bluuebunny/crossref_metadata_2025 huggingface dataset:
The effect of productive SafetyNet program on wasting among under-five children in the rural community of South Gondar Zone, Northwest Ethiopia
Authors: Engidaw Melaku Tadege , Gebremariam Alemayehu Digssie
Published: October 2020

Background

Undernutrition is a significant public health problem in a developing country like Ethiopia. Even if the cause of malnutrition is multifactorial, it is mainly related to socioeconomical, political, and health-related problems. All these problems will lead to more severe nutrient deficiencies among households without assets. The Productive SafetyNet program is implemented for beneficiaries in the rural community to prevent household assets depletion. So, this study aimed to assess the effect of a Productive SafetyNet program on wasting among under-five children in the rural community of South Gondar Zone.

Methods

A community-based cross-sectional study was done among 803 children paired with their mother/caregivers. Particepnts were selected by a simple random sampling technique. The data were collected by using a structured and pre-tested questionnaire. AnthroPlus software was used to analyse anthropometric data. The data entry employed by EpiInfo version 7.0 software for Windows. Then, the data exported to SPSS version 20.0 to carryout further statistical analysis. The anthropometric index (weight for height) was constructed to determine wasting. Both binary and multivariable logistic regression models were used to identify associated factors. Finally,P-Value ≤0.05 was used to declare statistical significance.

Results

In this study, the response rate was 95.76%. Of the total participants, 195(25.36%) children were from SafetyNet program beneficiaries. The overall prevalence of wasting was 29.9% (95% CI: 26.6, 33.2%). More than One-fourth of the children from SafetyNet beneficiary households were wasted. While considering all other variables constant, Productive SafetyNet Program reduce wasting by 46% (COR = 0.54. 95% CI (0.37, 0.79)). Wasting were significantly associated with marital status (divorced and/or separated: AOR = 3.33, 95% CI (1.71, 6.45)), being on the SafetyNet program (AOR: 0.63, 95% CI (0.40, 0.99)), family size (AOR = 0.13, 95% CI (0.09, 0.21)), father educational status (AOR: 0.25, 95% CI (0.09, 0.66)), age of the child (AOR = 0.51, 95% CI (0.33, 0.77)), and child dietary diversity score (AOR = 2.99, 95% CI (1.67, 5.35)).

Conclusion

Wasting was a severe public health problem. In this study, the Productive SafetyNet Program reduce wasting significantly. Marital status, SafetyNet program status, family size, father educational status, age of the child, and dietary diversity were factors associated with wasting among children. Early detection of household asset depletion and SafetyNet program implementation is vital with the usual nutritional assessment and counseling.
Ecological and floristic study of Hirmi woodland vegetation in Tigray Region, Northern Ethiopia
Authors: Girmay Mehari , Bekele Tamrat , Demissew Sebsebe , Lulekal Ermias
Published: October 2020

The dryland area in Ethiopia covers a substantial region endowed with diverse plant resources. However, the landmass has received less attention even if it has high ecological, environmental, and economic uses. The present study was conducted in Hirmi woodland vegetation, which is one of the dryland areas in Ethiopia, with the objective of investigating the floristic composition, plant community types, vegetation structure, community-environment relations and its regeneration status. Vegetation and environmental data were collected from 80 sampling plots with a size of 25 m × 25 m designated as the main plots. Diameter at breast height (DBH), height, basal area, density, vertical structure, importance value index (IVI), and frequency were computed. Species diversity and evenness were analyzed using Shannon diversity and evenness indices. The plant community types and vegetation-environment relationships were analyzed using classification and ordination tools, respectively. A total of 171 vascular plant species belonging to 135 genera and 56 families were recorded. About 5.3% of the species were endemic and near-endemic to Ethiopia. The highest number of species was recorded in families Fabaceae (16.4%) and Poaceae (11.7%) followed by Asteraceae (7.0%), Combretaceae, Lamiaceae, and Moraceae (3.5% each). Five plant communities were identified. According to the results from ordination analysis, the floristic composition of these plant communities was significantly affected by altitude, slope, sand, silt, soil organic matter, total nitrogen, and disturbance. The vegetation structure reveals that a large number of individual species was categorized in the lower DBH, frequency, and height classes. The highest Shannon diversity index and evenness values of the study area were 4.21 and 0.95, respectively.Anogeissus leiocarpa, Combretum hartmannianum, Ziziphus mucronata, Terminalia macroptera,andAcacia polyacanthawere the species with high IVI. Some endemic plants were in the IUCN red list categories of Ethiopia and Eritrea. The overall regeneration status of the study area was poor because of anthropogenic disturbances and grazing pressures. Although the study area is endowed with high plant species diversity including endemism, it is under poor regeneration status due to various disturbances. To overcome this challenge, integrated management measures including monitoring and application of restoration techniques by taking into consideration the significant environmental factors associated with species diversity as well as observed regeneration status and IUCN threat level of the species are highly recommended.
Effects of geoclimatic factors on the variability in Pinus pinea cone, seed, and seedling traits in Turkey native habitats
Authors: Balekoglu Safa , Caliskan Servet , Dirik Hüseyin
Published: October 2020

Background

Stone pine (Pinus pinea L.) is harvested for its edible kernels. It is an important forest tree species, and also plays an important role in afforestation. Successful afforestation activities strongly depend on the quality of seeds and seedlings. Five eastern native populations of stone pine were analyzed, in terms of their geographical and climatic parameters, in order to identify their cone, seed, pine nut, and seedling traits. With this regard, we aimed to contribute to the reforestation, yield, and breeding of this species.

Results

All native populations occur in the sub-humid bioclimatic zone, according to Emberger’s bioclimatic classification, ranging 74.7–63.2 of Emberger’s Q Index value (Q), which synthesizes humidity and temperature, with lower values indicating more arid conditions. With regard to geographical factors, altitude was found to have the greatest effect on cone diameter and seed weight, while there was a weak correlation of cone, seed, and pine nut dimension with longitude and latitude. In terms of climatic factors, Q and mean of the maximum temperature of June, July, and August (ME) were found to be the main drivers behind significant effects in cone, seed, and pine nut morphometric traits. The most negative effect on seed number cone−1 (r: − 0.897), pine nut number cone−1 (r: − 0.923), pine nut yield (r: − 0.903), and pine nut weight (r: − 0.878) was Q, whereas cone diameter, seed length, and seed weight were positively correlated with the ME (r: 0.939, r: 0.889, and r: 0.866, respectively). Cone and seed diameter and seed weight increased with decreasing summer drought index (r: − 0.806, r: − 0.846, and r: − 0.866, respectively). Rainfall in the June of the third year prior to harvest time (RJ) had a negative effect on the percentage of sound seeds per cone. Annual rainfall in the third year prior to harvest time (AR) significantly affected pine nut weight (r: 0.889), although rainfall during summer had a negative effect. The empty seed ratio of the different populations ranged from 20 to 68%, while considering all populations, the empty seed ratio was 46%.

Conclusions

The study suggests that the Q Index and ME should be taken into account to determine cone to pine nut yield. With this regard, plantations of stone pine should be established on sub-humid areas and Q values should not exceed 75.
Prevalence and distribution of resistance and enterotoxins/enterotoxin-like genes in different clinical isolates of coagulase-negative Staphylococcus
Authors: Nasaj Mona , Saeidi Zahra , Tahmasebi Hamed , Dehbashi Sanaz , Arabestani Mohammad Reza
Published: October 2020

Background

Coagulase-negative staphylococcus (CoNS) is considered to be the major reservoirs for genes facilitating the evolution of S. aureus as a successful pathogen. The present study aimed to determine the occurrence of genes conferring resistance to fluoroquinolone, determining of the prevalence of insertion sequence elements IS256, IS257 and different superantigens (SAgs) among CoNS isolates obtained from various clinical sources.

Materials and methods

The current study conducted on a total of the 91 CoNS species recovered from clinical specimens in Hamadan hospitals in western Iran in 2017–2019. The antimicrobial susceptibility testing was performed using disk diffusion method and the presence of the IS256 and IS257, genes conferring resistance to fluoroquinolone and enterotoxins/enterotoxin-like encoding genes were investigated by polymerase chain reaction (PCR) method.

Results

Among genes encoding classic enterotoxins, sec was the most frequent which was carried by 48.4% of the 91 isolates, followed by seb in 27.5% of the isolates. None of the CoNS isolates was found to be positive to enterotoxin-like encoding genes. In 11(12%) of all isolates that were phenotypically resistant to levofloxacin, 9 isolates (81.8%) were positive for gyrB, 8 isolates (72.7%) were positive for gyrA, 8 isolates (72.7%) harbored grlB and 7 isolates (63.6%) were found to carry grlA. The IS256 and IS257 were identified in 31.8% and 74.7% of the isolates, respectively. The results of statistical analysis showed a significant association between the occurrence of staphylococcal enterotoxins (SEs) encoding genes and antimicrobial resistance.

Conclusion

Antimicrobial resistant determinants and SEs are co-present in clinical CoNS isolates that confer selective advantage for colonization and survival in hospital settings. The coexistence of insertion elements and antibiotic resistance indicate their role in pathogenesis and infectious diseases.
Dietary L-citrulline supplementation modulates nitric oxide synthesis and anti-oxidant status of laying hens during summer season
Authors: Uyanga Victoria A. , Jiao Hongchao , Zhao Jingpeng , Wang Xiaojuan , Lin Hai
Published: October 2020

Background

L-citrulline (L-Cit), a non-protein amino acid, has been implicated in several physiological functions including anti-inflammatory, anti-oxidative, and hypothermic roles, however, there is a paucity of information with regards to its potential in poultry production.

Methods

This study was designed to investigate the effects of dietary L-Cit supplementation on the production performance, nitric oxide production, and antioxidant status of laying hens during summer period. Hy-Line Brown laying hens (n = 288, 34 weeks old) were allotted to four treatment, 6 replicates of 12 chickens each. Dietary treatments of control (basal diets), 0.25%, 0.50% and 1.00% L-Cit supplementation were fed to chickens for eight (8) weeks. Production performance, free amino acid profiles, nitric oxide production, and antioxidant properties were measured. Blood samples were collected at the 4thand 8thweeks of the experiment.

Results

Air temperature monitoring indicated an average daily minimum and maximum temperatures of 25.02 °C and 31.01 °C respectively. Dietary supplementation with L-Cit did not influence (P > 0.05) the production performance, and rectal temperature of laying hens. Egg shape index was increased (P < 0.05) with increasing levels of L-Cit. Serum-free content of arginine, citrulline, ornithine, tryptophan, histidine, GABA, and cystathionine were elevated, but taurine declined with L-Cit diets. Plasma nitric oxide (NOx) concentration was highest at 1% L-Cit. Likewise, nitric oxide synthase (NOS) activity for total NOS (tNOS) and inducible NOS (iNOS) were upregulated with increasing L-Cit levels, although, tNOS was not affected at the 4thweek. Anti-oxidant enzymes including catalase and superoxide dismutase (SOD) were increased with L-Cit supplementation, however, SOD activity was unchanged at 4thweek, while total anti-oxidant capacity increased at the 8thweek. L-Cit supplementation attenuated the extent of lipid peroxidation, and also inhibited glutathione peroxidase activity.

Conclusion

Dietary L-Cit supplementation modulated systemic arginine metabolism, nitric oxide synthesis, antioxidant defense system, and increased the egg shape index of laying hens during the summer season. 1% L-Cit supplementation proved most effective in potentiating these effects and may be adopted for feed formulation strategies.
Public spending on orphan medicines: a review of the literature
Authors: Gombocz Margit , Vogler Sabine
Published: October 2020

Background and objective

Little is known about how much public payers spend on orphan medicines. This study aimed at identifying information on orphan medicine expenditure incurred by public payers that was published in literature globally and at possibly synthesising their shares as portion of the total pharmaceutical expenditure.

Methods

A literature review was undertaken using Medline, the Orphanet Journal of Rare Diseases and Google Scholar. Titles and abstracts were screened, and full texts of potentially qualifying studies were reviewed for inclusion. Included articles were analysed, and bibliometric parameters as well as public expenditure data on orphan medicines were retrieved.

Results

Six hundred forty three articles excluding duplicates were identified. After screening of the abstracts and a review of the full texts, 13 articles qualified for in-depth analysis.

The 13 selected articles on orphan pharmaceutical expenditure were published between 2010 and 2018. Survey periods varied between 1 year and 12 years. One publication included 22 countries but the majority of the studies were related to a single country. Expenditure data was available in five of the 13 articles, and eight articles used ‘expenditure proxies’ such as sales data. Spending data had been sourced from public institutions (4 studies), private providers (5 studies) and a combination of both (3 studies, no information on data source in 1 study). In all included studies, secondary data were analysed. Reported expenditure shares for orphan medicines in relation to total pharmaceutical spend was frequently below 3%. Countries with higher shares included the USA, Canada, the Netherlands and Bulgaria—the latter reporting spending on orphan medicines as high as 9%.

Conclusions

A low number of studies that informed about pharmaceutical spending on orphan medicines was published, thereof only a few explicitly analysed expenditure data of public payers. A conclusive synthesis of public spending on orphan medicines is a challenge given to the diversity in methodologies to measure expenditure. There is a need for further research to survey primary data of public spending for orphan medicines, based on a sound methodology to measure these data and to compare them internationally.
Inquiry-based learning and E-learning: how to serve high and low achievers
Authors: Sotiriou Sofoklis A. , Lazoudis Angelos , Bogner Franz X.
Published: October 2020

Large-scale implementations of effective inquiry-based learning are rare. A European-wide initiative gave teachers access to innovative e-learning tools (ranging from virtual labs, virtual games and simulations to augmented reality applications) for lesson planning and classroom implementation. We examined 668 such implementations across 453 schools within the period of one school year. Teachers could use a platform with digital resources and tools and were encouraged to adopt five different phases of inquiry-based learning: orientation, hypothesizing, planning, analysis, and conclusion. Additionally, an integrated interface for lesson implementation tracked each students’ problem-solving competence (during the inquiry lessons), culminating in about 12,000 datasets. Every user generated an average of 22 digital inquiry-based digital scenarios, each of which required approximately 50.14 min for completion. These scenarios, using high quality resources adapted to school conditions, yielded significant learning outcomes for participating students (age: 14.4 years, gender balanced). While the PISA study identified 10% high achievers on average, we exceeded this number in our framework scoring 20–29% high achievers and 37–42% low achievers (which was close to the 45% PISA average). Offering tools to teachers, which help creating individual inquiry scenarios and monitoring students’ achievement, does not yield any insurmountable obstacles for classroom-implementation of inquiry-based lessons: Compared to the PISA study, levels of high achievers increased even if complex problem-solving competence was required.
Correction to: Celebrating a quarter century of the Injury Free Coalition for Kids®
Authors: Lee Lois K.
Published: October 2020

An amendment to this paper has been published and can be accessed via the original article.
Discoid lateral meniscus: importance, diagnosis, and treatment
Authors: Kim Jun-Ho , Ahn Jin Hwan , Kim Joo-Hwan , Wang Joon Ho
Published: October 2020

Discoid lateral meniscus (DLM) is a common anatomic variant in the knee typically presented in young populations, with a greater incidence in the Asian population than in other populations. As DLM is a congenital anomaly, the ultrastructural features and morphology differ from those of the normal meniscus, potentially leading to meniscal tears. Snapping and pain are common symptoms, with occasional limitations of extension, in patients with DLM. Examination of the contralateral knee is necessary as DLM affects both knees. While simple radiographs may provide indirect signs of a DLM, magnetic resonance imaging (MRI) is essential for diagnosis and treatment planning. Although DLM was traditionally classified into three categories, namely, complete, incomplete, and Wrisberg DLM, a recent MRI classification provides useful information for surgical planning because the MRI classification was based on the peripheral detachment in patients with DLM, as follows: no shift, anterocentral shift, posterocentral shift, and central shift. Asymptomatic patients require close follow-up without surgical treatment, while patients with symptoms often require surgery. Total or subtotal meniscectomy, which has been traditionally performed, leads to an increased risk of degenerative arthritis; thus, partial meniscectomy is currently considered the treatment of choice for DLM. In addition to partial meniscectomy, meniscal repair of peripheral detachment is recommended for stabilization in patients with DLM to preserve the function of the meniscus. Previous studies have reported that partial meniscectomy with or without meniscal repair is effective and shows superior clinical and radiological outcomes to those of total or subtotal meniscectomy during the short- to long-term follow-up. Our preferred principle for DLM treatment is reduction, followed by reshaping with reference to the midbody of the medial meniscus and repair as firm as possible.
Selection markers for transformation of the sequenced reference monokaryon Okayama 7/#130 and homokaryon AmutBmut of Coprinopsis cinerea
Authors: Dörnte Bastian , Peng Can , Fang Zemin , Kamran Aysha , Yulvizar Cut , Kües Ursula
Published: October 2020

Background

Two reference strains have been sequenced from the mushroom Coprinopsis cinerea, monokaryon Okayama 7/#130 (OK130) and the self-compatible homokaryon AmutBmut. An adenine-auxotrophy in OK130 (ade8-1) and a para-aminobenzoic acid (PABA)-auxotrophy in AmutBmut (pab1-1) offer selection markers for transformations. Of these two strains, homokaryon AmutBmut had been transformed before to PABA-prototrophy and with the bacterial hygromycin resistance marker hph, respectively.

Results

Gene ade8 encodes a bifunctional enzyme with an N-terminal glycinamide ribonucleotide synthase (GARS) and a C-terminal aminoimidazole ribonucleotide synthase (AIRS) domain required for steps 2 and 5 in the de novo biosynthesis of purines, respectively. In OK130, a missense mutation in ade8-1 rendered residue N231 for ribose recognition by the A loop of the GARS domain into D231. The new ade8+ vector pCcAde8 complements the auxotrophy of OK130 in transformations. Transformation rates with pCcAde8 in single-vector and co-transformations with ade8+-selection were similarly high, unlike for trp1+ plasmids which exhibit suicidal feedback-effects in single-vector transformations with complementation of tryptophan synthase defects. As various other plasmids, unselected pCcAde8 helped in co-transformations of trp1 strains with a trp1+-selection vector to overcome suicidal effects by transferred trp1+. Co-transformation rates of pCcAde8 in OK130 under adenine selection with nuclear integration of unselected DNA were as high as 80% of clones. Co-transformation rates of expressed genes reached 26–42% for various laccase genes and up to 67% with lcc9 silencing vectors. The bacterial gene hph can also be used as another, albeit less efficient, selection marker for OK130 transformants, but with similarly high co-transformation rates. We further show that the pab1-1 defect in AmutBmut is due to a missense mutation which changed the conserved PIKGT motif for chorismate binding in the C-terminal PabB domain to PIEGT in the mutated 4-amino-4-deoxychorismate synthase.

Conclusions

ade8-1 and pab1-1 auxotrophic defects in C. cinerea reference strains OK130 and AmutBmut for complementation in transformation are described. pCcAde8 is a new transformation vector useful for selection in single and co-transformations of the sequenced monokaryon OK130 which was transformed for the first time. The bacterial gene hph can also be used as an additional selection marker in OK130, making in combination with ade8+ successive rounds of transformation possible.
Immunopathogenesis of SARS-CoV-2-induced pneumonia: lessons from influenza virus infection
Authors: Miyazawa Masaaki
Published: October 2020

Factors determining the progression of frequently mild or asymptomatic severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection into life-threatening pneumonia remain poorly understood. Viral and host factors involved in the development of diffuse alveolar damage have been extensively studied in influenza virus infection. Influenza is a self-limited upper respiratory tract infection that causes acute and severe systemic symptoms and its spread to the lungs is limited by CD4+ T-cell responses. A vicious cycle of CCL2- and CXCL2-mediated inflammatory monocyte and neutrophil infiltration and activation and resultant massive production of effector molecules including tumor necrosis factor (TNF)-α, nitric oxide, and TNF-related apoptosis-inducing ligand are involved in the pathogenesis of progressive tissue injury. SARS-CoV-2 directly infects alveolar epithelial cells and macrophages and induces foci of pulmonary lesions even in asymptomatic individuals. Mechanisms of tissue injury in SARS-CoV-2-induced pneumonia share some aspects with influenza virus infection, but IL-1β seems to play more important roles along with CCL2 and impaired type I interferon signaling might be associated with delayed virus clearance and disease severity. Further, data indicate that preexisting memory CD8+ T cells may play important roles in limiting viral spread in the lungs and prevent progression from mild to severe or critical pneumonia. However, it is also possible that T-cell responses are involved in alveolar interstitial inflammation and perhaps endothelial cell injury, the latter of which is characteristic of SARS-CoV-2-induced pathology.
Visual order of Chinese ink paintings
Authors: Fan Zhen-Bao , Zhang Kang
Published: October 2020

Visual order is one of the key factors influencing the aesthetic judgment of artworks. This paper reports the results of evaluating the influence of extracted features on visual order in Chinese ink paintings, using a regression model. We use nine contemporary artists’ paintings as examples and extract features related to the visual order of their paintings. A questionnaire survey is conducted to collect people’s rating scores on the visual order. Via regression modeling, our research analyzes the significance of each feature and validates the influences of the features on the visual order.
Least-squares imaging of diffractions by solving a hybrid L1-L2 norm minimization problem
Authors: Zhao Jingtao , Yu Caixia , Peng Suping , Cao Jingjie
Published: October 2020

Traditional diffraction images without a specific migration kernel for promoting focusing abilities may cause confusion to seismic interpretation because diffraction images may show a finite-array response of diffracted/scattered waves. Because diffractors are discontinuous and sparsely distributed, a least-squares diffraction-imaging method is formulated by solving a hybrid L1-L2 norm minimization problem that imposes a sparsity constraint on diffraction images. It uses two different forward modeling operators for reflections and diffractions and L2 and L1 regularizations for penalizing the amplitudes of the reflection and diffraction images, respectively. A classic Kirchhoff diffraction demigration operator is implemented on an initial diffraction image model to synthesize diffracted/scattered waves. A Kirchhoff reflection demigration operator, formulated by considering the local reflection slopes and a cosine attenuation weighting function, is implemented on an initial reflection image to synthesize the reflected waves. A modified alternating direction approach of multipliers is developed for iteratively solving this minimization problem to create diffraction images and their separated diffractions. The depths and local reflection slopes of the reflection images are fixed during this iteration. To alleviate the energy leakage between diffractions and reflections, after performing the plane-wave destruction method on the conventional migration data, its estimated reflection image and residual image are provided as the initial reflection and diffraction images, respectively. Our method can remove steep-slope reflections, increase the focusing power of the diffractions, and eliminate noise. Two numerical experiments demonstrate its capability of separating and imaging small-scale discontinuities and inhomogeneities. The exposed geologic structures in the tunnel of field coal mining further illustrate this method’s potential in ascertaining hidden faults, edges, and collapsed columns. A safety warning should be definitely required if a mining working surface is advancing these hidden geologic disasters because an emergency of water bursting or gas leakage may happen.
Eliminating above-surface diffractions from ground-penetrating radar data using iterative Stolt migration
Authors: Li Chao , Lin Yi , Lv Wenmin , Zhang Jinhai
Published: October 2020

Above-surface diffractions (ASDs) received by unshielded ground-penetrating radar (GPR) antennas are known to contaminate subsurface reflections and diffractions. Existing ASD-removal methods either leave relatively strong residual ASDs within subsurface reflections or attenuate them excessively. We have developed an iterative migration-based ASD-removal method to address this issue that separates ASDs from subsurface reflections via surgical mute. First, we isolate ASDs within the GPR profile using an optimal window function, generated using the focal center of ASDs within the migrated domain. The remainder signifies the zeroth-order separation of subsurface reflections. Second, we perform Stolt migration on the isolated ASDs using the speed of light in air. Then, we mute out the regions dominated by ASDs from the migration results, characterized by highly focused ASDs that are well separated from the majority of subsurface reflections. Following that, we demigrate the separated ASDs and subsurface reflections back to the unmigrated domain using the speed of light in air. Next, we combine the demigrated subsurface reflections with the zeroth-order subsurface reflections, thereby completing the first iteration of the separation process. The entire aforementioned process is then repeated twice on the residual data to obtain further residual subsurface reflections from ASDs, using a lower velocity and a higher velocity in sequence. Our method is verified to suppress ASDs more effectively than existing approaches by retaining a greater proportion of subsurface reflections, and its residual error is negligible. It is robust with respect to energy levels, window widths of ASDs, and clustered ASDs.
Problem severity and waiting times for young people accessing mental health services
Authors: Edbrooke-Childs Julian , Deighton Jessica
Published: October 2020

Background

Access to timely care is a quality standard underpinning many international healthcare models, and long waiting times for child and adolescent mental health services are often reported as a barrier to help-seeking.

Aims

The aim of this study was to examine whether young people with more severe problems have shorter waiting times for mental health services.

Method

Multilevel multinomial regression analysis controlling for service-area deprivation, age, gender, ethnicity, referral source and contextual factors was conducted on N = 21 419 episodes of care (mean age 12.37 years (s.d. = 3.71), 11 712 (55%) female) using data from child and adolescent mental health services.

Results

There was high variation in waiting times, which ranged from 0 days to 1629 days (mean 50.65 days (s.d. = 78.03), median 32 days). Compared with young people with less severe problems young people with severe problems, self-harm, psychosis or eating disorders were less likely to experience longer waiting times. Moreover, referrals from sources other than primary care were generally less likely to have longer waiting times than referrals from primary care sources, especially referral from accident and emergency services.

Conclusions

The findings suggest that young people with more severe problems had shorter waiting times. Intermediary information and resources for support before access to services is needed to prevent escalation of problems and to support individuals and families while waiting for care. Interventions to reduce waiting times should be considered without compromising on the quality and experience of care that young people and families deserve when seeking help.
Patterns of use of secondary mental health services before and during COVID-19 lockdown: observational study
Authors: Tromans Samuel , Chester Verity , Harrison Hannah , Pankhania Precina , Booth Hanna , Chakraborty Nandini
Published: October 2020

Background

The coronavirus disease 2019 (COVID-19) pandemic has had a profound impact on both the physical and mental well-being of the global population. Relatively few studies have measured the impact of lockdown on utilisation of secondary mental health services in England.

Aims

To describe secondary mental health service utilisation pre-lockdown and during lockdown within Leicestershire, UK, and the numbers of serious incidents during this time frame.

Method

Data pertaining to mental health referral and hospital admissions to adult mental health, child and adolescent mental health, intellectual disability and mental health services for older people were collated retrospectively from electronic records for both 8 weeks pre-lockdown and the first 8 weeks of lockdown in England. Serious incidents during this time frame were also analysed.

Results

Significantly (P < 0.05) reduced referrals to a diverse range of mental health services were observed during lockdown, including child and adolescent, adult, older people and intellectual disability services. Although admissions remained relatively stable before and during lockdown for several services, admissions to both acute adult and mental health services for older people were significantly (P < 0.05) reduced during lockdown. Numbers of serious incidents in the pre-lockdown and lockdown periods were similar, with 23 incidents pre-lockdown, compared with 20 incidents in lockdown.

Conclusions

To the best of our knowledge, this is the first UK-based study reporting patterns of use of mental health services immediately prior to and during COVID-19 lockdown. Overall numbers of referrals and admissions reduced following commencement of COVID-19 lockdown. Potential reasons for these observations are discussed.
Risk of depression in family caregivers: unintended consequence of COVID-19
Authors: Gallagher Stephen , Wetherell Mark A.
Published: October 2020

Background

Coronavirus disease 2019 (COVID-19) is likely to exacerbate the symptoms of poor mental health in family caregivers.

Aims

To investigate whether rates of depressive symptomatology increased in caregivers during COVID-19 and whether the unintended consequences of health protective measures, i.e., social isolation, exacerbated this risk. Another aim was to see if caregivers accessed any online/phone psychological support during COVID.

Method

Data (1349 caregivers; 6178 non-caregivers) was extracted from Understanding Society, a UK population-level data-set. The General Health Questionnaire cut-off scores identified those who are likely to have depression.

Results

After adjustment for confounding caregivers had a higher risk of having depressive symptoms compared with non-caregivers, odds ratio (OR) = 1.22 (95% CI 1.05–1.40, P = 0.008) evidenced by higher levels of depression pre-COVID-19 (16.7% caregivers v. 12.1% non-caregivers) and during the COVID-19 pandemic (21.6% caregivers v. 17.9% non-caregivers), respectively. Further, higher levels of loneliness increased the risk of depression symptoms almost four-fold in caregivers, OR = 3.85 (95% 95% CI 3.08–4.85, P < 0.001), whereas accessing therapy attenuated the risk of depression (43%). A total of 60% of caregivers with depression symptoms reported not accessing any therapeutic support (for example online or face to face) during the COVID-19 pandemic.

Conclusions

COVID-19 has had a negative impact on family caregivers’ mental health with loneliness a significant contributor to depressive symptomatology. However, despite these detriments in mental health, the majority of caregivers do not access any online or phone psychiatric support. Finally, psychiatric services and healthcare professionals should aim to focus on reducing feelings of loneliness to support at-risk caregivers.
Transnationality and Coloniality in the Concept of Modern Korean Literature
Authors: Cho Heekyoung
Published: October 2020

This article discusses the discourse that appears in early theorizations of Korean literature through an examination of Yi Kwang-su’s theory of literature and related Russian and Japanese theories in colonial Korea. During the process of this formation, Korean intellectuals used the term “munhak” as a translation for “literature,” before there were any substantial works of “modern” literature in Korean. Yi’s theory of modern literature was translational and transnational from its inception, symptomatically revealing its coloniality, which became more complicated during the later colonial period. Yi frequently stressed Tolstoy’s influence on him while downplaying the impact of Japanese theorists whose ideas he used at least as much. Yi’s emphasis on Russian texts and on the materiality of Korean vernacular script, I argue, may be an indication of a colonial incongruity and predicament in which he struggled to conceal the coloniality of his own literary theory and, by extension, the coloniality of modern Korean literature. I hope that this paper will provide a better understanding of how modern theories of literature were entrenched in the complications of colonization from their foundation.
High glucose induces Nox4 expression and podocyte apoptosis through the Smad3/ezrin/PKA pathway
Authors: Guo Wanxu , Gao Hang , Pan Wei , Yu Panapn , Che Guanghua
Published: October 2020

Podocytes are the major target in proteinuric kidney diseases such as diabetic nephropathy. The underlying molecular mechanisms by which high glucose (HG) results in podocyte damage remain unclear. This study investigated the regulatory role of Smad3, ezrin, and protein kinase A (PKA) in NADPH oxidase (Nox4) expression, reactive oxidative species (ROS) production, and apoptosis in HG-treated podocytes. A human podocyte cell line was cultured and differentiated, then treated with 30 mM HG. Apoptosis and intracellular ROS levels were assessed using TUNEL and DCF assays, respectively. Expressions of Nox4, phospho-Smad3Ser423/425, phospho-PKAThr197, and phospho-ezrinThr567 were evaluated using western blotting. ELISA was used to quantify intracellular cAMP concentration and PKA activity. Knockdown assay was used to inhibit the expressions of Smad3, Nox4, and ezrin by lentiviral shRNA. In HG-treated podocytes, the level of phospho-Smad3Ser423/425 and phospho-ezrinThr567 was increased significantly, which was accompanied by the reduction of cAMP and phospho-PKAThr197. HG-induced apoptosis was significantly prevented by the Smad3-inhibitor SIS3 or shRNA-Smad3. In podocytes expressing shRNA-ezrin or shRNA-Nox4, apoptosis was remarkably mitigated following HG treatment. HG-induced upregulation of phospho-ezrinThr567 and downregulation of phospho-PKAThr197 was significantly prevented by SIS3, shRNA-ezrin or shRNA-Smad3. Forskolin, a PKA activator, significantly inhibited HG-mediated upregulation of Nox4 expression, ROS generation, and apoptosis. Additionally, an increase in the ROS level was prohibited in HG-treated podocytes with the knockdown of Nox4, Smad3, or ezrin. Taken together, our findings provided evidence that Smad3-mediated ezrin activation upregulates Nox4 expression and ROS production, by suppressing PKA activity, which may at least in part contribute to HG-induced podocyte apoptosis.
The twists and turns of left-right asymmetric gut morphogenesis
Authors: Grzymkowski Julia , Wyatt Brent , Nascone-Yoder Nanette
Published: October 2020

Many organs develop left-right asymmetric shapes and positions that are crucial for normal function. Indeed, anomalous laterality is associated with multiple severe birth defects. Although the events that initially orient the left-right body axis are beginning to be understood, the mechanisms that shape the asymmetries of individual organs remain less clear. Here, we summarize new evidence challenging century-old ideas about the development of stomach and intestine laterality. We compare classical and contemporary models of asymmetric gut morphogenesis and highlight key unanswered questions for future investigation.
Configural perception of a binary olfactory mixture in honey bees as in humans, rodents and newborn rabbits
Authors: Wycke Marie-Anne , Coureaud Gérard , Thomas-Danguin Thierry , Sandoz Jean-Christophe
Published: October 2020

How animals perceive and learn complex stimuli, such as mixtures of odorants is a difficult problem, for which the definition of general rules across the animal kingdom remains elusive. Recent experiments conducted in human and rodent adults as well as newborn rabbits suggested that these species process particular odor mixtures in a similar, configural manner. Thus, the binary mixture of ethyl isobutyrate (EI) and ethyl maltol (EM) induces configural processing in humans, who perceive a mixture odor quality (pineapple) that is distinct from the quality of each component (strawberry and caramel). Similarly, rabbit neonates treat the mixture differently, at least in part, from its components. In the present study, we asked if the properties of the EI.EM mixture extend to an influential invertebrate model, the honey bee Apis mellifera. We used appetitive conditioning of the proboscis extension response to evaluate how bees perceive the EI.EM mixture. In a first experiment, we measured perceptual similarity between this mixture and its components in a generalization protocol. In a second experiment, we measured bees’ ability to differentiate between the mixture and both of its components in a negative patterning protocol. In each experimental series, bees' performances with this mixture were compared with those obtained with 4 other mixtures, chosen from previous work in humans, newborn rabbits and bees. Our results suggest that when having to differentiate mixture and components, bees treat the EI.EM in a robust configural manner, similarly to mammals, suggesting the existence of common perceptual rules across the animal kindgdom.
Additive effects of temperature and water availability on pregnancy in a viviparous lizard
Authors: Brusch George A. , Gavira Rodrigo S. B. , Viton Robin , Dupoué Andréaz , Leroux-Coyau Mathieu , Meylan Sandrine , Le Galliard Jean-François , Lourdais Olivier
Published: October 2020

One of the greatest current threats to biodiversity is climate change. However, understanding of organismal responses to fluctuations in temperature and water availability is currently lacking, especially during fundamental life-history stages such as reproduction. To further explore how temperature and water availability impact maternal physiology and reproductive output, we used the viviparous form of the European common lizard (Zootoca vivipara) in a two-by-two factorial design manipulating both hydric and thermal conditions, for the first time. We collected blood samples and morphological measurements during early pregnancy and post-parturition to investigate how water availability, temperature and a combination of the two influence maternal phenology, morphology, physiology and reproductive output. We observed that dehydration during gestation negatively affects maternal physiological condition (lower mass gain, higher tail reserve mobilization) but has little effect on reproductive output. These effects are mainly additive to temperature regimes, with a proportional increase in maternal costs in warmer environments. Our study demonstrates the importance of considering combined effects of water and temperature when investigating organismal responses to climate changes, especially during periods crucial for species survival such as reproduction.
The best predictions in experimental biology are critical and persuasive
Authors: Fudge Douglas S. , Turko Andy J.
Published: October 2020

A powerful way to evaluate scientific explanations (hypotheses) is to test the predictions that they make. In this way, predictions serve as an important bridge between abstract hypotheses and concrete experiments. Experimental biologists, however, generally receive little guidance on how to generate quality predictions. Here, we identify two important components of good predictions – criticality and persuasiveness – which relate to the ability of a prediction (and the experiment it implies) to disprove a hypothesis or to convince a skeptic that the hypothesis has merit. Using a detailed example, we demonstrate how striving for predictions that are both critical and persuasive can speed scientific progress by leading us to more powerful experiments. Finally, we provide a quality control checklist to assist students and researchers as they navigate the hypothetico-deductive method from puzzling observations to experimental tests.
Applying an ecological framework to examine the multiple levels of influence affecting the utilisation of private sector adult asthma services in Khartoum, Sudan: a mixed methods study
Authors: Thomson Rachael , Noor Magde , Elsony Asma
Published: October 2020

Background: Asthma is the third most common cause of hospital visits in Sudan. Sudan has a pluralistic health care system, with a strong and varied private sector. While research examining public sector asthma services exists, very little is known about which asthma services are available in the private sector.  

Methods: An explanatory sequential mixed-method social ecological approach was used to examine influencing factors of asthma service utilisation in the private sector, considering five levels: policy, organisational, community, familial, individual environment. Quantitative research involved surveying private healthcare facilities to describe asthma services. Qualitative research involved in-depth interviews with asthma patients to explore facility decision-making. Nine private chest clinics, 44 pharmacies, and 21 private hospitals offering asthma services in Khartoum were studied - 46 female and 28 male health providers were surveyed; 7 male and 7 female asthma patients were interviewed.  

Results: At the health policy level, there is no current asthma management policy for the private sector. At the organisational and health systems level, the survey found low rates of diagnostic equipment available, little asthma-specific training, and little use of asthma treatment cards, guidelines, and registers. At the community level, high levels of stigma from the community were felt by most of the patients interviewed. At the familial level, asthma was often viewed as a hereditary condition, and, as a long-term condition, there were worries about marriage potential and impact on jobs/future activities. At the individual level, patients sought frequent, short-term care at private facilities for acute attacks. The severity of the disease and the major impact it had, particularly on younger adults’, was striking.  

Conclusions: Applying an ecological framework to examine asthma care management enables review of all levels of service provision: inclusive health policy, government commitment, high quality service delivery, uninterrupted affordable drug supply, community involvement, and patient empowerment.
Acknowledging the gap: a systematic review of micronutrient supplementation in infants under six months of age
Authors: Stelle Isabella , Venkatesan Sruthi , Edmond Karen , Moore Sophie E.
Published: October 2020

Background: Micronutrient deficiencies remain common worldwide, but the consequences to growth and development in early infancy (under six months of age) are not fully understood. We present a systematic review of micronutrient interventions in term infants under six months of age, with a specific focus on iron supplementation.

Methods: We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE (Ovid) and Embase (Ovid) from January 1980 through December 2019. Interventions included iron or multiple micronutrients (MMNs).

Results: Of 11,109 records identified, 32 publications from 23 trials were included (18 iron and five MMN supplementation trials). All 23 trials evaluated the effect of supplementation on biochemical outcomes, ten reported on growth, 14 on morbidity and/or mortality and six on neuro-behavioural development. Low- and middle- income countries made up 88% (21/24) of the total trial locations. Meta-analysis was not possible due to extensive heterogeneity in both exposure and outcome measures.  However, these trials indicated that infants less than six months of age benefit biochemically from early supplementation with iron, but the effect of additional nutrients or MMNs, along with the impacts on growth, morbidity and/or mortality, and neuro-behavioural outcomes remain unclear.

Conclusions: Infants less than six months of age appear to benefit biochemically from micronutrient supplementation. However, well-powered randomised controlled trials are required to determine whether routine supplementation with iron or MMNs containing iron should commence before six months of life in exclusively breast-fed infants in low-resource settings.
A Non-Standard Kripke Semantics for the Minimal Deontic Logic
Authors: Bezerra Edson , Venturi Giorgio
Published: October 2020

In this paper we study a new operator of strong modality ⊞, related to the non-contingency operator ∆. We then provide soundness and completeness theorems for the minimal logic of the ⊞-operator.