja myslenia
5
CHLUP, O.: Mateřská škola. Sborník přednášek o ško le ma teřské. Svazek 2. Praha : Nákla dem
Svazu učitelek škol mateřských, 1928. s. 29.
6 FRÖBEL, F.: Education of Man. New York : A. Lovell & Company, 1885. p. 30 – 38.
7
HUGHES,
J. L.: Froebel´ s Educational Laws for all Teachers.
New York
: D. Appleton
and
Company, 1897. p. 1 – 7.
STUDIA SCIENTIFICA FACULTATIS PAEDAGOGI CAE
UNIVERSITAS CATHOLICA RUŽOMBEROK 2020, č. 3
77
spája
dieťa so
širším
svetom a
ako
nám
sám Fröbel
8 podčiarkuje, dieťa hrou
a v hre zisťuje, čo môže urobiť, odhaľuje svoje možnosti, schopnosti, resp.
dôkladne
poznáva seba
samé.
Príťažlivou
a starostlivo vyberanou zacielenou
hrou,
ktorá
je
prispôsobená
záujmom
detí
sa
naučia
ovládať
svoje
telo,
ako
dosahovať
vlastné
ciele,
používať
jazyk,
učiť
sa
žiť
v
sociálnej
skupine,
spoznávať
svet,
objavovať,
rozv
íjať
svoje
vedomosti,
schopnosti
a
zručnosti
z každej vednej oblasti.
Fröbelom konštruovaná didaktická
metóda vyučovania je založená
na
4 kľúčových princípoch –
zásadách, ktoré Ravi
9
charakterizuje nasledovne:
zásada samosta tnej činnosti reprezentujúca tie aktivity, ktoré dieťa
mlad
šieho
šk
olské
ho veku vyk
onáva v kon
gruenc
ii so svoji
mi vlast
nými
potrebami, záujmom bez násilného vnúteni
a;
zásada učenia sa hrou vychádza z veľkého detského interesu o hry
a aktivity, pričom ako zásada je založená z presvedč enia, že stanovené
výchovno - vzdelávacie ciele sa majú napĺňať form ou hry a v hre;
zásada spoločenstva poukazuje na dobré spoločenské prostredie,
kolek
tív, ktorý
podporu
jú skupinové hry pre rozvoj empati
e,
so
lidarity,
tolerancie a priateľstva;
v neposlednom rade zásada a princíp slobody požaduje ponechať
úplnú slob
odu vo vyjadr
ovaní, precí
tení, stvárne
ní hier vo vzd
elávacom
procese, resp. požaduje zosúladiť spontánnosť s kont rolou.
Fröbel
zastával
kritický
postoj
k
odovzdávaniu
hotových
poznatkov,
veril
a požadoval od učiteľov, že budú deti viesť k
tomu,
aby
sa
stali
schopnými,
nezávislými
mysliteľmi,
t. j. mysliace a
inteligentné
bytosti
10
.
Jedn
ou z mno hých pozo ruhodný ch Fröbe lových ď alších zm ienok fuz ionova ných
s prínosom k pedagogickej teórii vo vzťahu k hre je i to, že vzdelávanie by
malo vzchádzať z
aktuálneho
individuálneho stavu poznania za
rešpektov
ania
štádií psychického vývinu
11
. Jedine a výlučne s plnou vážnosťou i akceptáciou
plynulosti
psychického
vývinu
a
prebiehajúc
ich
zmien
v
období
mladšieho
školského
veku
je
vytvorený
predpoklad
celostne
dokončeného
každého
nasledujúceho vývinového obdobia
12
.
8 FRÖBEL, F.: Education of Man. New York : A. Lovell & Company, 1885. p. 34.
9
RAVI,
S.
S.: Philosophical and Sociological Bases of Education.
Delhi :
PHI Learning
Pvt.
Ltd., 2015. p. 186.
10 FRÖBEL, F.: Education of Man. New York : A. Lovell & Company, 1885. p. 67.
11
LILLEY, I.: Friedrich Froebel: A Selection from His Writings Cambridge Texts and Studies
in the History of Education. Cambridge : Cambridge UniversityPress, 1967. p. 59.
12 OPRAVILOVÁ, E. – Š TVERÁK, V. : Fr iedrich Fr öbel. O výc hově člověka. Praha : Státní
pedagogické nakladatelství, n. p., 1982. s. 28.
Gejdoš, M., Prachárová, I.:
Fröbelova teória hry a jej relevancia pre súčasné vzdelávanie detí mladšieho školského veku
78
Prínos Fröbelových myšlienok pre primárn
e vzdelávanie
Fröbelova
teória
hry
,
ako
fundamentálneho
edukačného komponentu
vzd
elávan
ia detí a
žiak
ov primá
rneho vzde
lávani
a, vkompo
novaná
do
s
tarostl
ivo
sformulovaných
vývinových
štádi
í
ontogenézy
človeka,
tzv.
životných
fáz
bez
podmie
nečne ov
plyvn
ila rozv
oj mod
erného pedagog ickéh o i psyc hologi ckého
myslenia.
V kontinuite proponovaného Fröbelovho systému vzdelávania
zabezpečujúcom
pl
ynulé
nadobúdanie
vedomostí,
zručností
i
schopností
Provenzo
13 zdokumentoval ich usúvzťažnenosť s tým, čo neskôr vo svojej
teórii
častí
kognitívneho
konštruktivizmu
vyslovil
prominentný
psychológ
J. Piaget. Priam tak ak o Fröbelova teória i jeho sa zaoberá vekom dieťaťa
a štádiami rozvoja s
desk
ripciou
zmien
v psychike dieťaťa i súhlasne študuje
teóriu rozvoja poznávania schopností dieťaťa. Vzhľadom na to,
že poznávaci
a
sústava
detí
mladšieho
školského
veku
j
e
podľa
jeho
teórie
viazaná
na skutočné, hmatateľné i poznateľné skúsenosti, podmienené procesom
konkrétnych operácií, súhlasne postuluje, aby učenie bolo u žiakov a ktívne,
konštruovali
s i svoje vedomosti a poznanie v
agilnej
činnosti,
pretvárajúc
doterajšie
vedom
osti
na
nové
poznatky,
schémy
a
modely
asimilačne,
t. j.
prijatím
rozšírením
starej
alebo
ak
omodačne,
modifikáciou
starej
14
.
Piaget
zopakoval Fröbelov pohľad
v
tom, keď lapidárne n
apísal, že hra je
prvoradou
asimiláciou pred akomodáciou
15
.
Pred
stavi
teľ teórie
so
ciáln
eho konštr
uktiv
izmu L. S. Vygo
tsky tiež
ve
ril,
že
hra bol
a a
je
dôležitým
procesom i
komponentom
vzdelávania.
Tvrdil,
že
hra
je
eminentný
faktor
pre
rozvoj
osobnosti
dieťaťa,
pretože
najväčšie
úspechy zažíva a dosahuje výlučne len pri
hraní sa hier, ktoré sa v
nasledujúci
deň pre
menia vo ved
omosť. Ved
omosť
al
ebo súbor ved
omostí
ta
k reprez
entoval
Kilpatrickom
16 delimitovaný, aktívny výsledok multilaterálnych činností
realizo vaných v podnetnom prostredí, v yberaných učiteľom po dôkladnom,
systematickom
pozorovaní
detí
v
ich
samostatných
činnostiach
v zmysle
vlastného
bádania
a
učenia
sa
hrou.
Táto
minuciózne
ilustrovaná
Fröbelov
a
idea výchovy a vzdelávania detí mladšieho školského vek
u si zachováva svoju
aktuálnosť
do
dnes
a okrem J. Piageta i
L.
S.
Vygotského
ovplyvnila
i
iné
osobnosti
vrátane B.
Blooma,
J. Deweya,
M.
Montessori a
i.,
ktorí
vo
svo
jej
teórii
vychádzajú
z
predpokladu,
že
dieťa
nie
je
len
pasívnym
prijímateľom
13 PROVENZO, E.: Friedrich Froebel´s Gifts. Connecting the Spiritual and Aesthetic o the Real
World of Play and Learning. In American Journal of play.
2009. p. 93.
14
TUREK,
I. : Inovácie v didaktike : Príspevok k realizácii projektu Milénium vo vyučovacom
procese
na
str
edných a základných škol
ách. 2. vyd. Bratislava : Metodic ko- pedagogi cké centrum,
2005. s. 201 –
202.
15
PIAGET,
J. In JOHNSON,
J. E. –
EBERLE, S. G. –
HENRICKS, T.
S. –
KUSCHNER, D.:
The Handbook of the Study of Play 2. Lanham : Rowman & Littlefield, 2015. p. 290.
16
KILPATRIC, W. H.
In BOWLBY, P.: A Case Study of froebel Education in Ptractice.
2016,
p. 9.
STUDIA SCIENTIFICA FACULTATIS PAEDAGOGI CAE
UNIVERSITAS CATHOLICA RUŽOMBEROK 2020, č. 3
79
inf ormácií a objektom vzdelávania, ale naopak aktívny subjekt, ktorý si svoje
poznan
ie konštruuje sám
, vlastnou sna
hou, bádaním
, skúsenosťou
v priaznivom
prostredí
pod
starost
livým
vedením
učiteľa
v
spoločne kreujúcej a priaznivej
atmosfére v triede.
Sing
ular it ou cieľav edomý ch, relevan tných hie r vy chádza júcich z okruhu
záujmov
žiakov
,
všeteč
nosťou
v
ťahovaní do
vých
ovno -
vzdeláv
acieho systému
sa
stávajú
priamym
centrom
diania
a
zažívajú
v
hre
nové,
nepoznané,
v neposlednom
rade
vidia
v učení význam a má pre nich osobný rozmer.
Preniká
do každej
čiastočky ich
bytia. „Silné a hodnoverné zážitky z vlastnej
hry či činnosti, precítenie toho, čo učiteľ chce, aby si dieťa osvojilo,
preskúmanie
a
ohmatan
ie
všetkými
zmyslami“ sa podľa Cejpekovej
17
a iných
autorov zaoberajúcich sa
zm
ieňovanou
problematikou
pokladá za apodiktickú
cestu skutočného a
efektívneho učenia. Ako
sa zmieňuje Petty
18
, žiaci sú
radi,
ak
môžu
tvoriť,
konať
činnostne,
komunikovať,
hľadať
spôsoby
riešenia,
hrou spoznávať a objavovať vedomosť. K
problematik e aktivity žiakov sa
konzekventne vyjadruje Petlák
19
, ktorý náležite zdôrazňuje, aby každá činnosť
žiaka
v kongruencii s
cieľom
vyučovania a
obsahom
vzdelávania
prispievala
k rozvoju trvácnosti, tvorivosti, sam ostatnosti a v zásade, aby nebol aktívny
učiteľ, ale umožní priamu zainteresovanosť ž
iakovi.
Rezultu
júc
zo zistení z
historic
kého bádania
z
áverom poznamenávam
e
štyri
fundamentálne
princípy
prístupu
Fröbela
k
vzdelávaniu
detí
mladšieho
ško
lského
vek
u, ktorýc
h
gn
ómicko
sť a
aktuá
lnosť na zákl
ade vyššie
pr ezentov a-
ného je nespo
chybniteľn
á a
mali by byť int
egrálnym kom
ponentom prim
árneho
vzdelávania a
mal by ich mať na zreteli k
aždý učiteľ:
Hra pre svoju didaktickú tvárnos ť i fu nkčnosť vedie k učeniu a nema la
by sa z výchovno - vzdelávacieho procesu v ytrácať.
Dieťa mladšieho školského veku je schopné učiť sa len to, na čo je
vývinom pripravené.
Učiteľ by mal sprevádzať žiakove poz návanie a kategorickým pozoro -
vaním
jeho
progresu,
schopností
i
možností
prispôs
obovať
metódy
vyučovania.
Proces učenia, poznávania, objavovania nového by mal prebiehať
výlučne v
podnetnom prostredí a v
priaznive
j atmosfére.
17 CEJP EKOVÁ, J .: Peda gogika predškols kého vek u . Banská Bystric a : Pedagog ická fak ulta UMB,
2001, p. 43.
18
PETTY, G.: Moderní vyučování . Praha : Portál, s. r. o., 1996, s. 196.
19 PETLÁK, E.: Inovácie v edukačnom procese . Dubnica nad Váhom : Dubnický technologický
inštitút, 2012, s. 71 – 78.
Gejdoš, M., Prachárová, I.:
Fröbelova teória hry a jej relevancia pre súčasné vzdelávanie detí mladšieho školského veku
80
Záver
Vo
Fröbe lovej filozoficko-
pedagogickej
teórii
nachádzame
dodnes
veľa
hodnotného,
čo
n
epatrí
len
minulosti,
ale
s
určitosťou
i
súčasnosti
či
budúcnosti. Bol to práve Fröbel, kto zmenil spôsob uv
ažovania o hre a
povýšil
ju
na fundamentálny prostriedok
vzdelávania detí
mladšieho školského
veku,
rešpektujúc
ich
schopnosti, možnosti,
vek
i
interes.
Jeho
pedagogický
odkaz
v podobe diela reprezen tujúceho kontinui tu pedagogickej teórie a vývinovej
psy
chológ
ie je trvale
inšpira
tívnym
spisom
p
re učiteľ
ov primá
rneho vzd
eláva
nia,
ktorí
chcú rozvíjať
komplexne
žiakovu osobnosť
vyučovacími
stratégiami
či
metódami,
ktoré
sú
prínosné
primárne
pre
žiakov
a
podporujú
trvácnosť
v edomostí.
V štúdii sme našu pozornosť zameriavali na možnosti zlepšenia
a skvalitnenia primárneho vzdelávania jednou z možných Fröbelom determ i -
novaných progresívnych
metód,
ktorých platformou
sú inherentné
skúsenosti
pre
konštrukciu vlastnej
vedomostnej základne.
Hlavným cieľom
štúdie
bolo
analyzovať
a
zhodnotiť
prínos
myšlienok
Friedricha
Fröbela
pre
primárne
vzdelávanie. Súhrnne konštatujeme, že nami stanovený cieľ sme v plnej miere
dosiahli.
Eminentný
zámer
sa
naplnil
podrobnou
deskripciou
kvintesencie
Fröbelovej teórie
vzdelávania. Interpretovali sme
Fröbelove idey
o hre nielen
v intenciách histórie, ale i
v k ontexte súčasného primárneho vzdelávania
a z dôvodn ili jej relev antno sť pre rozv íjanie po znávan ia detí mla dšieho školskéh o
veku
. Impleme
ntácio
u hry
do vých
ovno -
v
zdeláv
acieho
pro
cesu s cieľav
edomý
m
pôsobením
na
priaz
nivý,
primeraný,
individuálny
rozvoj
osobnosti
ž
iaka
sa
doceňuje rešpekt
k prirodzenej aktivite die
ťaťa a
jej
vkom
ponovaním
odmení
učiteľa hneď dvakrát. Raz v
podobe žiackeho
záujm
u o
hru, prejavom radosti,
agilnosti
i všetečnosti o dozvedanie sa nového a druhý krát v podobe súboru
trvalo osvojených vedomostí, zručností, schop
ností.
Bibliografia
BOWLBY, P.: A Case Study of froebel Education i n Practice. [online].
Montreal : Concordia University, 2016. 90 p.
[cit. 2020.03.31.]
Dostupné na internete: <https://spectrum
.library.concordia.ca/
981703/14/Bowlby_MAed_F2016.pdf>.
CEJPEKOVÁ, J.: Pedagogika predškolského ve ku. Banská Bystrica :
Pedagogická fakulta UMB, 2001. 102 s. I
SBN 80 -8055-491-9.
CIPRO, M.: Průvodce dějinami výchovy
. Praha
: Panorama, 1984. 579 s.
ISBN 11-088-84.
FRÖEBEL, F.: The Education of Man . [online]. New Y ork : A. Lovell
& Company, 1885. 273 p. [cit. 2020.03.28.] Dost upné na internete:
<https://archive.org/details/educationofman00froe/pag
e/n285>.
STUDIA SCIENTIFICA FACULTATIS PAEDAGOGI CAE
UNIVERSITAS CATHOLICA RUŽOMBEROK 2020, č. 3
81
HUGHES, J. L.: Froebel´s Educational Laws for all Teachers. [online]. New
York : D. Appleton and Company, 1897. 296 p.
[cit. 2020.03.28.]
Dostupné na internete: <https://www.que
stia.com/read/85862625/
froebel-s-educational-laws-for-all-teachers>.
CHLUP, O.: Mateřská škola. Sborník přednášek o škol e mateřské. Svazek 2.
Praha : Nákladem Svazu učitelek škol m
ateřských, 1928. 381 s.
JOHNSON, J. E. –
EBERLE, S. G. –
HENRIC
KS, T. S. –
KUSCHNER, D.:
The Handbook of the Study of Play 2. [online]. La nham : Rowman
& Littlefield, 2015.
600 p. [cit. 2020.03.31.] D ostupné na internete:
<https://books.google.sk/books?id=vA
WTBgAAQBAJ&pg=PA287&lp
g=PA287&dq=gutek+froebel&source=bl&ots=P4
61XR1Lnv&sig=ACf
U3U0Afr055g3QG_nGQnLBTb7Vt0N5h=sk&sa=
X&ved=2ahUKEwj
Hl_j58foAhXPyaQKHWgkCWUQ6A
EwAHoECAsQLA#v=onepage&
q=assimilation&f=false>. ISBN 978-
1475-580-796-7.
LILLEY, I.: Friedrich Froebel: A Selection f rom His Writings Cambridge
Texts and Studies in the History of Educa
tion. Cambridge : Cambridge
University Press, 1967. 188 p.
OPRAVILOVÁ, E. –
ŠTVERÁK, V.: Friedrich Fröb el. O výchově člověka.
Praha : Státní pedagogické nakladatelství, n.
p., 1982. 178 s.
ISBN 14-354-82.
PETLÁK,
E.: Inováci e v eduka čnom proces e. Dubnica nad Váhom : Dubnický
technologický inštitút, 2012. 158 s. ISB
N 978 -80-89400-39-3.
PETTY, G.: Moderní vyučování. Praha : Portál, s. r . o., 1996. 380 s.
ISBN 80-7478-681-0.
PROVENZO, E.: Friedrich Froebel´s Gifts. C
onnecting the Spiritual and
Aesthetic of the Real World of Play and Learn
ing. In American Journal
of play. [online]. 2009. vol. 2, no. 1, p. 85-99. [ci t. 2020.03.31.]
Dostupné na internete: <https://www.
journalofplay.org/sites/
www.journalofplay.org/files/pdf-articles/2-1-
article-friedrich-froebels-
gifts.pdf>. ISSN 1938-0402.
QUICK, R. H.: Vychovávatelští reformátoři. Praha : Ján Laichter na Král.
Vinohradech, 1897. 415 s.
RAVI, S. S.: Philosophical and Sociological B ases of Education. [online].
Delhi : PHI Learning Pvt. Ltd., 2015. 488 p. [cit. 2020.03.31.
]
Dostupné na internete: < https://books.goog le.sk/books?id=PjgJCgAA
QBAJ&printsec=frontcover&hl=sk&source=gbs_g
e_summary_r&cad=
0#v=onepage&q&f=false>. ISBN 978-81-203-
5113-4.
TUREK, I.: Inovácie v didaktike : Príspevok k realizácii projektu Milénium vo
vyučovacom procese na stredných a základných
školách. 2. vyd.
Bratislava : Metodicko- pedagogické centrum , 2005. 358 s.
ISBN 80-8052-230-8.
Gejdoš, M., Prachárová, I.:
Fröbelova teória hry a jej relevancia pre súčasné vzdelávanie detí mladšieho školského veku
82
Doc. PaedDr. PhDr. Miroslav Gejdoš, PhD.
Katedra pedagogiky a špeciálnej pedagog
iky
Katolícka univerzita v Ružomberku, Pedag
ogická fakulta
Hrabo vská cesta 1, 034 01 Ružomberok
[email protected]
Mgr. Ivana Prachárová
Katedra predškolskej a elementárnej pedag
ogiky (interná doktorandka)
Katolícka univerzita v Ružomberk
u, Pedagogická fakulta
Hrabo vská cesta 1, 034 01 Ružomberok
[email protected]
STUDIA SCIENTIFICA FACULTATIS PAEDAGOGI CAE
UNIVERSITAS CATHOLICA RUŽOMBEROK 2020, č. 3
83
Inštitucionálna príprava a vzdelávanie u
čiteliek
v Košiciach do roku 1938
Institutional Training and Education of Wom
en Teachers
in Košice by 1938
Miroslava Gallová
Abstract
The article deals with
the education of girls at normal
schools in Košice
by
1938. The
first
part
discusses the
education
and
training
of women
teachers
of
national
(elem
entary)
and
burgher's
(civic)
schools.
Until
1919, there
were two Ro
man Catholic normal
schools (boys'
and girls')
in Košice. In the 1920
s there was a state normal school in Košice
whe re
girls
and boys
w
ere
educated
together.
Since
the school
y
ear
1937/38,
a Roman Catholic
normal school of Ursulines
was re-opened in
the city
to educate girls. In the second part, the stud
y is devoted to the education
and training
of kindergarten teachers
and female handicra
fts teachers at
Košice vocational nor
mal schools established in t
he 1930s', which were
administered
by
the
Dominican
Order.
The
study
points
to
legislation
that governed the
functioning of individual types
of normal schools and
the
study
of
girls
there.
It
brings
information
on
the
conditions
o
f
admission of pupils
and, it also provides an overvie
w
o
f the structure of
pupils from
a gender, nation
al and religious pe
rspective for som
e schools.
It also deals with the subjects of mentioned schoo
ls.
Keywords: Girls. Education. Teachers. Normal sc hools. Košice. Interwar
period.
Úvod
Učiteľské
ústavy
pred stavovali v druhej polovici 19.
storočia
pre
dievčatá
jednu
z
mála
možností
získania
vyššieho
vzdelania.
1
Absolvovanie
štúdia
a
nadobudnutie
kvalifikácie
na
výk
on
pov
olania
učiteľky
im
zároveň
umožnilo
zabezpečiť
si
vhodné
živobytie
a
uplatniť
sa
aj
mimo
domácej
sféry.
2 Učiteľské ústavy boli obľúbeným typom š kôl pre dievčatá nielen
1
V zmysle dnešného stredoškolského vzdelania.
2 Domáca sféra bola v minulosti tradične určená ženám, keďže ich p rvoradou úlohou bolo byť
dobrou manželkou, matkou a gazdinou.
Gallová, M.:
Inštitucionálna príprava a vzdelávanie učiteliek v Košiciach do roku 1938
84
v období dualizmu, ale aj v nasledujúcich rokoch. Cieľom predloženej práce
je
predstaviť vzdelávanie
dievčat
a
žien a
ich
prípravu na
povolanie
učiteľky
na
viacerých
uč
iteľských
ústavoch
v
Košiciach
s
dôrazom
na
medzivojnové
obdobie.
3 Dôvodom výberu tejto témy je najmä jej doterajšie nedostatočné
spracovanie v slovenskej historiografii.
4
Učiteľské ústavy
Zákonným
článkom
č.
38/1868,
5 ktorý upravoval ľudové školstvo
v Uhorsku, boli medzi ľudové školy zaradené aj učiteľské ústavy (tzv.
preparandie),
ktoré
mali
byť
zakladané
osobitne
pre
diev
čatá
a osobitne pre
chlapcov.
6 Podmienkou prijat ia chlapcov bolo dovŕšenie minimálne 15. roku
veku
a absolv ovani e prijímac ej skúšk y z učiva v rozsah u št yroch tr ied gymná zia.
U dievčat bola veková hranica 14 rokov a znížené boli i nároky na rozsah
učiva,
ktoré mali
ovládať –
učivo
vyššej národnej
školy. Rozdiely
boli
aj pri
záverečných skúškach
absolventov
a
absolventiek prípraviek. Žiaci
museli po
skúška
ch
z
jedn
otlivých predmetov
absolvov
ať
skú
šku
z
uči
va
vyšš
ej
národn
ej
i občianskej školy a
metodiky vyučovania. Dievčatá mali vykonať skúšku len
z tých predmetov, ktoré sa vyučovali v prípravke. Po ukončení štúdia
v učiteľskom ústave mohli dievčatá vyučovať v dievčenských triedach na
vyšších národných (ľudových) a
občianskych (m
eštianskych) školách.
7
3 Koši ce ako adm inistra tívne, hospodár ske, kul túrne a vz delanos tné centr um vých odného Sl ovenska
disponovali
vhodnými
podmienkami
a
predpokladmi
na
vznik
viacerých
typov
škôl
vrátane
učiteľských ústavov.
4 Vzdelávaním dievčat na ženskom učiteľskom ústave v Košiciach do roku 1918 sa zaoberala
Mária Mihóko
vá v
rámci spracovania bibli
ografie článkov
k
tém
e stredného školstva v Koš iciach
v období 1848 – 1918. MIHÓKO VÁ, Mária (ed.). Stredné školstvo v Košiciach v roko ch 1848 –
1918.
Tematická bibliografia
I. Košice : Štátna vedecká knižnica, 1981. 411s. MIHÓKOVÁ ,
Mária
(ed. ). Stredné školstvo v Košiciach v rokoch 1848 – 1918. Tematická bibliografia II.
Košice : Štátna vedecká knižnica, 1981. 439 s. Koedukačnému učiteľskému ústavu, ktorý
v Košiciach existoval v 20. rokoch 20. storočia, sa venovala Alžbeta Bojková. Autorka vo
svojej
práci
prináša
inf
ormácie
o
vzniku
daného
ústavu,
jeho
fungovaní
a s
tým
súvisiacimi
problémami. Neposk
y
tuje
však
pohľad na
zloženie žiactva
či profesorského
zboru
z
rodového
(genderového)
hľadiska,
ani
porovnanie
výučby
na
mužských
a
koedukačných
učiteľských
ústavoch
na
jednej
strane
a
ženských
učiteľských
ústavoch
na
strane
druhej.
BOJKOVÁ,
Alžbeta
. Primárn e problé my transfor mácie sl ovenských stredných a odborných škôl v Košiciach
v medzivojnovom období. Košice : UPJŠ v Košiciach, 2018. 205 s.
5 186 8. évi XXXVIII. törvénycikk a népiskolai közoktatás tárgyában [online].
6 Podľa zákona existovali 4 typy škôl: elementárne (ľudové), vyššie národné (vyššie ľudové),
občiansk
e
(meštia
nske)
a
u
čiteľské prípravne (učiteľské ústavy). Vyučovanie dievčat
a c hlapcov
na
vyšších národných
a
občianskych školách
muselo p
rebiehať oddelene,
teda v
samostatných
triedac
h.
BIL
ČÍK, Jozef. Vývoj školstva na Slovensku do roku 1960
a
s
pracovávanie
písom
ností
škôl. In Slovenská
archivistika, 1973, roč. 8, č. 1, s. 31 - 33.
7 BILČÍK, J. Vývoj školstva na Slovensku ..., s. 34.
STUDIA SCIENTIFICA FACULTATIS PAEDAGOGI CAE
UNIVERSITAS CATHOLICA RUŽOMBEROK 2020, č. 3
85
V druhej
p olovici 19. st oročia pôsobili v Košiciach dva učiteľské
ústavy.
V
roku
1856
bol
do
Košíc
presťahovaný
rím
skokatolícky
učiteľský
ústav
z
Miškovca, avšak
riadne
štúdium
bolo
na
tejto škole
až
do
jej
zániku
v roku 1919 sprístupne né len chlapcom. Dievčatá a ženy tam napriek tomu
mohli
skladať
súkromné skúšky
a
nadobudnúť
tak
učiteľský
diplom.
8 Druhý
rímskokatolícky
učiteľský
ústav,
ktorý
v
K
ošiciach
založili
uršulínky,
bol
dievčenský.
9 Vyučovať sa na ňom začalo od roku 1860 v maďarskom
a nemeckom
jazyku . Ústav mal spočiatku dva ročníky. Medzi predmety,
v ktorý ch sa žiačky vzdelávali, patrili: z emepis, deje pis, prírod opis, matem atika,
fyzika,
náboženstvo, maďarský
jazyk a
literatúra, pedagogika,
spev,
krasop
is
a ručné prá ce. Keďže podľa § 109 zák ona č. 38/1868 bolo nariad ené predĺženi e
štúdia
na
učiteľských
ústavoch
na
tri
roky,
musel
sa
tomuto
predpisu
prispôsobiť aj
košický učiteľský ústav ur
šulínok
.
10 Štúdium sa tu predĺžilo na
tri r
oky v ro
ku 1870
.
11 Od šk olskéh o roku 1 884/85 bol ústa v postu pne pre tváran ý
na
4- ročný podľa ďalšieho nariadenia o rozšírení š túdia z roku 1881.
12
Vo
všetkých
4
ročníkoch
súčasne
však
vyučovanie
prebiehalo
až
od
školského
roka 1903/04.
V tomto období mal ústav ročne okolo 40 –
45 absolventiek.
13
Napriek tomu, že ústav bol
v správe
Rádu sv. Uršule, štúdium bolo umožnené
aj
dievčatám
iného
ako
rímskokatolíckeho
vierovyznania.
Značnú
časť
budúcich
učiteliek tvorili
dcéry
zo
židovských rodín.
V rokoch 1860 – 1896
bolo
v ústav e zapísaných dokopy 711 riadnych žiačok, z ktorých 521 bolo
r ímskokatolíckeho, 127 židovského a necelý ch 10 % dievčat bolo iného
vierovyznania. Počas
prvý
ch
36 rokov existencie
ústavu absolvovalo štúdium
úspešne 574 riadnych žiačok a
64 externých.
14
Ženské učiteľské ústavy sa
stali obľúbeným typom školy pre
dievčatá
a ich počet, ako aj počet žiačok postupne narastal v rámci celého Uhorska.
Počet
mužských
učiteľských
ústavov
na
prelome
19.
a
20.
storočia
klesal.
V ro ku 1913 doko nca počet štu dentie k na učiteľs kých ústav och (471 8) presia hol
počet
študentov
(4503).
15
P odob ná si tuácia bola aj v
mes
te Košice, kde
počet absolventiek učiteľského ústavu tiež začal postupne prevyšovať počet
absolventov.
Na mužskom
učiteľskom
ústave bolo
v
školskom
roku 1910/11
8 MIHÓKOVÁ, M. Stredné školstvo ..., s. 143, 161.
9 II. výročná zpráva rádového čsl. dievč. reálneho gymnázia sv. Uršule v Košiciach a I. výročná
zpráva
rádového
čsl.
ženského
učit. ústa
vu uršuliniek
v
Košiciach
za
školský rok
1937
– 38 .
Košice : Nákladom ústavu, 1938, s. 31.
10 MIHÓKOVÁ, M. Stredné školstvo ..., s. 167.
11 Felvidéki Tanügy , 15. október, 1881, č. 1 -2, s. 44- 45.
12 Počas prvých 24 rokov existencie ústavu ho z 340 prihlásených dievčat absolvovalo 320,
z ktorých sa 65 zam estnalo na pozícii učiteľky a 150 – 160 absolventiek sa uplatnilo vo funkcii
vychovávateľky. MIHÓKOVÁ, M. Stredné školstvo ..., s. 169-170.
13 II. výročná zpráv a rá dového čsl. dievč. reálneho gymnáz ia sv. Ur šule v Košiciach a I. výročná
zprá
va rád
ového č
sl. že
nského
učit.
ústavu
uršul
iniek v Košic iach z a škols ký rok 1937 – 38 ..., s. 31.
14 MIHÓKOVÁ, M. Stredné školstvo ..., s. 174.
15 PUKÁNSZKY, B. Bevezetés a nőnevelés történetébe
.
Gallová, M.:
Inštitucionálna príprava a vzdelávanie učiteliek v Košiciach do roku 1938
86
zapísaných 74
žiakov.
Na ženskom
učiteľskom ústave
študovalo v Košicia ch
v tom istom školskom roku 127 riadnych ž iačok a 5 privatistiek.
16
Ako
už
bolo
vyššie
uvedené,
učiteľské
ústavy,
ktoré
okrem
štátu
zakladali aj cirkvi, a to predovšetkým rímskokatolícka, boli pôvodne zaradené
do
systému
z
ákladného
školstv
a.
Stredným
i
škol ami boli do roku 1918 len
gymnáz
iá. Zákon č. 293/1
919 Sb. z. a
n. zo dň
a 27. mája 1919 zara
dil učiteľské
ústavy
v
rátane odborný
ch učiteľský
ch ústavov medzi stre
dné školy.
17 Na územ í
Slovenska
(aj
Podkarpatskej
Rusi)
boli
učiteľské
ústavy
zakladané
podľa
zák
onného
článku č.
38/1868
a
zákon
a č. 293/1
919 Sb. z.
a
n. Orga
nizačný
štatút
bol v
ydaný
dňa 18
. decem
bra 190
0 pod čí
slom 4
5.781.
18
V rá mci ČS R exist ovalo
niekoľko
mužských
alebo
ženských
učiteľských
ústavov,
ale
viac
bolo
koeduk
ačných, ktoré bo
li vytvorené na zák
lade výnosu č. 17
.714 zo dňa 6. júna
1919: „Aby se vyhovělo přáním s mnoha stran projeveným, povoluje se pro ta
města, kde jest pouze jeden ústav učite
lský, spoluvýchov
a (koedukace) druhé
ho
pohl
aví až do jedn
é třetiny
m
aximál
ního poč
tu chovan
ců.“
19 Výn osom č. 40.0 25
zo
dňa
12.
apríla
1929
bolo
navyše
povolené
prijať
do
prv
ého
ročníka
20
chlapcov
a 20 dievčat. Dovtedy mohli dievčatá tvoriť maximálne 1/3 zo 40
prijatých žiakov. Celkovo však v 30. rokoch 20.
storočia prevažov
al na učiteľ -
ských
ústavoch počet dievčat nad počtom chlapcov .
20
Československý štátny učiteľský ústav v Koš
iciach
Obidva vyššie
uvedené košické cirkevné učiteľské
ústavy, na ktorých
prebiehalo
vyučovanie v
maďarčine,
boli
v
roku
1919
zrušené
bez toho,
aby
sa
uvažovalo
o
založení
nového
slovenského
učiteľského
ústavu.
Vzhľadom
k tomu, že v neďalekom Prešove existovali v tom čase tri učiteľské ústavy,
prev
ládal
názor
, že Ko
šice uč
iteľsk
ý ústa
v nepo
trebu
jú. Kvô
li pot
rebe p
ritiah
nutia
študentov
zo
vzdialenejších
oblastí
východného
Sloven ska k
učiteľskému
povolaniu, šírenia
osvety a
posilnenia národného
povedomia došlo predsa
len
k založ eniu Česk oslovenskéh o štátneho učiteľské ho ústav u v Košiciac h v roku
1921
. V šk olskom roku 1 921/22 bol otv orený prvý r očník . Ústav bol do budova ný
až
v
školskom r
oku 1924/25,
kedy
boli
otvorené
všetky
štyri r
očník
y.
Kvôli
neustálym
problémom
s
umiestnením
ústavu
a
neustálem
u
sťahovaniu
jeho
tried, ako
aj
nedostatk
u
učebných pomôcok,
čo ovplyvňovalo
kvalitu výučby
i rozvoj samotného ústavu, b olo v
roku
19
27
ro zhodnuté o jeho zru šení,
resp. zlúčení so Štátnym československým koedukačným učiteľským ústavom
16 Magyar statisztikai évkönyv 1911 [online]. Budape st : Magyar Királyi Központi Statisztikai
Hivatal, 1912,
s. 370-371.
17 Zákon č. 293/1919 Sb. z. a n. ze dne 27. května 1919 o změně plat nosti ustanovení o středn ích
školách na Slovensku [online].
18
PLACHT, O. –
HAVELKA, F. Příručka školské
..., s. 567.
19 Citované podľa PLACHT, O. – HAVELKA, F. Příručka školské ..., s. 816.
20
PLACHT, O. –
HAVELKA, F. Příručka školské
..., s. 816.
STUDIA SCIENTIFICA FACULTATIS PAEDAGOGI CAE
UNIVERSITAS CATHOLICA RUŽOMBEROK 2020, č. 3
87
v Prešove.
21 Od školského roku 1927/28 už neboli prij ímaní žiaci do prvého
ročníka.
22
V školskom roku 1929/3 0 bol posledný štvrtý ročník učiteľského
ústavu
pričlenený
ako
pobočka
k
Československej
štátnej
vyššej
reálke
v Košiciach.
23
Podmienkami
na
prijatie
do
ústavu
bola
okrem
telesne
j
vyspelosti
a mravnej zachovalosti aj adekvátna príprava, čiže predchádzajúce dosiahnuté
vzdelanie,
kto
ré
malo
z
ahŕňať
napríklad
i
hudobné
vzdelanie.
Z
áujemcovia
o štúdium museli absolvovať pr ijímaciu skúšku, pričom museli spĺňať
i vekovú hranicu, ktorá bola stanovená na m inimálne 15 rokov veku života.
K žiado
sti
o prijatie mali dievčatá a chlapci pripojiť krstný, resp. rodný list,
posledné
získané
vysvedčenie,
lekárske
potvrdenie
o
telesnej
spôsobilosti,
ukážky
z krasopisu a
výkresy,
ktoré
museli
byť
overené
školou,
ktorú
uchádzač
napos
ledy
navštevoval. Od
dievčat sa
vyžadovali tiež
ženské ručné
práce.
V
prípade,
ak
záujemcovia
ukončili
predchádzajúce
štúdium
už
skôr,
mali predložiť i
vysv
edčenie
o
mravnosti, ktoré im mal
vystaviť obecný úrad.
Písomná
a
ústna
prijímacia
skúška
sa
skladala
z
vyučovacieho
j
azyk
a
a matematiky. Okrem
toho sa
preverovala i telesná zdatnosť a hudobný sluch
záujem
cov o
štúdium. Učiteľsk
ý
ús
tav bol
poč
as
sv
ojej existencie koeduk
ačný.
Každoročne
mohlo
byť
prijatých
40
žiakov
do
jedného
ročníka,
pričom
dievčatá
mali
tvoriť
najviac 1/3
z c
elkového
počtu
žiactva.
24
S tým súvisí aj
prevaha
v počte chlapcov nad počtom dievčat študujúcich na učiteľskom
ústave, čo zobrazuje nasledujúca tabuľk
a.
Tabuľka č. 1: Počet riadnych žiakov a žiačok Československého štátneho
učiteľského ústavu v Košiciach
25
Školský
rok
1921/22
1922/23
1923/24
1924/25
1925/26
1926/27
1927/28
1928/29
1929/30
Žiaci
13
45
55
80
83
84
59
36
19
Žiačky
10
23
34
40
36
40
30
23
14
21
Viac
o organizácii ústavu a problémoch s tým spojených BOJKOVÁ, Alžbeta. Primárne
problémy ..., s. 168-174.
22 Výročná zpráva českoslov. št . učit. ústavu v Košiciach za roky 1921/22 – 1927/28 . Košice,
1928, s. 10-12, 25.
23 Čsl. štátna reálka v Košiciach a pobočka býv. št. učiteľského ústavu v Košiciach. XI. (za uč.
pobočku:
V.). Výročná
zpráva za š
kolský rok 19
29 - 30 . Košice : Nákladom v lastným, 1930, s. 10.
24 Výročná zpráva českoslov. št. učit. ústavu v Košiciach za roky 1921/22 – 1922/23 . Košice,
1923, s. 21-22.
25 Čsl. štátna reálka v Košiciach a pobočka býv. št. učiteľského ústavu v Košiciach. XI. (za uč.
pobočku: V.
). výročná zpráva za škol
ský rok 1929 - 30 ..., s. 19. Čsl. št. učiteľský úst av v Košiciach.
Štvrtá výročná
zpráva za
školský rok 1928 - 29 . Košice, 1929, s. 13.
Výročná
zpráva českoslov.
št. učit. ústavu v
Košiciach za ro
k
y 1921/22
– 1922/23 ..., s. 6, 18.
Výročná zpráva českoslov.
št.
učit. ústavu v
Košiciach za roky 1921/22 – 1927/28 ..., s. 18, 34.
Gallová, M.:
Inštitucionálna príprava a vzdelávanie učiteliek v Košiciach do roku 1938
88
Pre por
ovnan
ie uvádzam
e, že na začiatk
u 20. storo
čia, kedy v Ko šiciac h
pôsobili
dva
uč
iteľské
ústav
y
–
ženský
a
mužský,
prevažoval
počet
dievčat
nad
počtom
chlapcov.
Napr.
v
školskom
roku
1913/
14,
teda
pred
pr
vou
svetovou vojnou, mal mužský
učiteľský
ústav 70 žiakov a
na ženskom uči
teľ -
skom ústave študovalo v
tom čase 164 žiačok.
26
Spomed
zi
ži
ačok navštevovali učiteľsk
ý
ústa
v
na
jmä
koši
cké dievčatá.
Tie tvorili viac
ako polovicu žiačok ( 52,18 %)
učiteľského ústavu v
školskom
roku 1
922/23. U ži
akov však ko
šickí chlapc
i predstavo
vali len 13
,3
%. Dievča
tá
sa hlásili
k slovenske j (82,61 %) alebo českej národno sti (17,39 %). U chlapcov
bol
podobný
stav.
K
slov
enskej
národnosti
sa
prihlásilo
75,56 % chlapcov,
k českej 22,22 %.
27 Neprítomnosť žiakov a žiačok ďalších národností na
učiteľskom ústave súvisela s
poprevratovým budovaním slovenského
školstva
a s tým spojenou potrebou vychovať a vzdelať dostatok slovenských učiteľov
a učiteliek, ktorých bolo v povojnových rokoch veľ m i málo. Vzhľadom
k tomu, že po vzniku Československa prichádzali nielen do Košíc, ale aj na
ostatné
územie
Slovenska
českí
učitelia
ale
i
úradníci
a
odborníci
z
rôznych
sfér,
ktorí zapĺňali
prázdne
pracovné miesta,
je
sam
ozrejmé,
že na
košických
ško
lách, v
rátane
učite
ľského
ústav
u, štud
ovali
ich ro
dinní p
rísluš
níci.
Nábože
nské
zložen
ie žiactva ústavu bolo
pes
trejšie. Najvia
c bolo zastúpené rím
skokatolícke
vierovyznanie,
ku
ktorému
sa
hlásilo
86,9
6
%
dievčat
a 77 ,78 % chlapcov.
V prípad e dievčat na sledovalo g réckokatolí cke, evanjel ické a. v. a českobrat ské,
ktoré
mali zhodné
zastúpenie po
4,35 %. U chlapcov nasledoval
o
za
rímsko -
katolíckym
vierovyznaním
evanjelické
a. v. (11,11 %) a
gréckokatolícke
(4,44 %). K československ ému, helvétskemu a židovskému vierovyznaniu sa
prihlásil len jeden žiak.
26 ASZTALOS, József. Kassa közoktatási és közművelődési intézmenyei. In Statisztikai Szemle
[online], 1939, roč. 17, č. 5, s. 587.
27
K židovskej národnosti sa prihlásil len jeden ži
ak.
STUDIA SCIENTIFICA FACULTATIS PAEDAGOGI CAE
UNIVERSITAS CATHOLICA RUŽOMBEROK 2020, č. 3
89
Tabuľka č. 2: Štatistické ukazovatele žiakov a žiačok v školskom roku
1922/23 (1. a 2. ročník)
28
Chlapci
Dievčatá
Spolu
Rodisko
Počet
%
Počet
%
Počet
%
Košice
5
11,11
2
8,70
7
10,29
Slovensko okrem Košíc
30
66,67
13
56,52
43
63,24
Ostatné časti ČSR
9
20,00
3
13,04
12
17,65
Zahraničie
1
2,22
5
21,74
6
8,82
Spolu
45
100
23
100
68
100
Bydlisko
Košice (u rodičov)
6
13,33
12
52,18
18
26,47
Košice (u zodpoved. dozorcov)
11
24,44
3
13,04
14
20,59
V internáte
25
55,56
8
34,78
33
48,53
Dochádzajú
3
6,67
-
-
3
4,41
Národnosť
Slovenská
34
75,56
19
82,61
53
77,94
Česká
10
22,22
4
17,39
14
20,59
Židovská
1
2,22
-
-
1
1,47
Náboženstvo
Rímskokatolícke
35
77,78
20
86,96
55
80,88
Gréckokatolícke
2
4,44
1
4,35
3
4,41
Československé
1
2,22
-
-
1
1,47
Evanjelické a. v.
5
11,11
1
4,35
6
8,82
Evanjelické českobratské
-
-
1
4,35
1
1,47
Evanjelické helv. v.
1
2,22
-
-
1
1,47
Židovské
1
2,22
-
-
1
1,47 Na základe výnosu č. 38.985 z 29. augusta 1919 a výnosu č. 21.788
z 27. júla 1922 sa mali žiaci a žiačky učiteľských ústavov vzdelávať v
nasle-
dujúcich predmetoch: náboženstvo, pedagogika a prax, vyučovací j azy k,
nemecký jazyk,
zemepis, dejepis
a
vlastiveda,
matem
atika,
prírodopis, fyzika
a chémia, poľné hospodárstvo, krasopis, kreslenie, spev a všeobecná náuk a
o hudbe, hra na husliach, hra na klavíri, hra na organe, ženské ručné práce,
telocvik,
výchovné
ručné
práce
(nepovinné).
Rozdiely
vo
vyučovacích
predmetoch
na
mužských
a
koedukačných
učiteľských
ústavoch
na
jednej
28 Výročná zpráva českoslov. št. učit. ústavu v Košiciach za roky 1921/22 - 1922/23 ..., s. 18-19.
Gallová, M.:
Inštitucionálna príprava a vzdelávanie učiteliek v Košiciach do roku 1938
90
strane
a ženských učiteľských ústavoch na strane druhej boli minimálne.
Mužské
a koed
ukačné
ústavy
mali
v
poslednom
štvrtom
ročníku
o jednu
hodinu
vyučov
acieho
jazyka
viac
a o jednu hodinu kreslenia menej ako to
bolo
n
a
ž
enskýc
h
ú
stavoc
h. V
treťom
ročníku
sa
vy
učoval
o poľné hosp
odárstv
o,
pričom na
ženských
ústavoch takýto
predmet dievčatá
neabsolvovali. Pokým
predmet hra na
huslia
ch
bol povinný pre všetky typy učiteľských ústavov, hra
na
klavíri
a
hra
na
organe
boli
predmety,
k
toré
sa
mali
vyučovať
len
na
mužských
a
koedukačných
učiteľských ústavoch
a
pre
dievčatá
študujúce
na
koedukačných
ústavoch
bolo
ich
absolvovanie
nepovinné.
Na
ženských
učit
eľský
ch ústav
och moh
ol byť pr
edmet h
ra na klav
íri zav
edený ak
o nepov
inný.
Žiačky
ženských
učiteľských
ústavov
absolvovali
počas
prvých
troch
rokov
štúd
ia pred
met žen
ské ruč
né prác
e. Žiač
ky a
žia
ci koe
dukačn
ých ale
bo mužsk
ých
učit
eľský
ch ústavov
m
ohli v
posl
ednýc
h
dv
och ročn
íkoch abs
olvova
ť
n
epovin
ný
predmet výchovné ručné práce.
29
Výučba vy
ššie uvedenýc
h predmetov prebi
ehala i
na Česko
slovenskom
štátnom
učiteľskom
ústave
v
Košiciach.
Hoci
i
šlo
o koedu
kačný
ústav,
pre
kto
rý nebol
i predp
ísané ž
enské ru
čné prá
ce, ale l
en nepov
inný pr
edmet
výchov
né
ručné prá
ce (v dobov
ej terminológ
ii vo
výročn
ých správach
„rukodelné p
ráce“),
vyučovali
sa
tam
oba
spomínané
predmety.
30 Okrem toho absolvovali ž iaci
a žiačky i
predmet
zdravoveda
a metodika elementárnej triedy. Na danom
ústave
vyučovali
v
prevažnej
miere
profesori
–
muži.
Ženy
sa
tam
uplatnili
len
ako
výpomocné
profesorky
pri
vyučov
aní
predmetu
ženské
ručné
práce
a telocvik pre dievčatá. Výnimkou bol školský rok
1927/28,
kedy
jedna
z výpomocných profesoriek dočasne prevzala počas zastupovania profesora
výučbu predmetov spev, hra na husliach, hra na k
lavíri a hra na organe.
31
Rádový československý ženský učiteľský ústav s
v. Uršule v Košiciach
V roku
1937
bol
po
18- ročnej prestávke znovuotvorený Rádový
českos
lovenský žen
ský učiteľský
ústav sv. Urš
ule v Košiciach .
32 Rád sv. U ršule
v Košiciach uvádzal ako hlavný dôvod j eho otvorenia nedostatok česko
-
slovenských
a
profesorsk
ých
síl.
33 Keďže išlo o rá dový ženský učiteľský
ústav, jeho žiačkami sa mohli stať len dievčatá, pričom pri ich prijímaní platili
29
PLACHT, O. –
HAVELKA, F. Příručka školské
..., s. 617.
30 Na niek torých koeduka čných učiteľ ských ústavoc h bol predmet ž enské ručné práce považova ný
za povinný. PLACHT, O. – HAVELKA, F. Příručka školské ..., s. 592.
31 Výročná zpráva českoslov. št. učit. ústavu v Košiciach za roky 1921/22 – 1927/28 ..., s. 24-25.
32 II. výročná zpráv a rá dového čsl. dievč. reálneho gymnáz ia sv. Ur šule v Košiciach a I. výročná
zpráva
rádovéh
o čsl. že
nského uč
it. ústav
u uršul
iniek v
K
ošiciach
za školsk
ý rok 19
37 – 38 ..., s. 31.
33 Arcibiskupský archív v Košiciach (ďalej AACass), fond (ďalej f.) Košické biskupstvo (ďalej
KB),
oddelenie
(ďalej
odd.)
Košický
biskupský
ordinariát 1883 –
1946
(ďalej
KBO),
číslo
spisu (ďalej č. sp.) 2447, 1936.
STUDIA SCIENTIFICA FACULTATIS PAEDAGOGI CAE
UNIVERSITAS CATHOLICA RUŽOMBEROK 2020, č. 3
91
predpisy,
ktoré boli
ustanovené
pre
štátne ženské
učiteľské
ústavy. Rovnako
aj učebná osnova bola taká istá, ako v
prípade štátny
ch učiteľských ústavov.
34
Prvý školský rok 1937/38
absolvov
alo
38 žiačok. Z
Košíc pochádzalo
9 dievčat a z
územia Slovenska (mimo Košíc) zvy
šných 29, z
ktorých bolo 28
ubytovaných
v
internáte
rádu
sv.
Uršule
a
jedna
v
súkromnom
byte.
Všetky
žiačky
uviedli
za
svoju
materinskú
reč
„československú“,
ktorá
označovala
slovenský
aj
český
jazyk.
Vzhľadom
k
tomu,
že
všetky
ž
iačky
pochádzali
z územia Slovenska, môžeme predpokladať, že išlo len o slovenský jazyk.
Z hľad iska vierovyznan ia bolo najv iac zastúpené rímsko katolícke nábože nstvo,
ku ktorému sa hlásilo 35 dievčat a
okrem neho i gréckokatolícke náboženstvo,
ku kto
rému sa hlás
ili 3 dievč
atá. Uveden
é údaje zob
razuje nasle
dujúca tabu
ľka.
Tabuľka č. 3: Štatistické ukazovatele žiačok v školskom roku 1937/38
35
Školský rok
Počet žiačok
Rodisko
Materinská reč
Náboženstvo
Košice
Slovensko (okrem
Košíc)
Zvyšok ČSR
Zahraničie
Československá
Nemecká
Maďarská
Rímskokatolícke
Gréckokatolícke
1937/38
38
9
29
-
-
38
-
-
35
3 Profesorský zbor ženského učiteľského ústavu uršulínok tvorili okrem
správkyne
ďalšie
4
profesork
y
(vyučov
ali
slovenský
jazyk,
nemecký
jazyk,
dejepis,
zemepis,
prírodopis,
spev,
hru
na
husliach,
telocvik
a
ženské
ručné
práce) a
6
profesori (vy
učovali nábož
enstvo, chém
iu, fyziku,
kreslenie, kra
sopis
a m
atemat
iku).
36 Pred mety, k toré ab solvov ali žia čky prv ého roč níka, z odpove dali
pred
pisom
týk
ajúcim
sa štátn
ych učiteľ
ských ústa
vov. Žiačky
si svoje
vz
delani
e
doplnili
i abso lvovaním 10 - hodinov ého kur zu výcho v nej rytm iky. Okrem toho
sa 15 žiačok zúčas
tnilo ošetrovat
eľského kurzu,
kt
orý od 19. marca do 18. júna
1938
organizoval
Československý
Červený
kríž
v Košiciach.
37 Obnovený
Rádový
československý
ženský
učiteľský
ústav
sv.
Uršule
v
Košiciach
však
34 AACass, f. KB, odd. KBO, č. sp. 1354, 1937.
35 II. výročná zpráv a rá dového čsl. dievč. reálneho gymnáz ia sv. Ur šule v Košiciach a I. výročná
zpráva
rádového čsl.
ženského učit.
ústavu uršulin iek v
Košiciach za
školský rok
1937
– 38 ...,
s. 37-38.
36 II. výročná zpráv a rá dového čsl. dievč. reálneho gymnáz ia sv. Ur šule v Košiciach a I. výročná
zpráva
rádovéh
o čsl. že
nského uč
it. ústav
u uršul
iniek v
K
ošiciach
za školsk
ý rok 19
37 – 38 ..., s. 33.
37 II. výročná zpráv a rá dového čsl. dievč. reálneho gymnáz ia sv. Ur šule v Košiciach a I. výročná
zpráva
rádovéh
o čsl. že
nského uč
it. ústav
u uršul
iniek v
K
ošiciach
za školsk
ý rok 19
37 – 38 ..., s. 36.
Gallová, M.:
Inštitucionálna príprava a vzdelávanie učiteliek v Košiciach do roku 1938
92
fungoval
v tomto meste le n jeden školský rok. V novembri nasledu júceho
školského
roka,
teda
po
viedenskej
arbitráži,
bol
ústav
presťahovaný
do
Bratislavy.
38
Odborné učiteľské ústavy
Okrem
učiteľských
ústavov
existovali
i
„odborné
uč
iteľské
ústavy“.
Toto pomenovanie ne bolo úradne stanovené, ale použ ívalo sa z organizačných
dôvo
dov v praxi M iniste rstva školstv a a ná rodne j osvety v Pra he (ďa lej MŠa NO).
Označovalo
zariadenia, ktoré
slúžili
na
vz
delávanie
učiteliek
domácich náuk
a učiteliek materských škôl. Štúdium na odborných učiteľských ústavoch
trvalo dva
roky, pričom
sa každý
rok ot
váral len
jeden z
dvoch
ročníkov tak,
ako
to
určoval
organizačný
štatút
MŠaNO
č.
29
387
zo
dňa
14. novembra
1919.
39 Podľa n eho mali ústav y domácich ná uk poskytnúť dievčatám vz delanie,
ktoré potrebovali pri vedení domácnosti, výchove v rodine a
uspôsobovalo ich
vyučovať
domáce
náuky,
teda
žensk
é
ručné
práce.
Ústavy
pre
vzdelávanie
učitelie
k materský
ch škôl umož
ňovali absolv
entkám zam
estnať sa v m aterských
školách
alebo
detských
opatrovniach
ako
vychovávateľky.
Obidva
druhy
inšt
itúcií
ma
li byť zakla
dané pri štátn
ych učite
ľských
ús
tavoch
. Iní zriaďov
atelia
ich mohli udržiavať
i
samosta
tne,
čo využívali najmä cirkvi. Do roku
1918 na
území Slovenska odborné učiteľské ústavy
neexistovali.
40
Učiteľské ústavy pre vzdelanie pestúnok (opat
rovateliek)
Okrem
dvoch
vyššie
spomenutých
r
ímsk
okatolíckych
učiteľských
ústavo
v bola v roku 1918 v Košiciac h založená i škola pre vz delávanie uči teliek
materských škôl (opatrovní), ktorá patrila pod správu dom
inikánok. Pr edmety,
v k torých sa mali d ievčat á počas š tvorro čného štúdia v zdeláv ať, bol i nábož enstvo
a morálka, vyučovanie o duševnom a telesnom živote, pedagogik a a didaktika
na ľudových školách, štruktúra uhorského ľudového škols
tva, história pedago -
giky, pedagogická prax, maďarský j azy k a literatúra, nemecký jazyk, druhý
domáci
jazyk
(voliteľný),
história,
poznatky
o
uhorskej
ústave,
zemepis,
mate
matik
a,
pr
írodop
is, chémia
,
fyz
ika, zdravo
veda, hospo
dárst
vo
(d
omácn
osť),
38 Esti újság , 1938, 10. november, roč. 3, č. 256, s. 9. Slov ák , 1938, 6. novem ber, roč. 20, č. 253,
Nový učiteľský ústav v Bratislave, s. 7.
39 Predtým boli ústavy pre vzdelávanie učiteliek materských škôl zriaďované na základe naria -
denia
uhorského Ministerstva
kultu a
vý
učby
č.
3632, ktoré
bolo prijaté
3.
júla 1914
a
neskôr
zase na základe orga
nizačného štatútu č. 167 279/ 36- II prijatého 15. marca 1937 . PLACHT, O. –
HAVELKA, F. Příručka školské
..., s. 572.
40 Jozef Bilčík uvádza, že prvý odborný učiteľský ústav vznikol v Prešove v roku 1922. Avšak
už v roku 1918 bola v
Košiciach založená škola pre vzdelávanie učiteliek opatrovní. BILČÍK, J.
Vývoj školstva na Slovensku (III) ..., s. 154.
STUDIA SCIENTIFICA FACULTATIS PAEDAGOGI CAE
UNIVERSITAS CATHOLICA RUŽOMBEROK 2020, č. 3
93
spev,
hudba,
kreslenie,
krasopis,
ru čná práca, gymnastika a
hry.
41 Škola
fungov
ala
prav
depodobne
len jeden školský rok
(1
918/19). V
štatistike žiactv
a
v jedno tlivých školsk ých zariadenia ch dominikán ok v Košiciach za prvý polrok
školského roka 1919/20 sa ústav pre vz
delanie pestúnok už nespomí na.
42
Pre
územie
Slovenska
platil
ohľadom
ústavov
pre
vzdelanie
opatro -
vateliek až do roku 1919 zákonný článok č. 15/1891.
43 Zákonom č. 293/1919
Sb. z.
a n. boli tieto predpisy nahradené predpismi, ktoré dovtedy platili
v ostatných častiach ČSR.
44 Ústavy pre vzdelanie pestúnok (opatrovateliek) sa
teda aj na Slovensku mali od roku 1919 riadiť organiza
čným štatútom č. 3.632
zo
dňa
3.
júla
1914.
Založené
mohli
by
ť
buď
pri
učiteľsk
om
ústave
alebo
samost
atne. Ich úlohou
bolo poskytnúť žia
čkam vzdelanie
, ktoré: „[...] je nutn é
pro
zdárnou
práci
v
mateřských
školách
(opatrovně),
zvláště
pochopení
pro
dětskou
povahu,
přesné
obeznámení
s
cíli,
prostředky
a
rázem
výchovy
v mateřských školách (opatrovnách), zručnost a
jistotu
v provádění všech
povinností pěstounky (opatrovatelky).“
45
Uchádzačky
o
štúdium
na
tomto
type
ústavu
museli
mať
minimálne
16 rokov, byť mravne bezúhonné a telesne spôsobilé na zastávanie postu
vych
ováva
teľky,
byť
zr
učné v
žen
ských
ru
čných prác
ach (mali pred
ložiť
vl
astné
ručné práce), mať hudobný sluch a
dobrý spevácky hlas a
mať predchádza
júce
vzdelanie,
ktoré
bolo
podmienkou
aj
pre
prijatie
do
učiteľských
ústavov
(overovalo
sa
prijímacou
skúškou).
Počas
dvojročného
štúdia
boli
žiačky
vzdeláv
ané v
nasled
ujúcich predm
etoch: nábožen
stvo, vychováv
ateľstvo,
náuka
o mater skej škole (opatrovn i), praktické cvičenie v m aterskej škole (opatro vni),
vyučovací jazyk,
vecné vyučovanie
(prírodopis a
občianska
náuka), kreslenie
a modelovanie, výtvarné ručné práce, ženské ručné práce, sp
ev
a telocvik.
Medzi nepovinné predmety patril cudzí jazyk, hra na husliach a
hra
na klavíri.
Po úspešnom ukončení štúdia získali
absolventky
vysvedčenie
spôsobilost
i
na
výkon pov
olania pestúnk
y (opatrovateľ
ky). Absolve
ntky 4 -
ročného učit
eľského
ústavu po najmenej t
ro
jmesačnom hospitovaní
v
materskej škole a dodatočnej
skúške mohli túto spôsobilosť získať v
o forme dodatku k vysvedčeniu.
46
Československý rádový ústav pre vzdelanie u
čiteliek materských škôl
Kongregácie sestier dominikánok v Košiciach
V roku
19 29 zaslala Kongregácia sestier dominikánok v Košiciach
žiadosť
MŠaNO
o
povolenie
na
zriadeni
e
ústavu
pre
vzdelan
ie
učiteliek
detský
ch opatrovní v
Ko
šiciach. Do začia
tku roka 1934 však
ostala táto žiadosť
41 AACass, f. KB, odd. KBO, č. sp. 3264, 1930.
42 AA Cass, f. KB, odd. KBO, č. sp. 328, 1920.
43 1891. évi XV. törvénycikk a kisdedóvásról [online].
44
PLACHT, O. –
HAVELKA, F. Příručka školské
..., s. 581.
45
PLACHT, O. –
HAVELKA, F. Příručka školské
..., s. 574.
46
PLACHT, O. –
HAVELKA, F. Příručka školské ..., s
. 574.
Gallová, M.:
Inštitucionálna príprava a vzdelávanie učiteliek v Košiciach do roku 1938
94
nevybav
ená.
47 Českos lovenský rádov ý ústav pre vzd elanie učiteliek materských
škôl Kongr
egácie sestier domin
ikánok v Košiciach bol založ
ený až v
ško
lskom
roku
1934/35.
48 Ústav bol dvojročný, pričom prv ý ročník sa otv áral každý
druhý ro
k, takže v
škols
kom roku 1935
/36 prebiehala v
ýučba v
druhom
ročníku
a v školskom roku 1936/37 bol otvorený znova prvý ročník.
Okrem predmetu
nábože
nstvo, ktorý bo
l vyučovaný pr
iorom dominik
ánskeho klášto
ra, vyučoval
i
všetky ostatné predmety sestry dom
inikánky.
49
Praktický
výcvik žiačok
prebiehal
trikrát
týždenne
v
materskej
škole
ústavu.
Na praxi
sa
dievčat
á
striedali
a
každé z
nich
ju
počas školského
roka
absolvovalo
minimálne
šesťk
rát.
Okrem
povinných
predmetov
sa
diev
čatá
súkromne
vz
delávali
v
cudzích
jazykoch
(francúzskom
a ruskom), v hre n a
klav
íri ale
bo v spev e. Ich šk olské vz delan ie bolo do pĺňané účasťou na premi etaní
filmov,
exkurziách
či
vý
stavách.
Žiačky
sa
zapájali
tiež
do
mimoškolský
ch
aktivít.
V
decem
bri
1935
posky
tli
svoje
ručné
a
výtvarné
práce
v prospec h
vianočného trhu,
ktorý v
meste
usporiadali dobročinné
organizácie na
pomoc
chudobným.
50 Charitatívnou činnosťou sa zaoberali aj v decembri 1937, kedy
v predvianočnom obdob í darovali chudobným deťom bielizeň a šaty, ktoré
vlastnoručne
ušili.
51
V máji a júni 1936 sa 26 žiačok úst avu zúčastnilo
samaritánskeho
kurzu
v
rozsahu
30
hodín,
k
torý
usporiadal
Česk
oslovenský
Červený
kríž.
Po
vykonaní
skúšky
z
ískali
diplom
o
spôsobilosti
na
výkon
funkcie samaritánky.
52 Podobný kurz absolvovali žiačky aj v máji a júni 1938,
kedy
sa
zúčastnili
prednášok
o
anatómii,
hygiene
a prvej pomoci ako aj
praktického
výcviku
prvej
pom
oci.
Kurz
bol
ukončený
vykonaním
v
erejnej
skúšky.
53
47
V roku 1932 bol takýt o ústav založený v Ružom berku. AACass, f. KB, odd. KBO , č. sp. 2256,
1934.
48 I. výročná z práva rádového čsl. diev čen. reálneho gymnázia k ongr. sestier dominikánok
v Košiciach za školský rok 1936 - 37 . Košice : Nákladom ústavu, 1 937, s. 4.
49 Hlavná výročná zpráva čsl. rádového ústavu pre vzdelávanie učiteliek materských škôl
v Košiciach. Školský rok 1935 –
1936. Košice, 1936, b. s.
50 Hlavná výročná zpráva čsl. rádového ústavu pre vzdelávanie učiteliek materských škôl
v Košiciach. Školský rok 1935 –
1936. .., b. s.
51 Výročná zpráva čsl. rádového ústavu pre vzdelanie u čiteliek domácich náuk a čsl. rádového
ústavu pre vzdelanie učiteliek materských škôl. Školský rok 1937 – 1938 . Košice, 1938, s. 12.
52 Hlavná výročná zpráva čsl. rádového ústavu pre vzdelávanie učiteliek materských škôl
v Košiciach. Školský rok 1935 –
1936 ..., b. s.
53 Výročná zpráva čsl. rádového ústavu pre vzdelanie u čiteliek domácich náuk a čsl. rádového
ústavu pre vzdelanie učiteliek materských škôl. Školský rok 1937 – 1938 ..., s. 11.
STUDIA SCIENTIFICA FACULTATIS PAEDAGOGI CAE
UNIVERSITAS CATHOLICA RUŽOMBEROK 2020, č. 3
95
Učiteľské ústavy pre vzdelanie učiteliek do
mácich náuk (ženských
ručných prác)
Výnosom
MŠaNO
č.
29.387
zo dňa
14.
novembra
1919
bol
vydaný
organiz
ačný štatút ústavov pre vzdelania
uči
teliek domácich náuk.
54 Dvojroč né
ústavy
pre
vzdelanie
učiteliek
domácich
náuk
sa
mali
zakladať
pr
i
š
tátnych
učiteľských ústavoch. Podľa organizačného štatútu bolo ich
úlohou poskytnúť
žiačkam
také
vzdelanie: „[...] aby dovedly vésti dívky ku pochopení úkolu
ženy
v
domácnosti
a
vychovávati
je
k
vytrvalé
a
uvědomělé
práci
pro
sebe,
rodinu a sv é bližní.“
55 Počas dvo jročného štúdia sa diev čatá vzdeláv ali v týc hto
predmetoch:
pedag
ogika
s praktickými cvičeniami, vyučovací jazyk, počty,
občiansk
a
náuk
a
a
výchov
a,
organ
izácia sociálnej
sta
rostlivost
i,
náuka
o tkani-
nách, telesná výchova, zdravotníctvo, spev a hudobná výchova, kreslenie,
ženské
ručné
práce
a
výtvarné
ručné
práce,
náuka
o
vedení
domácnosti
s praktickými cvičeniami vo varení. V jednom ročníku mohlo byť najviac 30
žiačok,
od
školského
roku
1933/34
len
25,
pričom
neplatili
žiadne
šk
olné.
Medz
i podm
ienky,
ktoré mu
seli sp
lniť zá
ujemky
ne o
št
údium,
patril
o dosia hnutie
minim
álne 17. roku v
eku, ďalej mr
avná bezúho
nnosť, telesné
a
duševné z
dravie
a absolvovanie meštianskej školy alebo nižšej strednej školy a dvoch ročníkov
priemyselnej školy. Prednosť
mali absolventky gazdinskej školy. Okrem
toho
museli
uchá
dzačky vykonať prijí
maciu skúšku, ktorá sa sklada
la
z m atematiky,
vyučovacieho
jazyka
a
základných
techník
ženských
ručných
prác
(pletenia
a háčkovania). Žiačky, ktoré úspešne absolvovali celé štúdium, získali na
konci
druhého
ročníka
vysvedčenie
učiteľskej
spôsobilosti
vyučovať
ženské
ručné prá
ce (domáce n
áuky) na obecn
ých (ľudový
ch) školách.
56 Po absolv ovaní
minimálne
dvojročnej praxe
na
obecnej
škole
sa
mohli učiteľky
prihlásiť
na
skúšku,
po
vykonaní
ktorej
mohli
vyučovať
domáce
náuky
(ženské
ručné
práce) na meštianskej škole.
57
Československý rádový ústav pre vzdelanie u
čiteliek domácich náuk
Kongregácie sestier dominikánok v Košiciach
Na základe výnosu MŠaNO č. 86.468/37 -
II/2 zo dňa 13. júla 1937 bol
na
začiatku
školského
roka
1937/38
otvorený
Č
eskoslovenský
rádový
ústav
pre
vzdelanie
učiteliek
domácich
náuk
Kongregácie
sestier
dominikánok
v Košic iach. Okrem vy ššie uvedenýc h predmetov mali žiačky košick ého ústavu
v rámci vyučovania i náboženstvo. Každý týždeň absolvovali jednu ho spitáciu
54
PLACHT, O. –
HAVELKA, F. Příručka školské
..., s. 572.
55
PLACHT, O. –
HAVELKA, F. Příručka školské
..., s. 573.
56 MÁTEJ, J. et al. Dejiny českej a slovenskej pedagogiky . Bratislava : S lovenské pedagogické
nakladateľstvo, 1976. 501 s. 347.
57
PLACHT, O. –
HAVELKA, F. Příručka školské
..., s. 574.
Gallová, M.:
Inštitucionálna príprava a vzdelávanie učiteliek v Košiciach do roku 1938
96
na cvičnej ľudov
ej
šk
ole, za
k
torou nasledovala
pora
da s d ôkladným rozborom
vzo
rového
vy
učovan
ia. V
pos
lednom
š
tvrťrok
u školsk
ého roka im k ho spitác iám
pribudla prax
na danej
ľudovej škole.
Rovnako, ako
to bolo
v
prípade ústavu
pre
vzdelávanie
učiteliek
materských
škôl,
aj
na
ústave
pre
vzdelávanie
učiteliek ženských
ručných prác vyučovali
okrem náboženstva všetky ost
atné
predmety sestry dominikánky.
58
Výročné
správy
košický
ch
odbo
rných učiteľských ústavov neobsahu
jú
štatistické
údaje
o
žiačkach,
ktoré
na
nich
študovali.
Nezachovali
sa
ani
úradné
knihy
alebo
spisový
materiál
z
činnosti
t
ýchto
ústav,
preto
nie
je
možné zistiť náboženské, národnostné alebo
sociálne zloženie žiactva.
Zakladanie
odborných
učiteľských
ústavov
na
území
Slovenska
prebiehalo
pomaly.
V školskom roku 1937/38 existov ali na Slovensku len
štyri
ústavy,
ktoré
vzdelávali
učiteľk
y
domácich
náuk
(v
Košiciach,
Levoči,
Nových
Zámkoch
a Prešove ) a
dva
ústavy,
ktoré
pr
ipravov
ali
učiteľky
mate
rskýc
h škôl (v Košic
iach a Ru žomber ku).
59
V dôsl edku uda lostí z n ovembr a
1938 obidva odborné učiteľské ústavy
v
Košiciach zanikli.
Záver
V Košici ach bolo od 6 0. rokov 19. storočia až do roku 1938 zalo žených
ni ekoľko škôl, ktoré posky tovali dievčatám vzdelanie a prípravu na povolanie
učiteľky.
Do
roku
1919
pôsobili
v
Košiciach
dva
rímskokatolícke
učiteľské
ústavy
–
osobitn
e
pre
d
ievčatá
a
osobitne
pre
chlapcov.
Po
vzniku
Česko -
slovenskej
republiky
tieto
ústavy
z anikli a v roku 1921 bol založený š tátny
učiteľský
ústav
(zanikol
koncom
20.
rokov).
Ten
bo
l
síce
koedukačný,
ale
počet
prijatých
dievčat
nemal
presiahnuť
1/
3
z
celkového
počtu
prijatých
žiakov.
Uršulínkam
sa
podarilo
v
roku
1937
obnov
iť
ich
žensk
ý
učiteľský
ústav,
na ktorom
začalo
znova prebiehať
vzdelávanie učiteliek
(avš ak len do
novembra
1938).
V 30. rokoch
vznikli
v Košiciach dva odborné učiteľské
ústavy,
ktoré
slúžili
na
vzdelávanie
učiteliek
materských
škôl
a
učiteliek
ženských
ručných
prác.
Ústavy
fungovali
pod
správou
dominikánok.
Prvú
školu
na
vzdelávanie
učiteliek
detský
ch
opatrovní
(materských
škôl)
založili
dominikánky v
Košiciach ešte v
roku
1918, fungovala však len počas jedného
školského roka.
58 Výročná zpráva čsl. rádového ústavu pre vzdelanie u čiteliek domácich náuk a čsl. rádového
ústavu pre vzdelanie učiteliek materských škôl. Školský rok 1937 – 1938 ..., s. 1-2, 14.
59 BILČÍK, J. Vývoj š kolstva na Slovensku (III) ..., s. 154-155.
STUDIA SCIENTIFICA FACULTATIS PAEDAGOGI CAE
UNIVERSITAS CATHOLICA RUŽOMBEROK 2020, č. 3
97
Bibliografia
Archívne pramene
Arcibiskupský archív v Košiciach ,
Fond Košick
é biskupstvo, oddeleni e
Košický biskupský ordinariát 1883 – 1946.
Výročné správy
I. výročná zpráva rádového čsl. dievčen. reá
lneho gymnázia kongr. sestier
dominikánok v
Košiciach za školský rok 1936 -37 . Košice : Nákladom
ústa vu, 1937. 15 s.
II. výročná zpráva rádového čsl. dievč. reá
lneho gymnázia sv. Uršule
v Košiciach a I. výročná zpráva rádového čsl. žens kého učit. ústavu
uršuliniek v
Košiciach za školský rok 1937 – 38 . Koši ce : Nákladom
ústavu, 1938. 40 s.
Čsl. štátna reálka v
Košiciach a
pobočka býv. št. u
čiteľského ústavu
v Košiciach. XI. (za uč. pobočku: V.). výro čná zpráva za školský rok
1929-30 . Košice : Nákladom vlastným , 1930. 30 s.
Čsl. št. učiteľský ústav v
Košiciach. Štvrtá výročná zpr
áva za školský rok
1928-29 . Košice, 1929. 17 s.
Hlavná výročná zpráva čsl. rádového ústavu pre
vzdelávanie učiteliek
mate
rských
škôl
v
Koš
iciach
. Škol
ský ro
k 193
5 – 1936. Ko šice, 1936. B. s.
Výro
čná z
práva
českos
lov. š
t. uči
t. úst
avu v Košici ach za roky 1921/ 22 – 1 922/23 .
Košice, 1923. 22 s.
Výro
čná z
práva
českos
lov. š
t. uči
t. úst
avu v Košici ach za roky 1921/ 22 – 1 927/28 .
Košice, 1928. 38 s.
Výročná zpráva čsl. rádového ústavu pre vzde
lanie učiteliek domácich náuk
a čsl. rádového ústavu pre vzdelanie učiteliek ma terských škôl. Školský
rok 1937 –
1938 . Košice, 1938. 14 s.
Dobová periodická tlač
Felvidéki Tanügy, 1881 .
Esti újság, 1938 .
Slovák, 1938 .
Právne normy
1868. évi XXXVIII. törvénycikk a népiskola
i közoktatás tárgyában [online].
[cit. 2. 11. 2019]. Dostupné na internete: <h
ttp s://net.jogtar.hu/getpdf?
docid=86800038.TV&targetdate=&printTitle=186
8.+%C3%A9vi+XX
XVIII.+t%C3%B6rv%C3%A9nycik
k&referer=1000ev>
1891. évi XV. törvénycikk a kisdedóvásról [online]. [ cit. 19.3.2020]. Dostupné
na internete: <https://net.jogtar.hu/getpdf
?docid=89100015.TV
&targetdate=&printTitle=1891.+%C3%A9v
i+XV.+t%C3%B6rv%C3%
A9nycikk&referer=1000ev>
Gallová, M.:
Inštitucionálna príprava a vzdelávanie učiteliek v Košiciach do roku 1938
98
Zákon č. 293/1919 Sb. z. a
n. ze dne 27. května 1919 o změně platnosti
usta novení o středních školách na Slovensku [online]. [cit. 5.3.2020].
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UNIVERSITAS CATHOLICA RUŽOMBEROK 2020, č. 3
99
Prílohy
Tabuľka č. 4: Učebný rozvrh pre učiteľské ústav y na Slovensku
60
Vyučovací
predmet
Počet vyučovacích hodín v jednotlivých ročníkoch
Mužský alebo koedukačný
ústav
Ženský ústav
I.
II.
III.
IV.
Spolu
I.
II.
III.
IV.
Spolu
Náboženstvo
2
2
2
2
8
2
2
2
2
8
Pedagogika
a prax
-
3
5
9
17
-
3
5
9
17
Vyučovací
jazyk
7
7
5
6
25
7
7
5
5
24
Nemecký
jazyk
2
2
2
2
8
2
2
2
2
8
Zemepis
2
2
2
2
8
2
2
2
2
8
Dejepis
a vlastiveda
3
3
2
2
10
3
3
2
2
10
Matematika
4
3
3
2
12
4
3
3
2
12
Prírodopis
2
2
2
1
7
2
2
2
1
7
Fyzika
a chémia
2
2
2
2
8
2
2
2
2
8
Poľné
hospodárstvo
-
-
1
-
1
-
-
-
-
-
Krasopis
1
-
-
-
1
1
-
-
-
1
Kreslenie
2
2
2
1
7
2
2
2
2
8
Spev
a všeobecná
náuka o hudbe
2
2
2
2
8
2
2
2
2
8
Hra na
husliach
2
2
1
1
6
2
2
1
1
6
Hra na klavíri
2
2
-
-
4
-
-
-
-
-
Hra na organe
-
-
2
1
3
-
-
-
-
-
Ženské ručné
práce
-
-
-
-
-
2
2
2
-
6
Telocvik
2
2
2
2
8
2
2
2
2
8
Výchovné
ručné práce
(nepovinné)
-
-
2
2
4
-
-
-
-
-
Spolu
35
36
37
37
145
35
36
34
34
139
60
PLACHT, O. –
HAVELKA, F. (eds.). Příručka školské
..., s. 617.
Gallová, M.:
Inštitucionálna príprava a vzdelávanie učiteliek v Košiciach do roku 1938
100
Tabuľka č.
5: Prehľad vyučovacích predmetov a počtu hodín na učiteľských
ústavoch pre vzdelanie opatrovateliek (učitel
iek materských škôl)
61
Predmet
Počet hodín
1. ročník
2. ročník
Povinné predmety:
Náboženstvo
1
1
Vychovávateľstvo
2
2
Náuka o
materskej škole (opatrovni)
1
1
Praktické cvičenie v
materskej škole (opatrovni)
6
6
Vyučovací jazyk
3
23
Vecné vyučovanie
2
2
Kreslenie a modelovanie
2
2
Výtvarné ručné práce
2
2
Ženské ručné práce
2
2
Spev
2
2
Telocvik
2
2
Spolu
25
25
Nepovinné predmety:
Cudzí jazyk
3
3
Hra na husliach
2
2
Hra na klavíri
2
2
Spolu
32
32
Tabuľka č.
6: Prehľad vyučovacích predmetov a počtu hodín na učiteľských
ústavoch pre vzdelanie
učiteliek domácich náuk
62
Predmet
Počet hodín
1. ročník
2. ročník
Pedagogik
a s hospitác iami a praktick ými cvičeniam i
3
4
Vyučovací jazyk
2
2
Počty
2
2
Občianska náuka a výchova
2
-
Zdravotníctvo
2
-
Sociálna starostlivosť
-
2
Náuka o tkaninách
2
-
Telesná výchova
2
2
Spev a hudobná výchova
1
1
Kreslenie
5
4
Výtvarné práce
-
1
Ženské ručné práce
7
10
Náuka o
vedení domácnosti a
praktické cvičenia
2
-
Varenie
4
6
Spolu
34
34
61
PLACHT, O. –
HAVELKA, F. (eds.). Příručka školské
..., s. 574.
62
PLACHT, O. –
HAVELKA, F. (eds.). Příručka školské
..., s. 573.
STUDIA SCIENTIFICA FACULTATIS PAEDAGOGI CAE
UNIVERSITAS CATHOLICA RUŽOMBEROK 2020, č. 3
101
Mgr. Miroslava Gallová
Katedra histórie
(interná doktorandka)
Univerzita Mateja Bela, Filozofická fakulta
Tajovského 40, 974 01 Banská Bystrica
Spoločenskovedný ústav
(interná doktorandka)
Centrum spoločenských a
psychologických v
ied SAV
Karpatská 5, 040 01 Košice
[email protected]
Punčová, A.:
Zmeny a reformy slovinského vzdelávacieho systému od roku 1991 po súčasnosť
102
Zmeny a reformy slovins kého vzdelávacieh o systému
od roku 1991 po súčasnosť
Changes and Reforms of the Slovenian
Education System
from 1991 to the Present
Alexandra Punčová
Abstract
The
Republic
of
Slov
enia
is
currently
gaining
public
attention
due
to
the
excellent
results
of
its
students
in
international
testing.
The
paper
focuses o
n the
changes and
reforms of
the Slovenia
n education
system
over the last 30 years, respectively from its independence to the present.
Ke ywords: Slovenia. Education system. Reform s.
Úvod
Slovin
ská republika si mom
entálne získ
ava pozornosť
verejnosti vďak
a
výborný
m
vý
sledkom jej
ž
iakov v
medzinárod
ných testovaniach
.
Väčši
nu
čas
u
svojej existencie bolo
Slovi
nsko l
en slovinsky hovoriacou skupinou tvoriacou
súčasť v
äčšieho celku
. Slovinské vzd
elávanie sa až do osa
mostatnenia
(25. júna
1991) rozvíjalo v rámci iných –
väčších vzdelávacích sy
stémov: tvorilo súčasť
rakúskej
m
onarchie,
vďaka
vplyvu
ktorej
v roku 1918 predstavovalo jeden
z najlepších a najmoderne jších vzdelávacích systémov vtedajšej Juhoslávie.
Prís
pevok
sa
sú
streďu
je na zmeny
a
r
eformy
s
lovinsk
ého vzd
elávac
ieho systé
mu
za posledných 30 rokov, resp. od osam
ostatnenia krajiny po súčasnosť.
Deväťdesiate roky 20. storočia
Deväťdesiate roky boli pre viaceré európske krajiny obdobím veľkých
zmien a obratov
v ich histórii. V roku 1990 prvý slovinský minister školstva,
kresťanský
demokrat
Peter
Vencelj,
zdôraznil,
že
napriek
požiadavkám
na radikálne zmeny vo vzdelávacom systéme, by sa tento proces nemal
uskutočňovať
unáhlene.
Obhajoval
postupnú
zm
enu
z
aloženú
na
odborných
znalostiach,
ktorá
by
priblížila
slovinský
vzdelávací
systém
k
s
ystém
om
rozvinutých
krajín
západu.
Rok
1991
bol
prelom
om
vo
vývoji
súčasného
vzdelávacieho
systému.
Po
získaní
nezávislosti
a
demokratizácii
Slovin skej
republiky nastali v krajine zásadné štrukturá lne zmeny vo všetkých oblastiach
spoločnosti
(Plut -
Pregelj,
2001).
Vo
svojom
úsilí
o
vy
tvorenie
kvalitného
STUDIA SCIENTIFICA FACULTATIS PAEDAGOGI CAE
UNIVERSITAS CATHOLICA RUŽOMBEROK 2020, č. 3
103
školského
systému,
ktorý
by
maxim
álnemu
počtu
občanov
umožnil
nielen
uplatniť
svoje
práva
na
vzdelanie,
ale
aj
získať
požadované
z
amestnanie,
Slovinsko
zaviedlo
nové
právne predpisy
na
reguláciu
celého
vzdelávacieho
sys
tému od p
redško
lskej vý
chovy
až po vyso
koško
lské vzd
eláva
nie (199
3 -1996) .
Od r
oku 199
3 je pre
dškol
ské vzd
eláva
nie neo
ddelite
ľnou s
účasťo
u vzdel
ávacie
ho
systému
a
pa
trí
do
právomoci
ministerstva
školstva,
vedy
a
športu.
V
roku
1995
m
inister
školstva
prijal
príslušné
usmernenia
a
bola
uverejnená
b
iela
kni
ha „Vzde
lávani
e v Slovi
nskej re
publik
e.“ Nov
é vzdelá
vacie z
ákony sc
hválen
é
v
roku
1996
n a základe Bielej knihy sú založené na zásadách demokracie,
slobody
výberu,
autonómie,
prof
esionality,
kvality,
excelentnosti,
blízkosti
k občanom, rovnakých príležitostí pre všetkých, ako aj práva na vzdelanie pre
všetkých,
bezplatné
základné
vzdelávanie,
právo
rodičov
na
zvolenie
formy
vzdelávania
svojich
detí,
povinnosť
štátu
sponzorovať
súkromné
školy
a posky tovať im rovnak ý práv ny ráme c. Teoret ickým základom vzdelávaci eho
systému
musia
byť
ľudské
práva
a
štát
dodržiavajúci
právne
predpisy.
Všeobecnými c ieľmi vzdelávania sú: p oskytovanie rovnaký ch vzdelávacích
príležitostí
pre
optimálny
rozvoj
všetkých
jednotlivc
ov;
podpora
vzájomnej
tolerancie;
rozvoj
životných
zručností
demokratickej
spoločnosti
v
rámci
celoživotného
vzdelávania; podpora
rovnakých
príležitostí
pre
obe
pohlavia;
rešpektovanie
a
spolupráca
s
tými,
ktorí
sú
odlišní;
dodržiavanie
práv
detí
a ľudských práv. Právo na výber m edzi verejnými a súkrom nými školami
alebo
vzdelávaním
v
domácom
prostredí
je
súčasťou
práv
a
povinností
žiakov,
ktoré sú
zdôraznené aj
v
Zákone o
základných školách
(1996),
ktorý
usmerňuje
základné
vzdelávanie,
definuje
ciele
základného
vzdelávania
a zahŕň a: m edzinárodnú poro vnateľnosť výk onnostných štandard ov; získavanie
vedomostí pre ďalšie vzdelávanie; spoznávanie cudzíc
h kultúr; učenie cudzích
jazykov;
výučbu
všeobecných kultúrnych
hodnôt
a
civilizácie
vyplývajúcich
z európskej t radície; vzdelávanie zamerané na podporu vzájomnej tolerancie,
rešpektovania odlišností,
spolupráce s ostatnými,
dodržiavania ľudských práv
a základných slobôd; a následne rozvoj schopnosti žiť v
demokratickej
spoločnosti.
Spolu
so
Zákonom
o
organizácii
a
financovaní
vzdelávania
upravuje Zákon
o
základných školách základné
zásady riadenia
a organizácie
a
r
ozdeľu
je
zodpovednosť
a
autonómiu
medzi
štát,
obce
a
školy.
Zákon
o gymnáziu uvádza, ž e jednou zo základných úloh gymnázií je posk ytovať
medzinárodne
porovnateľnú
úroveň
vedomostí,
ktorá
j
e
potrebná
na
pokračovanie
vo
vyššom
vzdelávaní.
Toto
obdobie
možno
považovať
za
začiatok
slovinskej
politiky
suverénneho
vzdelávania
(Štremfel,
Lajh,
2012;
Mlakar, 2015; UNESCO, 2012). Jedným z najdôležitejších cieľov reformného
obdobia
1996- 2001 bolo dosiahnutie porov nateľnosti a väčšej kompatibility
odborného vzdelávania, prípravy a kvalifikácií s ostatnými európskymi
systémami. Zákon o odbornom a
technickom vzdelávaní poskytuje základ pre
system
atickú podporu medzinárodne
j
činnos
ti
v odbornom
vzdelá
vaní, pretože
definuje internacionalizáciu ako základné kritérium
riadenia
kvality a úspešne
konk
urenč
ných sy
stémov
vzde
lávan
ia a o
dborne
j príp
ravy (
Štremf
el, L
ajh, 2
012).
Punčová, A.:
Zmeny a reformy slovinského vzdelávacieho systému od roku 1991 po súčasnosť
104
Prvá dekáda 21. storočia
Po
systémových
zmenách
nasledovali
podsta
tné
zmeny
v
kurikule
(1999/2000),
ktoré pripravila
Kurikulárna komisia
pre predškolské
inštitúcie.
Na
prelome
tisícročí
sa
na
všetkých
základných
školách
v
Slovinsku
začala
vyučovať
počítačová
g
ramotnosť.
Bol
vyvinutý
tzv.
Koncept
celoživ
otného
učenia a
vzdelávania
– to sa prejavilo v
jeho väčšej systematickej
propagácii,
zavádzaní systémov
kontinuálneho vzdelávania,
podpore rozvoja
efektív
neho
prenosu vedomostí
a dôrazu na
interdisciplina
ritu
vedomostí. Tento proces
sa
začal väčším dôrazom na vzdelávanie dospelých a zamestnancov a
neustále sa
rozširoval medzi
žiakmi a
mladými ľuďmi,
ktorí
čoraz viac
vnímajú význam
celoživotného
učenia
(O
koliš,
2008).
Sociálne
zmeny
v
Slovinsku
a
rozvoj
celoživotného
vzdelávania
viedli
k
novým
reformám
a
zmenám
v
oblasti
vzdelávania
detí,
mládeže
a
dospelých.
Začali
sa
objavovať
nové
typy
vzdelávania okrem formálneho (bežného školského systému)
aj neformálneho
vzdelávania
(v rámci
jednotlivých
inštitúcií,
sam
ovzdelávania,
e -
vzdelávania
atď.)
(Šverc
a
kol.
2007).
Zákon
o
postsekundárnom
odbornom
vz
delávaní
a zmeny a doplnenia zákona o vysokých školách za viedli všetky prvky
Bolonských
reforiem
terciárneho
vzdelávania:
terciárnu
štruktúru,
do
datok
k diplomu, eur ópsky systém prenosu a akumulácie kreditov (ECTS) a zabez-
pečenie
kvality
(Štremfel,
Lajh,
2012). V
roku
2006
bol
prijatý
zákon
upravujúci národné odborné
kvalifikácie,
ktorý vytvoril základ pre
vytváranie
sietí
formálneho
a
neformálneho
vzdeláv
ania.
Okrem
toho
zákon
vytvoril
základ
na
prenos
výsledkov
a
poznatkov
získaných
v
rôznych
oblastiach
a úrov niach vzdelávacie ho pro cesu. Najdôležite jšie politiky a ciele v zdelávania
v Sl ovinsk u uverejn ilo mini sterstv o školstv a a športu v dokum ente „Vzd eláva nie
v Slovinsku:
včera,
dnes, zajtra“
(2007). Zásadný význam
má implementácia
troch hlavných cieľov zameraných na oblasti zručností: zručnosti na
kreatív
ne
ri ešenie problém ov, zručnosti na spoluprácu a komunik áciu s ostatn ými ľuďmi
a
zručno
sti
na
celoživotné
vzdelávanie.
Celoživotné
v
zdelávanie
nie
je
iba
podstatnou
vzdeláv
acou
politikou
z hľadiska
spoločenského vývoja,
ale je
to
aj
postoj
k
životu,
ktorý
ovplyvňuje
k
aždého
jednotlivca.
Začiatkom
roku
2007
Slovinsko
začalo
s
k
oncepciou
celoživotného
v
zdelávania,
v
k
torej
sa
prenos
poznatkov
a
skúseností
medzi
g
eneráciami
stal
kľúčovým
prvkom.
Okrem
toho
Slovinsko
zaviedlo osobitné
stratégie
a
opatrenia,
ktoré
čerpajú
zo
skúseností v
rámci Európskej
únie
s cieľom
zlepšiť
form
álne,
neformálne
a informálne vzdelávanie (Mlakar, 2015). Zákon o základnej škole (zmenený
a
doplnený
v
rok
u
2007)
na
riešenie
problému
ne
dostatočného
prospechu
v ranom štádiu stanovu je, že základné školy musia poskytov ať doplnkové
hodiny,
individuálnu
a
skupinovú
pomoc
žiakom
so
slabými
výsledkami
a s poruchami učenia. Slovinsko tiež zaviedlo opatre nia na podporu z nevý -
hodnených
žiakov.
V
zmenenom
a
doplnenom
zákone
sa
tiež
stanovuje,
že
predškolské zariadenia a
školy si každý rok
prehodnocujú kvalitu programov,
ktoré
poskytu
jú.
Podľa
zákona
o
základných
školách
(článok
60
písm.
D)
STUDIA SCIENTIFICA FACULTATIS PAEDAGOGI CAE
UNIVERSITAS CATHOLICA RUŽOMBEROK 2020, č. 3
105
z roku 2008 musí každá škol a pripraviť školský vzdelávací plán založený na
cieľoch
školy
s
cieľom
vytvoriť
bezpečné
a
zlepšujúce
sa
prostredie
na
dosahovanie cieľov základného vzdelávania
(OECD, 2016; UNESCO, 2012).
Druhá dekáda 21. storočia
Nový
prístup
založený
na
kompetenciách
v
kurikule
odborného
vzdelávania (2008 -
2011) zaviedol modulovú štruktúru vo výučbe a učení,
ako
aj
zvýšený
podi
el
praktického
výcviku.
Učebné
osnovy
predmetov
boli
aktualizované
vo
všeobecnom
vyššom
sekundárnom
vzdelávaní
(gimnazija)
(200
8/200
9) a zákla
dnom vzd
eláva
ní (201
1/2012
), pričom
základ
né kompe
tencie
boli
zavede
né do vš
eobecn
ého vzde
lávani
a. Nove
la zákon
a o zákla
dných
školách
(2012) zav
iedla povinné národn
é
ho
dnotenie na konci VI. ročn
íka pre všetkých
žiak
ov. Okr
em toho
boli zave
dené čí
selné z
námky,
ktoré na
hrádza
jú desk
riptív
ne
hodnotenia
pre
žiakov,
počnúc
III.
ročníkom.
Národný
program
pre
m
ládež
(2013- 2022) sa zameriava na zabezpečenie lepších príležitostí pre mladých
ľudí
(form
álne
aj
n
eformálne
vzdelávanie).
Tento
prog
ram
je
strategickým
dokumentom,
ktorý
definuje
ciele,
základné
op
atrenia
a
ukazov
atele,
ktoré
sa použijú pri hodnotení jeho vplyvu (OECD, 2016). Iniciatíva Otvorenie
Slov
inska – Opening Up Slove nia (201 4) sa zame riava na doplnen ie exist ujúcic h
vzd
elávac
ích postu
pov o inova
tívne,
dy
namick
é a otvore
né vzdelá
vacie
pr
ístupy
.
Cieľom je
usk
utočniť
zmeny
vo vzdelávaní v
siedmich kľúčových oblastiach:
1) prem
eniť exi
stujúce
v
zdeláv
acie met
ódy na inova
tívne,
dy
namick
é a otvoren
é
vzdelávacie
nástroje;
2)
obnoviť
prostredie
spolupráce
medzi
verejným,
súkromným
a
dobrovoľným
sektorom
výskumu;
3)
rozvíjať
a
zavádzať
otvoren
ejšie vzdelávanie
;
4) budovať
právn
e
mech
anizmy na
po
dporu vykoná -
vania otvor
eného vzdelávania;
5) vyb
udovať otvorenú platform
u informačnýc
h
technoló
gií, obsahu, služieb,
ped
agogických konce
ptov a
prís
tupov; 6) obnoviť
mechanizmy
na
z
abezpečenie
vysokej
úrovn e k
vality
a
hodnotenia
služieb;
7) rozvíjať digitálne kompetencie v rámci celého vzdelávacieho systému
a vykonávať konkrétne, medzidimenzionálne otvorené v zdelávacie pro jekty.
Táto iniciatíva je podporovaná širokou škálou zainteresovaných strán a zahŕňa
vý skum a vývoj nových konce ptov, modelov a metód v otvorenom vz delávaní.
Nepretržitý
rozvoj
systému
vzdelávania
v
Slovinskej
republike
je
špecifiko -
vaný
v
národných
prog
ramoch
a
iných
dokumentoch
týkajúcich
sa
jednej
alebo
viacerých úrovní
alebo oblastí
vzdelávania. Modernizáciou
základného
vzdelávania
opísanou
v
reformách
v
roku
2017
tretina
všetkých
škôl
(144)
začala v
školskom roku
2018/2019 rôzne
implementačné modely
modernizo -
vaného konceptu rozšíreného programu. Žiaci budú mať možnosť vykonávať
ďalšie
aktivity
v
oblasti
športu
a
zdravia.
Devätnásť
z
týchto
škôl
realizuje
skú
šobné hod
iny povin
ného prv
ého cudzi
eho jazyk
a už v I. ročník
u a povinné
ho
druhého cudzieho j
azy
ka
v VII. ročníku.
Koncom roka 2018 a
v januári 2019
bol
uverejnený zmenený
a doplnený
vzdelávací
program pre
základné školy.
Punčová, A.:
Zmeny a reformy slovinského vzdelávacieho systému od roku 1991 po súčasnosť
106
Nasledovalo
rozhodnutie Rady
expertov
Slovinskej
republiky
pre
všeobecné
vzdelávanie o
rozšírení predmetového kurikula pre
slov
inčinu
a včelárstvo na
povi
nne volit
eľné predm
ety a definov
anie kurik
ula predm
etov film
ovej výc hovy
a
slovinskej
znakovej
reči.
Ich
uplatňovanie
sa
začína
školským
rokom
2019
/2020
. V dece
mbri 20
19 vlá
da Slov
inskej r
epubl
iky pri
jala ná
rodnú s
tratég
iu
rozvoja
čitateľskej
gramotnosti
2019 -
2030.
Nová
stratégia
sa
zam
eriava
na
čitateľskú
gramotnosť
ako
základný
kameň
iných
gramotností.
Dôležitou
súčasťou
je
kultúra
čítania,
ktorá
zahŕňa
čít
anie
ako
hodnotu
samu
o sebe,
a zdôrazňuje význam motivácie na čítanie. Cieľom tejto stratégie je, aby
každý v
Slovinsku
rozv
íjal
úroveň
gram
otnosti
potrebnú na
to, aby sa mohol
kvalifikovať
v
a
ktív
nom
živote
a
práci.
Vo
februári
2020
schválili
rady
expe
rtov Slovi
nskej repub
liky pre všeob
ecné vzdelá
vanie a odborné
a techn
ické
vzdelávanie
zmenené
a
doplnené
programy
vyššieho
stredného
vzdelávania.
Prog
ramy
z
ahŕňajú
novú
zlo
žku
ale
bo
iné formy
vz
deláv
acích
ak
tivít:
povinn
ý
súbor
obsahu
o
aktívnom obči
anstve, ako
aj
nepovinný
obsah
pre
gymnáziá
a záujmové činnosti v odbornom a technickom vzdelávaní. Rada expertov
Slovinskej
r
epublik
y
pre
všeobecné
vzdelávanie
okrem
toho
vo
februári
schválila
predmetové
študijné
programy
a
k
atalógy
vedom
ostí
pre
uvedený
obsa
h.
Rev
idova
né
prog
ramy
n
adobud
nú
úči
nnosť v
škols
kom
ro
ku
202
0/2021
(European Comission, EACEA, EURY
DICE).
Záver
Od
roku
1990
p
rechádza
slovinský
vzdelávací
systém
nepretržitou
reformou a
zm
enami.
Krajina sa stala
nezávislou len nedávno.
Zo začiatku sa
pozornosť
v
oblasti
vzdelávania
sústredila
na
zmenu
organizačnej
štruktúry,
stanovenie
nových
vzdelávacích
cieľov,
zásad...
Dnes
krajina
disponuje
vzdelávacím
systémom,
ktorý
zahŕňa
všetky
úrovne
vzdelávania
– od pred-
primárneho po
univerzitné. Podľa
Európskej komisie
(2017, 2019)
Slov
insko
investuje
do vzdelávania
a odbornej
prípravy
viac ako
je
priemer EÚ.
Účasť
na vzdelá
vaní a starostliv
osti v ranom
detstve sa zvyšu
je a predčasné ukon
čenie
školsk
ej
doch
ádzky je
zrie
dkavé (väčšinou mužská
časť populácie
).
Dô
ležitým
posunom
je
úplné
zavedenie
výučby
cudzích
jazykov
v
skorších
ročníkoch
základn
ého vzdeláv
ania. Zákla
dné zručnost
i slovinský
ch pätnásťro
čných žiak
ov
sú
na
celkovo
vysokej
úrovni
a
zlepšujú
sa
–
dosahujú
dobré
výsledky
v
o
všetký
ch troch oblastiach tes
tovaných v priesk
ume OECD (PISA) z roku 2015:
prír
odné vedy
, matemat
ika a
číta
nie. Slov
insko usi
lovne
pra
cuje na mode
rnizá
cii
odborné
ho vzdelávania a
prípr
avy, a na
pod
pore vzdelávania dospe
lých. Podiel
dospelých
s
nízkou
kvalifikáciou
je
malý,
účasť
na vzdelávaní
dospelých
je
tesne nad priemerom EÚ.
STUDIA SCIENTIFICA FACULTATIS PAEDAGOGI CAE
UNIVERSITAS CATHOLICA RUŽOMBEROK 2020, č. 3
107
Bibliografia
MINISTR
Y OF EDUCA
TION, SCIEN
CE AND SPO
RT OF THE R
EPUBLIC
OF SLOVENIA. 2017. The EDUCATION SYSTEM in the Republic of
Slovenia 2016/2017. Ljubljana: Ministry of Educa tion, Science and
Sport of the Republic of Slovenia, 2017. 72 s.
ISSN 2536-3352.
MLAKAR, J. 2015. Slovenia.
(pp. 743-757). I n Hörner, W. – Döbert, D. –
Reuter, R. R. –
Kopp, B. The Education System
s of Europe.
Switzerland: Springer, 2015. 908 s. ISBN
978-3-319-07472-6.
OECD. 2016. Education Policy Outlook: Slov enia. [Online]. [Cit. 5.6.2020].
Dostupné z: www.oecd.org/education/policyout look.htm.
OKOLIŠ, S. 2008. Zgodovina šolstva na Slove ns kem. Ljubljana: Slovenski
šolski muzej, 2008. 144 s. SBN 978 -961-6764- 00-1.
OUSlovenia. Opening Up Slovenia. [Online]. [C it. 6.6.2020] Dostupné z:
https://www.ouslovenia.net/.
PLUT-PREGELJ, L. 2001. Educational Reform in the First Decade of
Slovenian Political Pluralism. Wilson Center Ea st European Studies
Meeting report 229. [Online]. [Cit. 4.6.2020]. Do
stupné z:
https://www.wilsoncenter.org/publicati
on/229-educational-reform-the-
first-decade-slovenian-political-pluralism.
ŠTREMFE
L, U. – L AJH, D. 2012 . Development of Slovenia n education policy
in the e
uropean con
text and b
eyond. (pp. 130-154). In Bulgaria n Journal
of Science and Education Policy (BJSEP).
Volume 6, Number 1, 2012.
ŠVERC,
A. –
MEŽAN
, J . –
ŠKRIN
JAR, M. A KO L. 2007. Sl ovene Educa tion
System Yesterday, Today, Tomorrow. Ljubjana: M inistry of Education
and Sport, 2007. 152 s.
UNESCO, 2012. World Data on Education
. 7th edit
ion, 2010/11. [Online].
[Cit. 5.6.2020]. Dostupné z:
http://www.ibe.unesco.org/sites/default/files/S
lovenia.pdf.
Mgr. Alexandra Punčová
Katedra predškolskej a elementárnej pedag
ogiky (interná doktorandka)
Katolícka univerzita v
Ružomberku, Pedag
ogická fakulta
Hrabovská cesta 1, 034 01 Ružomberok
[email protected]
Zastkov
á, Z.:
Kooperatívne učenie ako prostriedok napĺňania
filozofie inkluzívnej edukácie
108
Kooperatívne učenie ako prostriedok
napĺňania
filozofie inkluzívnej edukácie
Cooperative Learning as a Means of Ac
hieving
the Philosophy of Inclusive Education
Zdenka Zastková
Abstract
In
the
article
we
present
the
reasons
for
strengthening
inclusive
education
in the condit
ions of
Sl
ovak schools, while perceiving inclus
ive
education in
a broader
context, meaning, as
an approach
that applies
to
all
students
with
various
educational
needs.
In
accordance
with
the
support and development
of the individual potential o
f each student, we
clarify
the
inclusive
approach
in
education
and
define
it
as
the
unco
ndition
al accept
ance of
the speci
al needs
of all chi
ldren. By
specify
ing
the main
features o
f cooperative
learning, we
emphasize this
particular
organizat
ional form of teaching as one of
the
relev
ant means for creating
an inclusive environment.
Keywords: Inclusive education. Coopera tive learning. Principles of
cooperative learning.
Úvod
Jednou
z aktuálnych t ém , ktoré v oblasti školstva rezonujú, je
problematika
inkluzívnej
edukácie,
ktorej
saturácia
sa
okrem
iného
stala
hlavnou doménou zadefinovanou v Národnom programe rozvoja výchovy
a vzdelávania pre roky 2018 - 2027. Podľa tohto dokumentu sa javí podpora
inkluzívneho
prístupu
v
eduk
ácií
ako
najvhodnejšia
stratégia
pre
z
lepšenie
stavu
kritických
ukazovateľov v
školstve,
ktoré
súv isia s
nízkou
mierou
participácie
detí
na
predprimárnom
vzdelávaní,
v
nízkej
miere
účasti
na
ďalšom vzdelávaní
dospelých, ale
najmä sú
prepojené s
dosiah
nutím
nízkych
zručností
v
testovaní
PISA,
a
to
predovšetkým
v
súvislosti
s
výsledkami
žiakov
zo
sociál
n e
slabšieho
prostredia
(NPRVV,
s.
14).
Hoci
je
stratégia
inkluzívnej
edukácie
obsiahnutá
v
základných
legislatívnych
dokumentoch
a má oporu aj v m nožstve projektov, publikácií a metodík konkretizujúcich
možnosti
realizácie
tohto
princípu
v
slovenských
školách,
je
otázne,
ako
sa
uvedenú filozofiu vzdelávania darí v
praxi reálne pr
esadzovať.
STUDIA SCIENTIFICA FACULTATIS PAEDAGOGI CAE
UNIVERSITAS CATHOLICA RUŽOMBEROK 2020, č. 3
109
Podstata inkluzívnej edukácie
Povinnosťou školy je poskytnúť všetkým žiakom bez rozdielu (etnika,
jazyka,
náboženskej
príslušnosti,
špecifických
vzdelávacích
potr
ieb
a po d.)
kvalitn
ú
vý
chovu a
vzdelávan
ie.
Na
jmä žiaci so
špec
iálnymi výchov
no - vzdelá -
vacími potrebami a rôznym znevýhodnením boli donedávna do škôl prevažne
integro
vaní. Podľ
a V. Kleina a V. Šilonov ej (2016) spo číva rozd ielnosť inkl úzie
a integrácie n ajmä v tom, že pokiaľ pri integrácií ide fyzické začleňovanie
žiakov
do
bežnej
školy,
pri
inklúzií
ide
o
naplneni
e
základného
práva
na
prístup všetkých
ku vzdelaniu čo
najvyššej kvality, ktoré
vo svojej obsahovej
zložke
zahŕňa
aj
hod
notový
aspekt
a v
prístupe
ku
skupinám
a
osobám
so
špec
iálnym
i výc
hovno - vzdelá vacím i potre bami rešpek tuje p rincípy sprav odliv osti
a rovnosti šancí. Z hľadiska výchovy inklúzia znamená vytvorenie t akého
edukačného
pro
stredia,
aby
bol
každý
žiak
ochotný
a
schopný
rešpektovať
osobnosť ostatný ch.
Z množstva prístupov r ôzny ch autorov sa nám javí najvhodnejšie
vystihnutie
podstaty inkluzívnej
edukácie
podľa
Š.
Porubského a kol. (2014,
s.
3),
k
torí
chápu
inklúziu
ako
„ spôsob uskutočňovania výchovno - vzdelá -
vacieho
procesu , v ktorom učiteľ neustále uvažuje nad tým, ako vyhovieť
rozvojovým potrebám jeho žiakov tak, aby predchádzal zlyhaniu žiakov a
aby
zároveň
zabezpečil
ich
plnohodnotný
rozvoj
v
rámci
ich
individuálnych
možností,
k
toré
sú
u
každého
žiaka
odlišné.“
Môžeme
tak
konštatovať,
že
inkluz
ívne vzdelávanie sa neorientuje iba na individuáln
e
potr
eby špecifického
jedn
otlivc
a, ale týka sa všetk
ých žiak
ov, ktorí sú proc
esu výchov
y a vzdel ávania
účastní. V
rámci inkluzívnej edukácie
potom
nie je dôležité to, akí
žiaci školu
či
triedu navštevujú,
al e to, ako sa s
nimi pedagogicky
zaobchádza, teda
ako
sa k nim pristupuje.
Inkluzívny prístup
vhodne zadefinoval V. Klein
a
R. Rosinský (2013,
s. 185) ako „bezpodmie
nečné akceptovani
e
šp
eciálnych potrieb všet
kých detí.“
Ak hovoríme o
triede, ktorá má vyhovieť potrebám všetký
ch žiakov, máme na
mysli
vytvorenie
takého
prostredia,
ktoré
prijíma
heterogenitu,
podporuje
sociálnu koherenciu a
dokáže refl
ektov
ať
potreby všetkých jej členov, pričom
je založená na hodnotách tolerancie, akcep
tácie, spolupráce a empat ie.
Z mnohý ch k omponentov determ inujúcich kvalitu vytvor enia inkluzív -
neho prostredia (odborné, personálne, materiálne, finančné komponenty) sa
ďalej budeme
venovať konkrétnemu spôsobu
vyučovania, ktorý má
potenciál
podieľať sa na budovaní inkluzívnej kultúry triedy.
Implementácia princípov kooperatívneho uč
enia v intenciách
inkluzívnej edukácie
Vytvoriť
prostredie,
ktoré
bude
zodpovedať
zásadám
inklúzie,
predpokladá etablovanie takej edukačnej bázy, ktorá sa musí uskutočňovať
v celkovom kontexte spolupráce a vzájomnej podpory. Máme na mysli nielen
Zastkov
á, Z.:
Kooperatívne učenie ako prostriedok napĺňania
filozofie inkluzívnej edukácie
110
súlad
edukačných
a
odborných
postupov
jednotlivý
ch
členov
inkluzívneho
tímu,
ale
najmä
spoluprácu
a
vzájomnú
podporu
konkrétnych
žiakov
v kon-
kré
tnych so
ciálny
ch sku
pinách
. Práve s
tratég
ia koo
peratív
neho u
čenia z
dôrazň
uje
nenahraditeľnosť
sociálnych interakcií
pre
rozvoj
oso
bnosti
z aspektu kogni-
tívneho,
ale
najmä
socio -
emocionálneho.
M.
Adams
a M. Hamm (1994, In
Tsay
, M. – Bran dy, M. 2010, s. 78) vníma jú koo peratí vne uč enie ako org aniza čnú
formu
založenú
na
presvedčení,
že
žiaci
sa
v
nej
učia
využitím
sociálneho
kontextu.
V atmosfére rov noprávnosti a spolupráce si žiaci podľa I. Tureka
(2008, s.
371) majú príležitosť navyknúť
a
osvojiť si také
zručnosti a postoje,
akými
sú
plánovanie
a
organizácia
práce,
vzájomná
pomoc,
spolupráca,
komun
ikácia, koordinácia úsilia, povinnosť,
zodpov
ednosť, tolerancia, váženie
si cudzej pomoci, nenásilné riešenie konf
liktov a pod.
Kľúčovým
bodom pre
vytvorenie
inkluzívneho
prostredi
a
v
triede
je
idea
vytvorenia
kooperatívneho
učebného
spoločenstva
–
prostredníctvom
uplatnenia nasledovných princípov:
Vytvoriť pozitívnu vzájomnú závislosť , kedy sa žiaci v rôznych
učeb
ných sit
uáciác
h snažia
do
siahnu
ť svoj cieľ
a uspejú za predpok ladu,
ak
aj ostatní
žiaci,
kto
rí
sú
s
nimi pri
riešení
úlohy spojení,
svoj cieľ
dosiahnu.
Vytvorenie
vzájomnej
závislosti
medzi
žiakmi
teda
závisí
od
cieľa
a
cha
rakteru
učebne
j
úlohy,
pričom
vzdelávacia
činnosť
je
uskutočňovaná
prostredníctvom
interakcie
jednotlivcov
bez
ohľadu
na
ich
sociálny,
kultúrny, etnický,
zdravotný,
či
ekonomický
pôvod.
Uplatnenie
uvedeného
princípu
v
praxi
tak
má
potenciál
„narušiť“
vytvorenie
hierarchie
a
„nálepkovania“
žiakov
a
umožňuje
všetkým
žiakom zapojiť sa do práce v
skupine, spolupracov
ať a profitovať.
Podľ
a T.
Ja
blons
kého (I
n Lech
ta, V. 2010, s . 137) vo väčš ine ko operat ív -
nych
skupín sp
olupra
cujú žia
ci s
rôzn
ou úrovň
ou schop
ností a s rôzny mi
životnými
skúsenosťami.
Uvedené
východisko
považujeme
v
súlade
so zásadam
i inkluzívne
j edukácie ako kľúč
ové, keďže odlišno
sť žiakov
tu nie
je vnímaná ako
negatívny, či rušivý faktor
pre vzdelávanie, ale
má pozitívnu hodnotu (Janoško, P. –
Neslušanová, S.
2014, s. 9).
Posi lniť indi viduá lnu zodpov ednosť , ktor á sa tý ka úsilia o d osiah nutie
skup
inové
ho cieľ
a a
náp
omoci d
ruhým
v
tomt
o úsilí.
H. Kasí
ková (
2004,
s.
85)
bližšie
konkretizuje
uvedený
princíp
pričom
tvrdí,
že
činnosť
a výkon každého člena je zhodnotený a využitý pre celú skupinu
a všetci členovia skupiny majú z kooperatívneho u čenia úžitok.
Umožniť vzájomný kontakt a komunikáciu tvárou v tvár , aby
došlo
k
zdieľaniu
učebných
zdrojov,
k pomoci, povzbudeniu medzi
členmi
skupiny
a
podpore
dôležitej
pre
vytvorenie
poci
tu
spolupa -
tričnosti
v triede.
Interakcia v
kooperatívnych
situáciách
vedie podľa
H. Ka
síkove
j (2004,
s. 70) k
č
astejše
j, presn
ejšej,
otvor
enej kom
uniká
cií,
k jasnejšiemu porozumeniu perspektívy druhého, k diferencovaným,
dynamickým a
realistickým pohľadom
medz
i
žiak mi, k zdravej seba-
dôvere, k
očakávaniu budúcej pozitívnej a
produktívn
ej interakcie.
STUDIA SCIENTIFICA FACULTATIS PAEDAGOGI CAE
UNIVERSITAS CATHOLICA RUŽOMBEROK 2020, č. 3
111
Vzh
ľadom k tomut o princ ípu V. Battis tich (I n Gilli es, R. M., 200 3, s. 37 )
dokázal, že efektívnosť kooper
atívneho učenia nezávisí od frekvencie
apli
kovan
ia koo
peratív
nych a
ktiví
t, ale
od kv ality skupi novej i nterak cie.
Viesť ži akov k formovan iu požadova ných interper sonálnych a sk u-
pi nových z ručností. S cie ľom koordi novať úsilie o d osiahnutie sp oloč -
ných cieľov sa žiaci musia: spoznávať sa a vzájomne si dôv erovať;
presne, zrozumiteľne a jednoznačne komunik ovať; počúvať sa navzá -
jom;
vzájomne
sa
prijímať a
podporov
ať
a v neposlednom rade kon-
štruktívne
riešiť
konflikty
(J ohnson, D. W. – Johnso n, R. T. 1990,
s. 30). Uvedeným zručnostiam je potrebné ži akov postupne naučiť.
Ref lektovať skupinové činnosti prostredníctvom diskusie o tom, ako
efektívne skupina dosahuje ciele a ktoré činnosti a
správanie členov je
pre
skupinu
užitočné
alebo
neužitočné.
Reflexia
skupinov
ej
činnosti
podmieňuje rozhodnutie o
ďalšom správaní
jej č
lenov .
Spojenie
princ
ípov,
resp.
char
akteristických
znakov
kooperatívneho
prístupu vo vyučovaní (Johnson, D. W. – Johnson, R. T. 2009, 366-369) spolu
so
zásadami
inklúzie,
zodpovedá
požiadavkám
podčiarknutým
v
úvode
príspevku, pričom môžeme hovoriť o spôsobe uskutočňovania výchovno -
- vzdelávacieho pro cesu tak, aby bol v súlade s humanistickými a dem okra-
tickými
hodnotami
spoločnosti . V. Lechta (2016, s. 166) v
závislosti
od
špeciálnych potrieb žiakov uvádza podporné podmienky, ktoré sa vzťahujú na
oblasť edu
kácie, a ktoré je možné cháp
ať ako „debarieriz
áciu“ činnosti v ško
le.
Odporúča:
‒ koncipovať činnosti tak, aby sa do nich mohli v maximálne j možnej
miere
zaangažovať
všetci
žiaci,
teda
aj
žiaci
so
špeciálnymi
vzdelá -
vacími potrebami,
‒ stanoviť ciele, ktoré sú dosiahnuteľné pre všetk ých žiakov,
‒ nevyčleňovať špecifické deti zo skupiny, ale prijímať ich ako plno -
hodnotných členov skupiny,
‒ netolerovať neadekvátne správanie žiakov,
‒ podp orovať súťaž ivosť výhrad ne pri dosah ovaní takých cieľov , v kto rých
si môžu deti spravodlivo konkurov ať.
Môžeme si
všimnúť, že prostredníctvom
kooperatívneho učenia je
vo
vyučovaní
možnosť dosiahnuť
všetky
uvedené
odporúčania,
t. j.
pristupovať
k plánovaniu, realizovaniu a hodnoteniu vyučovania tak, aby každý žiak uspel
na vl astnej úrovni, tým plne rozvíjal a využíval svoj potenciál a zároveň, aby
sa nauč
il efektív
ne komunik
ovať a
spo
lupra
covať s
os
tatným
i. Sme toho názor
u,
že uvedený
spôsob vyučovania
pre inklúziu
ponúka vytvoriť bezpečnú
klímu
založenú
na
pocite
spolupráce,
participácie,
vzájomnosti
a
podpory,
ktorá
by mala byť súčasťou všetkého, čo sa v triede deje. Schopnosť škôl reagovať
na rôznorodosť potrieb
žiakov a efektívne s
nimi pracovať nemá vplyv
len na
výs
ledky žiako
v
s
o
šp
eciáln
ymi potreb
ami, ale v
súla
de s
uv
edeným
ovp
lyvňuj
e
Zastkov
á, Z.:
Kooperatívne učenie ako prostriedok napĺňania
filozofie inkluzívnej edukácie
112
vzd
elávac
ie možnos
ti „bežný
ch“
ži
akov. Na záve
r spomeni
eme niek
oľko výho
d,
ktoré
prináša
inkluzívne
vzdelávanie
z
pohľadu
žiaka
(bliž
šie
Bagalová,
Ľ.
a kol., 2015, s. 14):
‒ rozma nitosť tr iedy pos kytuje ž iakovi r eálny ob raz o spo ločnosti, v ktore j
bude žiť, pracovať a
tým sa pripravuje na budúcno
sť,
‒ žiaci sa prirodzene učia vnímať rozdielnosti medzi ľuďmi, chápu ich
ako prirodzenú súčasť života,
‒ v he terog énnom kolek tíve (prost redníc tvom inter akcie medzi osta tnými )
si
žiaci
ľahšie
rozv
íjajú
sociálne
a
občianske
cítenie,
umenie
komu -
nikovať
a
schopnosť
riešiť
problémy
,
ktoré
zovšeobecnia
a
prenesú
ich do iných oblastí spoločenského živ
ota,
‒ v ko opera tívnyc h úlo hách majú žiaci možno sť zaž iť úspech, čo zvyšuje
ich pozit ívnu hodnotu a
sebavedomie.
Záver
Škola,
ako jedna
z
n
ajdôležitejš
ích
inšt
itúcií zasahujúcich
do utvárania
osobnosti
človeka
sa
v
súčasnosti
zaoberá
aj
otázkami,
ako
sa
postaviť
k rozdielom žiakov, vysporiadať sa s
nimi a ako ich využ ívať vo vzdelávaní.
P oprednú ú lohu pritom zohráva postoj školy, ktorá je schopná postaviť sa
k rozmanitosti ako k neoc eniteľném u potenciálu pri prehlbovaní humánnych
hodnôt. Úlohou učiteľa j
e v
tomto zmysle štruktúrovať vzdelávacie a
sociálne
prostredie tak, aby
si žiaci rozvíjali
zručnosti a postoje potrebné na
interakciu
medzi
rôznorodým
i
žiakmi.
V
príspevku sme
sa preto
zamerali
na konkrétny
spôsob
vyučovania,
ktorý
(podobne
ako
inklúzia)
stavia
na
heterogenite
a pomáha nám nielen pozitívne vnímať rozdielnosti (vy rovnávať ro zdiely,
učiť
žiakov
vnímať
rozdielnosti
cez
hranice
etnicity,
schopnost
í,
sociálno -
- ekonomického statusu, záujmov, fyzický ch obmedzení a pod.), ale najmä
kreovať
kooperatívne
inkluz
ívne
edukačné
prostredie.
Sme
toho
názoru,
že
prác
a
v hete rogénny ch skupin ách posky tuje žiak om viac prílež itost í na vn ímani e
a oceňovanie rozmanitosti, ktorá existu je v triede aj v spoločnosti.
Bibliografia
BAGALOVÁ, Ľ. –
BIZÍKOVÁ, Ľ. –
FATULOVÁ, Z
. 2015. Metodika
podporujúca inkluzívne vzdelávanie v
školách. Brat islava: ŠPU. 154 s.
ISBN 978-80-8118-143-6.
GILLIES, M. R. 2003. Structuring coopera
tive group work in classrooms. In
International Journal of Educational Resear
ch. Vol. 39, p. 35-49.
JANOŠKO, P. –
NESLUŠANOVÁ, S. 2014. Škola s i nkluzívnou klímou.
Ružomberok: Ver bum. 98 s. ISBN 978-80- 561-0193-3.
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JOHNSO
N, D. W. –
JOHNSON, R
. T. 1990. S
ocial skills
for succes
sful group
work. In Educational leadership. Dec/Jan.
p. 29-
33. [cit. 29.06.2020].
[online]. Dostupné na:
https://www.researchgate.
net/publication/
234590538_Social_Skills_for_Successful_Group_Wo
rk
JOHNSON, D. W. –
JOHNSON, R. T. 2009. An Educ
ational Psychology
Success Story: Social Interdependence Theo
ry and Cooperative
Learning. In Educational Researcher.
Vol. 38, p. 36
5 –
379.
eISSN 1935-102X.
KASÍKO
VÁ, H. 2 004. Ko operativní uč ení a vyučo vání. Teor etické a pra ktické
problémy. Praha: Karolinum. 179 s. ISB N 978-80-246-0192-2.
KLEIN, V. – ROSINSKÝ, R. 2013. Sociálna pedagog ika pre pomáhajúce
profesie. Nitra: UKF. 168 s. ISBN 978-80- 8094-835-1.
KLEIN, V. – ŠILONOVÁ, V. 2016. Inkluzívna edukác ia – výzva k pozitívnym
zmen
ám sú
časnej
školy
. [onl ine]. [cit. 29.06. 2020]. Dostu pné na inte rnete:
https://www.academia.edu/37601824/I
NKLUZÍVNA_EDUKÁCIA_
VÝZVA_K_POZITÍVNYM_ZMENÁM_SÚČ
ASNEJ_ŠKOLY_
INCLUSIVE_EDUCATION_A_CHA
LLENGE_FOR_POSITIVE_
CHANGES_IN_PRESENT_DAY_SCHO
OL
LECH
TA, V
. 2010
. Zákl ady in kluziv ní ped agogi ky; dí tě s p ostižen ím, n arušen ím
a ohrožením ve škole. Praha: Portál. 440 s. I SBN 978 -80-7367-679-7.
LECHTA, V. 2016. Inkluzivní pedagog ika. Praha: P ortál. 463 s.
ISBN 978-80-262-1123-5.
Národný
program r
ozvoja výc
hovy a vzdel ávan ia 2018- 2027. [cit. 29.06.2020 ].
[online]. Dostupné na: https://www.m inedu.sk/data/att/13285.pdf
PORUBS
KÝ, Š. –
S
TRÁŽIK, P. – VANČÍKOVÁ , K. – ROSI NSKÝ, R. 20 14.
Pedagogický model inkluzívneho vzdelávania
na základných školách.
Prešov: MPC. 68 s. ISBN 978 -80-565- 0373-7.
TSAY, M. –
BRANDY, M. 2010. A case study of ccop
erative learning and
communication pedagogy: Does working in
teams make difference? In
Journal of the Scholarship of Teaching and L
earning. Vol. 10, No. 2,
p. 78-89.
TUREK, I. 2008. Didaktika.
Bratislava: I
ura Edition. 598 s.
ISBN 978-80-8078-198-9.
Mgr. Zdenka Zastková
Katedra predškolskej a elementárnej pedag
ogiky (interná doktorandka)
Katolícka univerzita v
Ružomberku, Pedag
ogická fakulta
Hrabovská cesta 1, 034 01 Ružomberok
[email protected]
Recenz
ie
114
Recenzie
Critiques
Ligoš, M.:
Vyučovanie slovenčiny ako materinského jazyk
a v
minulosti, prítomnosti
a bu dúcno sti (K apitol y z de jín vyu čovan ia slo venčin y s vý zvami d o bud úcnos ti) .
Bratislava: VEDA, 2019, 240 s. ISBN 978-80-
224-1770-9.
Súčasný
proces
vyučovania
slovenského
jazyka
má
svoj
základ
už
v dávnej minulosti. História je teda podstatným pilierom pri vytváraní niečoho
nového. Práve
historické hľadisko v
r
ámci vyučovania slovenského
jazyk
a
sa
stalo východiskom pre vznik novej publikácie autora M. Ligoša. Publikácia
zobrazuje
pohľad
na
najstaršie
časy
vyučovania
slovenčiny,
ktoré
autor
rozdelil
do
štyroch
rámcových
etáp.
Prvá
etapa
sa
začína
opisom
obdobia
Veľkej
Moravy
po
vy
danie
1.
školského
zákona Ratio educationis (1777,
1806). Druhá etapa pokračuje obdobím od Ratio educationis po r. 1918. Tretia
etapa približuje
obdobie od
r. 1918 do
začiatku 60.
rokov 20.
storočia. Štvrtá
etapa
zobrazuje
obdobie
od
začiatk
u
60.
rokov
20.
storočia
po
súčasnosť,
ko nkrétne po r. 2008/2009.
V publik ácii sa sp omínajú význam né m edzníky formovania slov enčiny
ako spisovného jazyka.
Autor vychádza z
byzantskej misie
solúnskych bratov
a s ňou spojenou inštitucionálnou výučbou spisovnej staroslovienč iny, pričom
upozorňuje
zároveň
aj
na
v
tomto
období
už
existujúcu
formu
domáceho
jazyka – starej slovenčiny. Spomína predspisovné obdobie, ktoré bolo charak
-
teristické
používaním
latinčiny
ako
diplom
atického
jazyka.
Pokračuje berno -
lák
ovskou
a štúrov skou kod ifikác iou, na kto rú nadvia zala hodž ovsko - hatta lovsk á
refo
rma. Jedn
otliv
é obdobia
sú
do
plnen
é o
releva
ntné kodi
fikač
né a jazyk ovedn é
publikácie a
periodiká orientujúce sa
na rozvoj spisovného jazyka a j azyk ovej
kultúry.
Nechýba
ani
zmienka
o
významných
inštitúciách,
ako
je
vznik
a pôsobenie
Matice
slovenskej
(1863 – 1875), prvé oficiálne zavedenie
slovenčiny
ako
vyučovacieho
jazyka
na
Gym
náziu
A.
Sládkoviča
v Banskej
Bystric
i
(18
50) ako aj
vzn
ik prvého učiteľskéh
o
ústa
vu v Uhorsku – v Spišskej
Kapi
tule (1
819), k
de bo
la zave
dená spo
lu so s
lovenč
inou aj m
etod
ika vyu
čovan
ia
materinského jazyka
v
rámci
sam
ostatného
učebného predmetu.
Významným
dielom, ktoré
autor spomína vo
svojej publikácii, je Pedagogia slovenská pre
triwiálske
školi (1820) od Juraja Pál eša – prvého riaditeľa Pedagogického
inštitútu v
Spišskej Kapitule.
Bola
to prvá
metodik
a
vyučovania slovenského
jazyk
a,
napísa
ná
v bernolákovč ine. Ob dobie vyučovania slovenčin y do r. 1918
autor
analyzuje z pohľadu jednotlivých protichodných tendencií. Obdobie od
r. 1918 je
predstave né ako obdobie ideológie čechoslovakizmu. Ľudové školy
STUDIA SCIENTIFICA FACULTATIS PAEDAGOGI CAE
UNIVERSITAS CATHOLICA RUŽOMBEROK 2020, č. 3
115
boli
zamerané
na
zvládnutie
elementárneho
čítania
a
písania,
osvojenia
si
pravopisu a základov jazyka, pričom v slohovej oblasti išlo zväčša o zručnosti
spájajúce sa s reprodukciou.
Autor
vo
svojej
mo nografii predstavuje učebné osnovy pre školy
spišskej diecézy, významné gymnáziá ako
aj spoločensko -
politické a
kultúrne
pomery
v rámci vyučovania slovenčiny. Podáva charakteristiku metodickej
príručk
y Listár z
2. polovice 19. storočia
,
op
isuje učebné osnovy
pre slov
enské
ľudové školy (1930), učebné osnovy pre
stredné školy a
učiteľské ústavy, ako
aj
metodiku
československého
jazyka
pre
národné
školy
a
vyberá
kľúčové
práce učiteľov slovenčiny z obdobia pred rok
om 1989.
Záverečná kapitola
publikácie je venovaná
súčasnej koncepcii vyučo -
vania
slovenčiny
ak
o
materinského
jazyka
s
víziami
do
bu
dúcnosti.
Autor
v nej vyzdvihuje elementárnu znalosť slovenčiny, ktor á tak ako v minulosti, aj
v dnešnej dobe je vnímaná ako základ zvládnutia vlastnej reči slovom
a písmom. Predstavuje rôzne prístupy a koncepcie vyučovania slovenčiny od
minulosti
po
súčasnosť.
Zau
jímavá
je
časť,
v
ktorej
sa
autor
venu
je
novým
podnetom a výzvam v rámci vyučovania slovenčiny ako materinského jazyka.
Približ
uje
tu trilater
álny koncept výrazových
prostri
edkov, silu jazyka a komu-
nikácie ako aj výrazovo -
komunikačnú kategóriu zrozumiteľnosti a
komplexnú
štylistiku.
Monografia
M.
Ligoša
je
významným
dielom,
ktoré
komplexne
podáva prehľad o
dôležitých medzníkoch, ktoré ovplyvnili úroveň vyučovania
sloven
ského jazyka ak
o vyučovacieho
predmetu. Prí
nosnou je aj charak
teristika
pedagogických dokumentov a diel vý
znamných osobností.
PaedDr. Beáta Murinová, PhD.
Code of Ethics for Publishing Articles in the Scientific Journal:
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that their manuscripts
are entirely original
works.
The
following
duties
listed
for
authors,
editors,
reviewers
and
the
publisher
are
binding
for
them
and
they
must
adhere
to
the
principles
of
the
journal
STUDIA SCIENTIFICA FACULTATI
S PAEDAGOGICAE.
Standard for Manuscripts, Access to Data and The
ir Retention
The
authors
of
articles
are
obliged
to
use
objective
reasoning
and
objective
results
of scientific
researc
h.
The data
base of
a
scientific research
should be
explicitly
presented.
Scientific
s
tudies
must
be
sufficiently
detailed
and
the
references used must enable readers to reprod
uce their work objectively.
The
authors
of
the articles
may
be
asked
to
provide
source
data used
in
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studies
and
articles
for
ed
itorial
control
purposes,
and
if
it
is
possible,
the
author
should
retain
th
e
used
data
for
a
reasonably
long
period
after
the
publication.
Misleading or intentionally incorrect statem
ents are considered unethical.
Originality and Plagiarism
The authors
should ensure
that they have
written entirely
original works, and
if
the
authors have
used
the
work and/or
words
of
others,
that this
has
been
appropriately cited
or quoted. Plagiarism
in all
its forms cons
titutes unethical
behaviour
and
is
unacceptable.
Plagiarism
takes
many
forms,
from
‘passing
off’
another’s
paper
as
the
author’s
own
paper,
to
copying
or
paraphrasing
substantial
parts
of
another’s
paper
(without
attribution),
to
claiming
res ults
from research conducted by others.
Multiple, Redundant and Concurrent Publica
tion
An author should not in general publish manuscripts describing essentially the
same research in more than one journal of primary publication. Subm
itting the
Code of Ethics for Publishing Articles in the Scientific Journal:
STUDIA SCIENTIFICA FACULTATIS PAEDAGOGICAE
1 18
same
manuscript to
more
than
one journal
concurrently constitutes
unethical
behaviour and is unacceptable
Citing sources
Authors
should
cite
publications
that
have
significantly
influenced
the
reported article.
The
article
should
always
contain
correct
and
full
qu otation of another’s
paper.
Information
obtained
privately
must
not
be
used
or
reported
without
explicit, written permission from the source, or
from the owner of the property
rights.
Authorship of the Article
Authorship
should
be
limited
to
those
who
have
made
a
significant
contribution to the fi
nal
conception, design, execution, or interpretation of the
reported
study,
article
or
paper.
All
t
hose
who
have
made
substantial
contributions should be
listed as co-authors. Where there
are others who have
participated
in
certain
substantive
aspects
of
the
paper,
they
should
be
recognised
i
n
the
article.
The
corresponding
(responsible)
author
should
ensure
that
all
appropriate
co-authors
and
no
inappropriate
co-authors
are
included on the paper, and that all co-authors have seen
and approved the final
version of the paper and have agreed to it
s submission for publication.
Fundamental Errors in the Published Works
When
an
author
discovers
a
significant
error
or
inaccuracy
in
their
own
published
work,
it
is
the
aut hor’s obligation to promptly notify the journal
editor or publisher and cooperate with the
editor to retract or correct the paper
if
deemed
necessary by
the
editor.
If
the
editor or
the
publisher
learns
from
a third party that a
published work contains an error, it
is the obligation of the
author to
cooperate with the
editor, including providing
evidence of accuracy
of the original results to the editor when reque
sted.
Duties of Editors According to the Code of Eth
ics
Publication
decision:
Editor
in
Chief
of
STUDIA
SCIENTIFICA
FACULTATIS
PAEDAGOGICA
E
m
ay
accept,
reject
or
request
corrections
of the articles reported to the journal for pub
lication.
In case both reviews
are positive, the text is accepted to be
published with the
approval of editorial board. If both reviews are negative, the text is rejected. If
one of
the reviews
is positive
and the
other negative,
the author is
invited by
STUDIA SCIENTIFICA FACULTATIS PAEDAGOGI CAE
UNIVERSITAS CATHOLICA RUŽOMBEROK 2020, č. 3
119
the
editor
in
chief
to
edit
the
article.
Subsequently,
the
article
will
be
reconsidered. Unpublished materials
disclosed in
a submitted article must
not
be
used in
anyone's
own
research without
the
express written
consent
of the
author.
Publication Decision
Accepting
articles
into
individual
issues
of
the
scientific
journal
STUDIA
SCIENTIFICA
FACULTATIS
PAEDAGOGI
CAE
is
in
the
competence
of
editorial board
of
the journal
which takes
into
accou
nt
the reviews
and
other
material
acquired
from
the
managing
editor. T
he
vali
dation
of
the
article
in
question
and
its
importance
t
o
researchers
and
r
eaders
must
be
r
ealized
in
accordance
with
the
editorial
rules.
The
managing
editor
is
thus
subject
to
legal
requ
irements
in
case
of
libel,
copyright
infringement
and
plagiarism.
The
managing
editor
may
confer
with
other
editors
or
reviewers
in
m
aking
these decisions. T
he managing editor works
with the manuscripts
solely from
the perspective of their content and qual
ity
Confidentiality
The
editor
in
chief
or
anyone i
n the
editorial
office
of
the
scientific
journal
STUDIA
SCIENTIFICA
FACULTATIS
PAEDAGOGICAE
must
not
provide
any
info
rmation
about
submitted
manuscripts
to
a
ny
subjects
other
than the corresponding author, reviewers, potential
reviewers, members of the
editorial board and publisher.
Participation and Cooperation on Handling Comp
laints
The
editorial
o
ffice
shall
take
specific
measures
in
case
of
complaints
of
ethical
character
regarding
the
submitted
or
published
manuscript.
These
measures
will
generally
include
contacting
the
autho
r
of
the
m
anuscript
or
paper
and
giving
due
consideration
to
the
respective
com
plaint
or
claims
made.
The
measures
further
include
communications
to
the
relevant
institutions
and
research
bodies
and
if
the
complaint
proves
to
be
justified,
correction will be published, or the article wi
ll be retracted, or other correction
will be
implem
ented.
Each reported case of
unethical behaviour in publishing
in
the journal
must be
investigated, even
in the
case
that the
article has
been
published long time ago.
Code of Ethics for Publishing Articles in the Scientific Journal:
STUDIA SCIENTIFICA FACULTATIS PAEDAGOGICAE
120
Duties of Reviewers According to the Code o
f Ethics
Promptness:
The
accepted
texts
will
be
provided
to
two
reviewers
who
are
professionals
in
the
given
area
and
come
from
other
workplaces
than
the
author
of
the
text.
If
the
reviewer
is
not
able
to
finish
the
review
of
the
manuscript
w
ithin
the
agreed
deadline,
h
e/she
must
communicate
with
the
editor so that the manuscript will be provid
ed to another reviewer.
Contribution to Editorial Decisions
Reviewer
helps
the
editor
and
editorial
board
of
the
scientific
journal
STUDIA
SCIENTIFICA
FACULTATIS
PAEDAGOGICAE
with
editorial
decisions
about publishing/rejecting articles.
Reviewer’s comments
assist t
he
author
in
improving
the
paper.
Peer
review
is
an
essential
com
ponent
of
formal scholarly communication.
Further Aspects/Time Perspective of Review P
rocedure
Each
suggested
reviewer
who
doe
s
not
feel
qualified
to
review
a
certain
manuscript,
or
who
knows
tha
t
he/she
will
not
be
able
to
m
ake
the
review
within
the
agreed
deadline,
should
notify
the
redaction
office
and
excuse
him/herself from the review process.
Confidentiality
Any
manuscripts
received
for
review
must
be
treated
as
confidential
documents.
Reviewers
must
not
show
the
manuscript
or
discuss
t
he
manuscript
with
anyone unless
the
redactor
in
chief
of
the journal
STUDIA
SCIENTIFICA FACULTATIS PAED
AGOGICAE permits it.
Objectivity
Reviews
shoul
d
be
conducted
objectively.
Personal
criticism
of
the
author
is
inappropriate.
Referees
should
express
their
views
clearly
with
supporting arguments.
Citation of Sources
Reviewers should point out
the data and information that are
wrongly cited or
not
cited at
all
by
the author.
Any
proclamation that
the
data
or information
were
already
publ
ished
in
the
past
must
be
supported
by
relevant
documentation.
A
reviewer
should
bring
to
the
attention
of
the
editor
any
substantial
similarity or
overlap
between
the manuscript
under
consideration
and any other published paper of which the rev
iewer has personal knowledge.
STUDIA SCIENTIFICA FACULTATIS PAEDAGOGI CAE
UNIVERSITAS CATHOLICA RUŽOMBEROK 2020, č. 3
121
Publishing and Competing Interests
Unpublished
m
aterials
disclosed
in a
submitted manuscript
must not
be
used
in
a
reviewer’s
own
research
without
the
express
written
consent
of
the
author.
Substantial
in
formation
or
ideas
obtained
th
rough
peer
review
are
considered
confidential
and
must
not
be
used
for
personal
advantage
of
the
reviewer. Reviewers should not
review articles in which a conflict of
interests
resulting from competitive or other relations wi
th the author may arise.
DUTIES OF THE PUBLISHER
The publisher defines the relationship between the publisher, editors and other
contracting
parties,
respects the
confidentiality
(e.g.
towards
the
participants
of
a
research,
authors,
professional
reviewers),
protects
intellectu
al
property
and copyright, and also supports editorial ind
ependence. S T U D I A S C I E N T I F I C A F A C U L T A T I S P A E D A G O G I C A E / / 3 2020 U N I V E R S I T A S C A T H O L I C A R U M B E R O K Ž O S T U D I A S C I E N T I F I C A F A C U L T A T I S P A E D A G O G I C A E / / r 3 2020 oč ní k XIX.
/
/
r
3 2020
oční
k XIX.
ISSN 1336-2232
9
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Citations (0) References (54)
ResearchGate has not been able to resolve any citations for this publication.
Development of Slovenian education policy in the European context and beyond. Article Full-text available
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Nowadays lifelong learning is widely recognized as a solu-tion in facing the intense new challenges of an increasingly globalized world. In facing these challenges and in order to achieve common educational goals, the nation states are included in different forms of international cooperation. It is very interesting to see how these different forms of international coopera-tion have impact on different aspects of national education policy and how the idea of lifelong learning has helped countries to increasingly perceive them-selves as similar with respect to necessary educational changes.Taking into consideration both inherent perspective (international cooperation influence and national responses to it), first of all it is essential to understand nation state’s historical legacies, the history of its policy paradigms and the history of its policy-making in the education field. From that point of view, on the one hand, the article explores the development of Slovenian education policy from its early beginning (the Reformation) till today. On the other hand, it focuses on the impact of different forms of international cooperation on the national education policy. On the basis of analysis of formal and informal documents and conducted semi-structured interviews, the article concludes that although Slovenia is included in various different forms of international cooperation, their influence on Slovenian education policy is limited. However, this cannot be solely attributed to education as a sensitive policy area with a low level of implementation imperative, where cooperation is in most cases voluntary, but also to the trends in Slovenian history.
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People do not know instinctively how to interact effectively with others. For cooperation to succeed, students must get to know and trust one another, communicate accurately and unambiguously, accept and support one another, and resolve conflicts constructively. A seven-step recommended procedure is outlined. Includes nine references. (MLH)
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The widespread and increasing use of cooperative learning is one of the great success stories of social and educational psychology. Its success largely rests on the relationships among theory, research, and practice. Social interdependence theory provides a foundation on which cooperative learning is built. More than 1,200 research studies have been conducted in the past 11 decades on cooperative, competitive, and individualistic efforts. Findings from these studies have validated, modified, refined, and extended the theory. From the theory, procedures for the teacher’s role in using formal and informal cooperative learning and cooperative base groups have been operationalized. Those procedures are widely used by educators throughout the world. The applications have resulted in revisions of the theory and the generation of new research.
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The education systems of Europe, second edition
Book
Jan 2015
W. Hörner H. Döbert L.R. Reuter Botho von Kopp
This updated second edition presents an analytical description of the education systems of all European countries, following common guidelines. These conceptual guidelines consider various criteria concerning presumptions as to the quality of a good education system. One of the book central aims is to explore the paradoxical character of education, i.e. the relationship between universal values and the search for a national identity. The common structure of the different country analyses oriented by crucial problems of education worldwide guides to discover common patterns of European education compared to that of education systems outside Europe, making its reading relevant to educators around the world. The handbook provides many suggestions for further study. © Springer Science+Business Media B.V. 2007 and Springer International Publishing Switzerland 2015.
View Show abstract
Kooperativní učení a vyučování : teoretické a praktické problémy /
Article
Jan 2004
Hana Kasíková Univerzita Karlova. Filozofická fakulta
1. vyd.
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Jazyková specifikace školské komunikace a výuka mateřštiny /
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Cooperative, small-group learning is widely recognised as a pedagogical practice that promotes learning and socialisation across a range of curriculum areas from primary school through to high school and college. When children work cooperatively together, they learn to give and receive help, share their ideas and listen to other students’ perspectives, seek new ways of clarifying differences, resolving problems, and constructing new understandings and knowledge. The result is that students attain higher academic outcomes and are more motivated to achieve than they would be if they worked alone. This paper provides an overview of five different studies that the author has conducted that demonstrate clearly the importance of explicitly structuring cooperative small-group work in classrooms if children are to derive the benefits widely attributed to this pedagogical practice.
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Pedagogická diagnostika v primárnom vzdelávaní. Bratislava: SPN, 2011, s. 26 -51 Jan 2011
Z Hirschnerová M Kožuchová
HIRSCHNEROVÁ, Z. 2011. Diagnostikovanie žiaka v jazykovom vzdelávaní.
In: KOŽUCHOVÁ, M. et al. Pedagogická diagnostika v primárnom
vzdelávaní. Bratislava: SPN, 2011, s. 26 -51. ISBN 978-80-10-02053-9.
Pedagogická diagnostika v primárnom vzdelávaní. Bratislava: SPN
Jan 2011
M Kožuchová
KOŽUCHOVÁ, M. et al. 2011. Pedagogická diagnostika v primárnom
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Molecules | Free Full-Text | Co-Adsorption of H2O, OH, and Cl on Aluminum and Intermetallic Surfaces and Its Effects on the Work Function Studied by DFT Calculations
The energetics of adsorption of H2O layers and H2O layers partially replaced with OH or Cl on an Al(111) surface and on selected surfaces of intermetallic phases, Mg2Si and Al2Cu, was studied by first-principle calculations using the density function theory (DFT). The results show that H2O molecules tended to bind to all investigated surfaces with an adsorption energy in a relatively narrow range, between & ndash;0.8 eV and & ndash;0.5 eV, at increased water coverage. This can be explained by the dominant role of networks of hydrogen bonds at higher H2O coverage. On the basis of the work function, the calculated Volta potential data suggest that both intermetallic phases became less noble than Al(111); also, the Volta potential difference was larger than 1 V when the coverage of the Cl-containing ad-layer reached one monolayer. The energetics of H2O dissociation and substitution by Cl as well as the corresponding work function of each surface were also calculated. The increase in the work function of the Al(111) surface was attributed to the oxidation effect during H2O adsorption, whereas the decrease of the work function for the Mg2Si(111)& ndash;Si surface upon H2O adsorption was explained by atomic and electronic rearrangements in the presence of H2O and Cl.
Co-Adsorption of H 2 O, OH, and Cl on Aluminum and Intermetallic Surfaces and Its Effects on the Work Function Studied by DFT Calculations
by Min Liu 1,2 , Ying Jin 1,* , Jinshan Pan 2 and Christofer Leygraf 2,*
1
National Center for Materials Service Safety, University of Science and Technology Beijing, Beijing 100083, China
2
Division of Surface and Corrosion Science, School of Chemistry, Biotechnology and Health, KTH Royal Institute of Technology, SE-100 44 Stockholm, Sweden
Authors to whom correspondence should be addressed.
Molecules 2019 , 24 (23), 4284; https://doi.org/10.3390/molecules24234284
Received: 6 September 2019 / Revised: 29 October 2019 / Accepted: 30 October 2019 / Published: 25 November 2019
Abstract
The energetics of adsorption of H
2
O layers and H
2
O layers partially replaced with OH or Cl on an Al(111) surface and on selected surfaces of intermetallic phases, Mg
2
Si and Al
2
Cu, was studied by first-principle calculations using the density function theory (DFT). The results show that H
2
O molecules tended to bind to all investigated surfaces with an adsorption energy in a relatively narrow range, between –0.8 eV and –0.5 eV, at increased water coverage. This can be explained by the dominant role of networks of hydrogen bonds at higher H
2
O coverage. On the basis of the work function, the calculated Volta potential data suggest that both intermetallic phases became less noble than Al(111); also, the Volta potential difference was larger than 1 V when the coverage of the Cl-containing ad-layer reached one monolayer. The energetics of H
2
O dissociation and substitution by Cl as well as the corresponding work function of each surface were also calculated. The increase in the work function of the Al(111) surface was attributed to the oxidation effect during H
2
O adsorption, whereas the decrease of the work function for the Mg
2
Si(111)–Si surface upon H
2
O adsorption was explained by atomic and electronic rearrangements in the presence of H
2
O and Cl.
Keywords:
aqueous ad-layer
;
work function
;
micro-galvanic effect
;
DFT
;
aluminum
;
intermetallics
Graphical Abstract
1. Introduction
Al alloys are widely used in many applications because of their mechanical properties, easy fabrication, and good resistance to corrosion in various environments. While improving strength, intermetallic particles (IMPs) commonly increase the susceptibility of Al alloys to localized corrosion. Mg 2 Si and Al 2 Cu are among the most common phases in 2xxx and 7xxx aluminum alloys [ 1 ]. The coupling of these IMPs to an Al matrix results in the so-called micro-galvanic effects induced by their potential difference, which may trigger localized corrosion [ 2 ].
On one hand, Cl − ions are believed to damage metal surfaces and hinder the re-passivation of localized corrosion of metals [ 3 , 4 , 5 , 6 ]. In a previous work, we studied co-adsorption of Cl and O 2 molecules on an Al(111) surface by density functional theory (DFT) and found that the interaction of Cl and Al weakened the O–Al bond when the Cl/O ratio increased [ 5 ]. Moreover, co-adsorption of H 2 O and Cl − ions on two of the common IMPs in Al, i.e., Al 2 Cu and Al 2 CuMg, was recently studied by DFT, and the results suggested that Cl − ions can distort the structure within Al–Cu layers and lead to the formation of corrosion products [ 7 ]. On the other hand, surface adsorption was also frequently reported to alter the measured work function [ 8 , 9 ], which can consequently change the micro-galvanic effect. This issue was also addressed in a previous paper by the authors, suggesting that the adsorption of pure water had a significant effect on the relative nobility of different IMPs [ 10 ]. Thus, in order to further study the impact of a more corrosive environment on the micro-galvanic effect, Cl-containing aqueous ad-layers were explored in this work to possibly reveal their effect on micro-galvanic corrosion.
The work function is the minimum energy needed to emit an electron from the surface to vacuum, implying that a higher work function corresponds to a higher resistance against losing electrons, and vice versa. This means that the work function can be regarded as an indicator of corrosion tendency [
11
,
12
]. Scanning Kelvin probe force microscopy (SKPFM) is usually applied to measure the Volta potential difference of two phases, which directly responds to the work function of the probe and the phases [
13
]. Hence, it is expected that factors that can affect the work function can also have an impact on the Volta potential difference.
Halogen adsorption was reported by DFT to decrease the metal work function. Examples include Cl on the (001) surface of Pt, Pd, and Rh [ 14 ], in which the polarization of halogen atoms overcompensates the charge transfer. Other studies have reported that Cl tends to increase the work function of Cu(111) [ 15 ] and Al(111) [ 16 ], while Br would raise the work function of Mg(0001) [ 17 ]. This can be explained by the strong electronegative character of halogen atoms, particularly Cl, which facilitates the formation of a dipole moment pointing from the halogen species to the metal surface [ 15 ]. A recent paper by Marks [ 18 ] reported that the galvanic effect between different sites on the oxide might be caused by a Cl adsorption-induced work function increase on several oxide surfaces, including Al 2 O 3 .
Computational studies have shown that the adsorption of H 2 O decreases the work function of metal surfaces, such as Pt [ 19 , 20 , 21 ], Pd [ 22 ], and Cu [ 23 ]. This was attributed to electron transfer from H 2 O molecules to the interfacial region between the water layer and the metal surface because of the large polarizability of H 2 O [ 21 ], and different H 2 O adsorption orientations were believed to be the main reason for different directions of work function change [ 22 ]. A work function decrease caused by H 2 O adsorption was also observed in experimental studies [ 24 , 25 , 26 ]. Moreover, a correlation between the adsorption energy of H 2 O and the work function of the H 2 O-adsorbed Pt(111) surface could be discerned [ 20 ].
It should be mentioned that Cl atoms, rather than Cl − ions, are used in many DFT studies because of the lack of a clear description for ions in the calculation model, and some efforts have been made conceptually from an energetic point of view [ 27 , 28 ], in which the free energy of Cl − was replaced with that of gaseous Cl 2 . On the other hand, DFT calculations can reveal whether charge transfer occurs or not, so the use of Cl atoms in the DFT study can still provide valuable insights in the adsorption process.
In an experimental work, the addition of pure Br
2
molecules was found to increase the work function of Cu(110). Subsequent introduction of H
2
O, on the other hand, substantially decreased the work function, mainly because of the H
2
O dipole orientation [
29
]. With the development of computational capacity, theoretical efforts have been accomplished to approach more realistic solvation environments at the electrochemical liquid/solid interface by including explicit H
2
O molecules. For example, Wasileski et al. [
30
] concluded that a mild aqueous environment containing O
2
, Na, and H
2
O can reduce the work function fluctuations of Pt(111).
The theoretical studies mentioned above mainly focused either on single adsorbing species or on non-aggressive aqueous ad-layers. To better understand the localized corrosion mechanism of Al alloys, efforts are needed to study a more corrosive aqueous environment (e.g., with both Cl and H
2
O) on both pure and hydroxylated Al and on relevant IMPs, which can mimic more realistic electrochemical corrosion conditions. The objective of this theoretical work is to study several aqueous environments relevant to corrosion scenarios by DFT calculations of the energetics of adsorption of H
2
O molecules and of Cl on Al(111) and on two IMPs, Mg
2
Si and Al
2
Cu, and also the subsequent H
2
O dissociation and substitution by Cl. The corresponding work function changes will be discussed from a galvanic corrosion perspective, aiming at shedding some light on the localized corrosion mechanism. This work is a continuation of our previous study [
10
], in which micro-galvanic corrosion between an Al matrix and Mg
2
Si or Al
2
Cu was explored both computationally and experimentally in the presence of a pure H
2
O ad-layers without co-adsorption of other species.
2. Computational Details
2.1. Model Construction
In this work, Al, Mg
2
Si, and Al
2
Cu crystals were considered. Aluminum has a cubic structure with a = 4.05 Å [
31
], and Mg
2
Si is cubic with a = 6.35 Å, while Al
2
Cu is tetragonal with a = 6.06 Å, c = 4.87 Å [
32
]. For Al, its (111) surface was studied. The Mg
2
Si(111) surface with Si and Mg terminations was selected, as these two terminations show rather different work function values. In addition, the Al
2
Cu(110)–Cu was selected for comparison. Note that vacuum was set to be at least as high as the thickness of the slab layers, and all atom positions were allowed to be optimized (details of the model construction can be found in [
10
,
33
]). In the following, Al(111), Mg
2
Si(111)–Si, Mg
2
Si(111)–Mg, and Al
2
Cu(110)–Cu will be simply written as Al, Mg
2
Si–Si, Mg
2
Si–Mg and Al
2
Cu–Cu, respectively.
To begin with, intact H
2
O adsorption (this configuration is shortened INT herein) on each metallic surface with different coverages was constructed. Firstly, one H
2
O molecule was placed on the top site of each surface with flat or vertical orientation. After optimization, the configuration with the lowest total energy was selected and duplicated on another top site. Since there were a few top sites on each surface, non-equivalent adsorption configurations were constructed and optimized, and only that with the lowest total energy was used for further analysis. In this work, only the top site was considered, focusing on ad-layer coverage.
On the basis of the final H
2
O adsorption configurations on each metallic surface, aqueous ad-layers including one hydroxyl group (OH) or one Cl atom, were subsequently constructed by one dissociated H
2
O (shortened DIS) and one substitution (SUB) of the dissociated OH by one Cl. To build the dissociation system, one H
2
O molecule was torn apart in the calculations, with the OH group remaining, and the H atom relocated to another top site. Hence, a few different dissociation ways were possible, and only those with the lowest total energy were selected and discussed.
Figure 1
schematically depicts how the OH- and Cl-containing ad-layers were constructed.
Figure 1. Top view depicting the different calculated configurations of adsorbed aqueous ad-layers: intact H 2 O (INT), water with one OH (DIS), and water with one Cl (SUB). The metallic surface for H 2 O adsorption is only a representative substrate. Note that in the SUB case, a surface bond is formed between the Cl and a surface atom.
In this work, all results were discussed with the same coverage. The coverage of adsorbate, θ, is defined as the ratio of the number of adsorbates (e.g., water molecules, n
W
) to the number of atoms in the first layer. Here, coverages with 0.25 monolayers (ML), 0.5 ML, 1 ML, and 2 ML were considered. Note that the dissociation and substitution systems consist of a mixture of adsorbates, 1OH + 1H + (n
W
-1) H
2
O (DIS models) or 1Cl + 1H + (n
W
-1) H
2
O (SUB models). In the following, INT-θ, DIS-θ, and SUB-θ were used when needed. H
2
O orientations were not considered, as the focus was to create Cl-containing aqueous ad-layers.
Periodic DFT calculations together with the exchange–correlation functional, GGA-PW91, were performed using the Dmol3 code [
34
,
35
] implemented in MaterialsStudio. Core electrons were treated with DFT semi-core pseudopotentials (DSPP) with double numeric basis sets and polarization functions (DNP) [
34
]. A 6 × 6 × 1 k-point was used in all surface structures except for Al(111), for which a 3 × 3 × 1 k-point was used. Dipole correction was introduced vertically to each metallic surface to avoid dipole interactions. All atoms were relaxed until the energy, residual force, and displacement of each atom were less than 10
−5
Ha (Hartree), 0.002 Ha/Å (Ångström), and 0.005 Å, respectively.
2.2. Description of Energetics
The work function of any surface configuration can be obtained by the energy difference between the vacuum level and the Fermi level, which is straightforward in DMol3 [ 33 ]. As proposed before, the Volta potential between different IMPs and the Al matrix is equal to their work function difference divided by e [ 33 ].
The adsorption energy per H
2
O,
E ad
, was calculated by Equation (1):
E ad = ( E ( Surface + nH 2 O ) − E ( Bare surface ) − n · E ( H 2 O ) ) / n
(1)
where
E ( Surface + nH 2 O )
,
E ( Bare surface )
, and
E ( H 2 O )
are the total energy of the H
2
O-adsorbed surface, bare surface, and H
2
O molecule, and n is the number of adsorbates.
E ad
˂ 0 means that the adsorption is exothermic (favorable), and vice versa.
The energy needed for the dissociation (
E d
) of one H
2
O molecule into OH and H and for substitution (
E s
) of one OH by one Cl was calculated by Equations (2) and (3) [
36
], respectively:
E d = E DIS − E INT
(2)
E s = E SUB + E OH − E DIS − 1 / 2 E Cl 2
(3)
where
E INT
,
E DIS
, and
E SUB
are the total energy for the INT, DIS, and SUB adsorption systems, while
E OH
and
E Cl 2
are the energy for free OH and Cl
2
, respectively.
3. Results and Discussion
3.1. Adsorption of Pure H 2 O Ad-Layers
As proposed in our previous work, water may adsorb in different configurations on different surfaces depending on their intrinsic properties. Nobility inversion was observed by DFT as well as by SKPFM when considering the work function change against coverage of water ad-layers [ 10 ]. In that previous study, the effect of H 2 O with different coverages on the work function was considered. It was concluded that the derived Volta potential difference between IMPs and the Al matrix agreed well with the experimental observations.
In this work, however, the adsorption energy per H
2
O molecule with increasing H
2
O coverage,
θ H 2 O
, on each surface was further calculated by equation (1) and plotted in
Figure 2
. The results show that H
2
O adsorption on the Mg
2
Si–Si surface was unfavorable at low coverage, but became increasingly favorable with increasing
θ H 2 O
, as indicated by a drastic drop in
E ad
from positive values to −0.4 eV with 1 ML of H
2
O. This can be explained by a change of balance between H
2
O–surface interaction and H
2
O-H
2
O interaction [
37
]. A similar trend was seen for H
2
O adsorption on Al
2
Cu–Cu, whereas H
2
O adsorption on Al and Mg
2
Si–Mg was favorable at all coverages, with only a slight change in
E ad
with H
2
O coverage (
Figure 2
). This could indicate that the interaction between H
2
O and these two surfaces is a dominant factor, irrespective of H
2
O coverage. However, as will be shown in a later section, the hydrogen bonding between H
2
O molecules is a dominant factor, making the interaction between H
2
O and the substrate surface of minor importance. Besides, it can be seen in
Figure 2
that
E ad
of all surfaces fell into a rather narrow range, −0.8 eV to −0.5 eV, with increasing coverage.
Figure 2. Adsorption energy of H 2 O on Al, Mg 2 Si–Si, Mg 2 Si–Mg, and Al 2 Cu–Cu surfaces versus H 2 O coverage.
To understand the trend in adsorption energy shown in
Figure 2
, the energy difference between two hydrogen-bonded H
2
O molecules,
E H 2 O – H 2 O
, and two free H
2
O molecules was calculated to evaluate hydrogen bond strength (
E H – bond
). The molecules were not adsorbed on any surface during the calculation. Note that the van der Waals (VdW) force between H
2
O molecules was not considered, as it is not implemented in the DMol3 package:
E H – bond = E H 2 O – H 2 O − 2 × E H 2 O
(4)
The initial distance between the two H 2 O molecules ( d 0 ) bonded by hydrogen bonding was allowed to decrease from 2.45 Å to 1.65 Å. After optimization, a nearly constant distance, d 1 = 1.91 Å, and a corresponding E H – bond = −0.25 eV, were obtained, agreeing well with the experimental and theoretical values found in the literature [ 20 , 38 ].
The calculated E H – bond suggests an explanation for the converging trend of the adsorption energy of H 2 O at higher H 2 O coverage (see Figure 2 ). Assuming that each H 2 O molecule has saturated hydrogen bonds, i.e., four H-bonds, then each H 2 O possesses two H-bonds and contributes −0.50 eV to the adsorption of H 2 O. The strength of H-bonds can be enhanced [ 20 ] or weakened [ 39 ] after the interaction with the substrate. With possible surface interactions neglected, we can conclude that hydrogen bonding is predominant when relatively large amounts of H 2 O molecules are present.
On Mg 2 Si–Si, one of the four water molecules was found to spontaneously dissociate into OH and H ( Figure 3 ) when H 2 O adsorption reached 1ML. Looking back at the adsorption energy curve on the Mg 2 Si–Si surface ( Figure 2 ), it is evident that the dissociated OH can promote water adsorption at 1ML. Besides, the dissociated H atom binds to surface Si, as shown in Figure 3 b. Water dissociation on this surface may happen as the Si–H bond is stronger than the O–H bond in H 2 O [ 40 ]. Spontaneous dissociation was not observed on the other surfaces investigated. DFT calculations revealed a large energy barrier for H 2 O dissociation on Al(111) [ 41 ].
Figure 3. Optimized structure of H 2 O dissociation into OH and H (binding to surface Si) on Mg 2 Si–Si with 1ML H 2 O adsorption: ( a ) top view, ( b ) side view. Surface Si (Si s ) and bulk Si (Si b ) are indicated by dark and light orange color. Mg is in green, O in red, and H in white.
By plotting the work function at different H 2 O coverages of Al, Mg 2 Si–Si, Mg 2 Si–Mg, and Al 2 Cu–Cu (published previously [ 10 ]) against the corresponding adsorption energy, some special features were found ( Figure 4 ). For Mg 2 Si–Mg and Al 2 Cu–Cu, the work function and adsorption energy were linearly correlated with one deviating value at 2 ML for Al 2 Cu–Cu. A favorable adsorption at 2 ML may be attributed to the formation of a water network on the Al 2 Cu–Cu surface. The deviating work function of this adsorption system may be due to the large dipole of H 2 O adsorbed far from the surface. A positive relationship was also observed for Mg 2 Si–Si. This correlation indicates that the more stable the adsorption (more negative E ad ), the lower the work function of the adsorption system, in accordance with other studies [ 20 , 21 ]. The Mulliken charge analysis in our work implies that electron transfer from Mg 2 Si–Mg to H 2 O increased from 0.64 e to 0.77 e with increasing H 2 O coverage. It seems that electron transfer fails to explain the work function decrease, in comparison with the bare surface (blue dashed bar in Figure 4 ). We noticed that water molecules adsorbed on Mg 2 Si–Mg in an upward direction on average ( Figure S1 ), which could compensate the effect of electron transfer. Therefore, water orientation is regarded as the predominant factor affecting the work function of Mg 2 Si–Mg.
Figure 4. Plots of H 2 O adsorption energy on different surfaces versus work function under different H 2 O coverage (see the values without unit for each surface shown in the figure). The work function for each bare surface is highlighted by a dashed bar. Work function values for intact H 2 O adsorption were reported in our previous work [ 10 ].
For Al, the work function was nearly independent of the adsorption energy (
Figure 4
). Water molecules were ~ 4 Å away from the Al surface when the coverage was beyond 1 ML. As a result, a large dipole was built between water and Al, determining the work function change. On the other hand, hydrogen bond formation denoted a strong interaction among water molecules, as more water molecules were present on Al. Previous calculations confirm that the H
2
O adsorption energy is mainly determined by the hydrogen bond strength. Therefore, it is reasonable to conclude that the work function is independent of the adsorption energy on Al. The optimized structures of pure H
2
O on the four metallic surfaces are listed in
Figure S1
for comparison. We noticed that intact water adsorption caused a large surface relaxation on the Mg
2
Si–Si surface, even when only one H
2
O molecule was present. On the other hand, only a slight relaxation occurred on the Al
2
Cu–Cu surface with the formation of a Cu–H
2
O bond, and nearly no relaxation was seen on the other two surfaces (see
Figure S1
). It should be stressed, however, that there are many parameters that may influence the work function, such as surface relaxation, charge relaxation, and orientation of adsorbed H
2
O molecules. It is beyond the scope of this paper to be able to explain the relation between work function and adsorption energy for every investigated surface.
The above correlation between adsorption energy and work function provides complementary information about the reactivity of adsorbates towards the investigated surfaces ( Figure 4 ). Though there may be several key factors which determine both work function and adsorption energy, carefully designed simulations or experiments may further reveal their influence on these interfacial properties, as reported previously [ 21 , 42 ].
The possibility of H 2 O dissociation on each investigated surface is discussed next. Since OH and Cl were reported experimentally to compete on metal surfaces [ 4 ], the substitution of OH by Cl is also discussed with respect to the mechanism of initiation of localized corrosion.
3.2. H 2 O Dissociation and Cl Substitution of OH
Hydrolysis is common on aluminum surfaces exposed to a damp atmosphere or aqueous solution. The resulting hydroxyl species can generate a protective film on the aluminum surface as it may oxidize the aluminum surface, similar to oxygen species [ 43 ]. Therefore, the “dynamics” of the aqueous environment at the metal surface is of great interest for the metal performance in damp and aqueous environments.
The dissociation energy
( E d
) is a measure of the tendency of H
2
O dissociation. On the basis of the INT-aqueous ad-layer, the
E d
of H
2
O on the four surfaces was calculated by equation (2) with increasing
θ H 2 O
from 0.25 ML to 1 ML. Four or five dissociation paths were calculated at each H
2
O coverage, with several different top sites present on each investigated surface. To reduce the computing time, only up to 1 ML coverage was considered in each case, which is sufficient to represent the system. The minimum H
2
O dissociation energy,
E d min
,
versus H
2
O coverage is shown in
Figure 5
. More information about the dissociation energy for different paths is provided in the
supplementary materials (Figure S2
).
Figure 5. The minimum dissociation energy, E d min , as a function of H 2 O coverage for the four investigated surfaces.
The dissociation energy of H
2
O on Al and on Al
2
Cu–Cu was close to zero, nearly independent of H
2
O coverage, suggesting that water was unlikely to dissociate under the current calculation conditions. In contrast, the tendency for H
2
O dissociation on Mg
2
Si–Si was strong, although it became less favorable as the H
2
O coverage increased, indicating that the formed OH might inhibit further water dissociation. This was possibly due to limited surface sites available for the dissociated species.
E d min
on Mg
2
Si–Mg decreased monotonically with water coverage, and H
2
O dissociation became favorable when
θ H 2 O
was larger than 0.5 ML. This can be explained by electron transfer from Mg
2
Si–Mg to the water layer, as mentioned in the previous section. That is to say, the surface Mg atoms were oxidized, indicating that reaction (5) proceeded in the right direction. Then, reaction (6) was promoted by the electrons from (5), increasing the tendency of H
2
O dissociation.
Mg → Mg 2+ + 2e −
(5)
H 2 O + e − → H + OH −
(6)
On the basis of the dissociated ad-layers obtained above, ad-layers containing Cl were constructed by replacing the dissociated OH with one Cl on each investigated surface. The substitution energy (
E s
) values with increasing H
2
O are is listed in
Table S1
. The substitution of OH by Cl in most cases is endothermic (
E s
> 0), except for Al and Mg
2
Si–Si at
θ H 2 O
= 0.5 ML, which suggests that Cl can barely replace OH. One reason could be that Cl, upon substitution, disrupts the hydrogen bond networks between OH and H
2
O, which is energetically expensive [
44
]. Another possible reason is that Cl has a larger ionic radius than the OH group, making the substitution process unfavorable [
45
]. Cl substitution of OH was also found to be endothermic on NiO(111) when over 70% of OH species were replaced [
6
].
However, real metal surfaces possess different kinds of defects, and it is well known that Cl
−
ions can induce localized corrosion of many metallic materials. It is believed that defects or an applied electrode potential may drive the substitution process, as verified by other DFT studies [
6
,
46
]. Moreover, competitive adsorption has been observed experimentally [
4
]. Obviously, more complicated models relevant for real metal surfaces are needed for further calculations. Though the substitution process seems to be energetically favorable in only selected cases based on the current models and calculating parameters, the effect of Cl-containing ad-layers on the work function of Al(111) and Mg
2
Si–Si surfaces is discussed below for all coverages.
3.3. Effect on Work Function of Cl in the Aqueous Ad-Layer
On the basis of the above optimized structures within the three aqueous environments (INT, DIS, and SUB configurations), the work function of the four metallic surfaces upon adsorption of each ad-layer was calculated as a function of H 2 O coverage from 0.25 ML to 1 ML, see Figure 6 .
Figure 6. Work function change with adsorbed INT, DIS, SUB aqueous ad-layers on ( a ) Al and ( b ) Mg 2 Si–Si. Data for bare surfaces and INT aqueous ad-layer systems are from our earlier work [ 10 , 33 ].
The adsorption of pure intact water reduced the work function, compared to the value 4.16 eV for bare Al, as indicated by the dashed line in Figure 6 a. This was due to the slightly upward pointing of the water molecules ( Figure S1 ), which formed an upward dipole. In comparison with intact water adsorption, dissociation most likely increased the work function, except at coverage of 1 ML. This has been observed also on other metal surfaces, with OH being an electron acceptor [ 24 , 38 , 47 ]. Introduction of Cl raised the Al work function even further, as a result of a significant change of water molecules’ orientation upon adsorption of 1 ML of aqueous ad-layer, as seen in Figure S1 and Figure 7 a.
Figure 7. Optimized structure of Cl-containing aqueous ad-layer on Al ( a ) and Mg 2 Si–Si ( b ). Deformation electron density (DED) maps on Al sliced through ( c ) one H 2 O plane, ( d ) the Cl atom, ( e ) both the Cl atom and H 2 O. DED maps on Mg 2 Si–Si ( f ) and schematic charge distribution in the surface layers ( g ) based on Figure 7 f. In Figure 7 c–f, the blue and red colors indicate electron deficiency and accumulation, respectively.
Another important point depicted in Figure 7 a is that Cl stayed above the water layer. Thus, a direct interaction between Cl and the Al surface was largely screened by the water molecules. In agreement with experimental data, Cl − ions were observed to stay in the outer sphere of an Al 3+ ion when surrounded by Cl − and H 2 O molecules [ 48 ].
Intact water also decreased the work function of Mg 2 Si–Si at all coverages ( Figure 6 b). Different from the Al surface mentioned above, H 2 O dissociation or Cl substitution did not increase the work function. Cl adsorbed instead below the water layer, enabling Cl to interact directly with the surface at 1 ML of aqueous ad-layer adsorption ( Figure 7 b). On the other hand, the adsorption of Cl too close to the surface may be insufficient to create a surface dipole [ 14 , 49 ]. For comparison, the optimized structures for Mg 2 Si–Mg and Al 2 Cu–Cu upon adsorption of aqueous ad-layers containing Cl are also shown in Figure S4 in the Supplementary materials .
When focusing only on the Cl-containing aqueous ad-layer, we found that it increased the work function of Al but decreased that of Mg 2 Si–Si with respect to their bare surfaces (see Figure 6 ). To illustrate this phenomenon, deformation electron density (DED) maps on both surfaces are displayed in Figure 7 c–g, by taking SUB-1 ML as an example.
On the Al surface, there was electron transfer from the outmost Al surface to the aqueous layer (
Figure 7
c). As a result, a dipole pointing from the water layer to the Al surface was built, which explains the work function increase. Meanwhile, this electron transfer also implied that the Al surface was oxidized by the water ad-layer. In qualitative agreement with this, experimental data have shown that the surface potential of an Al matrix increased after immersion in NaCl solutions [
50
]. Similarly, the work function increased in an Al–Mg alloy was attributed to surface oxidation by the water ad-layer [
51
], whereas the work function increase of Cu(110) with subsequent introduction of Br
2
and H
2
O was attributed to the water dipole formed according to other experimental observations [
29
From Figure 7 d it is seen, however, that slight electron density rearrangements occurred within surface Al, which could partly compensate for the work function change caused by the oxidation effect mentioned above [ 52 ]. Comparing the scale bars of Figure 7 c,d, the work function increase by oxidation was dominant over that caused by rearrangements within the Al surface. Due to its strong electron affinity, Cl gained a concentrated electron density atop of it, while it created an electron depletion area around it, indicated by the color contrast in Figure 7 d. However, direct electron transfer from Cl to Al was absent. By slicing another atomic plane ( Figure 7 e), Cl was demonstrated to gain electrons from an adjacent H 2 O, indicating a possible electronic interaction between these two species.
The DED map of the Mg 2 Si–Si, sliced through Si–H and the metallic plane ( Figure 7 f), revealed strong atomic as well as electron rearrangements in the surface layer. The relaxation of the metallic surface may also contribute to the change in work function [ 49 ]. Electron transfer between Mg 2 Si–Si and the aqueous layer was missing, which was expected since a bare surface with large work function is more resistant to losing electrons [ 53 ]. For visualization, we marked the electron-depleted area with “+” (white), and the electron-rich area with “−” (grey). Then a net dipole pointing upwards was seen in the first metallic layer and the aqueous ad-layer ( Figure 7 g), resulting in a decreased work function.
To demonstrate the impact of the Cl-containing aqueous ad-layer on the relative nobility of IMP and Al under the current conditions, we calculated Volta potential differences between the IMPs and Al, i.e., V IMP − V Al , covered by a SUB aqueous ad-layer, as shown in Figure 8 . The data in Figure 8 show how the galvanic effect between the IMP and Al surfaces may vary depending on the Cl/H 2 O ratio in the ad-layer. Note that in the SUB aqueous ad-layer cases, since the concept of H 2 O coverage was also used here, the real ad-layer contained 1Cl + 1H + (n W -1) H 2 O. At 1 ML coverage, Cl occupied one of the surface sites of the calculation system, corresponding to a Cl/H 2 O ratio of 1:3.
Figure 8. Volta potential difference of Mg 2 Si–Si, Mg 2 Si–Mg, and Al 2 Cu–Cu relative to Al, with the adsorption of a Cl-containing aqueous ad-layer at different coverage levels.
The Volta potential difference data in Figure 8 indicate that upon ad-layer adsorption at 0.25 ML, with actually the adsorption of Cl + H on the Mg 2 Si–Si surface and of Cl + H + H 2 O on the Al 2 Cu–Cu surface, the two IMPs transformed from cathode (bare) to anode relative to Al, while Mg 2 Si–Mg remained anodic. As the coverage increased to 0.5 ML, the Volta potential difference of all the three IMPs relative to Al increased in comparison with a decrease in coverage, and the two Mg 2 Si surfaces terminated by Mg and Si remained anodic relative to Al, while Al 2 Cu–Cu changed back to cathode at 0.5 ML. Furthermore, as the coverage of the Cl-containing ad-layer reached 1 ML, all three IMP surfaces became less noble than the Al surface, with a rather large Volta potential difference (>1 V). As can be seen from the work function at SUB-1 ML in Figure 6 and Figure S3 , the Al work function was the highest among those of all the studied surfaces, mainly due to the strong oxidation phenomenon, as described in Figure 7 c.
Meanwhile, the initial galvanic couples Mg 2 Si–Si (cathode)/Al (anode) as well as Al 2 Cu–Cu (cathode)/Al (anode) were reversed with the adsorption of the SUB aqueous ad-layer, indicating a possible mechanism for the previously observed, so-called “nobility inversion” [ 54 ]. In all, this implies that different interactions (e.g., electron transfer and dipole formation) between the metallic surface and the aqueous ad-layer can result in changes of the galvanic effect. As has been recently calculated by L. Marks [ 18 ], Cl adsorption can increase the work function of Al 2 O 3 , which promotes heterogeneous oxidation in areas where Cl adsorbs, compared to areas where there is no Cl adsorption.
3.4. Short Summary and Implications
In this theoretical work, we studied the effect of Cl-containing aqueous ad-layers on the Volta potential difference between three intermetallic surfaces and Al. This was accomplished by DFT calculations of the energetics of adsorption and dissociation of H 2 O as well as by substitution of OH with Cl within the ad-layers, followed by calculations of the work function of the surfaces covered by the aqueous ad-layers. To begin with, explicit H 2 O molecules up to 2 ML adsorbed on Al, Mg 2 Si–Si, Mg 2 Si–Mg, and Al 2 Cu–Cu surfaces were studied. Then, one OH was introduced by dissociation of one adsorbed H 2 O molecule, and afterward one Cl was introduced into the aqueous ad-layer by substitution of the OH. In this way, a more realistic corrosive environment was constructed for the assessment of the effect of the Cl-containing ad-layer on the galvanic corrosion due to the coupling between the IMPs and the Al matrix. These three model scenarios correspond to molecular H 2 O adsorption, subsequent H 2 O dissociation, and competitive adsorption between Cl and OH on an Al alloy surface containing Mg 2 Si or Al 2 Cu particles.
The results showed that intact H 2 O adsorption on all four surfaces was exothermic when the H 2 O coverage increased to 1 ML ( Figure 3 ), and an enhanced H-bonding within the H 2 O ad-layer was observed. The introduction of one OH in the intact H 2 O ad-layer showed that H 2 O dissociation was not favorable on Al and Al 2 Cu–Cu under the examined calculation conditions, whereas H 2 O had a strong tendency to dissociate on Mg 2 Si–Si and Mg 2 Si–Mg ( Figure 5 ). By calculating the reaction free energy of H 2 O dissociation on the Al surface based on the methodology proposed by J.K. Nørskov [ 55 ], we found that H 2 O dissociation was favorable at a positive electrode potential (to be published elsewhere) [ 56 ]. In the future, the VdW corrections should also be taken into account because of the moderate modification of the adsorption energy produced by the VdW force, especially for energies around 0.1 eV [ 57 ].
When introducing one Cl into the aqueous ad-layer in replace of the OH, the present calculation indicated that the substitution process was endothermic in most of the calculation conditions ( Table S1 ). Since it is well known that chloride ions usually promote the corrosion of metals, further considerations are needed in the interpretation of the calculation results. Real metal surfaces contain different kinds of defects and are much more complicated than the calculation models used herein, which only represent single-crystal surfaces. On the other hand, DFT calculations, though only for simple systems, provide a fundamental understanding of the surface processes and interactions at the atomic scale. For example, when one Cl atom is added to the surface, DFT calculations can tell where electrons go and thus provide information about charge transfer or dipole formation, which can be viewed by the DED maps sliced at different atomic planes of the surface layer. Such information is helpful for understanding the effect of surface adsorbates on the work function of metal surfaces. The calculation of low-H 2 O-coverage models yielded some theoretical insights, while the model with one full monolayer (1 ML) of aqueous adsorbates was more relevant for corrosive environments.
The work function of the metallic surfaces with Cl together with H 2 O molecules under varying H 2 O coverages ( Figure 6 a,b) agrees with both theoretical and experimental studies [ 15 , 16 , 29 ]. On Al, the adsorbed H 2 O layer attracted electrons from Al surface atoms ( Figure 7 c), forming a dipole at the surface and causing an increase in the work function [ 29 ]. The effect of Cl, positioned nearly 5 Å above the surface, seemed to be screened by the H 2 O molecules. The DED map evidenced electronic interactions between Cl and adjacent H 2 O ( Figure 7 e). In contrast, the adsorption of SUB-1 ML aqueous ad-layer on Mg 2 Si–Si led to a serious rearrangement both structurally and electronically ( Figure 7 f). The upward dipole formed at the surface layer was the main reason for the work function decrease ( Figure 7 f,g).
Derived from the work function data, the Volta potential difference between the three IMP surfaces and Al covered by the adsorbates suggests that co-adsorption of Cl and H 2 O molecules makes the IMPs significantly less noble compared to Al at 1 ML coverage of the aqueous ad-layer ( Figure 8 ). This may provide an explanation for the effect of chloride ions in promoting localized corrosion of Al alloys. In this case, the dissolution of the IMPs is driven by micro-galvanic coupling with the Al matrix.
4. Conclusions
In this study, we constructed a series of aqueous ad-layers containing H 2 O molecules up to two monolayers and aqueous ad-layers with one OH group or Cl atom on Al(111), Mg 2 Si(111)–Si, Mg 2 Si(111)–Mg, and Al 2 Cu(110)–Cu surfaces, seeking to mimic a simplified but, yet, realistic system relevant for micro-galvanic corrosion of Al alloys containing Mg 2 Si or Al 2 Cu particles. DFT calculations were performed to obtain the energetics of adsorption of H 2 O ad-layers, during dissociation of H 2 O and subsequent substitution of OH by Cl, the work function of the surfaces covered by the different aqueous ad-layers, and Volta potential differences between the intermetallic surfaces and Al with a Cl-containing aqueous ad-layer. The following conclusions can be drawn:
For adsorption of pure H 2 O, there was an enhancement of H bonding under higher H 2 O coverage, which promoted stable adsorption on the surfaces and adsorption energies in a relatively narrow range between −0.8 and −0.5 eV for all surfaces investigated.
Spontaneous H 2 O dissociation was only observed on Mg 2 Si(111)–Si, where H was bound to surface Si atoms. A large dissociation tendency was seen on Mg 2 Si(111)–Si and also on Mg 2 Si(111)–Mg at higher H 2 O coverage. However, subsequent substitution of OH with Cl was largely prevented within explicit H 2 O ad-layers, especially at higher H 2 O coverage.
Electron transfer from surface Al atoms to the H 2 O ad-layer can explain the work function increase of Al(111) covered by the Cl-containing aqueous ad-layer, whereas atomic and electronic rearrangements on Mg 2 Si(111)-Si are the main reason for the work function decrease caused by the Cl-containing aqueous ad-layer.
The Volta potential difference between the intermetallic surfaces and Al(111) suggests that co-adsorption of Cl and H 2 O molecules makes the IMPs significantly less noble compared to Al(111) at 1ML coverage of the aqueous ad-layer.
Supplementary Materials
The supplementary materials are available online.
Author Contributions
Conceptualization, M.L.; Data curation, M.L., Y.J., J.P., C.L.; Formal analysis, M.L., Writing-original draft, M.L.; Review & Editing, Y.J., J.P., C.L.
Funding
We acknowledge the partial support by the Swedish Foundation for Strategic Research (SSF project RMA11-0090) and the National Natural Science Foundation of China (U1837602) and we also thank the support from the Overseas Expertise Introduction Project for Discipline Innovation (B12012) in China for promoting the international collaboration.
Acknowledgments
The constructive discussions from Henrik Grönbeck from Chalmers University of Technology are greatly appreciated. The scholarship from the Chinese Scholarship Council to Min Liu for her PhD study at KTH is acknowledged. We are also grateful to the Swedish National Infrastructure for Computing (SNIC) for the use of Swedish super-computing resource in the DFT calculations.
Conflicts of Interest
The authors declare no conflict of interest.
References and Note
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Figure 1. Top view depicting the different calculated configurations of adsorbed aqueous ad-layers: intact H 2 O (INT), water with one OH (DIS), and water with one Cl (SUB). The metallic surface for H 2 O adsorption is only a representative substrate. Note that in the SUB case, a surface bond is formed between the Cl and a surface atom.
Figure 2. Adsorption energy of H 2 O on Al, Mg 2 Si–Si, Mg 2 Si–Mg, and Al 2 Cu–Cu surfaces versus H 2 O coverage.
Figure 3. Optimized structure of H 2 O dissociation into OH and H (binding to surface Si) on Mg 2 Si–Si with 1ML H 2 O adsorption: ( a ) top view, ( b ) side view. Surface Si (Si s ) and bulk Si (Si b ) are indicated by dark and light orange color. Mg is in green, O in red, and H in white.
Figure 4. Plots of H 2 O adsorption energy on different surfaces versus work function under different H 2 O coverage (see the values without unit for each surface shown in the figure). The work function for each bare surface is highlighted by a dashed bar. Work function values for intact H 2 O adsorption were reported in our previous work [ 10 ].
Figure 5. The minimum dissociation energy, E d min , as a function of H 2 O coverage for the four investigated surfaces.
Figure 6. Work function change with adsorbed INT, DIS, SUB aqueous ad-layers on ( a ) Al and ( b ) Mg 2 Si–Si. Data for bare surfaces and INT aqueous ad-layer systems are from our earlier work [ 10 , 33 ].
Figure 7. Optimized structure of Cl-containing aqueous ad-layer on Al ( a ) and Mg 2 Si–Si ( b ). Deformation electron density (DED) maps on Al sliced through ( c ) one H 2 O plane, ( d ) the Cl atom, ( e ) both the Cl atom and H 2 O. DED maps on Mg 2 Si–Si ( f ) and schematic charge distribution in the surface layers ( g ) based on Figure 7 f. In Figure 7 c–f, the blue and red colors indicate electron deficiency and accumulation, respectively.
Figure 8. Volta potential difference of Mg 2 Si–Si, Mg 2 Si–Mg, and Al 2 Cu–Cu relative to Al, with the adsorption of a Cl-containing aqueous ad-layer at different coverage levels.
Sample Availability: Samples of the compounds are not available from the authors.
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Traveling in Europe with Family - My Family Travels
Traveling in Europe with Family
I think it is always a god idea to travel with family to Switzerland. You can always find a beautiful Boutique Hotel and as well the mountains and nature everywhere can bring you and your family a lot of peace.
Europe is an amazing destination for family travel. There’s so much to see and experience, from the historic landmarks to the diverse cultures and cuisines. And let’s not forget about the fun activities that the whole family can enjoy together, like theme parks, beaches, and outdoor adventures. If you’re planning a trip to Europe, don’t forget to do your research and plan ahead for a smooth and stress-free trip. And if you’re looking for another great destination, I highly recommend Bermuda – it’s a beautiful island paradise with stunning beaches, friendly locals, and plenty of fun activities for all ages. I’m sure you will enjoy your holiday in Bermudahttps://www.travelsafe-abroad.com/if you decide to go there one day.
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Europe is an amazing destination for family travel. There’s so much to see and experience, from the historic landmarks to the diverse cultures and cuisines. And let’s not forget about the fun activities that the whole family can enjoy together, like theme parks, beaches, and outdoor adventures.
I would recommend Italy as a great European country to visit with your family. Italy is a country that is rich in history and culture, and there are so many amazing sights to see and experiences to be had. From the stunning architecture and art of cities like Rome and Florence to the beautiful beaches and countryside of the Amalfi Coast, there is something for everyone in Italy. Additionally, Italian food is world-renowned and the country is home to many delicious and unique dishes that the whole family can enjoy. Overall, Italy is a wonderful destination for families and offers something for everyone.
I totally agree, we planned several trips to Italy for customers travelling with family. All their feedback were amazing!
Europe has so much to offer whether you’re a backpacker type of traveler or you want a luxurious trip, Europe got you. As a traveler who has just been to Rome, it was really the best time of my life. The trip wouldn’t be so smooth without the help of the local tour guidehttps://gowithguide.com/italy/romebut if you are more into adventure and down for challenges then a DIY trip would exciting as well.
There is also written in detail about Bishops park and Postman’s park – I really liked them
I am coming to Frankfurt for a Business visit. I would like to know if there is any good Chauffeur service available in Frankfurt that you guys can recommend.One of my friends recommended FBL service, Let me know if anyone knows about this.
Hi!If you would like to enjoy sun and warm water take a look at Southern Cyprus! Paphos, Coral Bay are wonderful places! [email protected] are some fine variants to find perfect summerhouse
https://www.cyprusvillas.com/villas.htmlI left an email and here it is a link
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Hello!I am student of the department of tourism at the University of Piraeus in Greece and i am excited that we are conducting a survey about Family Travel.I would be really happy if you completed this quick survey:https://docs.google.com/forms/d/1s1OjLYV6AtLcEgkaa6UsqtxjVCnLQ1NMjTGANmOqyAw/editThank you very much!
Guys, hello everyone! I love traveling around Europe with my parents! Our last trip was to Germany. And we’re utterly in awe. We didn’t know where to go and what to see (except for the overused sights). My dad started looking on the Internet for a list of different places to walk or relax and found an exciting guide to Germany . And then it started …. all three days, we constantly walked, went to interesting museums, drank the most delicious beer and ate the most delicious Bavarian sausages. To be honest, it was the best trip of my entire life.
wow still you guys made that trip awesomehats off to you
If you’re planning a holiday in Sweden, come visithttps://cabinsinsweden.com/. They have the most amazing cabins that you can stay in. By the lake or near a river, whatever suits you the most. It’s the perfect holiday destination in wintere – lots of snow and Christmas vibes. Greetings from London!
I was recently in the Maldives. It was the best vacation of my life!
If you want to visit Barcelona this summer, which it is a fantastic idea according with all the culture, family and leisure offer that you can find in this mediterranean city, I recommend you to stay in a Barcelona luxury apartment called Mercedes Heritage rather than in a hotel because there you can enjoy of all commodities (the best of a house and the best of a hotel) and being in a very convenient location.
Hi,i was reading and i taught i could help. if i,m a travel designer i will be happy to craft a tour for you if you like. With amazing discounts.Thanks
I’m visiting Chernobyl with chernobyl tours in July (been watching the HBO series ‘Chernobyl’, would love to visit Pripyat!), and have 3 days in Kyiv after. Good techno club recommendations to go to at night are also welcome.
I’d recommend one of theseYoga retreats, it will be good for both your soul and body
Travelling to new places is my hobby. I love to gather interesting information related to that place. Iceland is such a wonderful place to visit. I had visited in 2019 at that time I had seen beautiful waterfalls, ice caves and volcanoes. I recommended Discover Iceland for my trip.
I’m so envy of you guys folks! I’m still waiting to get my 2nd vaccine and start travelling in Europe again. My kids and I are planning on renting a 4×4 and visit all sorts of places in Italy and Greece this summer. We’ve been doing trips like this for the past four years with the exception of last year due to Covid restrictions on Americans. Hopefully we’ll join you guys soon!
Last year I was lucky enough to visit a very interesting place. Pripyat in general has such a powerful atmosphere and energy that you can’t feel anywhere else in the world. And here is the information I took at a specialized resource chernobyl.org.uk/ where the history and stories about Chernobyl are fully described, as well as all of the possible risks associated with such a trip. But all went well and if anyone has not been there yet, I recommend confidently)
The best way to make a low-budget trip is to walk more and to rest a hostel bed. that´s all.
Hii,If you want to travel to Europe with family then you can visit the Amalfi Coast. I visited in September last year and I fell in love with the place. The scenery is dramatic, and breathtakingly beautiful, the food is superb and the Italian culture is so rich and welcoming.
What do you guys think about this Travel blog?
HelloIf you may be travelling with family then Europe is amazing with its stuffed with culture, art and good food & music.
How about tours in other cities of Ukraine. I think the most populous is Chernobyl but there are a lot of small cities like Chernihiv. I would advise to visit them too.
We cover the Pembrokeshire region of Wales (UK). Few people think of the UK for a place to visit, but we have some fantastic coastal areas, especially in Pembrokeshire!
Marloes Sands Beach is one of my personal favourites!
This stunning beach has been the location for several Hollywood movie backdrops, is packed with wildlife and is near the lovely town of Pembroke and its 1000yr old Pembroke Castle!
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Cells | Free Full-Text | Decidua Basalis Mesenchymal Stem Cells Favor Inflammatory M1 Macrophage Differentiation In Vitro
Placental mesenchymal stem cells from maternal decidua basalis tissue (DBMSCs) are promising cells for tissue repair because of their multilineage differentiation and ability to protect endothelial cells from injury. Here, we examined DBMSC interaction with macrophages and whether this interaction could modulate the characteristics and functions of these macrophages. We induced monocytes to differentiate into M1-like macrophages in the presence of DBMSCs. DBMSC effects on differentiation were evaluated using microscopy, flow cytometry, and ELISA. DBMSC effects on M1-like macrophage induction of T cell function were also examined. The culture of DBMSCs with monocytes did not inhibit monocyte differentiation into M1-like inflammatory macrophages. This was confirmed by the morphological appearance of M1-like macrophages, increased expression of inflammatory molecules, and reduced expression of anti-inflammatory molecules. In addition, DBMSCs did not interfere with M1-like macrophage phagocytic activity; rather, they induced stimulatory effects of M1-like macrophages on CD4+ T cell proliferation and subsequent secretion of inflammatory molecules by T cells. We showed that DBMSCs enhanced the differentiation of M1-like inflammatory macrophages, which function as antitumor cells. Therefore, our findings suggest that DBMSCs are inflammatory cells that could be useful in cancer treatment via the enhancement of M1- like macrophages.
Decidua Basalis Mesenchymal Stem Cells Favor Inflammatory M1 Macrophage Differentiation In Vitro
by
Mohamed H. Abumaree 1,2,* ,
Seham Al Harthy 3 ,
Abdullah M. Al Subayyil 1 ,
Manal A. Alshabibi 3 ,
Fawaz M. Abomaray 4,5 ,
Tanvier Khatlani 1 ,
Bill Kalionis 6 ,
Mohammed F. El- Muzaini 7 ,
Mohammed A. Al Jumah 1 ,
Dunia Jawdat 1 ,
Abdullah O. Alawad 3 and
Ahmed S. AlAskar 1,8,9
1
Stem Cells and Regenerative Medicine Department, King Abdullah International Medical Research Center, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, P.O. Box 22490, Riyadh 11426, Mail Code 1515, Saudi Arabia
2
College of Science and Health Professions, King Saud Bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, P.O. Box 3660, Riyadh 11481, Mail Code 3124, Saudi Arabia
3
National Center for Stem Cell Technology, Life Sciences and Environment Research Institute, King Abdulaziz City for Science and Technology, P.O Box 6086, Riyadh 11442, Saudi Arabia
4
Department of Clinical Science, Intervention and Technology, Division of Obstetrics and Gynecology, Karolinska Institutet, 14186 Stockholm, Sweden
5
Center for Hematology and Regenerative Medicine, Karolinska Institutet, 14186 Stockholm, Sweden
6
Department of Maternal-Fetal Medicine Pregnancy Research Centre and University of Melbourne. Department of Obstetrics and Gynaecology, Royal Women’s Hospital, Parkville, Victoria 3052, Australia
7
Department of Obstetrics and Gynaecology, King Abdulaziz Medical City, Minstry of National Guard Health Affairs, P.O. Box 3660, Riyadh 11481, Mail Code 3124, Saudi Arabia
8
College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, P.O. Box 3660, Riyadh 11481, Mail Code 3124, Saudi Arabia
9
Adult Hematology and Stem Cell Transplantation, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, P.O. Box 22490, Riyadh 11426, Mail Code 1515, Saudi Arabia
*
Author to whom correspondence should be addressed.
Cells 2019 , 8 (2), 173; https://doi.org/10.3390/cells8020173
Received: 23 December 2018 / Revised: 25 January 2019 / Accepted: 28 January 2019 / Published: 18 February 2019
(This article belongs to the Special Issue Immunomodulation by Mesenchymal Stem Cells )
Abstract
Placental mesenchymal stem cells from maternal decidua basalis tissue (DBMSCs) are promising cells for tissue repair because of their multilineage differentiation and ability to protect endothelial cells from injury. Here, we examined DBMSC interaction with macrophages and whether this interaction could modulate the characteristics and functions of these macrophages. We induced monocytes to differentiate into M1-like macrophages in the presence of DBMSCs. DBMSC effects on differentiation were evaluated using microscopy, flow cytometry, and ELISA. DBMSC effects on M1-like macrophage induction of T cell function were also examined. The culture of DBMSCs with monocytes did not inhibit monocyte differentiation into M1-like inflammatory macrophages. This was confirmed by the morphological appearance of M1-like macrophages, increased expression of inflammatory molecules, and reduced expression of anti-inflammatory molecules. In addition, DBMSCs did not interfere with M1-like macrophage phagocytic activity; rather, they induced stimulatory effects of M1-like macrophages on CD4
+
T cell proliferation and subsequent secretion of inflammatory molecules by T cells. We showed that DBMSCs enhanced the differentiation of M1-like inflammatory macrophages, which function as antitumor cells. Therefore, our findings suggest that DBMSCs are inflammatory cells that could be useful in cancer treatment via the enhancement of M1- like macrophages.
Keywords:
placental stem cells
;
inflammation
;
M1 macrophages
;
inflammatory cells
1. Introduction
Macrophages are leukocytes and function as antigen presenting cells with distinctive role in tissue homeostasis [ 1 ]. Macrophages are generally distributed throughout many tissues and help repair injured tissues in several human diseases [ 2 ]. Monocytes are recruited from the circulation into tissues by chemotactic signals initiated in response to physiological phenomena or pathological insults, where they differentiate into macrophages [ 2 ]. In addition, macrophages are also involved in the clearance of dead cells as part of their role in the later phases of tissue homeostasis and repair [ 2 ]. Macrophages are grouped into classically activated macrophages (M1 inflammatory macrophages) and alternatively activated macrophages (M2 anti-inflammatory macrophages) [ 2 ].
During acute inflammation, M1 macrophages are activated by agonists recognized by Toll-like receptors (TLRs) and by cytokines secreted from T helper 1 (Th1) cells, such as interferon-γ (IFN-γ). This increases their phagocytic activity against pathogens, stimulates their production of inflammatory cytokines, such as interleukin-1β (IL-1β), IL-12, and tumor necrosis factor-α (TNF-α); induces their production of reactive oxygen species; and enables their ability to present antigens to T cells through major histocompatibility complex (MHC) class II molecules [
3
,
4
]. In addition, M1 macrophages function as tumor suppressive cells through the activation of a Th1 cell inflammatory response against tumor cells [
5
].
Conversely, macrophages are induced to differentiate into the M2 phenotype by cytokines secreted by Th2 cells, such as IL-4 and IL-13. These cells are characterized by secretion of high levels of the anti-inflammatory cytokine IL-10, low levels of inflammatory cytokines, increased ability to inhibit the adaptive immune cell response, and increased cell-surface expression of CD14 (pattern recognition receptor), CD36 (class B scavenger receptor), CD163 (hemoglobin scavenger receptor), CD204 (class A scavenger receptor), CD206 (mannose receptor), and B7-H4 (co-inhibitory molecule) [ 2 , 3 , 4 , 6 ]. After an acute inflammatory phase, M2 macrophages become activated to resolve inflammation and induce tissue remodeling and wound repair [ 2 , 3 , 7 ]. In addition, M2 macrophages provide an anti-inflammatory microenvironment that is essential for tumor growth and progression [ 8 ].
Protective therapeutic effects of macrophages in response to various tissue injuries, including the central nervous system, have also been demonstrated [
9
]. For instance, M1 macrophages induce neuronal damage, whereas M2 macrophages promote neuronal regeneration [
9
]. In addition, since macrophages have an important role in the development of tumor, they are a target for potential therapeutic strategy [
1
]. Few potential strategies have been proposed to treat cancers by preventing the recruitment of macrophages into the microenvironment of tumor and promote the differentiation of macrophages into the anti-tumorigenic phenotype [
1
].
Mesenchymal stem cells, also known as multipotent stromal cells (MSCs), modulate the functions of innate and adaptive immune cells, including lymphocytes (T cells, B cells, and natural killer cells) and macrophages as well as dendritic cells [ 10 ]. We have previously shown that MSCs from chorionic villi of the human term placenta (pMSCs) induce an anti-inflammatory phenotype in human macrophages [ 6 ] and dendritic cells [ 11 ], and inhibit proliferation of T cells [ 11 ]. Furthermore, we previously reported the isolation and characterization of mesenchymal stem/multipotent stromal cells from maternal decidua basalis tissue (DBMSCs) of the human term placenta [ 12 ]. These DBMSCs express a unique combination of molecules involved in many important cellular functions including migration, proliferation, differentiation, immunomodulation, and blood vessel formation [ 12 ]. In addition, DBMSCs protect endothelial cells from injury induced by monocytes [ 13 ]. These phenotypic and functional characteristics make DBMSCs suitable for cellular therapy. However, the modulatory effects of DBMSCs on human macrophages are currently unknown.
For DBMSCs to be used in cellular therapy, it is essential to determine their effects on the phenotypic properties and functional activities of macrophages. Here, we examined whether the interaction of DBMSCs with human monocytes would result in shifting monocyte differentiation from M1 inflammatory macrophages into M2 anti-inflammatory macrophages, and to determine the characteristic and functions of these differentiated macrophages. We found that DBMSCs enhanced the differentiation of M1 inflammatory macrophages, which produce inflammatory molecules that are known for their anticancer properties. In addition, DBMSCs induced M1 macrophage stimulation of CD4
+
T cell proliferation and secretion of inflammatory cytokines. DBMSCs have the potential to treat cancer by inducing the anticancer activities of M1 macrophages directly on cancer cells or through T cell stimulation.
2. Experimental Section
2.1. Ethics, Collection of Human Placentae, and Adult Peripheral Blood
The institutional review board at King Abdulla International Medical Research Centre (KAIMRC), Saudi Arabia, approved this study. Samples [placentae from uncomplicated human pregnancies (38–40 weeks of gestation) and peripheral blood samples from healthy adult participants] were used immediately after obtaining informed consent. KAIMRC research guidelines and regulations were followed to conduct all clinical and experimental procedures of this study.
2.2. Isolation and Culture of DBMSCs
MSCs were isolated from the decidua basalis (DBMSCs) of the maternal part of human term placenta using our previously published method [ 12 ]. DBMSCs were then cultured in a complete DBMSC culture medium (DMEM-F12 medium containing 10% MSCFBS (mesenchymal stem cell certified fetal bovine serum, catalogue number 12-662-011, Life Technologies, Grand Island, NE, USA), and antibiotics (100 µg/mL streptomycin and 100 U/mL Penicillin)), and then incubated at 37 °C in a humidified atmosphere containing 5% CO 2 and 95% air (a cell culture incubator). DBMSCs (passage 3) of 30 placentae were used in this study.
2.3. Isolation of Human Monocytes
Mononuclear cells from peripheral blood (PBMNCs) of 30 normal healthy subjects were isolated using our previously published method [ 14 ]. Monocytes were isolated using human Monocyte Isolation Kit II (catalogue number 130-091-153, Miltenyi Biotec, Bergisch Gladbach, Germany) and a magnetic cell separation system (MACs: Miltenyi Biotec) as we previously described [ 14 ]. Trypan blue was used to determine the viability of monocytes while the purity was evaluated using anti-CD14 monoclonal antibody (R&D Systems, Systems, Abingdon, UK) in a flow cytometry. The purity was greater than 98%.
2.4. Culture of Monocyte Derived Macrophages with DBMSCs
M1 macrophages were differentiated from monocytes as we previously described [ 6 ]. Monocytes were seeded in 6-well plates in M1 macrophage differentiation medium (RPMI-1640 medium containing 50 ng/mL GM-CSF (R and D Systems), 10% FBS, 2 mM L-glutamine, and antibiotics indicated above), and then cultured at 37°C as described above for six days ( Figure 1 ). For conditioned medium experiments (CMDBMSC), supernatant were prepared from the culture of unstimulated DBMSCs as previously described [ 6 ], and then added to the culture of monocytes ( Figure 1 ). For the coculture experiments [soluble factor (SFDBMSC) and intercellular direct contact (ICDBMSC)], cells (DBMSCs and monocytes) were separated by transwell chamber membrane culture system (catalogue number 657640, ThinCert™ Cell Culture Inserts, Greiner Bio-One, Germany). For the experiments of SFDBMSC, DBMSCs were seeded on the upper compartments while monocytes were seeded in the lower compartment ( Figure 1 ). For the experiments of ICDBMSC, DBMSCs were seeded on the reverse side of the membrane while monocytes were seeded on the upper side of the membrane ( Figure 1 ). These two culture systems separate DBMSCs from monocyte-derived macrophages and therefore allow macrophage harvesting without contamination by DBMSCs. In all culture systems, cells were cultured in M1 macrophage differentiation medium (above). On Day 7, macrophages were harvested with TrypLE™ Express detachment solution (Life Technologies) and characterized using macrophage markers, MHC molecules, and costimulatory molecule ( Table 1 ) in a flow cytometry technique as we previously described [ 6 ]. In some experiments, CMDBMSC, SFDBMSC, and ICDBMSC were added to the culture of monocyte-derived M1 macrophages on either Day 3 or Day 7 and then incubated for further three days and characterized as described above. In selected experiments, we added CMDBMSC, SFDBMSC, and ICDBMSC to the initial culture of monocyte- derived M1 macrophages incubated in RPMI-1640 medium without GM-CSF (spontaneous differentiation), incubated as described above, and the morphological changes were characterized by microscope examination. Different concentrations of DBMSC conditioned medium, 10, 20, 30, 40, 50, 60, 80, and 100% were tested. For SFDBMSC and ICDBMSC experiments, different ratios were used (1:1, 1:5, and 1:10 DBMSCs: monocyte-derived macrophages). Viability of macrophages were assessed using Trypan blue staining.
Figure 1.
M1 macrophage culture system. Untreated control experiment consisted of M1 macrophages cultured on a surface of 6-well culture plate in a medium containing GM-CSF, CMDBMSC experiment consisted of M1 macrophages cultured on a surface of 6-well culture plate in a medium containing GM-CSF and CMDBMSC (conditioned medium), SFDBMSC (soluble factor), and ICDBMSC (intercellular direct contact) experiments. In SFDBMSC and ICDBMSC experiment, cells (DBMSCs and monocytes) were separated by transwell chamber membrane culture system. For the experiments of SFDBMSC, DBMSCs were seeded on the upper compartments while monocytes were seeded in the lower compartment. For the experiments of ICDBMSC, DBMSCs were seeded on the reverse side of the membrane while monocytes were seeded on the upper side of the membrane. GM-CSF medium was added to SFDBMSC and ICDBMSC experiments. Effects of human DBMSCs on the morphology of human monocytes differentiated into macrophages by GM-CSF. (
A
–
F
) Represent phase-contrast microscopic images showing monocyte (round-shaped morphology) differentiation into M1-like macrophages (fried egg-shaped morphology) after six days of culture in a medium containing GM-CSF (
A
), in a medium containing GM-CSF and DBMSCs at a 20:1 monocyte: DBMSC ratio (
B
), at a 10:1 monocyte: DBMSC ratio (
C
), at a 1:1 monocyte: DBMSC ratio (
D
), in the presence of 10% CMDBMSC (
E
), or in the presence of 20% CMDBMSC (
F
). (
G
–
K
) Representative phase-contrast microscopic images showing monocyte-like cells after six days of culture in a medium containing GM-CSF and 30% CMDBMSC (
G
), 40% CMDBMSC (
H
), 50% CMDBMSC (
I
), 60% CMDBMSC (
J
), 80% CMDBMSC (
K
), or 100% CMDBMSC (
L
). Experiments were carried out in duplicate and repeated 30 times using 30 individual preparations of both monocyte-derived macrophages and DBMSCs. Scale bars represent 50 µm.
Table 1. Markers used in this study.
Before using DBMSCs in the coculture systems (SFDBMSC and ICDBMSC), DBMSCs were treated with 25 µg/mL Mitomycin C to inhibit their proliferation as we previously described [
6
]. To determine the reversibility of DBMSC effects on the differentiation of macrophages, CMDBMSC, SFDBMSC, and ICDBMSC were removed after three days of culturing with monocyte, and macrophages were then washed thoroughly and re-cultured in fresh M1 macrophage differentiation (above) for another three days. The negative control was monocyte-derived macrophages cultured alone in M1 macrophage differentiation. Experiments were carried out in duplicate and repeated 30 times using 30 individual preparations of both monocyte-derived macrophages and DBMSCs.
2.5. Phagocytic Activity of Monocyte-Derived Macrophages
The phagocytic activity of monocyte-derived macrophages was studied using the CytoSelect™ phagocytosis kit (catalogue number CBA-224, Cell Biolabs, San Diego, CA, USA) as we previously published [ 6 ]. Briefly, macrophages were harvested from the three culture systems described above, and their phagocytic activities were then measured as we previously described [ 6 ]. Negative controls were monocyte-derived macrophages cultured alone in M1 macrophage differentiation, and macrophages cultured without Zymosan particles. Experiments were carried out in duplicate and repeated 10 times using 10 individual preparations of both monocyte-derived macrophages and DBMSCs.
2.6. T Cell Proliferation Assay
Monocyte-derived macrophages cultured alone or cultured with DBMSCs in the culture system described above were harvested, washed with PBS, treated with 25 μg/mL Mitomycin C (described above), and different ratios of macrophages were then cultured with allogeneic CD4
+
T cells (1:5, 1:10, and 1:20 macrophages: T cells) in triplicate in 96-well flat-bottomed plates. T cells were purified from PBMCs using CD4
+
T Cell isolation Kit (catalogue number 130-096-533, Miltenyi Biotec) as we previously described [
11
]. All cultures were carried out in RPMI-1640 medium containing 10% FBS, 2 mM L-glutamine, and antibiotic as indicated above. After four days, T cell proliferation was measured using a tetrazolium compound [3-(4,5-dimethylthiazol-2-yl)-5-(3-carboxymethoxyphenyl)-2-(4-sulfophenyl)-2Htetrazolium, inner salt; MTS] kit (catalogue G5421, CellTiter 96® Aqueous Non-Radioactive Cell Proliferation Assay, Promega, Germany) as we previously described [
11
]. Experiments were carried out in triplicate and repeated 10 times using 10 individual preparations of T cells and macrophages harvested from 10 individual experiments of macrophages cultured with DBMSCs (CMDBMSC, SFDBMSC, and ICDBMSC). Results are presented as means of standard errors (± SE). T cell cultured alone served as a negative control.
2.7. Quantification of Human Cytokines
ELISA Kits (R&D Systems or MyBiosource, California, USA) were used according to the manufacturer’s instructions to quantify IL-1β, IL-6, IL10, IL-12, and IFN-γ in the supernatants obtained from macrophages cultured alone or with DBMSCs in the culture systems described above and from the T cell cultured alone or cultured with macrophages as described above. Complete RPMI-1640 and DMEM-F12 media were included as a negative control.
2.8. Flow Cytometry
Cells (1 × 10 5 ) were stained with antibodies listed in Table 1 for 30 min. Flow cytometry was then performed as we previously described [ 13 ]. Negative controls were cells stained with FITC or PE-labeled mouse IgG isotype antibody.
2.9. Statistical Analysis
GraphPad Prism 5 was used to analyze data using non-parametric tests (Mann–Whitney U and Kruskal–Wallis). Data were deemed statistically significant if p < 0.05.
3. Results and Discussion
3.1. DBMSCs Effect on M1-like Macrophage Differentiation from Human Monocytes
We used MSCs from decidua basalis of human term placenta (passage 3) as previously isolated and characterized by us [
12
]. DBMSCs at passage 3 are positive (> 95%) for MSC markers (CD44, CD90, CD105, CD146, CD166, HLA-ABC) and negative for hematopoietic markers (CD14, CD19, CD40, CD45, CD80, CD83, CD86, HLA-DR). DBMSCs at passage 3 also differentiate into adipocytes, chondrocytes and osteocytes [
12
]. Therefore, DBMSCs at passage 3 were used in all experiments. Monocytes were isolated from healthy human peripheral blood and induced to differentiate into M1-like macrophages using GM-CSF. After six days, cells exhibited a fried egg morphology a characteristic of M1-like macrophages (
Figure 1
A) [
6
]. These M1-like macrophages expressed CD14 (monocytic marker), but lacked expression of CD1a (dendritic cell marker) (data not shown).
To study the effect of DBMSCs on macrophages, monocytes were cultured in an M1 macrophage differentiation medium in SFDBMSC and ICDBMSC culture systems at different cell ratios of macrophages: DBMSC (1:1, 10:1, and 20:1) and with 10, 20, 30, 40, 50, 60, 80, and 100% (
v
/
v
) CMDBMSCs. DBMSCs had no effect on the viability of macrophages as their viability was > 90%. Compared to untreated monocyte-derived macrophages, none of the DBMSC treatments inhibited the differentiation of monocytes into M1 macrophages, as cells exhibited a fried egg-shaped morphology indicative of M1 macrophages (
Figure 1
B–F). However, with increasing numbers and concentrations of DBMSCs, cells were smaller in size, showing a round morphology with reduced ability to adhere, suggesting that they were monocytes (
Figure 1
G–L). Cells that were differentiated in the presence of DBMSCs expressed CD14 in the absence of CD1a (data not shown).
Next, we evaluated whether monocytes differentiated in the presence of DBMSCs at a ratio of 20:1 macrophages: DBMSC for both ICDBMSC and SFDBMSC culture systems and with 20% CMDBMSC expressed molecules characteristic of macrophages, as listed in Table 1 . These experimental conditions (20:1 macrophages: DBMSC ratio and 20% CMDBMSC) were used in all subsequent experiments. Expression of these functional markers was studied using flow cytometry. Their expression was recorded as mean fluorescence intensity (MFI). After six days in culture, compared to untreated macrophages, DBMSCs (CMDBMSC or SFDBMSC) significantly increased the expression of CD14 and CD163 on macrophages, p < 0.05 ( Figure 2 A and B). In addition, DBMSCs (SFDBMSC) significantly increased the expression of CD206 on macrophages compared with that on untreated macrophages, p < 0.05 ( Figure 2 D). By contrast, ICDBMSCs significantly decreased expression of CD163, CD204, CD206, and CD36 on macrophages compared to untreated macrophages, p < 0.05 ( Figure 2 B–E), but there was no significant effect on the expression of CD14 and B7-H4, p > 0.05 ( Figure 2 A and F). Similarly, CMDBMSCs and SFDBMSCs had no significant effect on either the expression of CD204, CD36, or B7-H4 on macrophages compared with to untreated macrophages, p > 0.05 ( Figure 2 C,E, and F). Finally, CMDBMSCs did not significantly affect the expression of CD206 on macrophages compared to untreated macrophages, p > 0.05 ( Figure 2 D).
Figure 2.
Effects of human DBMSCs on the expression of cell surface molecules CD14, CD163, CD204, CD206, CD36, and B7H4 on human monocytes differentiated into macrophages by GM-CSF, as analyzed by flow cytometry. After six days in culture, compared to untreated macrophages, CMDBMSCs significantly increased expression of CD14 (
A
) and CD163 (
B
) on macrophages while having no significant effect (
p
> 0.05) on expression of CD204 (
C
), CD206 (
D
), CD36 (
E
), and B7H4 (
F
) on macrophages. Compared to untreated macrophages, SFDBMSC significantly increased expression of CD14 (
A
), CD163 (
B
), and CD206 (
D
) on macrophages while having no significant effects (
p
> 0.05) on expression of CD204 (
C
), CD36 (
E
), and B7H4 (
F
) on macrophages. In addition, ICDBMSCs significantly decreased expression of CD163 (
B
), CD204 (
C
), CD206 (
D
) and CD36 (
E
) on macrophages while having no significant effects (
p
> 0.05) on expression of CD14 (
A
) and B7H7 (
F
) compared with that on untreated macrophages. Levels of expression are presented as median fluorescent intensity (MFI) as determined by flow cytometry. Experiments were carried out in duplicate and repeated 30 times using 30 individual preparations of both monocyte-derived macrophages and DBMSCs. *
p
< 0.05. Bars represent standard errors.
Next, the effects of DBMSCs on macrophage differentiation were evaluated after adding DBMSCs to monocyte cultures on Day 3 or Day 7 and culturing for a further three days. All DBMSC treatments showed similar effects on M1-like macrophage differentiation of monocytes as described above (data not shown). These results suggest that DBMSCs affect macrophage differentiation at various times during culture. Similarly, all three DBMSC culture systems showed a similar effects on M1-like macrophage differentiation after coculture with monocytes in the absence of GM-CSF for seven days (data not shown), suggesting that DBMSCs possess immunostimulatory properties.
3.2. DBMSC Effects on M1-like Macrophage Differentiation Are Irreversible
Next, we evaluated the reversibility of the effects of DBMSCs on the differentiation of macrophages. DBMSCs were removed from the monocyte cultures on Day 3, and monocyte-derived macrophages were then washed and cultured again in fresh M1-like macrophage differentiation medium without DBMSCs for a further three days. M1-like macrophage differentiation occurred under these experimental conditions, as evidenced by macrophages exhibiting the fried egg-shaped morphology of M1-like macrophages on Day 7. Moreover, these M1-like macrophages expressed similar levels of CD14, CD163, CD204, CD206, and B7-H4 to those of M1-like macrophages differentiated in the presence of DBMSCs for six days (
Figure 3
). These results suggest that the effect of DBMSCs on monocyte differentiation is irreversible.
Figure 3.
Reversibility effects of DBMSCs on macrophage differentiation. Human monocytes differentiated into macrophages by GM-CSF in the presence of DBMSCs. DBMSCs were removed from the monocyte cultures on Day 3, and monocyte-derived macrophages were then washed and cultured again in fresh M1-like macrophage differentiation medium without DBMSCs for a further three days. Macrophage differentiation was analyzed by morphological analysis using microscopic examination (Panels
A
,
B
, and
C
) and flow cytometric analysis of cell surface molecules (CD14, CD163, CD204, CD206, and B7-H4). (
A
–
C
) Representative phase-contrast microscopic images showing monocyte (round-shaped morphology) differentiation into M1-like macrophages (fried egg-shaped morphology) after six days of culture (
A
), in a medium containing GM-CSF and DBMSCs at a 20:1 monocyte: DBMSC ratio (
B
), in the presence of 20% CMDBMSC (
C
)
.
After six days in culture, compared to untreated macrophages, CMDBMSCs significantly increased the expression of CD14 (
D
) and CD163 (
E
) on macrophages, but had no significant effect on the expression of CD204 (
F
), CD206 (
G
), and B7-H4 (
H
) on macrophages. Compared to untreated macrophages, SFDBMSC significantly increased the expression of CD14 (
D
), CD163 (
E
), and CD206 (
G
) on macrophages, but had no significant effect on the expression of CD204 (
F
), and B7-H4 (
H
) on macrophages. In addition, ICDBMSCs significantly decreased the expression of CD163 (
E
), CD204 (
F
), CD206 (
G
) on macrophages, but had no significant effect on the expression of CD14 (
D
) and B7-H7 (
H
) compared with the effect on untreated macrophages. Levels of expression are presented as median fluorescent intensity (MFI) as determined by flow cytometry. Experiments were carried out in duplicate and repeated 10 times using 10 individual preparations of both monocyte-derived macrophages and DBMSCs. *
p
< 0.05. Bars represent standard errors.
3.3. DBMSC Effects on Expression of CD80, CD86, CD273, CD274, and HLA-DR on Macrophages
To determine the effect of DBMSCs on monocyte-derived macrophages with respect to macrophage function, a variety of immune functional markers ( Table 1 ) were examined using flow cytometry, and expression was recorded as MFI. After six days in culture, DBMSC-treated macrophages in the three culture systems expressed significantly less CD86 than untreated macrophages, p < 0.05 ( Figure 4 C), Table 2 . In addition, treatment with ICDBMSCs was associated with significantly decreased expression of co-inhibitory molecules (CD273 and CD274) on macrophages compared with that on untreated macrophages, p < 0.05 ( Figure 4 D,E), Table 2 . HLA-DR (antigen presenting molecule) and CD80 (co-stimulatory molecule) expression did not differ between treated and untreated macrophages for any culture system, p > 0.05 ( Figure 4 A,B), Table 2 . Similarly, CMDBMSC and SFDBMSCs did not significantly affect the expression of CD273 and CD274 on macrophages compared with that on untreated macrophages, p > 0.05 ( Figure 4 D,E), Table 2 . These data indicate that ICDBMSC maintained the antigen presentation activity of macrophages and with immunostimulatory effect by maintaining the expression of co-stimulatory molecule (CD80) and reducing the expression of the co-inhibitory molecules (CD273 and CD274).
Figure 4.
Effects of human DBMSCs on expression of the cell surface molecules HLADR, CD80, CD86, CD273, and CD274 by human monocytes differentiated into macrophages by GM-CSF, as analyzed by flow cytometry. After six days in culture, compared to untreated macrophages, CMDBMSCs and SFDBMSCs had no significant effects (
p
> 0.05) on expression of HLA-DR (
A
), CD80 (
B
), CD273 (
D
), and CD274 (
E
) on macrophages while significantly decreasing expression of CD86 (
C
). Compared to untreated macrophages, ICDBMSCs had no significant effects (
p
> 0.05) on expression of HLA-DR (
A
) and CD80 (
B
) on macrophages while significantly decreasing expression of CD86 (
C
), CD273 (
D
), and CD274 (
E
) on macrophages. Levels of expression are presented as median fluorescent intensity (MFI) as determined by flow cytometry. Experiments were carried out in duplicate and repeated 30 times using 30 individual preparations of both monocyte-derived macrophages and DBMSCs. *
p
< 0.05. Bars represent standard errors.
Table 2. DBMSC (CMDBMSC, SFDBMSC, and ICDBMSC) effects on macrophage expression of different functional markers, costimulatory molecules, co-inhibitory molecules, antigen presenting molecule, inflammatory cytokines, and anti-inflammatory markers as compared to untreated macrophages by flow cytometry recorded by mean of fluorescent intensity (MFI). Increased (↑, p < 0.05), decreased (↓, p < 0.05)), and no change ( p > 0.05).
3.4. DBMSCs Modulate Expression by Macrophages of IL-1β, IL-6, IL-8, IL-12, IFN-γ, and TNF-α
Next, we determined the effects of DBMSCs on expression by macrophages of the six inflammatory cytokines listed in Table 1 using flow cytometry, with expression recorded as MFI. After six days in culture, treatment with ICDBMSCs resulted in significantly increased expression of IL-1β, IFN-γ, and TNF-α by macrophages relative to untreated controls, p < 0.05 ( Figure 5 A,E and F, Table 2 . By contrast, ICDBMSCs significantly reduced the expression of IL-6 and IL-12 relative to controls, p < 0.05 ( Figure 5 B,D), while having no effects on the expression of IL-8, p > 0.05 ( Figure 5 C), Table 2 . Similarly, compared to untreated macrophages, SFDBMSCs significantly reduced the expression by macrophages of IL-1β and IL-12, p < 0.05 ( Figure 5 A,D), while significantly increasing the expression of IFN-γ, p < 0.05 ( Figure 5 E), Table 2 , and no effects on the expression of IL-6, IL-8, and TNF-α by macrophages were observed, p > 0.05 ( Figure 5 B,C, and F). In addition, CMDBMSCs significantly reduced the expression of IL-1β by macrophages relative to controls, p < 0.05 ( Figure 5 A), while having no effect on the expression of other inflammatory molecules, p > 0.05 ( Figure 5 B–F), Table 2 .
Figure 5.
Effects of human DBMSCs on expression of the intracellular cytokines IL-1β, IL-6, IL-8, IL-12, IFN-γ, and TNF-α by human monocytes differentiated into macrophages by GM-CSF, as analyzed by flow cytometry. After six days in culture, compared to untreated macrophages, CMDBMSCs significantly decreased expression of IL-1β (
A
) by macrophages while having no significant effects (
p
> 0.05) on expression of IL-6 (
B
), IL-8 (
C
), IL-12 (
D
), IFN-γ (
E
), and TNF-α (
F
) by macrophages. Compared to untreated macrophages, SFDBMSCs significantly decreased expression of IL-1β (
A
) and IL-12 (
D
) while having no significant effects (
p
> 0.05) on expression of IL-6 (
B
), IL-8 (
C
), and TNF-α (
F
), but significantly increasing expression of IFN-γ (
E
) by macrophages. In addition, compared to untreated macrophages, ICDBMSCs significantly increased expression of IL-1β (
A
), IFN-γ (
E
), and TNF-α (
F
) while decreasing IL-6 (
B
) and IL-12 (
D
), but having no significant effects (
p
> 0.05) on expression of IL-8 (
C
) by macrophages. Levels of expression are presented as median fluorescent intensity (MFI) as determined by flow cytometry. Experiments were carried out in duplicate and repeated 30 times using 30 individual preparations of both monocyte-derived macrophages and DBMSCs. *
p
< 0.05. Bars represent standard errors.
3.5. DBMSC Effects on Expression by Macrophages of IDO, TGFβ1, TGFβ1, 2, 3, and HMOX-1
We additionally assessed the consequences of the interaction between DBMSCs and macrophages on the expression of the immunosuppressive enzyme indoleamine 2,3-dioxygenase (IDO) and the anti-inflammatory molecules transforming growth factor-β 1 (TGFβ1), TGFβ1, 2, 3, and heme oxygenase 1 (HMOX-1) using flow cytometry, with expression recorded as MFI or median percentage of positive cells for HMOX-1. After six days of culture with ICDBMSCs, expression of IDO by macrophages was significantly decreased compared with that by untreated macrophages, p < 0.05 ( Figure 6 A), Table 2 . By contrast, CMDBMSCs and SFDBMSCs had no effect on expression of IDO by macrophages ( Figure 6 A), Table 2 . In addition, none of the DBMSC treatments significantly modulated the expression of TGFβ1, TGFβ1, 2, 3, or HMOX-1 by macrophages compared with that by controls, p > 0.05 ( Figure 6 B–D), Table 2 .
Figure 6.
Effects of human DBMSCs on expression of the intracellular molecules IDO, TGFβ1, TGFβ1, 2, 3, and HMOX-1 by human monocytes differentiated into macrophages by GM-CSF, as analyzed by flow cytometry. After six days in culture, compared to untreated macrophages, CMDBMSCs, and SFDBMSCs had no significant effects (
p
> 0.05) on expression of IDO (
A
), TGFβ1 (
B
), TGFβ1, 2, 3 (
C
), and HMOX-1 (
D
) by macrophages. In addition, after six days in culture, compared to untreated macrophages, ICDBMSCs significantly decreased expression by macrophages of IDO (
A
) while having no significant effects (
p
> 0.05) on expression of TGFβ1 (
B
), TGFβ1, 2, 3 (
C
), and HMOX-1 (
D
). Levels of expression are presented as median fluorescent intensity (MFI) or median percentage of HMOX-1 positive cells as determined by flow cytometry. Experiments were carried out in duplicate and repeated 30 times using 30 individual preparations of both monocyte-derived macrophages and DBMSCs. *
p
< 0.05. Bars represent standard errors.
3.6. DBMSCs Modulate Secretion by Macrophages of IL-1β, IL-6, IL-10, and IL-12
We further characterized the effect of DBMSCs on secretion of cytokines by macrophages, including IL-1β, IL-6, IL-10, and IL-12 (p70), into the supernatant of the three culture systems described above using ELISA. Compared with untreated macrophages, treatment with DBMSCs from all three culture systems was associated with significantly increased secretion by macrophages of IL-6, p < 0.05 ( Figure 7 B), Table 3 . In addition, CMDBMSCs significantly increased the secretion by macrophages of IL-10 relative to untreated controls, p < 0.05 ( Figure 7 C) Table 3 , while ICDBMSCs significantly decreased the secretion of IL-10, p < 0.05 ( Figure 7 C) Table 3 . None of the DBMSC treatments significantly affected secretion by macrophages of IL1β and IL-12, p > 0.05 ( Figure 7 A,D), Table 3 . Likewise, secretion of IL-10 was not significantly altered by SFDBMSCs compared with that of untreated macrophages ( Figure 7 C), Table 3 .
Figure 7.
Effects of DBMSCs on GM-CSF–stimulated human monocyte-to-macrophage differentiation, as analyzed by the secretion of IL-1β, IL-6, IL-10, and IL-12 using sandwich ELISA. CMDBMSCs had no significant effect (
p
> 0.05) on the secretion profiles of IL-1β (
A
), significantly increased (*
p
< 0.05) the secretion profiles of IL-6 (
B
) and IL-10 (
C
), and had no significant effect (
Table 3. DBMSC (CMDBMSC, SFDBMSC, and ICDBMSC) effects on macrophage secretion of inflammatory and anti-inflammatory cytokines as compared to untreated macrophages by ELISA. Increased (↑) and decreased (↓).
3.7. DBMSCs Do Not Alter Macrophage Phagocytic Activity
As described above, DBMSCs significantly modified the functions of macrophages by altering the expression of various immunological markers. Therefore, we tested whether DBMSCs affect the phagocytic activity of macrophages. For this purpose, phagocytic activity of macrophages cultured alone or initially cultured with CMDBMSCs, SFDBMSCs, or ICDBMSCs for six days was measured using the CytoSelect™ phagocytosis functional assay. None of the DBMSC treatments showed significant effects on the phagocytic activity of macrophages, p > 0.05 ( Figure 8 ).
Figure 8. Functional assay of the phagocytic activity of monocytes differentiated into macrophages by GM-CSF in the presence of human DBMSCs. Phagocytosed Zymosan particles were measured by reading the optical density at 405 nm. Phagocytosis of Zymosan particles by macrophages was not significantly affected by DBMSC treatments compared to macrophages cultured alone. Experiments were carried out in duplicate and repeated 10 times using 10 individual preparations of both monocyte-derived macrophages and DBMSCs. Bars represent standard errors.
3.8. DBMSCs Induce M1-like Macrophage Effects on T Cell Function
We further examined the combined effects of DBMSCs and M1-like macrophages on T cell function. Monocyte-derived M1-like macrophages that had either been cultured with DBMSCs (CMM1, SFM1, and ICM1) or cultured alone (M1) were added to allogenic CD4 + T cell cultures at T cell:M1-like macrophage ratios of 5:1, 10:1, and 20:1. T cell proliferation was then examined using the MTS assay. Compared to T cells alone, M1-like macrophages cultured either with DBMSC treatments (CMM1, SFM1, and ICM1) or without DBMSCs (M1) significantly increased T cell proliferation at all indicated ratios, p < 0.05 ( Figure 9 A). Similarly, ICM1 significantly increased T cell proliferation at all indicated ratios as compared to that with M1, p < 0.05 ( Figure 9 A). In addition, SFM1 significantly increased T cell proliferation at the 5:1 T cells: SFM1 ratio compared to that with M1, p < 0.05 ( Figure 9 A). By contrast, CMM1 significantly decreased T cell proliferation at the 10:1 and 20: 1 T cells: CMM1 ratios compared to that with M1, p < 0.05 ( Figure 9 A). Additionally, secretion of IL-10 by T cells stimulated with M1, CMM1, SFM1, and ICM1 was significantly reduced, p < 0.05 ( Figure 9 B), while the secretion of IL-12 and IFN-γ was significantly increased, p < 0.05 ( Figure 9 C,D), Table 4 .
Figure 9. T cell proliferation by M1-like macrophages (M1) generated in the presence of DBMSCs. After culturing M1 alone or with CMDBMSC (CMM1), SFDBMSC (SFM1), and ICDBMSC (ICM1), M1 were harvested and added to allogeneic CD4 + T cells at 5:1, 10:1, and 20:1 T cells:M1 (M1, CMM1, SFM1, and ICM1) ratios. M1 pre-treated with DBMSCs (CMM1, SFM1, and ICM1) or without (M1) significantly increased T cell proliferation at all indicated ratios. Similarly, ICM1 significantly increased T cell proliferation at all indicated ratios compared to that with M1, while SFM1 significantly increased T cell proliferation at the 5:1 T cells: SFM1 ratio compared to that with M1. By contrast, CMM1 significantly decreased T cell proliferation at the 10:1 and 20: 1 T cells: CMM1 ratios compared to that with M1 ( A ). In addition, the secretion of IL-10 by T cells stimulated with M1, CMM1, SFM1, and ICM1 was significantly reduced ( B ), while the secretion of IL-12 and IFN-γ was significantly increased, p < 0.05 ( C and D ). Experiments were carried out in triplicate and repeated 10 times using 10 individual preparations of T cells and macrophages harvested from 10 individual experiments of macrophages cultured with DBMSCs (CMDBMSC, SFDBMSC, and ICDBMSC). * p < 0.05, Bars represent standard error.
Table 4. DBMSC (CMDBMSC, SFDBMSC, and ICDBMSC) effects on macrophage stimulatory effects on T cell proliferation and secretion of inflammatory and anti-inflammatory cytokines as compared to untreated T cells measured by ELISA. Increased (↑) and decreased (↓).
3.9. Discussion
In this study, we examined the modulatory effects of DBMSCs on human macrophages, by coculturing DBMSCs with macrophages, which were generated from monocytes cultured in M1 macrophage differentiation medium [ 6 ]. Monocytes differentiated after six days into cells exhibiting the typical fried egg-shaped morphology of M1-like macrophages ( Figure 1 A) and expressed the monocytic marker CD14 without expressing the dendritic cell marker CD1a [ 6 ]. Addition of DBMSCs to monocyte cultures induced to differentiate into M1-like macrophages did not reverse M1 polarization nor shift it to M2 differentiation (elongated, spindle-like cells), as previously reported by us using pMSCs and by other researchers using MSCs from bone marrow, adipose tissues, gingival, or cord blood [ 6 , 15 , 16 , 17 , 18 , 19 , 20 , 21 ]. Morphologically, cells exhibited the typical morphology of M1-like macrophages ( Figure 1 B–F). We also observed that higher ratios of DBMSCs in the coculture inhibited monocyte differentiation into M1-like macrophages, as evidenced by the presence of cells smaller than macrophages with a round morphology and less adhesion, suggesting that these cells remained monocytes ( Figure 1 G–L). Phenotypically, M2-like macrophages express high levels of a number of cell surface markers, including CD14, CD36, CD163, CD204, CD206, and B7-H4, as we previously demonstrated with pMSCs [ 6 ]. In the presence of DBMSCs, M1-like macrophages upregulated the expression of only a subset (i.e. CD14, CD163, and CD206; Figure 2 ) of the markers. In this study, direct intercellular contact of DBMSCs (ICDBMSC) with monocyte-derived macrophages significantly decreased expression of CD36, CD163, CD204, and CD206 on macrophages, while paracrine communication between DBMSCs and monocyte-derived macrophages (SFDBMSC) increased the expression of CD14, CD163, and CD206 on macrophages ( Figure 2 B and D). In addition, soluble factors secreted by unstimulated DBMSCs (CMDBMSC) increased the expression of CD14 and CD206 on macrophages ( Figure 2 D). These data show the experimental conditions (mechanism of DBMSC communication with monocytes) modulate the phenotypic characteristics (inflammatory or anti-inflammatory phenotypes) of differentiated macrophages. However, at least with ICDBMSC, M1-like macrophages do not upregulate all markers, which suggests that ICDBMSCs are unable to induce an anti-inflammatory phenotype in macrophages, but rather they promote monocyte differentiation into inflammatory M1-like macrophages. One obvious explanation for this is that the original microenvironment (i.e., the niche) from which the MSCs were derived may determine the functional activities of MSCs on macrophage differentiation. DBMSCs are located in the maternal tissue of the placenta, which is continuously exposed to increased levels of inflammation and oxidative stress throughout human pregnancy [ 22 , 23 ]. By contrast, pMSCs are exposed to the fetal circulation, which experience relatively low levels of inflammation and exposure to oxidative stress mediators during normal pregnancy [ 24 , 25 ]. Likewise, bone marrow MSCs are generally exposed to low levels of oxidative stress in their bone marrow niche and only experience increased oxidative stress during injury or disease [ 26 ]. This phenomenon of monocyte polarization into immunostimulatory or immunoinhibitory macrophages was also reported for MSCs. It was shown that MSCs can be polarized into immunostimulatory or immunosuppressive cells similar to monocytes [ 27 ].
Kinetic experiments with monocyte-derived macrophages showed that the addition of all DBMSC treatments to monocytes cultured in M1 macrophage differentiation medium on Day 3 did not alter monocyte differentiation into M1-like macrophages, and was comparable to the effects of DBMSCs when added to the culture on the first day. Importantly, coculture with monocytes in M1 macrophage differentiation medium and DBMSCs from the time of plating up to Day 3 showed that the effects of DBMSCs on the differentiation of monocytes were not altered, as we observed the M1-like macrophage morphology was maintained at the end of the culture period. Hence, the effect of DBMSCs on the differentiation of M1-like macrophages is likely to be irreversible ( Figure 3 ).
CD163 is a hemoglobin scavenger receptor that mediates the resolution of inflammation by limiting damage induced by free hemoglobin [ 28 ] and stimulates the production of anti-inflammatory cytokines by M2-like macrophages [ 29 , 30 ]. Similarly, the scavenger receptor A (CD204), macrophage mannose receptor (CD206), and scavenger receptor B (CD36) are also involved in the resolution of inflammation by M2-like macrophages during the course of an innate immune response [ 31 , 32 , 33 ]. This further confirms that ICDBMSCs induced an inflammatory phenotype in macrophages. To support this observation, we demonstrated that ICDBMSCs decreased macrophage expression of CD273 and CD274 ( Figure 4 D,E), which are ligands for the inhibitory programmed death 1 (PD-1) receptor that signal to inhibit the function of T cells and to induce development of immunosuppressive regulatory T cells [ 34 ]. In addition, ICDBMSCs decreased macrophage expression of IDO ( Figure 6 A). IDO is an immunosuppressive enzyme that stimulates the catabolism of tryptophan, inhibiting the immune responses by repressing T cell function [ 35 ]. Moreover, ICDBMSCs decreased macrophage secretion of IL-10 ( Figure 7 C). IL-10 is an anti-inflammatory cytokine that inhibits the immune response by decreasing secretion of Th1 inflammatory cytokines and increasing the function of regulatory T cells [ 36 ]. Furthermore, ICDBMSC increased the secretion of IL-6 ( Figure 7 B). IL-6 activates the proliferative responses of lymphocytes, therefore shifting the immune response from an inhibitory to a stimulatory state [ 37 ]. These results suggest that intercellular contact between DBMSCs and monocyte-derived macrophages induces an inflammatory phenotype in macrophages. We further confirmed this by showing that ICDBMSCs increase the expression of inflammatory cytokines by M1-like macrophages, including IL-1β, IFN-γ, and TNF-α ( Figure 5 A,E and F). By contrast, ICDBMSCs decreased the expression of other inflammatory molecules by macrophages, including IL-6 and IL-12 ( Figure 5 B,D).
Additionally, we showed that paracrine communication between DBMSCs (SFDBMSC) and monocyte-derived macrophages increased the expression of IFN-γ ( Figure 5 E) and secretion of IL-6 ( Figure 7 B) while decreasing the expression of IL-1β and IL-12 ( Figure 5 A,D) by macrophages. Likewise, soluble mediators secreted by unstimulated DBMSCs (CMDBMSC) decreased the expression of IL-1β ( Figure 5 A) and increased the secretion of IL-6 and IL-10 by macrophages ( Figure 7 B,C). Collectively, our data indicate that DBMSCs may exert opposing effects on the phenotype of macrophages.
Several other studies support our findings that soluble factors secreted by MSCs mediate immunomodulatory effects on immune cells. Others have reported that separation of MSCs and immune cells by a semipermeable membrane does not prevent the immunomodulatory effects that MSCs exert [ 6 , 38 , 39 , 40 ]. Importantly, our results also demonstrate that the immune/inflammatory effects of DBMSCs on macrophages are mediated by soluble factors secreted by unstimulated DBMSCs, suggesting that direct crosstalk between DBMSCs and immune cells is unnecessary, as we previously reported [ 6 ]. However, this is in contrast with previous studies reporting that it is essential for MSCs to be activated in order to modulate responses of immune cells [ 20 , 41 , 42 ].
Activated M1-like macrophages usually phagocytose microbes, remove tumor cells, present antigen to T cells to trigger an immune response, and secrete high levels of inflammatory cytokines [ 43 ]. Although all DBMSC treatments did not affect expression of HLA-DR (antigen-presenting molecule) and CD80 (costimulatory molecule), and decreased the expression of another costimulatory molecule, CD86, on M1-like macrophages, they did not inhibit the phagocytic activities of M1-like macrophages ( Figure 8 ). In addition, all DBMSC treatments induced stimulatory effects of M1-like macrophages on the proliferation ( Figure 9 A) and production of high levels of inflammatory cytokines, including IL-12 and IFN-γ, and low levels of IL-10 ( Figure 9 B–D) by CD4 + T cells. These data demonstrate that although DBMSCs (ICDBMSC, SFDBMSC, and CMDBMSC) have differential effects on the inflammatory phenotype in M1-like macrophages, they induced similar modulatory effects on the functional activities of CD4 + T cells. This finding is important, because it suggests that DBMSCs are immune stimulatory cells with the potential for fighting cancer cells through their ability to induce the differentiation of M1-like macrophages, which have anticancer activity [ 5 , 44 ]. Additionally, DBMSCs induce an M1-like macrophage stimulatory effect on the function of CD4 + T cells, which also fight cancer cells [ 45 ]. The mechanisms by which DBMSCs stimulate M1 macrophage function are currently unknown. However, DBMSCs produce a large range of molecules that are involved in M1 macrophage differentiation. For example, DBMSCs produce IFN-γ and GM-CSF, which can induce M1 macrophage differentiation [ 46 , 47 ]. Therefore, these molecules may mediate the DBMSC effect on M1-like macrophages. However, further studies are required to elucidate these mechanisms and to determine the anticancer activities of DBMSCs.
4. Conclusions
This is the first study to show that human DBMSCs favor differentiation of human M1 macrophages by direct or indirect contact mechanisms or through soluble factors secreted by unstimulated DBMSCs. We show for the first time that DBMSCs induce an inflammatory phenotype in M1 macrophages with functional activities that induce the T cell proliferation and cytokine secretion. In addition, we show that the effect of DBMSCs on macrophage differentiation is irreversible. However, a future study will be conducted to confirm this in vitro finding of DBMSCs favoring M1 macrophage differentiation by performing an in vivo study. In light of these results, we propose that human DBMSCs are immunostimulatory cells with the potential to target cancer cells by acting on macrophages to enhance macrophage anticancer activities either directly or indirectly through CD4 + T cells.
Author Contributions
M.H.A. proposed and supervised the project. M.H.A. designed the experiments. S.A.H., A.M.A.S., and M.A.A. performed the experiments. M.H.A. analyzed the data. M.H.A., F.M.A., T.K., B.K., M.F.E.-M., M.A.A.J., D.J., A.O.A., and A.S.A. wrote the manuscript. M.H.A., F.M.A., T.K., B.K., M.F.E.-M., M.A.A.J., D.J., A.O.A., and A.S.A. contributed to data analysis and interpretation of results. All authors reviewed the manuscript.
Funding
This study was supported by grants from KAIMRC (grant no. RC12/133).
Acknowledgments
We thank the staff and patients of the Delivery Unit, King Abdul Aziz Medical City for their help in obtaining placentae.
Conflicts of Interest
The authors declare no conflict of interest.
Data Availability
All data generated or analyzed during this study are included in this published article.
Ethics approval and consent to participate
The institutional review board (IRB) at King Abdulla International Medical Research Centre (KAIMRC), Saudi Arabia approved this study.
Consent for publication
All authors agree to publish this manuscript.
Author Disclosure Statement
No competing financial interests exist. The authors declare that there is no conflict of interest regarding the publication of this paper.
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Heusinkveld, M.; de Vos van Steenwijk, P.J.; Goedemans, R.; Ramwadhdoebe, T.H.; Gorter, A.; Welters, M.J.; van Hall, T.; van der Burg, S.H. M2 macrophages induced by prostaglandin e2 and il-6 from cervical carcinoma are switched to activated m1 macrophages by cd4 + th1 cells. J. Immunol. 2011 , 187 , 1157–1165. [ Google Scholar ] [ CrossRef ]
Figure 1. M1 macrophage culture system. Untreated control experiment consisted of M1 macrophages cultured on a surface of 6-well culture plate in a medium containing GM-CSF, CMDBMSC experiment consisted of M1 macrophages cultured on a surface of 6-well culture plate in a medium containing GM-CSF and CMDBMSC (conditioned medium), SFDBMSC (soluble factor), and ICDBMSC (intercellular direct contact) experiments. In SFDBMSC and ICDBMSC experiment, cells (DBMSCs and monocytes) were separated by transwell chamber membrane culture system. For the experiments of SFDBMSC, DBMSCs were seeded on the upper compartments while monocytes were seeded in the lower compartment. For the experiments of ICDBMSC, DBMSCs were seeded on the reverse side of the membrane while monocytes were seeded on the upper side of the membrane. GM-CSF medium was added to SFDBMSC and ICDBMSC experiments. Effects of human DBMSCs on the morphology of human monocytes differentiated into macrophages by GM-CSF. ( A – F ) Represent phase-contrast microscopic images showing monocyte (round-shaped morphology) differentiation into M1-like macrophages (fried egg-shaped morphology) after six days of culture in a medium containing GM-CSF ( A ), in a medium containing GM-CSF and DBMSCs at a 20:1 monocyte: DBMSC ratio ( B ), at a 10:1 monocyte: DBMSC ratio ( C ), at a 1:1 monocyte: DBMSC ratio ( D ), in the presence of 10% CMDBMSC ( E ), or in the presence of 20% CMDBMSC ( F ). ( G – K ) Representative phase-contrast microscopic images showing monocyte-like cells after six days of culture in a medium containing GM-CSF and 30% CMDBMSC ( G ), 40% CMDBMSC ( H ), 50% CMDBMSC ( I ), 60% CMDBMSC ( J ), 80% CMDBMSC ( K ), or 100% CMDBMSC ( L ). Experiments were carried out in duplicate and repeated 30 times using 30 individual preparations of both monocyte-derived macrophages and DBMSCs. Scale bars represent 50 µm.
Figure 2. Effects of human DBMSCs on the expression of cell surface molecules CD14, CD163, CD204, CD206, CD36, and B7H4 on human monocytes differentiated into macrophages by GM-CSF, as analyzed by flow cytometry. After six days in culture, compared to untreated macrophages, CMDBMSCs significantly increased expression of CD14 ( A ) and CD163 ( B ) on macrophages while having no significant effect ( p > 0.05) on expression of CD204 ( C ), CD206 ( D ), CD36 ( E ), and B7H4 ( F ) on macrophages. Compared to untreated macrophages, SFDBMSC significantly increased expression of CD14 ( A ), CD163 ( B ), and CD206 ( D ) on macrophages while having no significant effects ( p > 0.05) on expression of CD204 ( C ), CD36 ( E ), and B7H4 ( F ) on macrophages. In addition, ICDBMSCs significantly decreased expression of CD163 ( B ), CD204 ( C ), CD206 ( D ) and CD36 ( E ) on macrophages while having no significant effects ( p > 0.05) on expression of CD14 ( A ) and B7H7 ( F ) compared with that on untreated macrophages. Levels of expression are presented as median fluorescent intensity (MFI) as determined by flow cytometry. Experiments were carried out in duplicate and repeated 30 times using 30 individual preparations of both monocyte-derived macrophages and DBMSCs. * p < 0.05. Bars represent standard errors.
Figure 4. Effects of human DBMSCs on expression of the cell surface molecules HLADR, CD80, CD86, CD273, and CD274 by human monocytes differentiated into macrophages by GM-CSF, as analyzed by flow cytometry. After six days in culture, compared to untreated macrophages, CMDBMSCs and SFDBMSCs had no significant effects ( p > 0.05) on expression of HLA-DR ( A ), CD80 ( B ), CD273 ( D ), and CD274 ( E ) on macrophages while significantly decreasing expression of CD86 ( C ). Compared to untreated macrophages, ICDBMSCs had no significant effects ( p > 0.05) on expression of HLA-DR ( A ) and CD80 ( B ) on macrophages while significantly decreasing expression of CD86 ( C ), CD273 ( D ), and CD274 ( E ) on macrophages. Levels of expression are presented as median fluorescent intensity (MFI) as determined by flow cytometry. Experiments were carried out in duplicate and repeated 30 times using 30 individual preparations of both monocyte-derived macrophages and DBMSCs. * p < 0.05. Bars represent standard errors.
Figure 5. Effects of human DBMSCs on expression of the intracellular cytokines IL-1β, IL-6, IL-8, IL-12, IFN-γ, and TNF-α by human monocytes differentiated into macrophages by GM-CSF, as analyzed by flow cytometry. After six days in culture, compared to untreated macrophages, CMDBMSCs significantly decreased expression of IL-1β ( A ) by macrophages while having no significant effects ( p > 0.05) on expression of IL-6 ( B ), IL-8 ( C ), IL-12 ( D ), IFN-γ ( E ), and TNF-α ( F ) by macrophages. Compared to untreated macrophages, SFDBMSCs significantly decreased expression of IL-1β ( A ) and IL-12 ( D ) while having no significant effects ( p > 0.05) on expression of IL-6 ( B ), IL-8 ( C ), and TNF-α ( F ), but significantly increasing expression of IFN-γ ( E ) by macrophages. In addition, compared to untreated macrophages, ICDBMSCs significantly increased expression of IL-1β ( A ), IFN-γ ( E ), and TNF-α ( F ) while decreasing IL-6 ( B ) and IL-12 ( D ), but having no significant effects ( p > 0.05) on expression of IL-8 ( C ) by macrophages. Levels of expression are presented as median fluorescent intensity (MFI) as determined by flow cytometry. Experiments were carried out in duplicate and repeated 30 times using 30 individual preparations of both monocyte-derived macrophages and DBMSCs. * p < 0.05. Bars represent standard errors.
Figure 6. Effects of human DBMSCs on expression of the intracellular molecules IDO, TGFβ1, TGFβ1, 2, 3, and HMOX-1 by human monocytes differentiated into macrophages by GM-CSF, as analyzed by flow cytometry. After six days in culture, compared to untreated macrophages, CMDBMSCs, and SFDBMSCs had no significant effects ( p > 0.05) on expression of IDO ( A ), TGFβ1 ( B ), TGFβ1, 2, 3 ( C ), and HMOX-1 ( D ) by macrophages. In addition, after six days in culture, compared to untreated macrophages, ICDBMSCs significantly decreased expression by macrophages of IDO ( A ) while having no significant effects ( p > 0.05) on expression of TGFβ1 ( B ), TGFβ1, 2, 3 ( C ), and HMOX-1 ( D ). Levels of expression are presented as median fluorescent intensity (MFI) or median percentage of HMOX-1 positive cells as determined by flow cytometry. Experiments were carried out in duplicate and repeated 30 times using 30 individual preparations of both monocyte-derived macrophages and DBMSCs. * p < 0.05. Bars represent standard errors.
Figure 7. Effects of DBMSCs on GM-CSF–stimulated human monocyte-to-macrophage differentiation, as analyzed by the secretion of IL-1β, IL-6, IL-10, and IL-12 using sandwich ELISA. CMDBMSCs had no significant effect ( p > 0.05) on the secretion profiles of IL-1β ( A ), significantly increased (* p < 0.05) the secretion profiles of IL-6 ( B ) and IL-10 ( C ), and had no significant effect ( p > 0.05) on the secretion profiles of IL-12 ( D ) of macrophages. In addition, SFDBMSCs had no significant effect ( p > 0.05) on the secretion profiles of IL-1β ( A ), significantly increased (* p < 0.05) the secretion profiles of IL-6 ( B ) and had no significant effect ( p > 0.05) on the secretion profiles of IL-10 ( C ) and IL-12 ( D ). Moreover, ICDBMSCs had no significant effect ( p > 0.05) on the secretion profiles of IL-1β ( A ), significantly increased (* p < 0.05) the secretion profiles of IL-6 ( B ), significantly decreased (* p < 0.05) the secretion profiles of IL-10 ( C ), and had no significant effect ( p > 0.05) on the secretion profiles of IL-12 ( D ). Experiments were carried out in duplicate and repeated 10 times using 10 individual preparations of both monocyte-derived macrophages and DBMSCs. Bars represent standard errors.
Figure 8. Functional assay of the phagocytic activity of monocytes differentiated into macrophages by GM-CSF in the presence of human DBMSCs. Phagocytosed Zymosan particles were measured by reading the optical density at 405 nm. Phagocytosis of Zymosan particles by macrophages was not significantly affected by DBMSC treatments compared to macrophages cultured alone. Experiments were carried out in duplicate and repeated 10 times using 10 individual preparations of both monocyte-derived macrophages and DBMSCs. Bars represent standard errors.
Figure 9. T cell proliferation by M1-like macrophages (M1) generated in the presence of DBMSCs. After culturing M1 alone or with CMDBMSC (CMM1), SFDBMSC (SFM1), and ICDBMSC (ICM1), M1 were harvested and added to allogeneic CD4 + T cells at 5:1, 10:1, and 20:1 T cells:M1 (M1, CMM1, SFM1, and ICM1) ratios. M1 pre-treated with DBMSCs (CMM1, SFM1, and ICM1) or without (M1) significantly increased T cell proliferation at all indicated ratios. Similarly, ICM1 significantly increased T cell proliferation at all indicated ratios compared to that with M1, while SFM1 significantly increased T cell proliferation at the 5:1 T cells: SFM1 ratio compared to that with M1. By contrast, CMM1 significantly decreased T cell proliferation at the 10:1 and 20: 1 T cells: CMM1 ratios compared to that with M1 ( A ). In addition, the secretion of IL-10 by T cells stimulated with M1, CMM1, SFM1, and ICM1 was significantly reduced ( B ), while the secretion of IL-12 and IFN-γ was significantly increased, p < 0.05 ( C and D ). Experiments were carried out in triplicate and repeated 10 times using 10 individual preparations of T cells and macrophages harvested from 10 individual experiments of macrophages cultured with DBMSCs (CMDBMSC, SFDBMSC, and ICDBMSC). * p < 0.05, Bars represent standard error.
Table 1. Markers used in this study.
Macrophage Markers Costimulatory and HLA Molecules Inflammatory Molecules Anti-inflammatory Molecules CD14 CD40 IL-1β IDO CD11b CD80 IL-6 TGFβ1 CD36 CD86 IL-8 TGFβ1, 2, 3 CD163 CD273 IL-12 HMOX-1 CD204 CD274 IFN-γ CD206 HLA-DR TNF-α B7-H4
Table 2. DBMSC (CMDBMSC, SFDBMSC, and ICDBMSC) effects on macrophage expression of different functional markers, costimulatory molecules, co-inhibitory molecules, antigen presenting molecule, inflammatory cytokines, and anti-inflammatory markers as compared to untreated macrophages by flow cytometry recorded by mean of fluorescent intensity (MFI). Increased (↑, p < 0.05), decreased (↓, p < 0.05)), and no change ( p > 0.05).
Markers Types CMDBMSC SFDBMSC ICDBMSC Markers Types CMDBMSC SFDBMSC ICDBMSC CD14 Functional Markers ↑ ↑ No Change IDO Anti-inflammatory Markers No Change No Change ↓ CD163 ↑ ↑ ↓ TGFβ1 No Change No Change No Change CD204 No Change No Change ↓ TGFβ1, 2, 3 No Change No Change No Change CD206 No Change ↑ ↓ HMOX-1 No Change No Change No Change CD36 No Change No Change ↓ B7H4 No Change No Change No Change CD80 Costimulatory Molecules No Change No Change No Change CD86 ↓ ↓ ↓ CD273 Co-Inhibitory Molecules No Change No Change ↓ CD274 No Change No Change ↓ HLA-DR Antigen Presenting Molecule No Change No Change No Change IL-1β Inflammatory Cytokines ↓ ↓ ↑ IL-6 No Change No Change ↓ IL-8 No Change No Change No Change IL-12 No Change ↓ ↓ IFN-γ No Change ↑ ↑ TNF-α No Change No Change ↑
Table 3. DBMSC (CMDBMSC, SFDBMSC, and ICDBMSC) effects on macrophage secretion of inflammatory and anti-inflammatory cytokines as compared to untreated macrophages by ELISA. Increased (↑) and decreased (↓).
Markers Type CMDBMSC SFDBMSC ICDBMSC IL-1β Inflammatory Cytokines No Change No Change No Change IL-6 ↑ ↑ ↑ IL-10 ↑ No Change ↓ IL-12 Anti-inflammatory Cytokine No Change No Change No Change
Table 4. DBMSC (CMDBMSC, SFDBMSC, and ICDBMSC) effects on macrophage stimulatory effects on T cell proliferation and secretion of inflammatory and anti-inflammatory cytokines as compared to untreated T cells measured by ELISA. Increased (↑) and decreased (↓).
Markers Type CM1 CMM1 SFM1 ICM1 IL-12 Inflammatory Cytokine ↑ ↑ ↑ ↑ IFN-γ IL-10 Anti-inflammatory Cytokine ↓ ↓ ↓ ↓
MDPI and ACS Style
Abumaree, M.H.; Al Harthy, S.; Al Subayyil, A.M.; Alshabibi, M.A.; Abomaray, F.M.; Khatlani, T.; Kalionis, B.; El- Muzaini, M.F.; Al Jumah, M.A.; Jawdat, D.; Alawad, A.O.; AlAskar, A.S. Decidua Basalis Mesenchymal Stem Cells Favor Inflammatory M1 Macrophage Differentiation In Vitro. Cells 2019, 8, 173.
https://doi.org/10.3390/cells8020173
AMA Style
Abumaree MH, Al Harthy S, Al Subayyil AM, Alshabibi MA, Abomaray FM, Khatlani T, Kalionis B, El- Muzaini MF, Al Jumah MA, Jawdat D, Alawad AO, AlAskar AS. Decidua Basalis Mesenchymal Stem Cells Favor Inflammatory M1 Macrophage Differentiation In Vitro. Cells. 2019; 8(2):173.
https://doi.org/10.3390/cells8020173
Chicago/Turabian Style
Abumaree, Mohamed H., Seham Al Harthy, Abdullah M. Al Subayyil, Manal A. Alshabibi, Fawaz M. Abomaray, Tanvier Khatlani, Bill Kalionis, Mohammed F. El- Muzaini, Mohammed A. Al Jumah, Dunia Jawdat, Abdullah O. Alawad, and Ahmed S. AlAskar. 2019. "Decidua Basalis Mesenchymal Stem Cells Favor Inflammatory M1 Macrophage Differentiation In Vitro" Cells8, no. 2: 173.
https://doi.org/10.3390/cells8020173
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DNA Testing & General Genetics [Archive] - Eupedia Forum
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Origin of human was an African
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Mal'ta boy had autosomal genes present in populations with Y-haplogroups M, P, Q & R
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Sima de los Huesos – Atapuerca
Baffling 400,000-Year-Old Clue to Human Origins
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Greeks have no brothers in Europe
New global analysis of Y-chromosomal haplotype 2014
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DNA from the Bronze Age Altai reveals signs of ancient admixture
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Neolithic western Carpathian Basin - 356 pages
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holmesr923
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Tuscany had a middle age admixture event?
New (July 3, 2015) Allentoft and Haak Analysis Comparison of DNA
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RCSB PDB - 7BYN: Cryo-EM structure of human KCNQ4 with linopirdine
Cryo-EM structure of human KCNQ4 with linopirdine
7BYN
Cryo-EM structure of human KCNQ4 with linopirdine
PDB DOI: https://doi.org/10.2210/pdb7BYN/pdb
EM Map EMD-30246: EMDB EMDataResource
Classification: MEMBRANE PROTEIN
Organism(s): Aequorea victoria , Homo sapiens
Expression System: Homo sapiens
Mutation(s): Yes
Membrane Protein: Yes OPM PDBTM MemProtMD mpstruc
Deposited: 2020-04-23 Released: 2020-12-02
Deposition Author(s): Shen, H. , Li, T. , Yue, Z.
Experimental Data Snapshot
Method: ELECTRON MICROSCOPY
Aggregation State: PARTICLE
Reconstruction Method: SINGLE PARTICLE
Literature
Structural Basis for the Modulation of Human KCNQ4 by Small-Molecule Drugs.
Li, T.
,
Wu, K.
,
Yue, Z.
,
Wang, Y.
,
Zhang, F.
,
Shen, H.
(2021) Mol Cell81: 25
PubMed : 33238160 Search on PubMed
DOI: https://doi.org/10.1016/j.molcel.2020.10.037
Primary Citation of Related Structures: 7BYL , 7BYM , 7BYN
PubMed Abstract:
Among the five KCNQ channels, also known as the K v7 voltage-gated potassium (K v) channels, KCNQ2-KCNQ5 control neuronal excitability. Dysfunctions of KCNQ2-KCNQ5 are associated with neurological disorders such as epilepsy, deafness, and neuropathic pain ...
Among the five KCNQ channels, also known as the K v7 voltage-gated potassium (K v) channels, KCNQ2-KCNQ5 control neuronal excitability. Dysfunctions of KCNQ2-KCNQ5 are associated with neurological disorders such as epilepsy, deafness, and neuropathic pain. Here, we report the cryoelectron microscopy (cryo-EM) structures of human KCNQ4 and its complexes with the opener retigabine or the blocker linopirdine at overall resolutions of 2.5, 3.1, and 3.3 Å, respectively. In all structures, a phosphatidylinositol 4,5-bisphosphate (PIP 2) molecule inserts its head group into a cavity within each voltage-sensing domain (VSD), revealing an unobserved binding mode for PIP 2. Retigabine nestles in each fenestration, inducing local shifts. Instead of staying within the central pore, linopirdine resides in a cytosolic cavity underneath the inner gate. Electrophysiological analyses of various mutants corroborated the structural observations. Our studies reveal the molecular basis for the modulatory mechanism of neuronal KCNQ channels and provide a framework for structure-facilitated drug discovery targeting these important channels.
Organizational Affiliation
:
Key Laboratory of Structural Biology of Zhejiang Province, School of Life Sciences, Westlake University, Hangzhou, Zhejiang 310024, China; Westlake Laboratory of Life Sciences and Biomedicine, Hangzhou, Zhejiang 310024, China; Institute of Biology, Westlake Institute for Advanced Study, Hangzhou, Zhejiang 310024, China. Electronic address: [email protected].
Macromolecules
100%
95%
90%
80%
70%
60%
50%
40%
30%
(by identity cutoff) |
3D Structure
(by identity cutoff) |
3D Structure
Entity ID: 2 Molecule Chains Sequence Length Organism Details Image Calmodulin-3 E [auth B] , F [auth D] , G [auth F] , H 149 Homo sapiens Mutation(s) : 0 Gene Names: CALM3 , CALML2 , CAM3 , CAMC , CAMIII UniProt & NIH Common Fund Data Resources Find proteins for P0DP25 (Homo sapiens) Explore P0DP25 Go to UniProtKB: P0DP25 PHAROS: P0DP25 Entity Groups Sequence Clusters 30% Identity 50% Identity 70% Identity 90% Identity 95% Identity 100% Identity UniProt Group P0DP25 Protein Feature View Expand Reference Sequence
Small Molecules
Ligands 3 Unique ID Chains Name / Formula / InChI Key 2D Diagram 3D Interactions PT5 (Subject of Investigation/LOI) Query on PT5 Download Ideal Coordinates CCD File Download Instance Coordinates SDF format, chain I [auth A] SDF format, chain M [auth C] SDF format, chain P [auth G] SDF format, chain O [auth E] MOL2 format, chain I [auth A] MOL2 format, chain M [auth C] MOL2 format, chain P [auth G] MOL2 format, chain O [auth E] I [auth A], M [auth C], O [auth E], P [auth G] [(2R)-1-octadecanoyloxy-3-[oxidanyl-[(1R,2R,3S,4R,5R,6S)-2,3,6-tris(oxidanyl)-4,5-diphosphonooxy-cyclohexyl]oxy-phospho
ryl]oxy-propan-2-yl] (8Z)-icosa-5,8,11,14-tetraenoate C 47 H 85 O 19 P 3 CNWINRVXAYPOMW-HJBQCNPJSA-N Ligand Interaction FCC (Subject of Investigation/LOI) Query on FCC Download Ideal Coordinates CCD File Download Instance Coordinates SDF format, chain N [auth C] MOL2 format, chain N [auth C] N [auth C] 1-phenyl-3,3-bis(pyridin-4-ylmethyl)indol-2-one C 26 H 21 N 3 O YEJCDKJIEMIWRQ-UHFFFAOYSA-N Ligand Interaction K Query on K Download Ideal Coordinates CCD File Download Instance Coordinates SDF format, chain J [auth A] SDF format, chain K [auth A] SDF format, chain L [auth A] MOL2 format, chain J [auth A] MOL2 format, chain K [auth A] MOL2 format, chain L [auth A] J [auth A], K [auth A], L [auth A] POTASSIUM ION K NPYPAHLBTDXSSS-UHFFFAOYSA-N Ligand Interaction
Experimental Data & Validation
Experimental Data
Method: ELECTRON MICROSCOPY
Resolution: 3.30 Å
Aggregation State: PARTICLE
Reconstruction Method: SINGLE PARTICLE
Structure Validation
Entry History
Deposition Data
Released Date: 2020-12-02
Deposition Author(s):
Shen, H.
,
Li, T.
,
Yue, Z.
Revision History (Full details and data files)
Version 1.0: 2020-12-02 Type: Initial release
Version 1.1: 2020-12-09 Changes: Database references
Version 1.2: 2021-01-27 Changes: Database references
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