bluuebunny/crossref_metadata_2025 huggingface dataset:
Health of migrants, refugees and asylum seekers in detention in Tripoli, Libya, 2018-2019: Retrospective analysis of routine medical programme data
Authors: Kuehne Anna , van Boetzelaer Elburg , Alfani Prince , Fotso Adolphe , Elhammali Hitham , Khamala Tom , Thorson Trygve , Angelova Ilina , Benvenuti Bianca , Pop-Stefanija Biserka , Verdecchia Maria , Kremer Ronald
Published: June 2021

Libya is a major transit and destination country for international migration. UN agencies estimates 571,464 migrants, refugees and asylum seekers in Libya in 2021; among these, 3,934 people are held in detention. We aimed to describe morbidities and water, hygiene, and sanitation (WHS) conditions in detention in Tripoli, Libya. We conducted a retrospective analysis of data collected between July 2018 and December 2019, as part of routine monitoring within an Médecins Sans Frontières (MSF) project providing healthcare and WHS support for migrants, refugees and asylum seekers in some of the official detention centres (DC) in Tripoli. MSF had access to 1,630 detainees in eight different DCs on average per month. Only one DC was accessible to MSF every single month. The size of wall openings permitting cell ventilation failed to meet minimum standards in all DCs. Minimum standards for floor space, availability of water, toilets and showers were frequently not met. The most frequent diseases were acute respiratory tract infections (26.9%; 6,775/25,135), musculoskeletal diseases (24.1%; 6,058/25,135), skin diseases (14.1%; 3,538/25,135) and heartburn and reflux (10.0%; 2,502/25,135). Additionally, MSF recorded 190 cases of violence-induced wounds and 55 cases of sexual and gender-based violence. During an exhaustive nutrition screening in one DC, linear regression showed a reduction in mid-upper arm circumference (MUAC) of 2.5mm per month in detention (95%-CI 1.3–3.7, p<0.001). Detention of men, women and children continues to take place in Tripoli. Living conditions failed to meet minimum requirements. Health problems diagnosed at MSF consultations reflect the living conditions and consist largely of diseases related to overcrowding, lack of water and ventilation, and poor diet. Furthermore, every month that people stay in detention increases their risk of malnutrition. The documented living conditions and health problems call for an end of detention and better protection of migrants, refugees and asylum seekers in Libya.
Access to care solutions in healthcare for obstetric care in Africa: A systematic review
Authors: Joiner Anjni , Lee Austin , Chowa Phindile , Kharel Ramu , Kumar Lekshmi , Caruzzo Nayara Malheiros , Ramirez Thais , Reynolds Lindy , Sakita Francis , Van Vleet Lee , von Isenburg Megan , Yaffee Anna Quay , Staton Catherine , Vissoci Joao Ricardo Nickenig
Published: June 2021

Background

Emergency Medical Services (EMS) systems exist to reduce death and disability from life-threatening medical emergencies. Less than 9% of the African population is serviced by an emergency medical services transportation system, and nearly two-thirds of African countries do not have any known EMS system in place. One of the leading reasons for EMS utilization in Africa is for obstetric emergencies. The purpose of this systematic review is to provide a qualitative description and summation of previously described interventions to improve access to care for patients with maternal obstetric emergencies in Africa with the intent of identifying interventions that can innovatively be translated to a broader emergency context.

Methods

The protocol was registered in the PROSPERO database (International Prospective Register of Systematic Reviews) under the number CRD42018105371. We searched the following electronic databases for all abstracts up to 10/19/2020 in accordance to PRISMA guidelines: PubMed/MEDLINE, Embase, CINAHL, Scopus and African Index Medicus. Articles were included if they were focused on a specific mode of transportation or an access-to-care solution for hospital or outpatient clinic care in Africa for maternal or traumatic emergency conditions. Exclusion criteria included in-hospital solutions intended to address a lack of access. Reference and citation analyses were performed, and a data quality assessment was conducted. Data analysis was performed using a qualitative metasynthesis approach.

Findings

A total of 6,457 references were imported for screening and 1,757 duplicates were removed. Of the 4,700 studies that were screened against title and abstract, 4,485 studies were excluded. Finally, 215 studies were assessed for full-text eligibility and 152 studies were excluded. A final count of 63 studies were included in the systematic review. In the 63 studies that were included, there was representation from 20 countries in Africa. The three most common interventions included specific transportation solutions (n = 39), community engagement (n = 28) and education or training initiatives (n = 27). Over half of the studies included more than one category of intervention.

Interpretation

Emergency care systems across Africa are understudied and interventions to improve access to care for obstetric emergencies provides important insight into existing solutions for other types of emergency conditions. Physical access to means of transportation, efforts to increase layperson knowledge and recognition of emergent conditions, and community engagement hold the most promise for future efforts at improving emergency access to care.
Bone marrow derived mast cells injected into the osteoarthritic knee joints of mice induced by sodium monoiodoacetate enhanced spontaneous pain through activation of PAR2 and action of extracellular ATP
Authors: Habuchi Hiroko , Izumi Masashi , Dan Junpei , Ushida Takahiro , Ikeuchi Masahiko , Takeuchi Kosei , Habuchi Osami
Published: June 2021

Conditions that resemble osteoarthritis (OA) were produced by injection of sodium monoiodoacetate (MIA) into the knee joints of mice. Bone marrow derived mast cells (BMMCs) injected into the OA knee joints enhanced spontaneous pain. Since no spontaneous pain was observed when BMMCs were injected into the knee joints of control mice that had not been treated with MIA, BMMCs should be activated within the OA knee joints and release some pain-inducible factors. Protease activated receptor-2 (PAR2) antagonist (FSLLRY-NH2) almost abolished the pain-enhancing effects of BMMCs injected into the OA knee joints, suggesting that tryptase, a mast cell protease that is capable of activating PAR2, should be released from the injected BMMCs and enhance pain through activation of PAR2. When PAR2 agonist (SLIGKV-NH2) instead of BMMCs was injected into the OA knee joints, it was also enhanced pain. Apyrase, an ATP degrading enzyme, injected into the OA knee joints before BMMCs suppressed the pain enhanced by BMMCs. We showed that purinoceptors (P2X4 and P2X7) were expressed in BMMCs and that extracellular ATP stimulated the release of tryptase from BMMCs. These observations suggest that ATP may stimulate degranulation of BMMCs and thereby enhanced pain. BMMCs injected into the OA knee joints stimulated expression of IL-1β, IL-6, TNF-α, CCL2, and MMP9 genes in the infrapatellar fat pads, and PAR2 antagonist suppressed the stimulatory effects of BMMCs. Our study suggests that intermittent pain frequently observed in OA knee joints may be due, at least partly, to mast cells through activation of PAR2 and action of ATP, and that intraarticular injection of BMMCs into the OA knee joints may provide a useful experimental system for investigating molecular mechanisms by which pain is induced in OA knee joints.
Heparan sulfate proteoglycans in beta cells provide a critical link between endoplasmic reticulum stress, oxidative stress and type 2 diabetes
Authors: Dhounchak Sarita , Popp Sarah K. , Brown Debra J. , Laybutt D. Ross , Biden Trevor J. , Bornstein Stefan R. , Parish Christopher R. , Simeonovic Charmaine J.
Published: June 2021

Heparan sulfate proteoglycans (HSPGs) consist of a core protein with side chains of the glycosaminoglycan heparan sulfate (HS). We have previously identified (i) the HSPGs syndecan-1 (SDC1), and collagen type XVIII (COL18) inside mouse and human islet beta cells, and (ii) a critical role for HS in beta cell survival and protection from reactive oxygen species (ROS). The objective of this study was to investigate whether endoplasmic reticulum (ER) stress contributes to oxidative stress and type 2 diabetes (T2D) by depleting beta cell HSPGs/HS. A rapid loss of intra-islet/beta cell HSPGs, HS and heparanase (HPSE, an HS-degrading enzyme) accompanied upregulation of islet ER stress gene expression in both young T2D-prone db/db and Akita Ins2WT/C96Y mice. In MIN6 beta cells, HSPGs, HS and HPSE were reduced following treatment with pharmacological inducers of ER stress (thapsigargin or tunicamycin). Treatment of young db/db mice with Tauroursodeoxycholic acid (TUDCA), a chemical protein folding chaperone that relieves ER stress, improved glycemic control and increased intra-islet HSPG/HS. In vitro, HS replacement with heparin (a highly sulfated HS analogue) significantly increased the survival of wild-type and db/db beta cells and restored their resistance to hydrogen peroxide-induced death. We conclude that ER stress inhibits the synthesis/maturation of HSPG core proteins which are essential for HS assembly, thereby exacerbating oxidative stress and promoting beta cell failure. Diminished intracellular HSPGs/HS represent a previously unrecognized critical link bridging ER stress, oxidative stress and beta cell failure in T2D.
Immunohistochemical expression of substance P in breast cancer and its association with prognostic parameters and Ki-67 index
Authors: Al-Keilani Maha S. , Elstaty Rana I. , Alqudah Mohammad A. , Alkhateeb Asem M.
Published: June 2021

Background

The neuropeptide substance P is a potential biomarker and therapeutic target in cancer. The main objectives of this study were to investigate the expression level of substance P in different breast cancer molecular subtypes and identify its association with clinicopathological parameters of patients and with Ki-67 index.

Methods

A retrospective analysis was performed for a total of 164 paraffin-embedded breast cancer tissue samples [42 Her2/neu-enriched, 40 luminal A, 42 luminal B (triple-positive) and 40 triple negative subtypes]. The tissue microarray slides containing specimens were used to determine the expression of substance p and Ki-67 by immunohistochemical staining.

Results

The mean age of the cohort was 51.35 years. Twenty two percent of cases had low substance P expression levels (TS ≤ 5), while 78% had high expression levels (TS > 5). A significant association was found between SP expression level and breast cancer molecular subtype (p = 0.002), TNM stage (p = 0.034), pN stage (p = 0.013), axillary lymph node metastasis (p = 0.004), ER and PR statuses (p<0.001) and history of DCIS (p = 0.009). The average percentage of Ki-67 expression was 27.05%. When analyzed as a continuous variable, significant differences were observed between the mean Ki-67 scores and molecular subtype (p = 0.001), grade (p = 0.003), pN stage (p = 0.007), axillary lymph node metastasis (p = 0.001), and ER and PR statuses (p <0.001).

Conclusion

SP is overexpressed in most of the analyzed tissues and has a negative prognostic value in the breast cancer patients. Besides substance P is a potential therapeutic target in breast cancer.
Characteristics and outcomes of pregnant women with placenta accreta spectrum in Italy: A prospective population-based cohort study
Authors: Ornaghi Sara , Maraschini Alice , Donati Serena ,   on behalf of The Regional Obstetric Surveillance System Working Group
Published: June 2021

Introduction

Placenta accreta spectrum (PAS) is a rare but potentially life-threatening event due to massive hemorrhage. Placenta previa and previous cesarean section are major risk factors for PAS. Italy holds one of the highest rates of primary and repeated cesarean section in Europe; nonetheless, there is a paucity of high-quality Italian data on PAS. The aim of this paper was to estimate the prevalence of PAS in Italy and to evaluate its associated factors, ante- and intra-partum management, and perinatal outcomes. Also, since severe morbidity and mortality in Italy show a North-South gradient, we assessed and compared perinatal outcomes of women with PAS according to the geographical area of delivery.

Material and methods

This was a prospective population-based study using the Italian Obstetric Surveillance System (ItOSS) and including all women aged 15–50 years with a diagnosis of PAS between September 2014 and August 2016. Six Italian regions were involved in the study project, covering 49% of the national births. Cases were prospectively reported by a trained clinician for each participating maternity unit by electronic data collection forms. The background population comprised all women who delivered in the participating regions during the study period.

Results

A cohort of 384 women with PAS was identified from a source population of 458 995 maternities for a prevalence of 0.84/1000 (95% CI, 0.75–0.92). Antenatal suspicion was present in 50% of patients, who showed reduced rates of blood transfusion compared to unsuspected patients (65.6% versus 79.7%, P = 0.003). Analyses by geographical area showed higher rates of both concomitant placenta previa and prior CS (62.1% vs 28.7%, P<0.0001) and antenatal suspicion (61.7% vs 28.7%, P<0.0001) in women in Southern compared to Northern Italy. Also, these women had lower rates of hemorrhage ≥2000 mL (29.6% vs 51.2%, P<0.0001), blood transfusion (64.5% vs 87.5%, P = 0.001), and severe maternal morbidity (5.0% vs 11.1%, P = 0.036). Delivery in a referral center for PAS occurred in 71.9% of these patients.

Conclusions

Antenatal suspicion of PAS is associated with improved maternal outcomes, also among high-risk women with both placenta previa and prior CS, likely because of their referral to specialized centers for PAS management.
Clarity of task difficulty moderates the impact of the explicit achievement motive on physical effort in hand grip tasks
Authors: Richter Michael , Mazeres Florence , Brinkmann Kerstin
Published: June 2021

Stable personality dispositions, like motives, are often assumed to exert a direct, stable impact on behavior. This also applies to the explicit achievement motive, which is supposed to influence the behavior that individuals select and how strongly they engage in it. Drawing on motivational intensity theory, we demonstrated in two studies that explicit achievement motive strength only predicted exerted force in a hand grip task if task difficulty was unclear. If task difficulty was clear, explicit achievement motive strength did not influence exerted force. Our findings suggest that the availability of information about the difficulty of motive satisfaction moderates the impact of the explicit achievement motive on behavior.
Molecular imaging can identify the location to perform a frozen biopsy during intraoperative frozen section consultation
Authors: Bryski Mitchell G. , Frenzel-Sulyok Lydia G. , Delikatny E. James , Deshpande Charuhas , Litzky Leslie A. , Singhal Sunil
Published: June 2021

Background

Intraoperative frozen section (FS) consultation is an important tool in surgical oncology that suffers from sampling error because the pathologist does not always know where to perform a biopsy of the surgical specimen. Intraoperative molecular imaging is a technology used in the OR to visualize lesions during surgery. We hypothesized that molecular imaging can address this pathology challenge in FS by visualizing the cancer cells in the specimen in the pathology suite. Here, we report the development and validation of a molecular-imaging capable cryostat called Smart-Cut.

Methods

A molecular imaging capable cryostat prototype was developed and tested using a murine model. Tumors grown in mice were targeted with a NIR contrast agent, indocyanine green (ICG), via tail vein injection. Tumors and adjacent normal tissue samples were frozen sectioned with Smart-Cut. Fluorescent sections and non-fluorescent sections were prepared for H&E and fluorescent microscopy. Fluorescent signal was quantified by tumor-to-background ratio (TBR). NIR fluorescence was tested in one patient enrolled in a clinical trial.

Results

The Smart-Cut prototype has a small footprint and fits well in the pathology suite. Fluorescence imaging with Smart-Cut identified cancerous tissue in the specimen in all 12 mice. No false positives or false negatives were seen, as confirmed by H&E. The mean TBR in Smart-Cut positive tissue sections was 6.8 (SD±3.8). In a clinical application in the pathology suite, NIR imaging identified two lesions in a pulmonary resection specimen, where traditional grossing only identified one.

Conclusion

Molecular imaging can be integrated into the pathology suite via the Smart-Cut device, and can detect cancer in frozen tissue sections using molecular imaging in a murine model.
Accident and pollution risk assessment for hazardous cargo in a port environment
Authors: Khan Rafi Ullah , Yin Jingbo , Mustafa Faluk Shair
Published: June 2021

The catastrophic environmental, life and monetary losses concomitant to the hazardous cargo accidents have remained a matter of critical concern for the maritime transportation officials. The factors that instigate these accidents while dealing with hazardous cargo in a port environment requires rigorous analysis and evaluation, which still remains in its infancy. In accord to these prevailing issues, this study focusses on the assessment of multifactor risks associated with the dealing of hazardous cargos inside a port. The methodology adopted is the amalgamation of expert judgment and literature review for the identification of factors and developing their causal relationship, while Bayesian Network (BN) for the inference, which was based on 348 past accident reports from the year 1990 to 2018. The results indicate that under normal circumstances, the probability of an accident with considerable consequences is 59.8, where human and management were found to be the highest contributing factors. Setting evidence at the environment and pollution accident to occur, the incidence probability of the “management” is raised by 7.06%. A sensitivity analysis was conducted to determine the most critical factors for the hazardous cargo accident. This study reveals that in order to evade the hazardous cargo accidents and curtail severity of the consequences, the port authorities, concerned government departments and other related institutions should pay specific attention to the qualification, training and attitude of the involved workforce. Moreover, the development and implementation of stringent safety protocols was also revealed to have critical prominence. This study holds practical vitality for enhancing safety and mitigating risks associated to hazardous cargo dealing in a port.
Deep learning-based prediction of future growth potential of technologies
Authors: Lee June Young , Ahn Sejung , Kim Dohyun
Published: June 2021

Research papers are a repository of information on the various elements that make up science and technology R&D activities. Generating knowledge maps based on research papers enables identification of specific areas of scientific and technical research as well as understanding of the flow of knowledge between those areas. Recently, as the number of electronic publishing and informatics archives along with the amount of accumulated knowledge related to science and technology has proliferated, the need to utilize the meta-knowledge obtainable from research papers has increased. Therefore, this study devised a model based on meta-knowledge (i.e., text information including citations, abstracts, area codes) for prediction of future growth potential using deep learning algorithms and investigated the applicability of the various forms of meta-knowledge to the prediction of future growth potential. It also proposes how to select the promising technology clusters based on the proposed model.
From the real device to the digital twin: A coupled experimental-numerical strategy to investigate a novel bioresorbable vascular scaffold
Authors: Antonini Luca , Berti Francesca , Isella Benedetta , Hossain Dipok , Mandelli Lorenzo , Pennati Giancarlo , Petrini Lorenza
Published: June 2021

The purpose of this work is to propose a workflow that couples experimental and computational activities aimed at developing a credible digital twin of a commercial coronary bioresorbable vascular scaffold when direct access to data about material mechanical properties is not possible. Such a situation is be faced when the manufacturer is not involved in the study, thus directly investigating the actual device is the only source of information available. The object of the work is the Fantom® Encore polymeric stent (REVA Medical) made of Tyrocore™. Four devices were purchased and used in mechanical tests that are easily reproducible in any mechanical laboratory, i.e. free expansion and uniaxial tension testing, the latter performed with protocols that emphasized the rate-dependent properties of the polymer. Given the complexity of the mechanical behaviour observed experimentally, it was chosen to use the Parallel Rehological Framework material model, already used in the literature to describe the behaviour of other polymers, such as PLLA. Calibration of the material model was based on simulations that replicate the tensile test performed on the device. Given the high number of material parameters, a plan of simulations was done to find the most suitable set, varying each parameter value in a feasible range and considering a single repetitive unit of the stent, neglecting residual stresses generated by crimping and expansion. This strategy resulted in a significant reduction of computational cost. The performance of the set of parameters thus identified was finally evaluated considering the whole delivery system, by comparing the experimental results with the data collected simulating free expansion and uniaxial tension testing. Moreover, radial force testing was numerically performed and compared with literature data. The obtained results demonstrated the effectiveness of the digital twin development pipeline, a path applicable to any commercial device whose geometric structure is based on repetitive units.
Development of an efficient one-step real-time reverse transcription polymerase chain reaction method for severe acute respiratory syndrome-coronavirus-2 detection
Authors: Nakura Yukiko , Wu Heng Ning , Okamoto Yuya , Takeuchi Muneyuki , Suzuki Koichiro , Tamura Yoshitaka , Oba Yuichiro , Nishiumi Fumiko , Hatori Nobuaki , Fujiwara Shinsuke , Yasukawa Kiyoshi , Ida Shinobu , Yanagihara Itaru
Published: June 2021

The general methods to detect the RNA of severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) in clinical diagnostic testing involve reverse transcriptases and thermostable DNA polymerases. In this study, we compared the detection of SARS-CoV-2 by a one-step real-time RT-PCR method using a heat-resistant reverse transcriptase variant MM4 from Moloney murine leukemia virus, two thermostable DNA polymerase variants with reverse transcriptase activity from Thermotoga petrophila K4 and Thermococcus kodakarensis KOD1, or a wild-type DNA polymerase from Thermus thermophilus M1. The highest performance was achieved by combining MM4 with the thermostable DNA polymerase from T. thermophilus M1. These enzymes efficiently amplified specific RNA using uracil-DNA glycosylase (UNG) to remove contamination and human RNase P RNA amplification as an internal control. The standard curve was obtained from 5 to 105 copies of synthetic RNA. The one-step real-time RT-PCR method’s sensitivity and specificity were 99.44% and 100%, respectively (n = 213), compared to those of a commercially available diagnostic kit. Therefore, our method will be useful for the accurate detection and quantification of SARS-CoV-2.
Visual preference for social vs. non-social images in young children with autism spectrum disorders. An eye tracking study
Authors: Vacas Julia , Antolí Adoración , Sánchez-Raya Araceli , Pérez-Dueñas Carolina , Cuadrado Fátima
Published: June 2021

Autism Spectrum Disorders (ASD) are associated to social attention (SA) impairments. A gaze bias to non-social objects over faces has been proposed as an early marker of ASD. This bias may be related to the concomitant circumscribed interests (CI), which question the role of competing objects in this atypical visual behavior. The aim of this study was to compare visual attention patterns to social and non-social images in young children with ASD and matched typical controls (N = 36; age range 41–73 months) assessing the role of emotion in facial stimuli and the type of competing object. A paired preference task was designed pairing happy, angry, and neutral faces with two types of objects (related or not related to autism CI). Eye tracking data were collected, and three indexes were considered as dependent variables: prioritization (attentional orientation), preference, and duration (sustained attention). Results showed that both groups had similar visual pattern to faces (prioritization, more attention and longer visits to faces paired with objects non-related to their CI); however, the ASD group attended to faces significantly less than controls. Children with ASD showed an emotional bias (late orientation to angry faces and typical preference for happy faces). Finally, objects related to their CI captured attention in both groups, significantly reducing SA in children with ASD. Atypical SA is present in young children with ASD regardless the competing non-social object. Identifying strengths and difficulties in SA in this population may have substantial repercussion for early diagnosis, intervention, and ultimately prognosis.
Electronic cigarette use (vaping) and patterns of tobacco cigarette smoking in pregnancy–evidence from a population-based maternity survey in England
Authors: Opondo Charles , Harrison Siân , Alderdice Fiona , Carson Claire , Quigley Maria A.
Published: June 2021

Objectives

Exposure to tobacco products during pregnancy presents a potential harm to both mother and baby. This study sought to estimate the prevalence of vaping during pregnancy and to explore the factors and outcomes associated with vaping in pregnancy.

Setting

England.

Participants

Women who gave birth between 15th and 28th October 2017.

Methods

A cross-sectional population-based postal survey of maternal and infant health, the National Maternity Survey (NMS) 2018. The prevalence of vaping and patterns of cigarette smoking were estimated, and regression analysis was used to explore associations between maternal characteristics and vaping, and between vaping and birth outcomes.

Outcome measures

Unweighted and weighted prevalence of vaping with 95% confidence intervals, and unadjusted and adjusted relative risks or difference in means for the association of participant characteristics and secondary outcomes with vaping. Secondary outcome measures were: preterm birth, gestational age at birth, birthweight, and initiation and duration of breastfeeding.

Results

A total of 4,509 women responded to the survey. The prevalence of vaping in pregnancy was 2.8% (95%CI 2.4% to 3.4%). This varied according to the pattern of cigarette smoking in pregnancy: 0.3% in never-smokers; 3.3% in ex-smokers; 7.7% in pregnancy-inspired quitters; 9.5% in temporary quitters; and 17.7% in persistent smokers. Younger women, unmarried women, women with fewer years of formal education, women living with a smoker, and persistent smokers were more likely to vape, although after adjusting for pattern of cigarette smoking and maternal characteristics, persistent smoking was the only risk factor. We did not find any association between vaping and preterm birth, birthweight, or breastfeeding.

Conclusions

The prevalence of vaping during pregnancy in the NMS 2018 was low overall but much higher in smokers. Smoking was the factor most strongly associated with vaping. Co-occurrence of vaping with persistent smoking has the potential to increase the harms of tobacco exposure in pregnant women and their infants.
One CGIAR and the Integrated Agri-food Systems Initiative: From short-termism to transformation of the world’s food systems
Authors: Govaerts Bram , Negra Christine , Camacho Villa Tania Carolina , Chavez Suarez Xiomara , Espinosa Anabell Diaz , Fonteyne Simon , Gardeazabal Andrea , Gonzalez Gabriela , Gopal Singh Ravi , Kommerell Victor , Kropff Wietske , Lopez Saavedra Victor , Mena Lopez Georgina , Odjo Sylvanus , Palacios Rojas Natalia , Ramirez-Villegas Julian , Van Loon Jelle , Vega Daniela , Verhulst Nele , Woltering Lennart , Jahn Molly , Kropff Martin
Published: June 2021

Agri-food systems are besieged by malnutrition, yield gaps, and climate vulnerability, but integrated, research-based responses in public policy, agricultural, value chains, and finance are constrained by short-termism and zero sum thinking. As they respond to current and emerging agri-food system challenges, decision makers need new tools that steer toward multi-sector, evidence-based collaboration. To support national agri-food system policy processes, the Integrated Agri-food System Initiative (IASI) methodology was developed and validated through case studies in Mexico and Colombia. This holistic, multi-sector methodology builds on diverse existing data resources and leverages situation analysis, modeled predictions, and scenarios to synchronize public and private action at the national level toward sustainable, equitable, and inclusive agri-food systems. Culminating in collectively agreed strategies and multi-partner tactical plans, the IASI methodology enabled a multi-level systems approach by mobilizing design thinking to foster mindset shifts and stakeholder consensus on sustainable and scalable innovations that respond to real-time dynamics in complex agri-food systems. To build capacity for these types of integrated, context-specific approaches, greater investment is needed in supportive international institutions that function as trusted in-region ‘innovation brokers.’ This paper calls for a structured global network to advance adaptation and evolution of essential tools like the IASI methodology in support of the One CGIAR mandate and in service of positive agri-food systems transformation.
Relationship between tongue pressure and dysphagia diet in patients with acute stroke
Authors: Nakamori Masahiro , Ishikawa Kenichi , Imamura Eiji , Yamamoto Haruna , Kimura Keiko , Ayukawa Tomoko , Mizoue Tatsuya , Wakabayashi Shinichi
Published: June 2021

A dysphagia diet is important for patients with stroke to help manage their nutritional state and prevent aspiration pneumonia. Tongue pressure measurement is a simple, non-invasive, and objective method for diagnosing dysphagia. We hypothesized that tongue pressure may be useful in making a choice of diet for patients with acute stroke. Using balloon-type equipment, tongue pressure was measured in 80 patients with acute stroke. On admission, a multidisciplinary swallowing team including doctors, nurses, speech therapists, and management dietitians evaluated and decided on the possibility of oral intake and diet form; the tongue pressure was unknown to the team. Diet form was defined and classified as dysphagia diet Codes 0 to 4 and normal form (Code 5 in this study) according to the 2013 Japanese Dysphagia Diet Criteria. In multivariate analysis, only tongue pressure was significantly associated with the dysphagia diet form (p<0.001). Receiver operating characteristic analyses revealed that the optimal cutoff tongue pressure for predicting diet Codes 1, 2, 3, 4, and 5 was 3.6 (p<0.001, area under the curve [AUC] = 0.997), 9.6 (p<0.001, AUC = 0.973), 12.8 (p<0.001, AUC = 0.963), 16.5 (p<0.001, AUC = 0.979), and 17.3 kPa (p<0.001, AUC = 0.982), respectively. Tongue pressure is one of the sensitive indicators for choosing dysphagia diet forms in patients with acute stroke. A combination of simple modalities will increase the accuracy of the swallowing assessment and choice of the diet form.
Characterization of Brassica rapa metallothionein and phytochelatin synthase genes potentially involved in heavy metal detoxification
Authors: Liu Jiayou , Zhang Jie , Kim Sun Ha , Lee Hyun-Sook , Marinoia Enrico , Song Won-Yong
Published: June 2021

Brassica rapa is an important leafy vegetable that can potentially accumulate high concentrations of cadmium (Cd), posing a risk to human health. The aim of the present study was to identify cadmium detoxifying molecular mechanisms in B. rapa using a functional cloning strategy. A cDNA library constructed from roots of B. rapa plants treated with Cd was transformed into the Cd sensitive yeast mutant strain DTY167 that lacks the yeast cadmium factor (YCF1), and resistant yeast clones were selected on Cd containing media. Two hundred genes potentially conferring cadmium resistance were rescued from the surviving yeast clones and sequenced. Sequencing analysis revealed that genes encoding for metallothionein (MT)1, MT2a, MT2b and MT3, and phytochelatin synthase (PCS)1 and PCS2 accounted for 35.5%, 28.5%, 4%, 11.3%, 18.7% and 2%, respectively of the genes identified. MTs and PCSs expressing DTY167 cells showed resistance to Cd as well as to Zn. PCS1 expressing yeast cells were also more resistant to Pb compared to those expressing MTs or PCS2. RT-PCR results showed that Cd treatment strongly induced the expression levels of MTs in the root and shoot. Furthermore, the different MTs and PCSs exhibited tissue specific expression. The results indicate that MTs and PCS genes potentially play a central role in detoxifying Cd and other toxic metals in B. rapa.
Dissect the immunity using cytokine profiling and NF-kB target gene analysis in systemic inflammatory minipig model
Authors: Suh Han Na , Kim Young Kyu , Lee Ju Young , Kang Goo-Hwa , Hwang Jeong Ho
Published: June 2021

Minipigs have remarkably similar physiology to humans, therefore, they it can be a good animal model for inflammation study. Thus, the conventional (serum chemistry, histopathology) and novel analytic tools [immune cell identification in tissue, cytokine level in peripheral blood mononuclear cells (PBMC) and serum, NF-kB target gene analysis in tissue] were applied to determine inflammation in Chicago Miniature Swine (CMS) minipig. Lipopolysaccharide (LPS)-induced acute systemic inflammation caused liver and kidney damage in serum chemistry and histopathology. Immunohistochemistry (IHC) also showed an increase of immune cell distribution in spleen and lung during inflammation. Moreover, NF-kB-target gene expression was upregulated in lung and kidney in acute inflammation and in heart, liver, and intestine in chronic inflammation. Cytokine mRNA was elevated in PBMC under acute inflammation along with elevated absolute cytokine levels in serum. Overall, LPS-mediated systemic inflammation affects the various organs, and can be detected by IHC of immune cells, gene analysis in PBMC, and measuring the absolute cytokine in serum along with conventional inflammation analytic tools.
Slampt, the ‘fans’ and ephemerality: Punk, subject and object
Authors: Dale Pete
Published: June 2021

Slampt Underground Organisation was conceived in 1992 by Rachel Holborow and Pete Dale, issuing music, fanzines and ephemera from then until 2000. Perceived as a record label, Slampt sold tens of thousands of units and seems to have had a significant impact on particular individuals who might or might not be best described as ‘fans’. This article uses the author’s archives and reflections to collate detail, much of it not publically available before, about a label/distributor/organization, which has already been a point of interest to several researchers and journalists but which is nonetheless unknown to most, even in punk-related music scenes, in the present century. The author, as one half of Slampt’s de facto leading partnership, reveals that this status as a largely forgotten arm of 1990s UK punk is not entirely accidental: Dale and Holborow actively believed in ephemerality as an ideal, particularly in punk. Using this case as a starting point, the article asks whether punk really ought to be as fixated on documenting its past, finding its place in museums/galleries and gaining recognition in rock history. Is punk about collectible objects, about a particular mode of subjectivity or, perhaps, about a phenomenological combination of the two? The irony of the author writing the article at this time is acknowledged: Slampt is being written back in to punk history, even if only in the margins, through the act of publishing this piece. Nonetheless, the article is based around the assumption that the present and the future will always be more important than the past.
Effectiveness of dry cow therapy and/or internal teat sealant on existing infections in smallholder dairy farms in Kenya
Authors: Sang Ronald K. , Gitau George K. , Van Leeuwen John A.
Published: June 2021

Background and Aim: Dry cow therapy (DCT) can be an effective treatment of mastitis that has not responded to conventional treatment during lactation. The aim of this study was to establish the effectiveness of DCT options available in reducing intramammary infections in smallholder dairy farms in Kiambu County, Kenya.

Materials and Methods: The study targeted smallholder dairy farms which were registered at the local dairy cooperatives and which had cows that were at the point of dry-off. A total of 32 cows with 121 quarters that were California Mastitis Test (CMT) positive were recruited, with the quarters randomly allocated to receive either DCT (DCT – neomycin sulfate, penethamate hydriodide, and procaine benzylpenicillin) and internal teat sealant (ITS) or ITS alone (bismuth nitrate) after aseptically collecting quarter milk samples for bacterial culture. Farm- and animal-level factors were captured through a questionnaire which was administered to the principal farmer or a person who was managing the animals. Post-calving, milk samples were also collected for bacterial culture to establish if the infection was cleared or if there was a new infection.

Results: DCT with ITS significantly reduced the proportion of quarters infected with Staphylococcus aureus from 64.0% at dry-off to 44.0% post-calving (35% reduction). In the control group, ITS alone, there was a small reduction in proportions of S. aureus from 46.8% to 40.4%. Proportions of quarter infections by coagulase-negative Staphylococcus in the treatment group reduced from 16.0% at dry-off to 2.0% post-calving, with a significant reduction in the control group too from 19.1% to 4.3%, which could be due to self-cure. Actinomyces species, Escherichia coli, Streptococcus species, and Pseudomonas species proportions slightly increased in the treatment group, as did E. coli and Pseudomonas species proportions in the control group.

Conclusion: In smallholder dairy farms with subclinical mastitis, DCT of CMT-positive cows leads to a significant decrease of S. aureus infections at calving.
Antioxidant and immune responses of broiler chickens supplemented with Rhazya stricta extract in drinking water
Authors: Albarrak Saleh M.
Published: June 2021

Background and Aim: Rhazya stricta is a herbal plant widely used in traditional medicine due to its proficiency and naturalness with few side effects. In this study, we investigated the impact of using an R. stricta extract supplement on broiler chickens' performance, especially the immune system.

Materials and Methods: In addition to the control group, one group received the methanol extract of R. stricta in drinking water for the first 2 weeks before being challenged with sheep erythrocytes (SRBCs), while the other group was challenged with SRBCs without receiving the R. stricta treatment. We evaluated cellular immunity by determining the phagocytic activity and lymphocyte (L) proliferation and assessed humoral immunity by quantification of the serum total IgM and IgG. We measured the serum levels of antioxidant enzymes and performed a histological examination of the spleen and the bursa of Fabricius (BF).

Results: Our results indicate a significant enhancement in cellular immunity in the group supplemented with R. stricta as demonstrated by a significant increase in the phagocytic activity, L proliferation, and percentages of circulating L (p<0.05). The chickens treated with R. stricta exhibit an enhanced humoral response shown by a significant elevation in the serum levels of the total antibodies of the IgM and IgG isotypes, along with a notable increase in BF activity. Furthermore, R. stricta supplementation is associated with a significant increase in the serum levels of catalase and superoxide dismutase (p<0.05), along with a significant improvement in broilers' general performance, body weight, and feed efficiency.

Conclusion: Our results suggest an immunomodulatory effect for the methanol extract of R. stricta and highlight the potential use of this plant in preventive and therapeutic medicine.
The Effectiveness of Mirror Therapy to Upper Extremity Rehabilitation in Acute Stroke Patients
Authors: Klinkwan Phassakorn , Kongmaroeng Chalunda , Muengtaweepongsa Sombat , Limtrakarn Wiroj
Published: June 2021

Rehabilitation is a crucial part of stroke recovery to help them regain use of their limb. The aim of this article was to compare the effectiveness of long-term training of mirror therapy with conventional rehabilitation therapy on neurological and recovery of upper limb in acute stroke patients. In this randomized and assessor-blinded control study, 20 acute stroke patients were analyzed in this study and allocated to a case (n = 10, 50.6 ± 17.90 years) and control group (n = 10, 55.9 ± 11.25 years). All the participants performed daily home exercise during 12 weeks. The patients in the control group were treated with conventional therapy (CT) and a group of cases were treated with mirror therapy (MT) alone program. The outcome measurements were assessed by a therapist blinded assessor using Fugl-Meyer Assessment (FMA) upper extremity score, Brunnstrom recovery stages (BRS), Modified Ashworth Scale (MAS) and Muscle Strength to evaluate upper limb motor function and motor recovery. Data were analyzed using Wilcoxon and Mann-Whitney U tests to compare within-groups and between-group differences. The results revealed that, after 12 weeks of treatment, patients of both groups presented statistically significant improvements in all the variables measured (p < 0.05). Compared with the control group, the patients of the MT group had greater improvement in the proximal movement portion of the FMA upper extremity mean score change (15.8 ± 3.2 versus 10.0 ± 2.7, p = 0.002) while there were no differences in other variables (p > 0.05). There were also no adverse events. It suggests that 12 weeks training of mirror therapy alone was likely to improve the motor recovery of the upper limb and activity of daily living in acute stroke patients than conventional therapy, if treated early.
Association Between Morning Surge in Systolic Blood Pressure and SYNTAX Score I in Patients With Stable Coronary Artery Disease
Authors: Quisi Alaa , Alici Gokhan , Harbalioglu Hazar , Genc Omer , Kurt Ibrahim Halil , Cayli Murat
Published: June 2021

A high morning surge in systolic blood pressure poses a risk in people who have cardiovascular disease. We investigated the relationship between this phenomenon and the SYNTAX score I in patients who had stable coronary artery disease.

Our single-center study included 125 consecutive patients (109 men and 16 women; mean age, 54.3 ± 9 yr) in whom coronary angiography revealed stable coronary artery disease. We calculated each patient's sleep-trough morning surge in systolic blood pressure, then calculated the SYNTAX score I.

The morning surge was significantly higher in patients whose score was >22 (mean, 22.7 ± 13.2) than in those whose score was ≤22 (mean, 12.4 ± 7.5) (P <0.001). Forward stepwise logistic regression analysis revealed that morning surge in systolic blood pressure was the only independent predictor of an intermediate-to-high score (odds ratio=1.183; 95% CI, 1.025–1.364; P=0.021).

To our knowledge, this is the first study to show an association between morning surge in systolic blood pressure and the SYNTAX score I in patients who have stable coronary artery disease.
Ethics as Medicine: Moral Therapy, Expertise, and Practical Reasoning in al-Ghazālī’s Ethics
Authors: Vasalou Sophia
Published: June 2021

The idea that ethics might be fruitfully understood in analogy with, or indeed as a form of, medicine has enjoyed a long and distinguished history. A staple of ancient philosophical thinking, it also achieved wide expression in the Islamic world. This essay explores the role of the medical analogy in the work of the eleventh-century Muslim intellectual Abū Ḥāmid al-Ghazālī. Al-Ghazālī’s use of this analogy offers a unique vantage point for approaching several key features of his ethics of virtue, as notably expressed in the Revival of the Religious Sciences. These include his understanding of the nature of virtue and moral education; the fundamental structure of value; and most importantly, the place of human reasoning in the ethical life. This analogy also illuminates the rhetorical context of the Revival, taken as a book that aims to foster skills of practical reasoning and train its readers to become their own physicians.
Comparison of the analytical performance of the PATHFAST high sensitivity cardiac troponin I using fresh whole blood vs. fresh plasma samples
Authors: Gopi Vinajak , Milles Barbara , Spanuth Eberhard , Müller-Hennessen Matthias , Biener Moritz , Stoyanov Kiril , Frey Norbert , Giannitsis Evangelos
Published: June 2021

Objectives

The PATHFAST hs-cTnI (high-sensitivity cardiac troponin) assay is the first point-of-care assay with a high-sensitivity designation that received FDA approval for diagnosis of myocardial infarction (MI). Testing from whole blood does not need centrifugation and therefore is faster and more convenient in the emergency room instead of plasma. However, there is sparse evidence whether point-of-care testing of Tn from whole blood is as reliable as from plasma samples.

Methods

We investigated the agreement between plasma and whole blood hs-cTnI by using the PATHFAST hs-cTnI assay. Hs-cTnT measured on Cobas 602 in the central laboratory and compared to a final diagnosis of NSTEMI using serial hs-cTnT served as reference. We assessed biases, limits of agreement (±1.96 SD) and coefficients of correlation, and tested the discriminatory ability of the baseline sample of plasma and whole blood hs-cTnI and plasma hs-cTnT to discriminate non-ST-segment elevation myocardial infarction (NSTEMI).

Results

A total of 224 paired fresh samples were collected simultaneously from 191 patients presenting with suspected acute coronary syndrome. There was an excellent correlation between plasma and whole blood hs-cTnI (r=0.99), and a very good inter-rater agreement (k=0.93) between elevated and normal plasma and whole blood results. Precision evaluation according to CLSI ep 15 revealed comparable coefficients of variation (CV) in whole blood and plasma. The discriminatory ability of baseline hs-cTnT, plasma and whole blood hs-cTnI was excellent (AUC 0.967, AUC 0.954 and AUC 0.953) without significant difference.

Conclusions

Whole blood can be used interchangeably with plasma for more convenient and less time and labor-consuming testing of hs-cTnI on the PATHFAST instrument.