bluuebunny/crossref_metadata_2025 huggingface dataset:
Primary health care case management through the lens of complexity: an exploratory study of naturopathic practice using complexity science principles
Authors: Graham Kim D. , Steel Amie , Wardle Jon
Published: April 2022

Background

Advances in systems science creates an opportunity to bring a complexity perspective to health care practices and research. While medical knowledge has greatly progressed using a reductionist and mechanistic philosophy, this approach may be limited in its capacity to manage chronic and complex illness. With its holistic foundation, naturopathy is a primary health profession with a purported alignment with a complexity perspective. As such this pilot study aimed to investigate the application of complexity science principles, strategies, and tools to primary health care using naturopathy as a case study.

Methods

A network mapping and analysis of the naturopathic case management process was conducted. Mind maps were created by naturopathic practitioners to reflect their clinical conceptualisation of a common paper clinical case. These mind maps were inputed intoGephi, a network mapping, exploration, and analysis software. Various layouts of the data were produced, and these were analysed using exploratory data analysis and computational network analysis.

Results

Seven naturopathic practitioners participated in the study. In the combined network mapping, 133 unique elements and 399 links were identified. Obesity, the presenting issue in the case, was centrally located. Along with obesity, other keystone elements included: systemic inflammation, dysbiosis, diet, the liver, and mood. Each element was connected on average to 3.05 other elements, with a degree variation between one and 36. Six communities within the dataset were identified, comprising: the nervous system and mood, gastroinstetinal and dietary factors, systemic inflammation and obesity, the endocrine system and metabolism.

Conclusions

This pilot study demonstrates that it is feasible to apply a complexity science perspective to investigating primary health care case management. This supports a shift to viewing the human organism as a complex adaptive system within primary health care settings, with implications for health care practices that are more cognisant with the treatment of chronic and complex conditions and research opportunities to capture the complex clinical reasoning processes of practitioners.
Retrospective descriptive assessment of clinical decision support medication-related alerts in two Saudi Arabian hospitals
Authors: Alsaidan Jamilah Ahmed , Portlock Jane , Ata Sondus I. , Aljadhey Hisham S. , Franklin Bryony Dean
Published: April 2022

Objectives

To determine the frequency of clinical decision support system (CDSS) medication-related alerts generated, accepted, or overridden, to assess appropriateness of alert display and overrides, and to characterise the documentation of clinician justification for these overrides in an academic medical centre in Saudi Arabia.

Materials and methods

System-generated CDSS reports for the period June 2015 to December 2017 were retrospectively reviewed and analysed. Alerts were classified into different types, and rates of alert overrides calculated as percentages of all generated alerts. A subset of 307 overridden alerts was assessed for appropriateness of display and override by two clinical pharmacists. Physician documentation of reasons for overriding alerts were categorised.

Results

A total of 4,446,730 medication-related alerts were generated from both inpatient and outpatient settings, and 4,231,743 (95.2%) were overridden. The most common alert type was ‘duplicate drug’, accounting for 3,549,736 (79.8%) of alerts. Of 307 alerts assessed for appropriateness, 246 (80%) were judged to be appropriately displayed and 244 (79%) were overridden appropriately. New drug allergy and drug allergy alerts had the highest percentage of being judged as inappropriately overridden. For 1,594,313 alerts (37.7%), ‘no overridden reason selected’ was chosen from the drop-down menu.

Conclusions

The alert generation and override rate were higher than reported previously in the literature. The small sample size of 307 alerts assessed for appropriateness of alert display and override is a potential limitation. Revision of the CDSS rules for alerts (focusing on specificity and relevance for the local context) is now recommended. Future research should prospectively assess providers’ perspectives, and determine patient harm associated with overridden alerts.
Multi-label annotation of text reports from computed tomography of the chest, abdomen, and pelvis using deep learning
Authors: D’Anniballe Vincent M. , Tushar Fakrul Islam , Faryna Khrystyna , Han Songyue , Mazurowski Maciej A. , Rubin Geoffrey D. , Lo Joseph Y.
Published: April 2022

Background

There is progress to be made in building artificially intelligent systems to detect abnormalities that are not only accurate but can handle the true breadth of findings that radiologists encounter in body (chest, abdomen, and pelvis) computed tomography (CT). Currently, the major bottleneck for developing multi-disease classifiers is a lack of manually annotated data. The purpose of this work was to develop high throughput multi-label annotators for body CT reports that can be applied across a variety of abnormalities, organs, and disease states thereby mitigating the need for human annotation.

Methods

We used a dictionary approach to develop rule-based algorithms (RBA) for extraction of disease labels from radiology text reports. We targeted three organ systems (lungs/pleura, liver/gallbladder, kidneys/ureters) with four diseases per system based on their prevalence in our dataset. To expand the algorithms beyond pre-defined keywords, attention-guided recurrent neural networks (RNN) were trained using the RBA-extracted labels to classify reports as being positive for one or more diseases or normal for each organ system. Alternative effects on disease classification performance were evaluated using random initialization or pre-trained embedding as well as different sizes of training datasets. The RBA was tested on a subset of 2158 manually labeled reports and performance was reported as accuracy and F-score. The RNN was tested against a test set of 48,758 reports labeled by RBA and performance was reported as area under the receiver operating characteristic curve (AUC), with 95% CIs calculated using the DeLong method.

Results

Manual validation of the RBA confirmed 91–99% accuracy across the 15 different labels. Our models extracted disease labels from 261,229 radiology reports of 112,501 unique subjects. Pre-trained models outperformed random initialization across all diseases. As the training dataset size was reduced, performance was robust except for a few diseases with a relatively small number of cases. Pre-trained classification AUCs reached > 0.95 for all four disease outcomes and normality across all three organ systems.

Conclusions

Our label-extracting pipeline was able to encompass a variety of cases and diseases in body CT reports by generalizing beyond strict rules with exceptional accuracy. The method described can be easily adapted to enable automated labeling of hospital-scale medical data sets for training image-based disease classifiers.
l-Arabinose improves hypercholesterolemia via regulating bile acid metabolism in high-fat-high-sucrose diet-fed mice
Authors: Wang Yu , Zhao Jiajia , Li Qiang , Liu Jinxin , Sun Yujie , Zhang Kuiliang , Fan Mingcong , Qian Haifeng , Li Yan , Wang Li
Published: April 2022

Background

Hypercholesterolemia is closely associated with an increased risk of cardiovascular diseases. l-Arabinose exhibited hypocholesterolemia properties, but underlying mechanisms have not been sufficiently investigated. This study aimed to elucidate the mechanisms of l-arabinose on hypocholesterolemia involving the enterohepatic circulation of bile acids.

Methods

Thirty six-week-old male mice were randomly divided into three groups: the control group and the high-fat-high-sucrose diet (HFHSD)-fed group were gavaged with distilled water, and the l-arabinose-treated group were fed HFHSD and received 400 mg/kg/day l-arabinose for 12 weeks. Serum and liver biochemical parameters, serum and fecal bile acid, cholesterol and bile acid metabolism-related gene and protein expressions in the liver and small intestine were analyzed.

Results

l-Arabinose supplementation significantly reduced body weight gain, lowered circulating low-density lipoprotein cholesterol (LDL-C) while increasing high-density lipoprotein cholesterol (HDL-C) levels, and efficiently alleviated hepatic inflammation and lipid accumulations in HFHSD-fed mice. l-Arabinose inhibited cholesterol synthesis via downregulation of 3-hydroxy-3-methylglutaryl-CoA reductase (HMGCR). Additionally, l-arabinose might facilitate reverse cholesterol transport, evidenced by the increased mRNA expressions of low-density lipoprotein receptor (LDL-R) and scavenger receptor class B type 1 (SR-B1). Furthermore, l-arabinose modulated ileal reabsorption of bile acids mainly through downregulation of ileal bile acid-binding protein (I-BABP) and apical sodium-dependent bile acid transporter (ASBT), resulting in the promotion of hepatic synthesis of bile acids via upregulation of cholesterol-7α-hydroxylase (CYP7A1).

Conclusions

l-Arabinose supplementation exhibits hypocholesterolemic effects in HFHSD-fed mice primarily due to regulation of bile acid metabolism-related pathways.
What is the impact of intellectual property rules on access to medicines? A systematic review
Authors: Tenni Brigitte , Moir Hazel V. J. , Townsend Belinda , Kilic Burcu , Farrell Anne-Maree , Keegel Tessa , Gleeson Deborah
Published: April 2022

Background

It is widely accepted that intellectual property legal requirements such as patents and data exclusivity can affect access to medicines, but to date there has not been a comprehensive review of the empirical evidence on this topic. The World Trade Organization’s Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS) requires Member States to implement minimum standards of intellectual property protection including patents for pharmaceutical products, but also contains ‘flexibilities’ designed to address barriers to access to medicines. National intellectual property laws can also include TRIPS-plus rules that go beyond what is required by TRIPS. We aimed to systematically review literature that measures the impact of intellectual property rules on access to medicines, whether implemented as a result of TRIPS, TRIPS-plus provisions in other trade agreements, or unilateral policy decisions.

Methods

We searched Proquest, SCOPUS, Web of Science, PubMed, JSTOR, Westlaw and Lexis Nexis. Peer reviewed articles, government reports and other grey literature were included. Articles were eligible for inclusion if they were quantitative, in English, included a measure of cost, price, availability of or access to medicines, were about intellectual property or data exclusivity rules and published between January 1995 and October 2020. Ninety-one studies met our inclusion criteria. We systematically reviewed the studies’ findings and evaluated their quality using a modified quality assessment template.

Results and conclusion

Five broad overarching themes and 11 subthemes were identified based on the articles’ foci. They were: trade agreements (divided into EU FTAs and those that include the USA); use of TRIPS flexibilities (divided into compulsory licencing and parallel importation); patent expiry/generic entry/generic pathway (divided into comparative studies and single country studies); patent policies (also divided into comparative studies and single country studies) and TRIPS-plus rules (divided into data exclusivity, patent term extensions and secondary patenting). Most studies focused not on specific trade agreements, but on TRIPS-plus provisions, which can also be found within some trade agreements.

The main finding of this review is that the stronger pharmaceutical monopolies created by TRIPs-plus intellectual property rules are generally associated with increased drug prices, delayed availability and increased costs to consumers and governments. There is evidence that TRIPS flexibilities can facilitate access to medicines although their use is limited to date. There were few studies that included resource poor settings, signalling a need for greater research in such settings where the impact on access to medicines is likely to be more damaging.
Neurofeedback for opioid dependent patients in an outpatient setting: a pilot feasibility study
Authors: Rempala Helena A. , Barterian Justin A.
Published: April 2022

Background

Neurofeedback (NF) has been described as “probably efficacious” when used in conjunction with other interventions for substance use disorders, including the recent studies in the population of individuals with opioid use disorder. Despite these promising outcomes, the seriousness of the opioid epidemic, and the high rate of relapse even with the most effective medication-assisted maintenance treatments NF continues to be an under-researched treatment modality. This article explores factors that affected the feasibility of adding Alpha/Theta Neurofeedback to treatment as usual for opioid dependence in an outpatient urban treatment center. The study strived to replicate previous research completed in Iran that found benefits of NF for opioid dependence.

Methods

Out of approximately two dozen patients eligible for Alpha/Theta NF, about 60% (n = 15) agreed to participate; however, only 2 participants completed treatment. The rates of enrollment in response to active treatment were monitored.

Results

The 4 factors affecting feasibility were: (1) the time commitment required of participants and providers, (2) ineffectiveness of standard incentives to promote participation, (3) delayed effects of training, and (4) the challenges of researching treatment options not reimbursed by the insurance companies.

Conclusions

The findings indicate that a large-scale study examining the use of NF for the treatment of opioid use disorder in the United States will likely be difficult to accomplish without modification to the traditional randomized control study approach and suggests challenges to the implementation of this treatment in an outpatient setting. A single-case methodology is proposed as a viable alternative.
Extending analytic methods for economic evaluation in implementation science
Authors: O’Leary Meghan C. , Hassmiller Lich Kristen , Frerichs Leah , Leeman Jennifer , Reuland Daniel S. , Wheeler Stephanie B.
Published: April 2022

Background

Economic evaluations of the implementation of health-related evidence-based interventions (EBIs) are conducted infrequently and, when performed, often use a limited set of quantitative methods to estimate the cost and effectiveness of EBIs. These studies often underestimate the resources required to implement and sustain EBIs in diverse populations and settings, in part due to inadequate scoping of EBI boundaries and underutilization of methods designed to understand the local context. We call for increased use of diverse methods, especially the integration of quantitative and qualitative approaches, for conducting and better using economic evaluations and related insights across all phases of implementation.

Main body

We describe methodological opportunities by implementation phase to develop more comprehensive and context-specific estimates of implementation costs and downstream impacts of EBI implementation, using the Exploration, Preparation, Implementation, Sustainment (EPIS) framework. We focus specifically on the implementation of complex interventions, which are often multi-level, resource-intensive, multicomponent, heterogeneous across sites and populations, involve many stakeholders and implementation agents, and change over time with respect to costs and outcomes. Using colorectal cancer (CRC) screening EBIs as examples, we outline several approaches to specifying the “boundaries” of EBI implementation and analyzing implementation costs by phase of implementation. We describe how systems mapping and stakeholder engagement methods can be used to clarify EBI implementation costs and guide data collection—particularly important when EBIs are complex. In addition, we discuss the use of simulation modeling with sensitivity/uncertainty analyses within implementation studies for projecting the health and economic impacts of investment in EBIs. Finally, we describe how these results, enhanced by careful data visualization, can inform selection, adoption, adaptation, and sustainment of EBIs.

Conclusion

Health economists and implementation scientists alike should draw from a larger menu of methods for estimating the costs and outcomes associated with complex EBI implementation and employ these methods across the EPIS phases. Our prior experiences using qualitative and systems approaches in addition to traditional quantitative methods provided rich data for informing decision-making about the value of investing in CRC screening EBIs and long-term planning for these health programs. Future work should consider additional opportunities for mixed-method approaches to economic evaluations.
Development of software enabling Chinese medicine-based precision treatment for osteoporosis at the gene and pathway levels
Authors: Li Jinyu , Feng Guiyu , He Haoyang , Wang Haolin , Tang Jia , Han Aiqing , Mu Xiaohong , Zhu Weifeng
Published: April 2022

Background

Precision medicine aims to address the demand for precise therapy at the gene and pathway levels. We aimed to design software to allow precise treatment of osteoporosis (OP) with Chinese medicines (CMs) at the gene and pathway levels.

Methods

PubMed, EMBASE, Cochrane Library, China National Knowledge Infrastructure (CNKI), China Science and Technology Journal Database (VIP database), and the Wanfang database were searched to identify studies treating osteoporosis with CMs. The TCMSP was used to identify bioactive ingredients and related genes for each CM. Gene expression omnibus (GEO) database and the limma package were used to identify differentially expressed genes in osteoporosis. Perl software was used to identify the shared genes between the bioactive components in CM and osteoporosis. R packages and bioconductor packages were used to define the target relationship between shared genes and their related pathways. Third-party Python libraries were used to write program codes. Pyinstaller library was used to create an executable program file.

Results

Data mining: a total of 164 CMs were included, but Drynariae Rhizoma (gusuibu) was used to present this process. We obtained 44 precise relationships among the bioactive ingredients of Drynariae Rhizoma, shared genes, and pathways. Python programming: we developed the software to show the precise relationship among bioactive ingredients, shared genes, and pathways for each CM, including Drynariae Rhizoma.

Conclusions

This study could increase the precision of CM, and could provide a valuable and convenient software for searching precise relationships among bioactive ingredients, shared genes, and pathways.
Knowledge and attitudes towards clinical trials among women with ovarian cancer: results of the ACTO study
Authors: Mosconi Paola , Roberto Anna , Cerana Nicoletta , Colombo Nicoletta , Didier Florence , D’Incalci Maurizio , Lorusso Domenica , Peccatori Fedro Alessandro ,   Network of Clinicians and Participants (1), Artioli Grazia , Cavanna Luigi , Ceccherini Rita , Cirigliano Giovanna , Comerci Giuseppe , Cormio Gennaro , Crippa Alessandra , Farolfi Alberto , Febbraro Antonio , Giardina Donatella , Greggi Stefano , Lalle Maurizio , Lapresa Mariateresa , Marzola Marina , Merisio Carla , Mosconi Anna Maria , Peiretti Michele , Ricci Giuseppe , Ronzino Graziana , Scambia Giovanni , Scollo Paolo , Sina Federica , Stella Giulia Carlo , Tomao Federica , Vici Patrizia , Zola Paolo
Published: April 2022

Background

Despite several initiatives by research groups, regulatory authorities, and scientific associations to engage citizens/patients in clinical research, there are still obstacles to participation. Among the main discouraging aspects are incomplete understanding of the concepts related to a clinical trial, and the scant, sometimes confused, explanations given. This observational, cross-sectional multicenter study investigated knowledge, attitudes and trust in clinical research.

We conducted a survey among women with ovarian cancer at their first follow-up visit or first therapy session, treated in centers belonging to the Mario Negri Gynecologic Oncology (MaNGO) and Multicenter Italian Trials in Ovarian Cancer (MITO) groups. A questionnaire on knowledge, attitudes and experience was assembled ad hoc after a literature review and a validation process involving patients of the Alliance against Ovarian Cancer (ACTO).

Results

From 25 centers 348 questionnaire were collected; 73.5% of responders were 56 years or older, 54.8% had a high level of education, more than 80% had no experience of trial participation. Among participants 59% knew what clinical trials were and 71% what informed consent was. However, more than half did not know the meaning of the term randomization. More than half (56%) were in favor of participating in a clinical trial, but 35% were not certain. Almost all responders acknowledged the doctor’s importance in decision-making. Patients’ associations were recognized as having a powerful role in the design and planning of clinical trials.

Conclusions

This study helps depict the knowledge and attitudes of women with ovarian cancer in relation to clinical trials, suggesting measures aimed at improving trial “culture”, literacy and compliance, and fresh ways of communication between doctors and patients.
CMMRD caused by PMS1 mutation in a sudanese consanguineous family
Authors: Hamad Reem S. , Ibrahim Muntaser E.
Published: April 2022

A consanguineous family of three siblings presented with different early onset pediatric cancers. Whole-exome sequencing of parents DNA revealed a deleterious frameshift mutation in hPMS1 the first to be reported in association to a CMMRD phenotype.
Effect of Baihu and Guizhi decoction in acute gouty arthritis: study protocol for a randomized controlled trial
Authors: He Yikun , Dai Chaoran , Shen Jiaying , Chen Qianwen , Gao Jiandong , Pan Xin , Gan Jing
Published: April 2022

Background

The prevalence rates of gout worldwide have increased annually. Acute gouty arthritis (AGA) accounts for a large proportion of gout patients and causes severe physical and mental pain in patients. Controlling the occurrence and development of gout inflammation is the first step in the treatment of gout. The main treatment drugs in gout are non-steroid anti-inflammatory drugs (NSAIDs), colchicine, and glucocorticoids, but these treatments have many adverse reactions which limit their clinical application. Baihu and Guizhi decoction (BHGZ) is one of the classic prescriptions in the Synopsis of the Golden Chamber and is a good prescription for AGA. Previous clinical studies have shown that BHGZ confers a strong benefit for treating AGA. However, the literature shows a lack of high-quality RCT research on BHGZ with respect to AGA. Therefore, in this study, we use a randomized, double-blind, controlled study with a placebo to evaluate the clinical efficacy and safety of BHGZ on the AGA of moist heat arthralgia spasm syndrome.

Methods

This study is a randomized, double-blind, controlled clinical trial. A total of 102 adult participants with AGA of moist heat arthralgia spasm syndrome will be enrolled, with balanced treatment allocation (1:1). The experimental intervention will be BHGZ plus the low-dose colchicine, and the control intervention will be placebo plus the low-dose colchicine for 10 days. To study the clinical efficacy (including VAS score; joint tenderness, joint swelling, joint movement disorder; TCM evidence efficacy score) and the changes of inflammatory indexes. At the same time, the improvement of joint inflammation in patients with AGA will be observed from musculoskeletal ultrasound imaging, and the safety evaluation will be carried out.

Discussion

This study will be the first placebo-controlled RCT to assess whether BHGZ plus low-dose colchicine have beneficial effects on changing reducing inflammation of joints for patients with AGA of moist heat arthralgia spasm syndrome. The results of this trial will help to provide evidence-based recommendations for clinicians.

Trial registration

Chinese Clinical Trials Register ChiCTR1900024974. Registered on 5 August 2019
A randomized sham-controlled trial on the effects of dual-tDCS “during” physical therapy on lower limb performance in sub-acute stroke and a comparison to the previous study using a “before” stimulation protocol
Authors: Klomjai Wanalee , Aneksan Benchaporn
Published: April 2022

Background

Dual-transcranial direct current stimulation (tDCS) has been used to rebalance the cortical excitability of both hemispheres following unilateral-stroke. Our previous study showed a positive effect from a single-session of dual-tDCS applied before physical therapy (PT) on lower limb performance. However, it is still undetermined if other timings of brain stimulation (i.e., during motor practice) induce better effects. The objective of this study was to examine the effect of a single-session of dual-tDCS “during” PT on lower limb performance in sub-acute stroke and then compare the results with our previous data using a “before” stimulation paradigm.

Method

For the current “during” protocol, 19 participants were participated in a randomized sham-controlled crossover trial. Dual-tDCS over the M1 of both cortices (2 mA) was applied during the first 20 min of PT. The Timed Up and Go and Five-Times-Sit-To-Stand tests were assessed at pre- and post-intervention and 1-week follow-up. Then, data from the current study were compared with those of the previous “before” study performed in a different group of 19 subjects. Both studies were compared by the difference of mean changes from the baseline.

Results

Dual-tDCS “during” PT and the sham group did not significantly improve lower limb performance. By comparing with the previous data, performance in the “before” group was significantly greater than in the “during” and sham groups at post-intervention, while at follow-up the “before” group had better improvement than sham, but not greater than the “during” group.

Conclusion

A single-session of dual-tDCS during PT induced no additional advantage on lower limb performance. The “before” group seemed to induce better acute effects; however, the benefits of the after-effects on motor learning for both stimulation protocols were probably not different.

Trial registration Current randomized controlled trials was prospectively registered at the clinicaltrials.gov, registration number: NCT04051671. The date of registration was 09/08/2019.
Effect of an acute exercise on early responses of iron and iron regulatory proteins in young female basketball players
Authors: Cichoń Justyna , Ostapiuk-Karolczuk Joanna , Cieślicka Mirosława , Dziewiecka Hanna , Marcinkiewicz Anita , Tafil-Klawe Małgorzata , Basta Piotr , Maciejewski Dariusz , Skarpańska-Stejnborn Anna
Published: April 2022

Background

The accumulation of physiological stress and the presence of inflammation disturb iron management in athletes during intense training. However, little is known about the mechanisms regulating iron levels in athletes during training periods with low training loads. In the current study, we analyzed the effect of an acute exercise on early responses of iron and iron regulatory proteins at the end of such training periods.

Methods

The study was performed at the end of competitive phase of training. A total of 27 trained female basketball players were included in the study after application of the inclusion/exclusion criteria. The participants performed an incremental exercise on a treadmill. Blood samples were taken before the test, immediately after exercise, and after 3 h of restitution. Parameters, such as interleukin (IL) 6, hepcidin, ferritin, transferrin, hemopexin, and lactoferrin levels, total iron-biding capacity (TIBC), unsaturated iron-biding capacity (UIBC) were determined by using appropriate biochemical tests.

Results

The level of iron increased significantly after exercise, and then decreased within next 3 h restitution. Except for iron levels, only TIBC levels significantly increased after exercise and decreased to baseline level during rest period. No significant changes in the levels of hepcidin, IL-6, and other proteins related to the iron homeostasis were observed.

Conclusions

The increases in iron level after acute exercise is short-term and transient and appear to have been insufficient to induce the acute systemic effects in rested athletes.
Simultaneous biodegradation of λ-cyhalothrin pesticide and Vicia faba growth promotion under greenhouse conditions
Authors: Abdelkader Aisha A. , Khalil Mary S. , Mohamed Mahmoud S. M.
Published: April 2022

λ-cyhalothrin is a widely used synthetic pyrethroid insecticide and its persistence in plant, soil and water exerts a detrimental effect on humans as well as the environment. There are many studies regarding isolated bacteria capable of degrading λ-cyhalothrin in vitro. However, limited work has been done examining the microbial degradation of λ-cyhalothrin together with plant growth promotion under greenhouse conditions. In this study, 43 bacterial strains were isolated from heavily polluted soil with λ-cyhalothrin by the enrichment technique. The plant growth promotion characteristics of all isolates were evaluated. The results revealed that five isolates were potential in λ-cyhalothrin biodegradation at high concentration (1200 mg/L) within only 24 h together with their high plant growth promotion abilities. The morphological, biochemical and 16S rDNA sequence analyses identified the isolates as Bacillus subtilis strains. The GC/MS analysis revealed that the selected isolates reached high levels of degradation after only two days, the degradation percentage ranged from 95.72 to 99.52% after 48 h of incubation. Furthermore, the degradation pathway for complete detoxification and metabolism of λ-cyhalothrin was established. Moreover, greenhouse experiment was conducted, the results indicate that the application of seed coat significantly enhanced Vicia faba seedling growth and caused an increase from 38.4 to 40.2% percentage of fresh and dry weight, respectively compared to untreated control. All isolates were effective to remove the pesticide residues in Vicia faba seedlings and recorded the highest degradation percentage of 83.79 under greenhouse conditions. Therefore, it can be concluded that the Bacillus subtilis strains isolated in this study have a dual potential role in complete mineralization of λ-cyhalothrin residues in vivo as well as effective biofertilization for future use in sustainable agriculture.
Potential of the microalgae Chlorella fusca (Trebouxiophyceae, Chlorophyta) for biomass production and urban wastewater phycoremediation
Authors: Arrojo María Ángeles , Regaldo Luciana , Calvo Orquín Jesús , Figueroa Félix L. , Abdala Díaz Roberto Teófilo
Published: April 2022

The present work focuses on: (1) the evaluation of the potential of Chlorella fusca to grow and synthesize metabolites of biotechnological interest, after being exposed for fourteen days to urban wastewater (UW) from Malaga city (UW concentrations: 25%, 50%, 75%, and 100%); (2) the study of the capacity of C. fusca to bioremediate UW in photobioreactors at laboratory scale; and (3) the evaluation of the effect of UW on the physiological status of C. fusca, as photosynthetic capacity by using in vivo Chl a fluorescence related to photosystem II and the production of photosynthetic pigments. C. fusca cell density increased in treatments with 50% UW concentration, followed by the treatment with 100% UW, 75% UW, the control, and finally 25% UW. Protein content increased to 50.5% in 75% UW concentration. Stress induced to microalgal cultures favored the increase of lipid production, reaching a maximum of 16.7% in 100% UW concentration. The biological oxygen demand (BOD5) analysis indicated a 75% decrease in 100% UW concentration. Dissolved organic carbon (DOC) levels decreased by 41% and 40% in 50% UW and 100% UW concentration, and total nitrogen (TN) decreased by 55% in 50% UW concentration. The physiological status showed the stressful effect caused by the presence of UW on photosynthetic activity, with increasing impact as UW concentration grew. In the framework of circular economy, we seek to deepen this study to use the biomass of C. fusca to obtain metabolites of interest for biofuel production and other biotechnological areas.

Graphical Abstract
Precious blood and nourishing offal: past and present slaughtering perspectives in Sámi reindeer pastoralism
Authors: Sara Ravdna Biret Marja E. , Syse Karen Lykke , Mathiesen Svein Disch
Published: April 2022

In the Arctic, indigenous reindeer herding peoples rely on a pastoralist food and knowledge system that supplies them with protein, vitamins, and minerals. Reindeer pastoralism is a product of the interaction between animals’ physical needs, their behaviour, and the skills of the herders. The food systems of Sámi reindeer pastoralists depend on indigenous knowledge about mountain slaughtering. When the first stationary reindeer slaughterhouse opened in Guovdageaidnu (Northern Norway) in 1957, rationalisation of reindeer husbandry and methods of reindeer slaughter took place. Animal welfare and reindeer slaughter within slaughterhouses are well-documented in Norway; the historical knowledge about slaughtering reindeer in the mountains, however, is barely documented and is in danger of being lost. A qualitative study entailing interviews with five Sámi reindeer herders (50–80 years old) from Guovdageaidnu and Varanger explains indigenous, nomadic methods of killing and slaughtering reindeer. The traditional Sámi way of killing reindeer (Sámi:giehtadit) was to pierce the heart with a large knife through the chest (Sámi:mielga), particularly in the pastures close to where the herd grazed to avoid distressing the reindeer before taking their lives. This allowed reindeer herders to use the whole reindeer for food, unlike the practice in stationary slaughterhouses, which merely utilises select muscles for human consumption. Although the Supreme Court of Norway in 2008 ruled that traditional slaughter practice without stunning was illegal, this historical account provides evidence that thegiehtaditmethod was a rational way to kill a reindeer, as bleeding (haemorrhage) in the thorax offers both high-quality blood, offal, and meat for human consumption. We conclude that the traditional Sámi method is based on systematic, complex, and holistic indigenous knowledge and determines the foods reindeer herders eat.
Reindeer herding statistics in Russia: issues of reliability, interpretation, and political effect
Authors: Istomin Kirill V. , Laptander Roza I. , Habeck Joachim Otto
Published: April 2022

Official reindeer herding statistics are an invaluable source of data for both social and natural scientists wishing to understand and model ecological systems in the Arctic. However, as with all official statistics, reindeer herding statistics are subject to certain distortions emerging from the way they are collected and processed as well as from a priori assumptions. In this article, we analyse Soviet/Russian reindeer herding statistics in order to reveal these distortions and assumptions and show how these statistics should be interpreted. Particularly, we analyse reindeer ownership categories and reindeer age/sex categories, spatial organization of the data, so-called magical numbers (statistical parameters used by the state to assess the quality of reindeer herding management), and the manner of collecting statistics. We show that official Soviet/Russian statistics reflected the world as the state wanted to see it, even if it obviously did not completely correspond to the world ‘out there’. In Soviet times, the state even made systematic attempts to change this world to better correspond to the statistics, which, however, was never fully achieved. On the basis of this analysis, we offer some recommendations for how an interested researcher should read and understand Russian reindeer herding statistics.
Crystal structure of the Ilheus virus helicase: implications for enzyme function and drug design
Authors: Wang De-Ping , Wang Mei-Yue , Li Yong-Mei , Shu Wen , Cui Wen , Jiang Fang-Ying , Zhou Xin , Wang Wen-Ming , Cao Ji-Min
Published: April 2022

Background

The Ilheus virus (ILHV) is an encephalitis associated arthropod-borne flavivirus. It was first identified in Ilheus City in the northeast Brazil before spreading to a wider geographic range. No specific vaccines or drugs are currently available for the treatment of ILHV infections. The ILHV helicase, like other flavivirus helicases, possesses 5ʹ-triphosphatase activity. This allows it to perform ATP hydrolysis to generate energy as well as sustain double-stranded RNA’s unwinding during ILHV genome replication. Thus, ILHV helicase is an ideal target for inhibitor design.

Results

We determined the crystal structure of the ILHV helicase at 1.75-Å resolution. We then conducted molecular docking of ATP-Mn2+to the ILHV helicase. Comparisons with related flavivirus helicases indicated that both the NTP and the RNA-ILHV helicase binding sites were conserved across intra-genus species. This suggested that ILHV helicase adopts an identical mode in recognizing ATP/Mn2+. However, the P-loop in the active site showed a distinctive conformation; reflecting a different local structural rearrangement. ILHV helicase enzymatic activity was also characterized. This was found to be relatively lower than that of the DENV, ZIKV, MVE, and ALSV helicases. Our structure-guided mutagenesis revealed that R26A, E110A, and Q280A greatly reduced the ATPase activities. Moreover, we docked two small molecule inhibitors of DENV helicase (ST-610 and suramin) to the ILHV helicase and found that these two molecules had the potential to inhibit the activity of ILHV helicase as well.

Conclusion

High-resolution ILHV helicase structural analysis demonstrates the key amino acids of ATPase activities and could be useful for the design of inhibitors targeting the helicase of ILHV.
Mapping evidence on the use of health promotion and disease prevention interventions as a strategy to sustaining pro-poor health insurance schemes: a scoping review protocol
Authors: Inkoom Loretta , Ansu-Mensah Monica , Bawontuo Vitalis , Kuupiel Desmond
Published: April 2022

Background

Removing financial barriers and making healthcare accessible to all who need it remains an essential component of the United Nations’ sustainable development goals. Pro-poor healthcare financing schemes are policies that enable patients to concentrate on obtaining absolute medical care when needed rather than worrying about the cost of care. The demand for health services in healthcare facilities has increased tremendously due to the increasing burden of communicable and non-communicable diseases. This potentially threatens the sustainability of pro-poor health financing schemes. This study seeks to synthesize literature and map evidence on the use of health promotion and disease prevention interventions as a strategy to sustaining pro-poor health financing schemes globally.

Methods

We will conduct a systematic scoping review utilizing the Arksey and O’Malley framework, Levac et al. recommendations, and the Joanna Briggs Institute guidelines. A comprehensive keyword search for relevant published articles will be conducted in MEDLINE through PubMed, Web of Science, Google Scholar, SCOPUS, CINAHL, and Science Direct from 1 January 2000 to the last search date in 2021. Limiters such as date and language (English) will be applied, but study design limitations will be removed during the search. Boolean term AND/OR Medical Subject Heading terms will also be included. The reference list of all included articles will also be searched for potentially eligible articles. Two investigators will independently screen the articles in parallel at the abstract and full-text stages using the eligibility criteria designed in a Google form. Charting of data will also be conducted independently by two investigators using a piloted data abstraction form and thematic analysis conducted. The emerging themes will be collated, summarized, and the results reported.

Discussion

We hope to provide evidence of diverse health promotion and disease prevention policies/strategies used by countries to sustain their pro-poor health financing schemes for possible adoption by other countries. We also anticipate finding research gaps for further studies to help find innovative contextualized health prevention and promotion strategies to sustain pro-poor health financing schemes especially those in LMICs. The findings will be comprehensively discussed and disseminated at conferences and publication in a peer-reviewed journal.
Tolerability of duloxetine in elderly and in non-elderly adults: a protocol of a systematic review and individual participant data meta-analysis of randomized placebo-controlled trials
Authors: Roy Jean-Charles , Rousseau Chloé , Jutel Alexis , Naudet Florian , Robert Gabriel
Published: April 2022

Background

Duloxetine is an antidepressant that benefits from a wide range of approval in the elderly population, while its safety for use compared to non-elderly is not clearly assessed. This protocol outlines a systematic review and individual participant data meta-analysis comparing the tolerability of duloxetine between elderly and non-elderly.

Methods

Searches will be conducted in PubMed, ClinicalTrials.gov, Clinicaltrialsregister.eu, data sharing platforms, FDA drug approval packages, European public assessment reports and withdrawn applications from the EMA website. The review will be performed on studies available in electronic databases from their date of inception to the 31 March 2022. Only randomized controlled clinical trials, comparing duloxetine to placebo, will be included in this meta-analysis. The studies will be selected if they comprise both elderly and non-elderly adults, in conditions of use of duloxetine approved by the European Medical Agency (EMA) and the Food and Drug Administration (FDA). The primary outcome will be the rate ratio of serious adverse events under duloxetine compared to placebo, between participants at least 65 years old and non-elderly. Second, the number of any adverse events, clinical efficacy and quality of life will be compared between elderly and non-elderly under both interventions. The quality of evidence in the tolerability of duloxetine will be assessed using the GRADE system. A one or two-stage individual participant data random effect meta-analysis will be conducted depending on the availability of the data.

Discussion

This meta-analysis will investigate the tolerability safety of duloxetine in the elderly population across all conditions approved by European and American regulatory authorities. The results from this meta-analysis are intended to help prescribers to provide better care for the elderly population.

Systematic review registration

The protocol has been registered at the International Prospective Register of Systematic Reviews (PROSPERO; registration number: CRD42019130488).
Effects of greenhouse gases and hypoxia on the population of aquatic species: a fractional mathematical model
Authors: Kumar Pushpendra , Govindaraj V. , Erturk Vedat Suat , Mohamed Mohamed S.
Published: April 2022

Study of ecosystems has always been an interesting topic in the view of real-world dynamics. In this paper, we propose a fractional-order nonlinear mathematical model to describe the prelude of deteriorating quality of water cause of greenhouse gases on the population of aquatic animals. In the proposed system, we recall that greenhouse gases raise the temperature of water, and because of this reason, the dissolved oxygen level goes down, and also the rate of circulation of disintegrated oxygen by the aquatic animals rises, which causes a decrement in the density of aquatic species. We use a generalized form of the Caputo fractional derivative to describe the dynamics of the proposed problem. We also investigate equilibrium points of the given fractional-order model and discuss the asymptotic stability of the equilibria of the proposed autonomous model. We recall some important results to prove the existence of a unique solution of the model. For finding the numerical solution of the established fractional-order system, we apply a generalized predictor–corrector technique in the sense of proposed derivative and also justify the stability of the method. To express the novelty of the simulated results, we perform a number of graphs at various fractional-order cases. The given study is fully novel and useful for understanding the proposed real-world phenomena.
Vertical program of screenings and check-ups in the Russian Federation: design, implementation and lessons learnt
Authors: Sheiman Igor , Shishkin Sergey , Sazhina Svetlana
Published: April 2022

Background

The Russian Federation has introduced a vertical large-scale program of ‘dispensarization’ (Program) that includes health check-ups and screenings for the entire adult population. It is expected to improve the results of medical interventions and ensure health gains at a relatively low cost. The major research question: Does the design and implementation of the program meet the expectations?

Methods

We analyze regulatory acts and the literature on the design and the outcomes of the Program. Physicians’ surveys and interviews are conducted to understand the capacity of primary care providers to meet the requirements of the Program, as well as the link between the early identification of new illnesses and their follow-up management, administration of the program, the barriers to its successful implementation.

Results

There is a substantial progress in the coverage of the population and increase in the number of identified illnesses. Some specific instruments of the Program implementation work well, others require more careful design and additional integrative and managerial activities. The capacity of primary care providers does not allow to provide high quality preventive services, as well as to ensure a continuum of preventive and curative work. The pattern of the Program administration facilitates its nation-wide implementation according to the unified rules, but makes it more difficult to account for the local conditions and limits the autonomy of professionals to choose specific population risk groups and a list of services. The interaction of providers in preventive activities is inadequate.

Conclusion

The expectations of the Program are too high due to the inconsistencies in its design and implementation. The major lesson learnt is that the program like this should meet the capacity of primary care and be designed as a complex of interrelated activities to identify illnesses and provide their follow-up management.