bluuebunny/crossref_metadata_2025 huggingface dataset:
THE RENEWABLE ENERGY POLICY OF TURKEY UNDER THE IMPACT OF THE EUROPEAN UNION
Authors: KULAÇ Onur , CİĞEROĞLU ÖZTEPE Mısra
Published: September 2020

Public policy analysis basically provides researchers and other relevant actors with comprehensive output to comprehend the effectiveness and the efficiency of the policies. Renewable energy sources are highly crucial especially for the maintenance of sustainable development. Therefore, most of the countries like Turkey, attempt and even struggle to have a functional renewable energy policy with the aim of having diverse energy sources and infrastructure. International actors such as the European Union (EU) have huge and practical impacts on the public policy making process of many countries. In this fashion, the renewable energy policy of Turkey is mostly shaped or formulated according to the EU acquis. The study is a significant effort to scrutinize the renewable energy policy of Turkey by benefiting from the energy chapter of regular progress reports (country reports) published by the European Commission which is the executive body of the EU. The fundamental aim of the study is to put forth the determinations and the expectations of the EU on renewable energy policy to conduct an extensive analysis. In this manner, various policy suggestions regarding renewable energy policy of Turkey is proposed and presented in order to make encouraging contributions.
Análise de e-maturity em uma instituição da ensino
Authors: Melo Caroline Oliveira , Luft Maria Conceição Melo Silva , Rocha Ronalty Oliveira , Lima Lucas Gabriel Bezerra
Published: September 2020

As tecnologias da informação e comunicação (TICs) ganharam expressiva relevância ao funcionamento e bons resultados de diferentes tipos de negócios, inclusive em instituições de ensino. Nesse contexto, este estudo, de caráter qualitativo, teve como objetivo analisar a e-maturity em uma instituição educacional. Para alcance do objetivo proposto foi empreendido um estudo com uso de narrativas no Instituto Federal de Sergipe (IFS). A coleta de relatos interpretativos foi realizada por meio de entrevistas semiestruturadas aplicadas a cinco gestores estratégicos e dois gestores de tecnologia da informação. Os resultados demonstram que os construtos de infraestrutura, liderança tecnológica e suporte para uso e disseminação de TICs constituem a e-maturity administrativa da instituição, contudo, novas ações e estratégias devem ser implementadas a fim de potencializar as funcionalidades e resultados obtidos pelo uso de ferramentas de tecnologia da informação.

 

Palavras-Chave: E-maturity, Infraestrutura, Liderança tecnológica, Suporte para uso e disseminação de TICs, Instituição de ensino.
Neighborhood's locality, road types, and residents' multimorbidity: evidence from China's middle-aged and older adults
Authors: Yu Xuexin , Zhang Wei
Published: September 2020

Background Neighborhood factors have gained increasing attention, while the association between the neighborhood's characteristics and multimorbidity has not been clarified. In this study, we aim to depict variations in the number of non-communicable chronic diseases (NCDs) as a function of urban vs. rural settings and road types.Methods The present cross-sectional study derived data from the China Health and Retirement Longitudinal Study 2011 National Baseline Survey. Negative binomial regression with clustered robust standard errors was performed to analyze variations in the number of NCDs among 13,414 Chinese middle-aged and older adults. Logistic regression models were employed to investigate the association between neighborhood-level characteristics and each NCD, respectively. Results First, over 65% of subjects had at least one NCDs, and over 35% had multimorbidity. Arthritis (33.08%), hypertension (24.54%), and digestive disease (21.98%) were the most prevalent NCDs. Urban vs. rural differences in multimorbidity were fully explained by neighborhood clustering variations (IRR = 1.02, 95% CI, 0.95 - 1.10). Living with paved roads was associated with a smaller number of NCDs relative to living with unpaved roads (IRR = 0.86, 95% CI, 0.78 - 0.95). Results from subgroup analyses suggested that in comparison with those living with unpaved roads, individuals living with paved roads respectively had lower odds of chronic lung disease (OR = 0.76, 95% CI, 0.63 - 0.93), chronic liver disease (OR = 0.74, 95% CI, 0.55 - 0.99), chronic kidney disease (OR = 0.68, 95% CI, 0.51 - 0.89), digestive disease (OR = 0.82, 95% CI, 0.69 - 0.97), arthritis or rheumatism (OR = 0.69, 95% CI, 0.55 - 0.87), and asthma (OR = 0.67, 95% CI, 0.51 - 0.88). Conclusions Urban vs. rural disparities in multimorbidity appeared to result from within-neighborhoods characteristics. The improvement in neighborhood-level characteristics, such as road pavement, holds promise to alleviate the increasing disease burden of chronic diseases.
Content Development for a Physical Activity and Sedentary Behaviour e-Learning Module for Early Childhood Education Students: A Delphi Study
Authors: Bruijns Brianne , Johnson Andrew M. , Tucker Trish
Published: September 2020

Background: Early childhood educators play a prominent role in promoting healthy activity behaviours in childcare. However, they have expressed that they lack the appropriate pre-service training to confidently lead physical activity (PA), and minimize sedentary behaviour (SB), in childcare. As such, the purpose of this Delphi study was to generate and reach agreement on content areas for inclusion in a PA and SB e-Learning module for Early Childhood Education (ECE) students.Methods: Purposeful sampling of Canadian/international researchers was used to form two expert panels: a PA/SB expert panel (n = 26), and a Canadian ECE panel. The PA/SB experts suggested their top 12 PA/SB topics for the module via online survey. These topics were then pooled to generate a list of 19 content areas. In a second online survey, both panels of experts rated the importance of each content area (0 = unimportant to 5 = very important). Mean ratings (M) were ranked separately for each panel, and then ratings were pooled to create an overall ranking of the 19 content areas. Inter-panel agreement of importance rankings was visually represented as a scatterplot and quantified using Spearman’s rho (rs).Results: The top-rated content area was Outdoor Play (M = 4.77 ± 0.64), followed by Benefits of PA in the Early Years (M = 4.75 ± 0.66), and Factors Influencing PA and SB in Childcare (M = 4.71 ± .74). Monitor PA and Sedentary Time Within Your Classroom had the lowest combined score (M = 3.77 ± 1.44). There was moderate-to strong inter-panel agreement for content area importance rankings (rs = 0.60, 95% CI: 0.20 to 0.83). The majority of the ECE expert panel considered this training important for ECE students (94.3%), aligning with ECE curriculum objectives (91.4%) and accreditation standards (78.8%), and complementary to the present ECE curriculum (88.6%).Conclusions: Providing PA and SB training to ECE students is a proactive way to ensure healthy movement behaviours are prioritized in childcare programming. With the PA/SB expert-developed content areas, and endorsement by the ECE expert panel, implementing this training within ECE programs is a necessary next step.
Association of Depression and Resilience with Fertility Quality of Life among patients presenting to the infertility Centre for treatment in Karachi, Pakistan
Authors: Bhamani Shireen Shehzad , Zahid Nida , Zahid Wajeeha , Farooq Salima , Sachwani Saima , Chapman Marilyn , Asad Nargis
Published: September 2020

Background: In Pakistan there is a dire need to explore the quality of life in infertile males and females and its undesirable psychological outcomes. This, study aimed to compare the quality of life (QoL) of males and females visiting an infertility centre for treatment and to assess its association with resilience, depression, and other socio-demographic factors.Methods: An Analytical Cross-Sectional study was conducted amongst infertile males and females at the Australian Concept Infertility Medical Centre (ACIMC), Karachi, Pakistan . The non-probability (purposive) sampling strategy was used to recruit the participants. The sample size was 668. Data was analysed using STATA version 12. FertiQoL tool, Beck II Depression Inventory Tool and Resilience Scale 14 (RS-14) were used for assessing the quality of life, depression and resilience respectively of infertile patients.Results: Total 668 infertile patients, 334 males and 334 females participated in the study.The mean age was 35.53 ±6.72, among males, and 30.87 ± 6.12 among females, The mean resilience scores were significantly higher among males, (77.64 ± 8.56), as compared to females (76.19 ±8.69) (95% CI; -2.757, -0.1347). However, a significantly higher proportion of females were depressed (13.8%) as compared to males (6%). The mean QoL scores for the general health domain, emotional domain, mind and body domain, and relational domain, and the total QoL were significantly higher in males as compared to females (p value< 0.001); however, QoL for the social domain was not significantly different in both the groups. On multivariable linear regression resilience and depression among males had a significant association with QoL, after adjusting for the covariates educational status, monthly income, and number of friends. Similar association was observed among females after adjusting for the covariate monthly income only.Conclusion: Fertility related QoL of men and women has a significant association with no formal education, number of friends, income, depression and resilience. Therefore, health care professionals in the field of infertility must be adequately trained to respond to the needs of individuals going through these psychological problems.
Health behaviors in major chronic diseases patients: Trends and regional variations analysis, 2008–2017, Korea
Authors: Jeon Young-Jee , Pyo Jeehee , Park Young-Kwon , Ock Minsu
Published: September 2020

Background: Improving the health behaviors of those with chronic diseases such as hypertension and diabetes is important for disease management. Few in-depth studies have been conducted in Korea on the health behaviors of chronic disease patients. This study examined the health behaviors of chronic disease patients over time and compared them with those of the general population.Methods: Cross-sectional time-series data obtained from the Korea Community Health Survey from 2008 to 2017 were analyzed. Thirteen diseases were included in this analysis, namely, hypertension, diabetes, dyslipidemia, stroke, myocardial infarction, angina, osteoarthritis, osteoporosis, asthma, allergic rhinitis, atopic dermatitis, cataract, and depression. The current smoking rate, drinking rate, and the walking rate, which are leading health behaviors necessary for preventing chronic diseases, were analyzed by disease type. We compared patients’ health behaviors with those of the general population and identified regional variations.Results: Although the current overall smoking rate was seemingly declining, the overall monthly drinking and high-risk drinking rates were increasing. In 2017, patients experiencing depression symptoms had a higher smoking rate than did the general population; hypertension and diabetes patients had a higher risk-drinking rate than did the latter. The general population’s walking rate was highest. There were considerable variations by region among chronic disease patients.Conclusions: Chronic disease patients displayed worse health behaviors than those of the general population, in some instances. Rather than focusing only on chronic disease patients’ medication adherence, strategies must be devised to increase their smoking cessation rate, decrease their drinking rate, and increase their walking rate.
Prevalence and associated factors of suicidality in Japanese adolescents: results from a population-based questionnaire survey
Authors: Nagamitsu Shinichiro , Mimaki Masakazu , Koyanagi Kenshi , Tokita Natsuko , Kobayashi Yoriko , Hattori Ritsuko , Ishii Ryuta , Matsuoka Michiko , Yamashita Yushiro , Yamagata Zentaro , Igarashi Takashi , Croarkin Paul E
Published: September 2020

Background Suicide is the leading cause of death among Japanese adolescents. However, knowledge gaps regarding contemporary demographics and factors associated with suicidality among Japanese adolescents are a major concern. This study examined the prevalence of suicidality among Japanese adolescents and investigated associated factors. Methods A population-based questionnaire survey investigating general health was administered to 22,419 adolescents aged 13–18 years. The 29-item questionnaire covered emotional status, family function, cyberbullying, suicidality, and stressors (e.g., relationships with parents/friends, school performance, and sexual identity). We conducted multiple logistic regression analysis to identify factors associated with suicidality in this population. Results The prevalence of suicidal ideation was 21.6% in males and 28.5% in females, and that of attempted suicide was 3.5% in males and 6.6% and in females. Bullying and stress related to family relationships had the strongest associations with suicidality. Exposure to cyberbullying had the highest odds ratio for both junior high (3.1, 95% confidence interval [CI] 2.1–4.4) and high school students (3.6, 95% CI 2.5–5.3). Other factors significantly associated with suicidality were sex, emotional status, and stress about relationships with friends, sexual identity, school records, and academic course. Adolescents accessed a variety of resources to cope with stressors, with the Internet being the most common resource consulted. Conclusions Suicidality is commonly experienced among Japanese adolescents. Although there are many associated risk factors, cyberbullying is of particular concern. Recognition of factors associated with adolescent suicidality will inform further research and suicide prevention efforts for healthcare providers and families.
Nutritional Perspectives on Sickle Cell Disease in Africa: A Systematic Review
Authors: Nartey Eunice Berko , Spector Jonathan , Adu-Afarwuah Seth , Jones Catherine L. , Jackson Alan A. , Ohemeng Agartha , Shah Rajiv , Koryo-Dabrah Alice , Kuma Amma Benneh-Akwasi , Hyacinth Hyacinth I. , Steiner-Asiedu Matilda
Published: September 2020

Background: Sickle cell disease (SCD), an inherited blood disorder, predominantly affects individuals in sub-Saharan Africa. While there are established studies that links its pathophysiology and nutritional status, the extent of research in this area involving African patients has not been previously described. This systematic review aimed to assess the nutrition-focused landscape of SCD studies in Africa, summarize findings, and highlight gaps in knowledge that could inform priority-setting for future research.Methods: The study was conducted using the Preferred Reporting items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. We included all original studies, conducted between 1995 and 2018, on nutritional status of individuals with SCD in Africa. ‘Nutritional status’ was defined by studies on dietary intake, measurements of growth/anthropometry, and nutritional biomarkers. Studies of anemia in non-SCD individuals and those with sickle cell traits were excluded. Databases used were Ovid Embase, Medline, Biosis and Web of Science. Results: The search returned 366 articles from which 62 studies were included in the final analyses. Seventy percent of the investigations were conducted in Nigeria. Studies were categorized into one of three main categories: descriptive studies of anthropometric characteristics (50%), descriptive studies of macro- or micronutrient levels (35%), and interventional studies (15%). Findings consistently found growth impairment, especially among children and adolescents. Studies assessing macro- and micro-nutrients generally had small sample sizes and were exploratory in nature. Only two randomized placebo-controlled trials were identified, which measured the impact of fatty acid supplementation and lime juice on health outcomes. Conclusions: The findings reveal a moderate number of descriptive studies, with small sample size, that focused on various aspects of nutrition and sickle cell disease in African patients. There was a stark lack of interventional studies that could be used to inform evidence-based changes in clinical practice. Findings of investigations were generally consistent with data from other regional settings, describing a significant risk of growth faltering and malnutrition among individuals with SCD. There is an unmet need for clinical research to better understand the potential benefits of nutritional-related interventions for patients with SCD in sub-Saharan Africa in order to promote optimal growth and improve health outcomes.
Articular chondrocyte-derived extracellular vesicles promote cartilage differentiation of human umbilical cord mesenchymal stem cells by activation of autophagy
Authors: Ma Ke , Zhu Bo , Wang Zetao , Cai Peian , He Mingwei , Ye Danyan , Yan Guohua , Zheng Li , Yang Lujun , Zhao Jinmin
Published: September 2020

Background: Umbilical cord mesenchymal stem cell (HUCMSC)-based therapies were previously utilised for cartilage regeneration because of the chondrogenic potential of MSCs. However, chondrogenic differentiation of HUCMSCs is limited by the administration of growth factors like TGF-β that may cause cartilage hypertrophy. It has been reported that extracellular vesicles (EVs) could modulate the phenotypic expression of stem cells. However, the role of human chondrogenic-derived EVs (C-EVs) in chondrogenic differentiation of HUCMSCs has not been reported.Results: We successfully isolated C-EVs from human multi-finger cartilage and found that C-EVs efficiently promoted the proliferation and chondrogenic differentiation of HUCMSCs, evidenced by highly expressed aggrecan (ACAN), COL2A, and SOX-9. Moreover, the expression of the fibrotic marker COL1A and hypertrophic marker COL10 was significantly lower than that induced by TGF-β. In vivo, C-EVs induced HUCMSCs accelerated the repair of the rabbit model of knee cartilage defect. Furthermore, C-EVs led to an increase in autophagosomes during the process of chondrogenic differentiation, indicating that C-EVs promote cartilage regeneration through the activation of autophagy.Conclusions: C-EVs play an essential role in fostering chondrogenic differentiation and proliferation of HUCMSCs, which may be beneficial for articular cartilage repair.
Online Readability of COVID-19 Health Information: a Comparison between Four English Speaking Countries
Authors: Worrall Amy P , Connolly Mary J , O'Neill Aine , O'Doherty Murray , Thornton Kenneth P , McNally Cora , McConkey Samuel J , de Barra Eoghan
Published: September 2020

Introduction: The internet is now the first line source of health information for many people worldwide. In the current Coronavirus Disease 2019 (COVID-19) global pandemic, health information is being produced, revised, updated and disseminated at an increasingly rapid rate. The general public are faced with a plethora of misinformation regarding COVID-19 and the readability of online information has an impact on their understanding of the disease. The accessibility of online healthcare information relating to COVID-19 is unknown. We sought to evaluate the readability of online information relating to COVID-19 in four English speaking regions: Ireland, the United Kingdom, Canada and the United States, and compare readability of website source provenance and regional origin.Methods: The Google® search engine was used to collate the first twenty webpage URLs for three individual searches for ‘COVID’, ‘COVID-19’, and ‘coronavirus’ from Ireland, the United Kingdom, Canada and the United States. The Gunning Fog Index (GFI), Flesch-Kincaid Grade (FKG) Score, Flesch Reading Ease Score (FRES), Simple Measure of Gobbledygook (SMOG) score were calculated to assess the readability. Results: There were poor levels of readability webpages reviewed, with only 17.2% of webpages at a universally readable level. There was a significant difference in readability between the different webpages based on their information source (p <0.01). Public Health organisations and Government organisations provided the most readable COVID-19 material, while digital media sources were significantly less readable. There were no significant differences in readability between regions. Conclusion: Much of the general public have relied on online information during the pandemic. Information on COVID-19 should be made more readable, and those writing webpages and information tools should ensure universal accessibility is considered in their production. Governments and healthcare practitioners should have an awareness of the online sources of information available, and ensure that readability of our own productions is at a universally readable level which will increase understanding and adherence to health guidelines.
Induction therapy with mesenchymal stromal cells in kidney transplantation: A meta-analysis
Authors: Zhao Lingfei , Hu Chenxia , Han Fei , Chen Dajin , Cheng Jun , Wu Jianyong , Peng Wenhan , Chen Jianghua
Published: September 2020

Objective The aim of this meta-analysis was to evaluate the therapeutic effects of mesenchymal stromal cells (MSCs) versus traditional regimens for induction therapy in kidney transplantation (KT), especially the safety of MSC infusion, practicability of MSCs as induction therapy agents and posttransplant complications.Methods PubMed, Embase, EBSCO, Ovid and the Cochrane Library were searched for prospective clinical trials that compared MSCs with traditional regimens for induction therapy in KT. Results Four trials were included, including a total of 197 patients. The pooled results revealed that MSC therapy had a lower 1-year infection rate than did the traditional therapies (RR=0.65, 95% CI: 0.46-0.9, P=0.01). There were no significant differences between the two protocols regarding the 1-year acute rejection (AR) rate (RR=0.77, 95% CI: 0.41–1.45, P=0.42), 1-year graft survival rate (RR=0.99, 95% CI: 0.95–1.03, P=0.74), delayed graft function (DGF) rate (RR=0.54, 95% CI: 0.21–1.38, P=0.2) and renal graft function at 1 month (MD=-1.56, 95% CI: -14.2– 11.08, p=0.81), 3 months (MD=0.15, 95% CI: -5.63– 5.93, p=0.96), 6 months (MD=-1.95, 95% CI: -9.87– 5.97, p=0.63), and 12 months (MD=-1.13, 95% CI: -7.16– 4.89, p=0.71) postsurgery. Subgroup analysis demonstrated that the 1-year AR rate, 1-year graft survival rate, DGF rate and renal graft function at 12 months postsurgery did not significantly differ between the low-dose calcineurin inhibitor (CNI) group and the standard-dose CNI group, indicating the potential benefits of successful CNI sparing in combination with MSC treatment. Moreover, when MSCs were applied as an alternative therapy rather than an additional therapy or allogeneic MSCs were utilized instead of autologous MSCs, all of the outcomes mentioned above were comparable. Conclusion Induction therapy with MSCs is safe and has immune response modulation effects to those of traditional regimens in the short term in KT recipients. However, regarding the long-term effects, as suggested by the 1-year infection rate and the potential of CNI sparing, MSC therapy has significant advantages. However, these advantages should be further verified in more well-designed, multicenter RCTs with large sample sizes and long follow-up periods.
Myocardial Disease and Ventricular Arrhythmia in Marfan Syndrome – a prospective study
Authors: Mosquera Laura Muino , De Wilde Hans , Devos Daniel , Babin Danilo , Jordaens Luc , Demolder Anthony , De Groote Katya , De Wolf Daniel , De Backer Julie
Published: September 2020

Background: Aortic root dilatation and -dissection and mitral valve prolapse are established cardiovascular manifestations in Marfan syndrome (MFS). Heart failure and arrhythmic sudden cardiac death have emerged as additional causes of morbidity and mortality.Methods: To characterize myocardial dysfunction and arrhythmia in MFS we conducted a prospective longitudinal case-control study including 86 patients with MFS (55.8% women, mean age 36.3yr - range 13-70yr-) and 40 age- and sex-matched healthy controls. Cardiac ultrasound, resting and ambulatory ECG (AECG) and NT-proBNP measurements were performed in all subjects at baseline. Additionally, patients with MFS underwent 2 extra evaluations during 30±7months follow-up. To study primary versus secondary myocardial involvement, patients with MFS were divided in 2 groups: without previous surgery and normal/mild valvular function (MFS-1; N=55) and with previous surgery or valvular dysfunction (MFS-2; N=31).Results: Compared to controls, patients in MFS-1 showed mild myocardial disease reflected in a larger left ventricular end-diastolic diameter (LVEDD), lower TAPSE and higher amount of (supra) ventricular extrasystoles ((S)VES). Patients in MFS-2 were more severely affected. Seven patients (five in MFS-2) presented decreased LV ejection fraction. Twenty patients (twelve in MFS-2) had non-sustained ventricular tachycardia (NSVT) in at least one AECG. Larger LVEDD and higher amount of VES were independently associated with NSVT.Conclusion: Our study shows mild but significant myocardial involvement in patients with MFS. Patients with previous surgery or valvular dysfunction are more severely affected. Evaluation of myocardial function with echocardiography and AECG should be considered in all patients with MFS, especially in those with valvular disease and a history of cardiac surgery.
Incidence And Risk Factors Of Inguinal Hernia Occurred After Radical Prostatectomy-comparisons of different approaches.
Authors: Liu Lijia , Xu Haoxiang , Qi Feng , Wang Shangqian , Shadhu Kamleshsingh , Ramlagun-Mungur Dadhija , Wang Shui
Published: September 2020

Background: To observe cumulative morbidity of postoperative inguinal hernia(PIH) and identify risk factors associated with its development in patients who underwent retropubic radical prostatectomy(RRP), laparoscopic prostatectomy(LRP) or robotic assisted laparoscopic prostatectomy (RALP) operation.Methods: From June 2009 to September 2016, 756 patients diagnosed with localized prostate cancer who had undergone RRP, LRP or RALP in our center were included in this study. Patients with PIH were retrospectively investigated in such factors as age, BMI, previous abdominal operations, diabetes mellitus history, hypertension history, prostate volume, previous hernia, operative methods, operative approach, preoperative Gleason, clinical T-stage, PLND situation, operative time, and estimated blood loss. Univariate and multivariate cox hazard regressions analysis were utilized to identify risk factors predisposing to PIH.Results: A total of 53 of 751(7.1%) patients developed PIH at a median follow-up period of 43 months. PIH rate in RRP was significantly higher compared to LRP and RALP group (RRP: 15.3%, LRP: 6.7%, RALP:1.9%, P=0.038). Right side (69.8%) and indirect (88.8%) PIH were dominant type in hernia group. Univariate and multivariate cox hazard regressions analysis indicated that age and RRP approach were identified to be implicated to PIH [adjusted hazard ratio7.39(1.18-46.39), 2.93(95% CI 1.47-5.84)].Conclusions: RRP technique and older age, especially patients over 80 years, are associated with higher incidence for PIH development. Appropriate prophylaxis during the operation should be evaluated for those in high-risk.
Validation of Loop Mediated Isothermal Amplification for the detection of Loa loa infection in Chrysops spp in experimental and natural field conditions
Authors: Amambo Glory Ngongeh , Abong Raphael Awah , Fombad Fanny Fri , Njouendou Abdel Jelil , Nietcho Franck , Beng Amuam Andrew , Ritter Manuel , Esum Mathias Eyong , Deribe Kebede , Cho Jerome Fru , Enyong Peter Ivo , Poole Catherine , Hoerauf Achim , Carlow Clotilde , Wanji Samuel
Published: September 2020

Background: The Mass Drug Administration of ivermectin for onchocerciasis control has contributed to a significant drop in Loa loa microfilaria loads in humans that led to reduction of the levels of infection in Chrysops vectors. Accurate parasite detection is essential for assessing loiasis transmission; as such a potential alternative or an indirect strategy to address the problem co-endemic loiasis presents to the LF and onchocerciasis elimination programme and also, further reflecting the true magnitude of the loiasis problem as excess human mortality has been reported to be associated with the disease. Although microscopy is the gold standard for detecting the infection, its sensitivity is compromised when the intensity of infection is low. The Loop-mediated isothermal amplification (LAMP) of parasite DNA is an alternative method for detecting infection which offers operational simplicity, rapidity and versatility of visual readout options. This study aimed at validating the Loa loa LAMP assay for the detection of infected Chrysops spp. under experimental and natural field conditions. Methods: Two sets of 18 flies were fed on volunteers with either a low (<10mf/ml) or high (>30,000mf/ml) microfilarial load. The fed flies were maintained under laboratory conditions for 14 days and then analysed with LAMP for the detection of L. loa infection. In addition, a total of 9,270 flies were collected from the North West, East, and South West regions of Cameroon using sweep nets and subjected to microscopy (7,841 flies) and LAMP (1,291 flies plus 138 nulliparous flies) analyses. Results: LAMP assay successfully detected parasites in Chrysops fed on both low and high microfilariaemic volunteers. Field validation and surveillance studies phase revealed LAMP-based infection rates ranging from 0.5 % to 31.6 %, with the lowest levels in the South West 2 and highest infection rates in South West 1. LAMP assay detected significantly higher infection rates than microscopy in 4 of 5 study sites. Conclusion: This study demonstrated the potential of LAMP as a simple surveillance tool, and is more sensitive than microscopy for the detection of experimental and natural L. loa infections in Chrysops vectors.
Microbial synthesis of poly- γ -glutamic acid ( γ -PGA) with fulvic acid powder, the waste from yeast molasses fermentation
Authors: Li Yazhou , Wang Jianghan , Liu Na , Ke Luxin , Zhao Xiuyun , Qi Gaofu
Published: September 2020

Background: Molasses is a wildly used feedstock for fermentation, but it also poses a severe wastewater-disposal problem worldwide. Recently, the wastewater from yeast molasses fermentation is being processed into fulvic acid (FA) powder as a fertilizer for crops, but it consequently induces a problem of soil acidification after being directly applied into soil. In this study, the low-cost FA powder was bioconverted into a value-added product of γ-PGA by a glutamate independent producer of Bacillus velezensis GJ11.Results: FA power could partially substitute the high-cost substrates such as sodium glutamate and citrate sodium for producing γ-PGA. With FA powder in the fermentation medium, the amount of sodium glutamate and citrate sodium used for producing γ-PGA were both decreased around one third. Moreover, FA powder could completely substitute Mg2+, Mn2+, Ca2+ and Fe3+ in the fermentation medium for producing γ-PGA. In the optimized medium with FA powder, the γ-PGA was produced at 42.55 g/L with a productivity of 1.15 g/(L·h), while only 2.87 g/L was produced in the medium without FA powder. Hydrolyzed γ-PGA could trigger induced systemic resistance (ISR), e.g. H2O2 accumulation and callose deposition, against the pathogen’s infection in plants. Further investigations found the ISR triggered by γ-PGA hydrolysates was dependent on the ethylene (ET) signalling and nonexpressor of pathogenesis-related proteins 1 (NPR1). Conclusions: To our knowledge, this is the first report to use the industry waste, FA powder, as a sustainable substrate for microbial synthesis of γ-PGA. This bioprocess can not only develop a new way to use FA powder as a cheap feedstock for producing γ-PGA, but also help to reduce pollution from the wastewater of yeast molasses fermentation.
Clinicopathological features of Epstein-Barr virus infection, microsatellite instability, tumor mutation burden and PD-L1 status in Chinese patients with gastric cancer
Authors: Zhang Li , Wu Aiwen , Li Zhongwu
Published: September 2020

Objectives: Gastric cancer (GC) is the 4th most common type of cancer worldwide. Different GC subtypes exhibit unique molecular features that may potentially guide therapeutic decisions. The aim of the present study was to investigate Epstein-Barr virus (EBV) infection, microsatellite instability (MSI) status, the expression of programmed death-ligand 1 (PD-L1) and gene mutations in patients with surgically-treated GC. Methods: The data of 2,504 GC patients, who underwent potentially curative gastrectomy with lymphadenectomy at Peking University Cancer Hospital between 2013 and 2018, were reviewed from a prospectively collected medical database. We also analyzed the clinicopathological factors associated with the immunohistochemistry (IHC) profiles of these patients, and genetic alterations were analyzed using next generation sequencing (NGS). Results: Mismatch repair-deficient (d-MMR) GC patients were found to have a higher probability of expressing PD-L1 (p<0.001, PD-L1 cutoff value = 1%). In addition, 4 and 6.9% of the 2,504 gastric cancer patients were EBV-positive and d-MMR, respectively. The number of MLH1/PMS2-negative cases was 126 (6%), and the number of MSH2/MSH6-negative cases was 14 (0.9%). d-MMR status was associated with a diffuse/mixed group (p<0.05), but not with tumor differentiation. Furthermore, MSI and d-MMR GC status (detected by NGS and IHC, respectively) were consistently high, and the rate of MSI was higher in patients with d-MMR GC. A number of genes associated with DNA damage repair were detected in GC patients with MSI, including POLE, ETV6, BRCA and RNF43. In patients with a high tumor mutation burden, the most significantly mutated genes were LRP1B (79.07%), ARID1A (74.42%), RNF43 (69.77%), ZFHX3 (65.12%), TP53 (58.14%), GANS (51.16%), BRCA2 (51.16%), PIK3CA (51.16%), NOTCH1 (51.16%), SMARCA4 (48.84%), ATR (46.51%), POLE (41.86%) and ATM (39.53%). Conclusions: Using IHC and NGS, MSI status, protein expression, TMB and genetic alterations were identified in patients with GC, which provides a theoretical basis for the future clinical treatment of GC.
The temperature of growth and sporulation modulates the efficiency of spore-display in Bacillus subtilis
Authors: Petrillo Claudia , Castaldi Stefany , Lanzilli Mariamichela , Saggese Anella , Donadio Giuliana , Baccigalupi Loredana , Ricca Ezio , Isticato Rachele
Published: September 2020

Background: Bacterial spores displaying heterologous antigens or enzymes have long been proposed as mucosal vaccines, functionalized probiotics or biocatalysts. Two main strategies have been developed to display heterologous molecules on the surface of Bacillus subtilis spores: i) a recombinant approach, based on the construction of a gene fusion between a gene coding for a coat protein (carrier) and DNA coding for the protein to be displayed, and ii) a non-recombinant approach, based on the spontaneous and stable adsorption of heterologous molecules on the spore surface. Both systems have advantages and drawbacks and the selection of one or the other depends on the protein to be displayed and on the final use of the activated spore. It has been recently shown that B. subtilis builds structurally and functionally different spores when grown at different temperatures; based on this finding B. subtilis spores prepared at 25, 37 or 42°C were compared for their efficiency in displaying various model proteins by either the recombinant or the non-recombinant approach.Results: Immune- and fluorescence-based assays were used to analyze the display of several model proteins on spores prepared at 25, 37 or 42°C. Recombinant spores displayed different amounts of the same fusion protein in response to the temperature of spore production. In spores simultaneously displaying two fusion proteins, each of them was differentially displayed at the various temperatures. The display by the non-recombinant approach was only modestly affected by the temperature of spore production, with spores prepared at 37 or 42°C slightly more efficient than 25°C spores in adsorbing at least some of the model proteins tested. Conclusion: Our results indicate that the temperature of spore production allows control of the display of heterologous proteins on spores and, therefore, that the spore-display strategy can be optimized for the specific final use of the activated spores by selecting the display approach, the carrier protein and the temperature of spore production.
Probiotic Lacticaseibacillus rhamnosus HA-114 suppresses age-dependent neurodegeneration via mitochondrial beta-oxidation
Authors: Labarre Audrey , Guitard Ericka , Tossing Gilles , Bareke Eric , Labrecque Marjorie , Tetreault Martine , Parker Alex
Published: September 2020

The human microbiota is believed to influence health. Microbiome dysbiosis may be linked to neurological conditions like Alzheimer’s disease (AD), amyotrophic lateral sclerosis (ALS) and Huntington’s disease (HD). We report the ability of a probiotic bacterial strain in reversing neurodegeneration phenotypes. We show that Lacticaseibacillus rhamnosus HA-114 is neuroprotective in C. elegans models of ALS and HD. Our results show that neuroprotection from L. rhamnosus HA-114 is unique from other L. rhamnosus strains, and resides in its fatty acid content. Neuroprotection by L. rhamnosus HA-114 requires acdh-1/ACADSB, kat-1/ACAT1 and elo-6/ELOVL3/6, which are key fatty acid metabolism and mitochondrial β-oxidation genes. Moreover, L. rhamnosus HA-114 delayed disease onset and suppressed motor neuron degeneration in an aggressive mouse model of ALS. Our data suggest that disrupted lipid metabolism contributes to neurodegeneration and that dietary intervention with L. rhamnosus HA-114 restores lipid homeostasis and energy balance through mitochondrial β-oxidation. L. rhamnosus HA-114 is suitable for human consumption opening the possibility of modifying disease progression by dietary intervention.
Headache Characteristics In COVID-19 Pandemic-A Survey Study
Authors: Uygun Özge , Ertas Mustafa , Ekizoğlu Esme , Bolay Hayrunnisa , Özge Aynur , Orhan Elif Kocasoy , Çağatay Arif Atahan , Baykan Betül
Published: September 2020

BackgroundHeadache is the most common COVID-19-related neurological symptom. We aimed to reveal diagnostic clues of headache for COVID-19 infection and to investigate the course of primary headaches during the pandemic. MethodsWe developed a detailed web-based questionnaire screening the characteristics and course of headaches besides clinical COVID-19 features. The participants were grouped according to being diagnosed with COVID-19 infection or not, and having previous or new-onset headaches. The COVID-19 related headache features and their associations with other clinical features were investigated. A binary logistic regression model was performed to differentiate the characteristics of headache related to COVID-19. Findings A total of 3458 participants (2341 females;67.7%, 1495 healthcare workers;43.2%) with a mean age of 43.21±11.2 years contributed to the survey. Among them, 262 participants had COVID-19 diagnosis and 126 (48.1%) were male. The rate of males in the group without COVID-19 was 31% (991 out of 3196 participants) showing significant gender difference between groups (p<0.000). COVID-19 related headaches were more closely associated with anosmia/ageusia and gastrointestinal complaints (p<0.000 and p<0.000), and showed different characteristics like pulsating, pressing, and even stabbing quality. Logistic regression analyses showed that bilateral headache, duration over 72 hours, analgesic resistance and having male gender were significant variables to differentiate COVID-19 positive patients from those without COVID-19 (p=0.04 for long duration and p<0.000 for others). A worsening of previous primary headaches due to the pandemic-related problems was not reported in the majority of patients.Interpretation Bilateral, long-lasting headaches, resistance to analgesics and having male gender were more frequent in people with COVID-19 in conjunction with anosmia/ageusia and gastrointestinal complaints. These features may be helpful for diagnosing the headache related to COVID-19 during the pandemic.
Direct Oral Anticoagulants Increase Bleeding Risk After Endoscopic Sphincterotomy: A Retrospective Study
Authors: Masuda Sakue , Koizumi Kazuya , Nishino Takashi , Tazawa Tomohiko , Kimura Karen , Tasaki Junichi , Ichita Chikamasa , Sasaki Akiko , Kako Makoto , Uojima Haruki , Sugitani Ayumu
Published: September 2020

Background: Bleeding is a serious adverse event of endoscopic sphincterotomy (EST). However, the risk of EST bleeding between direct oral anticoagulant (DOAC) users and those who received no antithrombotic agents has not been clarified. This study analyzed the risk factors for bleeding after EST in patients on DOAC and evaluated the Japan Gastroenterological Endoscopy Society (JGES) guidelines for gastroenterological endoscopy in patients undergoing antithrombotic treatment.Methods: We retrospectively analyzed 524 patients treated with EST who received DOAC or no antithrombotic drug from May 2016 to August 2019. We investigated the risk factors for bleeding. Cessation and resumption of DOAC treatment were determined according to the JGES guidelines, although DOAC cessation or heparin replacement was determined by the attending physician. Results: The number of patients on DOAC (DOAC group) and those without antithrombotic drug (no-drug group) were 42 (8.0%) and 482 (92.0%), respectively. DOAC was discontinued for <2 days in 24 (57.2%) patients and for ≥2 days in 18 (42.8%) patients. Of the 524 patients, 21 (4.0%) had EST bleeding. The bleeding rate was significantly higher in the DOAC group (14.3%, 6/42). Multivariate analysis showed that bleeding occurs more frequently in patients on DOAC, patients with low platelet counts (<100,000/µl), and elderly patients (>80 years old).Conclusions: DOAC treatment, low platelet count, and old age (>80 years old) are significant risk factors for EST bleeding. Although the bleeding incidence increased in patients on DOAC, which was discontinued according to the JGES guidelines, successful hemostasis was achieved with endoscopy in all cases with bleeding, and no thrombotic events occurred after cessation of DOAC. Thus, the JGES guidelines are acceptable.
Modeling Soil Organic Carbon Using Remotely-Sensed Predictors: A Case Study from Fuzhou City, China
Authors: Sodango Terefe Hanchiso , Sha Jinming , Li Xiaomei , Shang Jiali , Bao Zhongcong
Published: September 2020

Background: Assessing the spatial dynamics of soil organic carbon (SOC) is essential for carbon monitoring. Since, variability of SOC is mainly attributed to biophysical land surface variables, integrating a compressive set of such indices may support the pursuit for optimum set of predictor variables. Therefore, this study was aimed at predicting the spatial distribution of SOC in relation to remotely-sensed variables and other covariates. Hence, the land surface variables were combined from remote sensing, topographic, and soil spectral sources. Moreover, the most influential variables for prediction were selected using the RF and Classification and Regression Tree (CART).Results: The results indicated that the RF model has good prediction performance with corresponding R2 and RMSE values of 0.96, and 0.91 mg/g, respectively. The distribution of SOC content showed variability across landforms (CV=78.67%), land-use (CV=93%), and lithology (CV=64.67%). Forestland had the highest SOC (13.60 mg/g) followed by agriculture (10.43 mg/g), urban (9.74 mg/g), and water body (4.55 mg/g) land-uses. Furthermore, bauxite and laterite lithology had the highest SOC content (14.69 mg/g) followed by fluvial (14.52 mg/g) and shale (13.57 mg/g), whereas the lowest was predicted in sandstone (5.53mg/g). The mean SOC concentration was 11.70 mg/g, where the majority of area was classified as humous and organo-humus, distributing in the mountainous regions. The biophysical land surface indices, brightness removed vegetation indices, topographic indices (, and soil spectral bands, respectively were the most influential predictors of SOC. Conclusion: The spatial variability of SOC may be influenced by landform, land-use, and lithology of the study area. Remotely-sensed predictors including land moisture, land surface temperature and built-up indices added valuable information for prediction of SOC. Hence, the land surface indices may provide new insights into SOC modeling in complex landscapes of warm sub-tropical urban regions.
Sex Differences in Association Between Body Composition and Frailty or Physical Performance in Community-Dwelling Older Adults
Authors: Soh Yunsoo , Won Chang Won
Published: September 2020

BackgroundFrailty is a common geriatric condition due to aging, defined as a decrease in the functional reserve to maintain the homeostasis. As part of the aging process, body composition changes occur. This study investigated the relationship between body composition and frailty in a community-dwelling elderly Korean population.MethodsThis cross-sectional cohort study analyzed data of 2,385 elderly participants (aged 70–84 years, 1131 males and 1254 females) of the Korean Frailty and Aging Cohort Study from 2016 to 2017. Body composition, including total and trunk fat masses and fat-free mass, were measured with dual-energy X-ray absorptiometry. Fat mass index (FMI), trunk fat mass index (TFMI), and fat-free mass index (FFMI) represented total fat mass, trunk fat mass, and fat-free mass according to height. Based on the frailty index developed by Fried, we compared the frail and non-frail groups. Poor physical performance assessed with the short physical performance battery score of <9 is considered frailty. To evaluate the relationship between the variables, simple and fully adjusted multivariable logistic regression analyses were performed according to sex.ResultsAmong the participants, 462 (19.3%) were defined as the frail group, with a significantly high mean age of 77.9±4.0 years. In the logistic regression analysis of frailty based on body mass index (BMI) categories, underweight (BMI<18 kg/m2) participants showed a high incidence of frailty in both sexes. BMI showed an association with frailty only in males. In both sexes, FFMI was associated with a lower incidence of frailty, which was statistically significant in the fully adjusted models. In the female, fat-related indexes including body fat percentage, FMI, and TFMI showed a significant association with poor physical performance. In contrast, males with low FFMI only showed a significant association with poor physical performance.ConclusionsFrailty closely correlated with FFMI in both sexes. The poor physical performance associated with frailty correlated with fat-related body composition in females and fat-free mass in males owing to the difference in body composition between the sexes. In the assessment of frailty, body composition and sex-related differences should be analyzed.