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Introduction
Published in Hanna Laako, Georgina Sánchez-Ramírez, Midwives in Mexico, 2021
Hanna Laako, Georgina Sánchez-Ramírez
However, it is also important to emphasize that, because significant differences among Latin American countries exist, excessive generalization should be avoided. For example, in Chile, professional midwives—matronas—are heavily institutionalized, and played an important role in moving birth into hospitals during the 20th century, while traditional midwifery in Chile was eliminated long ago (Zárate and González 2018). In Peru, traditional midwives continue to struggle as a result of the medicalization of birth, but health policies increasingly acknowledge interculturality (Quiróz-Peréz 2018). In Argentina, the re-valuing of midwives came about during the second wave of feminism, with criticisms of the medicalization of birth, and with movements against obstetric violence and for the humanization of birth (Felitti and Abdala 2018).
Treatments and trials for genetic disease
Published in Angus Clarke, Alex Murray, Julian Sampson, Harper's Practical Genetic Counselling, 2019
It is possible that aiming at a single treatment to ‘cure’ the disease may be too ambitious. Perhaps, a few different strategies may be required to treat different aspects or manage different symptoms of the condition. One condition where there are good grounds for hoping that effective treatments will be possible is Rett syndrome, although there may be numerous obstacles to be overcome before this is achieved (Clarke and Abdala, 2018). It is also salutary to consider what an effective treatment would achieve for an adolescent affected by such a severe neurodevelopmental disorder. How would it feel to have been affected by mutation in the MECP2 gene and then for this to be reversed abruptly by gene editing in vivo? Assuming that the immediate effects on the autonomic system and the somewhat slower effects on intracranial pressure (from enlargement of cells in the brain, as in the mouse model) could be managed satisfactorily, such a girl would not suddenly become an age-appropriate teenager. How would she feel? How would those around her cope with the changes, and help her to do the same? Might she be confused and distressed by the changes happening to her? How would she behave in response?
Recent Advances In Otoacoustic Emissions
Published in Stavros Hatzopoulos, Andrea Ciorba, Mark Krumm, Advances in Audiology and Hearing Science, 2020
Originally, OAEs were classified into two types, spontaneous and evoked, based on how they were measured. Spontaneous OAEs (SOAEs) are present naturally in about 50% of normal-hearing people without any added external stimulation. These OAEs, like all classes, are believed to result from active cochlear mechanics. SOAEs are thought to reflect the activity of the cochlear amplifier, although they appear to be consistently present only in normal ears at lower intensities. High-intensity SOAEs can appear at the margins of cochlear damage after noise exposure, such as rock concerts. These isolated high-level SOAEs appear to be uncontrolled oscillations due to abnormal reflections within the cochlea (Nuttal, et al., 2004). SOAEs vary from one person to the next, are unique to an individual like a fingerprint, and are stable over repeated measurements. However, a recent report of SOAEs in a small number of people tested over a period of 20–33 years showed that SOAEs declined by an average of 0.25% per year (Burns, 2017). A large cross-sectional study showed that approximately 85% of newborns have measurable SOAEs as compared with 51–68% for young adults and 40% of elderly ears (Abdala et al., 2017). Newborn SOAEs are an average of 5–6 dB higher in level than those from young-adult ears, while SOAEs in elderly people were greatly reduced in level, likely due to lower power gain in the aging cochlea. These interesting studies convincingly demonstrate that the active cochlear processes responsible for producing OAEs decline with age. Occasionally, SOAEs can be extremely large, but those cases are unusual and may be due to abnormal oscillations near sharp transitions between normal and abnormal regions (Dewey and Dhar, 2017; Ruggero et al., 1983). Because SOAEs are not highly predictive of hearing status or tinnitus, they have not been adopted for clinical purposes. Later, the evoked OAEs were subdivided based on the stimuli used to evoked them into TEOAEs, DPOAEs, and single frequency tone-evoked OAEs (SFOAEs). Most recently, chirp-evoked OAEs (CEOAEs) have been studied and will be discussed later in this chapter.
Covid-19 vaccination reported side effects and hesitancy among the Syrian population: a cross-sectional study
Published in Annals of Medicine, 2023
Michel Najjar, Sara Albuaini, Mohammad Fadel, Fatema Mohsen
The vigilance around personal protective measures including wearing face masks, maintaining interpersonal 2-meter distance, avoiding mass gatherings, washing hands, and quarantine have slowly eased off. Although such measures might have mitigated the spread and thus saved lives, sustaining these measures in the long term must be balanced against the various health, social, and economic aspects [2]. Therefore, vaccines remain the only solution for this never-ending crisis, triggering a massive global effort [3], as leading pharmaceutical companies and scientists were in a race against time to develop and test the first effective vaccine. Several vaccines have been approved for emergency or full use by WHO: Pfizer–BioNTech, Oxford–AstraZeneca, Sinopharm BIBP, Moderna, Janssen, CoronaVac, Covaxin, Novavax, and Convidecia. Other vaccines are under assessment by the WHO: Sputnik V, Sinopharm WIBP, Abdala, Zifivax, Corbevax, V, COVIran Barekat, Sanofi–GSK, and SCB-2019 [4]. Immunization with the currently approved vaccines remains the only way to protect oneself against COVID-19, especially when there is no clear global consensus on the treatment guidinclusionnes for Covid-19.
A clinical comparison of DPOAE fine structure reduction methods
Published in International Journal of Audiology, 2021
Steven C. Marcrum, Eva Höfle, Erin M. Picou, Thomas Steffens, Peter Kummer, Pingling Kwok
The primary limitation of this study involves the inclusion of young adults, as opposed to young children, for whom DPOAE testing is of most clinical importance. Indeed, the existence of significant differences between paediatric and adult DPOAE characteristics is well established (Dhar and Abdala 2007; Abdala 2004; Abdala et al. 2014). For example, Dhar and Abdala (2007) reported that overall DPOAE level was on average 7 dB greater in newborns, compared to adults, while Abdala et al. (Abdala, Keefe, and Oba 2007) suggested DPOAE suppression tuning curves to be significantly narrower and with a sharper tip region in infants, relative to adults. Though age-related differences in DPOAE characteristics are most commonly considered products of differential outer- and middle-ear maturation (Abdala and Keefe 2006; Keefe and Abdala 2007), it cannot be excluded that inner ear development, such as in terms of passive basilar membrane motion (Dhar and Abdala 2007), might also impact the utility of fine structure reduction methods. However, it remains that age-related differences in DPOAE characteristics are generally explained in terms of differences in maturational stage, rather than in terms of distinct mechanisms. Future work should investigate the utility of f2 modulation and third tone suppression for the reduction of DPOAE fine structure in young children directly. However, given time constraints implicit in paediatric work, efforts could focus on stimuli of lower frequency and level, as present results suggest the probability of encountering significant fine structure would be greatest.
Advances in SARS-CoV-2 receptor-binding domain-based COVID-19 vaccines
Published in Expert Review of Vaccines, 2023
Xiaoqing Guan, Yang Yang, Lanying Du
Several recombinant RBD proteins have been tested in human trials to assess their immunogenicity or efficacy against SARS-CoV-2 in adults [127,128]. Among these, a phase 1 trial showed that three doses of a RBD protein (Noora) elicited neutralizing antibody responses without severe adverse effects [129]. A phase 2 study revealed that two doses of another RBD protein induced high-titer RBD-specific antibodies with neutralizing activity [130]. A phase 2 trial of a yeast-expressed RBD protein (Abdala) adjuvanted with alumina induced effective IgG antibody responses after three doses, with minimal adverse reactions from the injection sites [131]. In phase 1 and 2 trials, an RBD dimer protein vaccine generated by linking two original RBD molecules (ZF2001) was immunogenic; a phase 3 trial demonstrated that it was generally safe after three doses, and was effective at preventing severe to critical COVID-19 [127,132]. Fc-fused RBD proteins have also been evaluated in clinical trials. For example, two doses of an RBD-Fc protein (Betuvax-CoV-2) elicited IgG and anti-SARS-CoV-2 neutralizing antibodies and CD4+ T cell responses without obvious adverse effects, in a phase 1/2 trial [133]. A third dose (given 7–9 months after the primary immunization) of a Fc-fused RBD vaccine (UB-612) incorporating helper and cytotoxic T lymphocyte (Th/CTL) epitope peptides elicited high-titer neutralizing antibodies against the Omicron-BA1 and BA2 subvariants, in a phase 1 trial [134]. The safety and immunogenicity of this vaccine (when used as a single dose or as a booster dose) are currently being evaluated in a phase 3 clinical trial (NCT05293665).