bluuebunny/crossref_metadata_2025 huggingface dataset:
Comprehensive Review of Hepatocellular Carcinoma in India: Current Challenges and Future Directions
Authors: Shetty Vijith Vittal , Kellarai Adithi
Published: October 2022

There is not much information on hepatocellular carcinoma (HCC) in India. Here, we review the existing data, available treatment choices, and future directions in HCC management. An extensive search was conducted through PubMed and MEDLINE for studies published between January 2000 and June 2022 on the epidemiology of HCC in India using the following key words: atezolizumab, BCLC staging, hepatocellular carcinoma, immune checkpoint inhibitors, immunotherapy, and programmed cell death ligand-1, with the filters humans and English language. The most frequent risk factors for the development of HCC in India include nonalcoholic fatty liver disease, hepatitis B virus and hepatitis C virus infection, liver cirrhosis, and alcohol intake. On the basis of new findings, the Barcelona Clinic Liver Cancer (BCLC) Staging Criteria need to be revised. As most cases in India are discovered at a later stage, curative treatments such as surgical resection, ablation, or liver transplantation may not be an option. Clinical trials are underway for a number of immune checkpoint drugs that target cytotoxic T-cell lymphocyte-4 and programmed cell death-1/programmed cell death-ligand 1. In India, phase III trials of atezolizumab in combination with other drugs are underway for the treatment of various malignancies. Renin angiotensin system inhibitors, antivirals, primary hepatocyte transplantation, and bioartificial liver devices are among the future options for the management of HCC. In developing countries like India, HCC is often diagnosed at an advanced stage because of a delay in routine testing or screening. Therefore, developing effective treatment regimens for such stages is critical. Immunotherapy is a promising treatment option that has the potential to increase overall response and survival rate.
Outcomes of Children With Low-Grade Gliomas in Low- and Middle-Income Countries: A Systematic Review
Authors: Ward Richard , Jones Hannah M. , Witt Davis , Boop Frederick , Bouffet Eric , Rodriguez-Galindo Carlos , Qaddoumi Ibrahim , Moreira Daniel C.
Published: October 2022

PURPOSE

Pediatric CNS tumors are increasingly a priority, particularly with the WHO designation of low-grade glioma (LGG) as one of six index childhood cancers. There are currently limited data on outcomes of pediatric patients with LGGs in low- and middle-income countries (LMICs).

METHODS

To better understand the outcomes of LGGs in LMICs, this systematic review interrogated nine literature databases.

RESULTS

The search identified 14,977 publications. Sixteen studies from 19 countries met the selection criteria and were included for data abstraction and analysis. Eleven studies (69%) were retrospective reviews from single institutions, and one (6%) captured institutional data prospectively. The studies captured a total of 957 patients with a median of 49 patients per study. Seven (44%) of the studies described the treatment modalities used. Of 373 patients for whom there was information, 173 (46%) had a gross total or near total resection, 109 (29%) had a subtotal resection, and 91 (24%) had only a biopsy performed. Seven studies, with a total of 476 patients, described the frequency of use of radiotherapy and/or chemotherapy in the cohorts: 83 of these patients received radiotherapy and 76 received chemotherapy. The 5-year overall survival ranged from 69.2% to 93.5%, although lower survival rates were reported at earlier time points. We identified limitations in the published studies with respect to the cohort sizes and methodologies.

CONCLUSION

The included studies reported survival rates frequently exceeding 80%, although the ultimate number of studies was limited, pointing to the paucity of studies describing the outcomes of children with LGGs in LMICs. This study underscores the need for more robust data on outcomes in pediatric LGG.
Against Best Practices
Authors: Shea Anne
Published: October 2022

In this commentary, the author urges educators to consider how the discourse of best practices emerges out of and legitimizes neoliberalism's logic of differential worth.
Too Close for Context
Authors: Carter Jaclyn , Clarke Michael Tavel , Halpern Faye , Mason Derritt , Nicol Jessica , Vanek Morgan
Published: October 2022

The activity of close reading lies at the heart of literary studies, a “signature pedagogy” that distinguishes English from other disciplines. Despite its centrality to the discipline, however, close reading has been curiously resistant to analysis. This lesson study aimed to determine where students encounter challenges in close reading. Contrary to dominant narratives in the discipline, the university students in this study were adept at formal analysis. They were challenged, on the other hand, by invitations to make intertextual and personal connections to the text. Analyzing features of successful close reading, the essay proposes that intertextual thinking and personal connection are important components. The essay recommends assessing student skills in the initial stages of teaching close reading and, when warranted, integrating instruction in intertextual thinking and making personal connections alongside formal analysis. It also suggests group discussion may help leverage these neglected components of close reading.
“We Fight Anything That Fights the Circus”: Unions and Labor Organizing under the Big Top
Authors: Ringer Andrea
Published: October 2022

With seasons that often stretched across continents, and a diverse and cosmopolitan group of employees, the circus was a startlingly unique mobile, transient, and global workplace. This article focuses on the significant worker activism in the circus during the late 1930s and early 1940s, particularly as it intersected with labor organizations. In 1938, nearly sixteen hundred laborers with the Ringling Brothers Circus staged a sit-in to protest unfair wages with the help of the AFL. But they were shocked when the circus responded by shutting down for the season, leaving every worker out of a job. The 1938 circus strikes were at the tail end of a long history of negotiations and disputes. These various protests, led by a global workforce of sideshow performers, canvasmen, and high-paid stars from the center ring directly led to the modernization of the circus, along with its subsequent decline. This has larger implications for understanding early globalized workforces and the historic roots of employer responses to demands of a globalized working class.
ISL1/SHH/CXCL12 signaling regulates myogenic cell migration during mouse tongue development
Authors: Zhang Wei , Yu Jiaojiao , Fu Guoquan , Li Jianying , Huang Huarong , Liu Jing , Yu Dongliang , Qiu Mengsheng , Li Feixue
Published: October 2022

Migration of myoblasts derived from the occipital somites is essential for tongue morphogenesis. However, the molecular mechanisms of myoblast migration remain elusive. In this study, we report that deletion of Isl1 in the mouse mandibular epithelium leads to aglossia due to myoblast migration defects. Isl1 regulates the expression pattern of chemokine ligand 12 (Cxcl12) in the first branchial arch through the Shh/Wnt5a cascade. Cxcl12+ mesenchymal cells in Isl1ShhCre embryos were unable to migrate to the distal region, but instead clustered in a relatively small proximal domain of the mandible. CXCL12 serves as a bidirectional cue for myoblasts expressing its receptor CXCR4 in a concentration-dependent manner, attracting Cxcr4+ myoblast invasion at low concentrations but repelling at high concentrations. The accumulation of Cxcl12+ mesenchymal cells resulted in high local concentrations of CXCL12, which prevented Cxcr4+ myoblast invasion. Furthermore, transgenic activation of Ihh alleviated defects in tongue development and rescued myoblast migration, confirming the functional involvement of Hedgehog signaling in tongue development. In summary, this study provides the first line of genetic evidence that the ISL1/SHH/CXCL12 axis regulates myoblast migration during tongue development.
Improved Postoperative Outcomes after Prehabilitation for Colorectal Cancer Surgery in Older Patients: An Emulated Target Trial
Authors: Heil Thea C. , Verdaasdonk Emiel G. G. , Maas Huub A. A. M. , van Munster Barbara C. , Rikkert Marcel G. M. Olde , de Wilt Johannes H. W. , Melis René J. F.
Published: October 2022

Background

The aim of this study was to assess the effect of a multimodal prehabilitation program on perioperative outcomes in colorectal cancer patients with a higher postoperative complication risk, using an emulated target trial (ETT) design.

Patients and Methods

An ETT design including overlap weighting based on propensity score was performed. The study consisted of all patients with newly diagnosed colorectal cancer (2016–2021), in a large nonacademic training hospital, who were candidate to elective colorectal cancer surgery and had a higher risk for postoperative complications defined by: age ≥ 65 years and or American Society of Anesthesiologists score III/IV. Intention-to-treat (ITT) and per-protocol analyses were performed to evaluate the effect of prehabilitation compared with usual care on perioperative complications and length of stay (LOS).

Results

Two hundred fifty-one patients were included: 128 in the usual care group and 123 patients in the prehabilitation group. In the ITT analysis, the number needed to treat to reduce one or more complications in one person was 4.2 (95% CI 2.6–10). Compared with patients in the usual care group, patients undergoing prehabilitation had a 55% lower comprehensive complication score (95% CI −71 to −32%). There was a 33% reduction (95% CI −44 to −18%) in LOS from 7 to 5 days.

Conclusions

This study showed a clinically relevant reduction of complications and LOS after multimodal prehabilitation in patients undergoing colorectal cancer surgery with a higher postoperative complication risk. The study methodology used may serve as an example for further larger multicenter comparative effectiveness research on prehabilitation.
E. coli 6S RNA complexed to RNA polymerase maintains product RNA synthesis at low cellular ATP levels by initiation with non-canonical initiator nucleotides
Authors: Bonar Christopher David , Han Jonathan , Wang Robert , Panchapakesan Shanker Shyam Sundhar , Unrau Peter John
Published: October 2022

The E. coli 6S RNA is an RNA polymerase (RNAP) inhibitor that competes with σ70-dependent DNA promoters for binding to RNAP holoenzyme (RNAP:σ70). The 6S RNA when bound is then used as a template to synthesize a short product RNA (pRNA; usually 13-nt-long). This pRNA changes the 6S RNA structure, triggering the 6S RNA:pRNA complex to release and allowing DNA-dependent housekeeping gene expression to resume. In high nutrient conditions, 6S RNA turnover is extremely rapid but becomes very slow in low nutrient environments. This leads to a large accumulation of inhibited RNAP:σ70 complex in stationary phase. As pRNA initiates synthesis with ATP, we and others have proposed that the 6S RNA release rate strongly depends on ATP levels as a proxy for sensing the cellular metabolic state. By purifying endogenous 6S RNA:pRNA complexes using RNA Mango and by using reverse transcriptase to generate pRNA-cDNA chimeras, we demonstrate that 6S RNA:pRNA formation can be simultaneous with 6S 5' maturation. More importantly, we find a dramatic accumulation of capped pRNAs during stationary phase. This indicates that ATP levels in stationary phase are low enough for non-canonical initiator nucleotides (NCINs) such as NAD+ and NADH to initiate pRNA synthesis. In vitro, mutation of the well conserved 6S template sequence immediately upstream of the pRNA transcriptional start site can increase or decrease the pRNA capping efficiency, suggesting that evolution has tuned the biological 6S RNA sequence for an optimal capping rate in low nutrient conditions. NCIN-initiated pRNA synthesis may therefore be essential for cell viability in low nutrient conditions when ATP concentrations are low.
Overview of methods for measuring the mechanical strength of thin films
Authors: Bespalov V. , Tovarnov D. , Dyuzhev N. , Mahiboroda M. , Gusev E. , Zolnikov Konstantin
Published: October 2022

This review article discusses methods for measuring the main mechanical properties of thin films: tensile testing, indentation, evaluation of the mechanical strength margin for the curvature of the plate-thin film system, bulge method and research using a deformed and resonant cantilever. In the process of critical analysis of domestic and foreign literary sources, the advantages and disadvantages of the methods were revealed; the authors' motivation for conducting such studies was explained. In addition to the existing widely used methods, an original and relatively new technique is given - the use of electric current as a controlled means of applying thermo mechanical stresses to electrical conductors to characterize their fatigue behavior. Approaches for increasing the mechanical strength of thin films are also indicated.
Collaborating with Local and Federal Law Enforcement for Disrupting Sex Trafficking Networks
Authors: Freeman Nickolas K. , Keskin Burcu B. , Bott Gregory J.
Published: October 2022

Sex trafficking, a form of human trafficking that involves sexual exploitation, has been facilitated through the use of online classified advertisements. Our research team has been collaborating with law enforcement agencies at the local, state, and national levels since May 2019 to detect and disrupt sex trafficking activities identified by applying advanced analytics to ad data collected from the internet.
Solving the Ride-Sharing Productivity Paradox: Priority Dispatch and Optimal Priority Sets
Authors: Krishnan Varun , Iglesias Ramon , Martin Sebastien , Wang Su , Pattabhiraman Varun , Van Ryzin Garrett
Published: October 2022

Ride-sharing platforms face a “productivity paradox,” whereby any efficiency gained through improved dispatch or pricing strategies will not benefit drivers or riders. We show that this is a limit of the traditional ride-hailing model and a consequence of the Hall-Horton driver equilibrium earning hypothesis. In response to this challenge, Lyft introduced Priority Mode (PM), which allows drivers to concentrate their work during specific prioritized hours. We prove that PM solves the productivity paradox. As a result, the average driver earnings increase, and the platform and the riders also benefit. Implementing PM requires significant changes to the platform’s dispatch and pricing policy but most importantly requires careful control of the number of drivers that can be offered the opportunity to be prioritized at any given time. In this paper, we introduce a queuing setting to model the market dynamics of PM and illustrate the challenges of this control problem. We then leverage this intuition to build a real-time priority admission control system that can balance the number of drivers offered priority and achieve the desired productivity increase. Lyft has successfully rolled out PM throughout North America, and drivers have completed hundreds of thousands of driving hours thus far. It has generated tens of millions of dollars of value that the drivers, the riders, and Lyft have shared, with the potential to generate much more when rolled out in all markets. Finally, our internal driver surveys reveal that it has been well received by drivers.
Eğitim Fakültelerindeki Paternalist Liderlik ile Örgütsel Politika Algısı Arasındaki İlişkinin İncelenmesi
Authors: YAŞAR Özgür , EROL Evrim
Published: October 2022

İlişkisel tarama modelinde desenlenen bu araştırmada eğitim fakültelerinde çalışan araştırma görevlilerinin paternalist liderliğe ilişkin görüşleri ile örgütsel politika algıları incelenmiştir. Araştırmanın evrenini Türkiye’deki devlet üniversitelerinin eğitim fakültelerinde çalışan araştırma görevlileri oluşturmaktadır. Araştırmada tabakalı örnekleme ve seçkisiz örnekleme yöntemleri aşamalı olarak kullanılmıştır. Araştırmanın verileri 459 araştırma görevlisinden Paternalist Liderlik ve Örgütsel Politika Algısı ölçekleri ile e-posta yoluyla toplanmıştır. Verilerin analizinde parametrik istatistikler kullanılmıştır. Araştırma sonuçlarına göre araştırma görevlileri birlikte çalıştıkları öğretim üyelerini yardımseverlik açısından orta, ahlakilik açısından orta-yüksek, otoriterlik açısından ise orta-düşük seviyesinde değerlendirmektedirler. Araştırma görevlilerinin örgütsel politika algıları, yükselmek için gerekeni yapmak ve dürüstlük / iş ahlakı boyutlarında orta-yüksek seviyesinde iken genel politik davranış boyutunda orta seviyededir. Ayrıca paternalist liderlik boyutları ile örgütsel politika algısı boyutları arasında negatif ilişkiler saptanmakla birlikte paternalist liderliğin örgütsel politika algısının önemli bir yordayıcısı olduğu görülmüştür. Bu sonuçlardan yola çıkılarak araştırma görevlilerinin örgütsel politika algılarını azaltmak için öğretim üyelerine otoriterlikten ziyade yardımsever ve ahlaki davranışlarda bulunmaları önerilmektedir.
Dilemma of sigmoid volvulus management
Authors: Abdelrahim A , Zeidan S , Qulaghassi M , Ali O , Boshnaq M
Published: October 2022

Introduction

Patients with sigmoid volvulus (SV) are at a high risk of recurrence with increased morbidity and mortality. This study aims to review whether patients with SV underwent definitive surgical treatment after initial endoscopic reduction according to the guidelines, and to compare mortality rate between surgical and conservative management.

Methods

Retrospective study conducted at East Kent Hospitals University NHS Foundation Trust, included all patients with SV between 2016 and 2018. The primary outcome was 30-day mortality following the initial management of the acute attack. Secondary outcomes were recurrence rate and overall mortality. The median follow-up period was 3 years.

Results

A total of 40 patients were identified with a median age of 82 years; 27 (67%) were males. Of these 40 patients, 6 (15%) had emergency surgery, 26 (65%) received endoscopic decompression only, and 8 (20%) had planned definitive resection; 32 patients (80%) had recurrence and the median interval between any two episodes was 86 days. The mortality rate among patients with ASA grade 3 or 4 in the three groups, elective surgery, emergency surgery and decompression only, was 0%, 25% and 70% respectively, whereas it was 0%, 50% and 33% in those with ASA grade 2. The mortality rate among patients with similar ASA who had a planned surgery was significantly lower compared with those who did not undergo surgery (p=0.003).

Conclusions

In patients with sigmoid volvulus, regardless of ASA grade, performing early definitive surgery following initial endoscopic decompression resulted in a statistically significant lower mortality rate.
Three-dimensional bi-functional refractive index and fluorescence microscopy (BRIEF)
Authors: Xue Yi , Ren David , Waller Laura
Published: October 2022

Fluorescence microscopy is a powerful tool for imaging biological samples with molecular specificity. In contrast, phase microscopy provides label-free measurement of the sample’s refractive index (RI), which is an intrinsic optical property that quantitatively relates to cell morphology, mass, and stiffness. Conventional imaging techniques measure either the labeled fluorescence (functional) information or the label-free RI (structural) information, though it may be valuable to have both. For example, biological tissues have heterogeneous RI distributions, causing sample-induced scattering that degrades the fluorescence image quality. When both fluorescence and 3D RI are measured, one can use the RI information to digitally correct multiple-scattering effects in the fluorescence image. Here, we develop a new computational multi-modal imaging method based on epi-mode microscopy that reconstructs both 3D fluorescence and 3D RI from a single dataset. We acquire dozens of fluorescence images, each ‘illuminated’ by a single fluorophore, then solve an inverse problem with a multiple-scattering forward model. We experimentally demonstrate our method for epi-mode 3D RI imaging and digital correction of multiple-scattering effects in fluorescence images.
Improving sensitivity of an amplitude-modulated magneto-optical atomic magnetometer using squeezed light
Authors: Li Jiahui , Novikova Irina
Published: October 2022

We experimentally demonstrate that a squeezed probe optical field can improve the sensitivity of magnetic field measurements based on nonlinear magneto-optical rotation (NMOR) with an amplitude-modulated pump when compared to a coherent probe field under identical conditions. To realize an all-atomic magnetometer prototype, we utilize a nonlinear atomic interaction, known as polarization self-rotation, to produce a squeezed probe field. An independent pump field, amplitude-modulated at the Larmor frequency of the bias magnetic field, allows us to extend the range of most sensitive NMOR measurements to sub-Gauss magnetic fields. While the overall sensitivity of the magnetometer is rather low (

>

250

p
T

/

H
z

), we clearly observe a

15
%

sensitivity improvement when the squeezed probe is used. Our observations confirm the recently reported quantum enhancement in a modulated atomic magnetometer [Phys. Rev. Lett. 127, 193601 (2021)PRLTAO0031-900710.1103/PhysRevLett.127.193601].
Graphene oxide enhanced phase change tolerance of Ge2Sb2Se4Te1 for all-optical multilevel non-volatile photonics memory
Authors: Gan Soon Xin , Ng Kok Bin , Chew Jing Wen , Tey Lian Seng , Chong Wen Sin , Chong Wu Yi , Goh Boon Tong , Lai Choon Kong , Madden Steve , Choi Duk-Yong , Ahmad Harith
Published: October 2022

The low optical loss of

G
e

2

S
b

2

S
e

4

T
e

1

(GSST) makes it a potential functional material for all-optical multilevel photonics memory devices that can operate in the optical telecommunication wavelength band. However, the same characteristic also restricted the tolerance of GSST phase change conditions using 1550 nm as an excitation light source. This work reports on the enhancement of GSST phase change condition tolerance using a graphene oxide (GO) intermediate layer on a polymer waveguide platform. The hybrid waveguide exhibits an insertion loss of around 1 dB and a maximum readout contrast of 25% between amorphous and crystalline states, with a step increase in readout contrast of around 5% per step. This work serves as a proof of concept for the implementation of a GSST–GO hybrid structure as an optical functional material in all-optical photonics memory applications.
Open investigation on the interaction length between a terahertz wave and an embedded dielectric ZRIM structure, and also phase tuning
Authors: Ghaffari Amir Hosein , Zandi Hesam
Published: October 2022

In this paper, we have focused on the near field behaviour of 2D Photonic Crystal-based dielectric zero refractive index metamaterial lattices with cylindrical silicon rods embedded in THz waveguides having PMC sidewalls. An "interaction length" is expected in both input and output sides of a ZRIM lattice, after illumination of a TE polarized THz electromagnetic wave. In other words, by getting closer than a specific distance to the ZRIM lattice area from both input and output sides, which is called the interaction length, the wave profile will be affected significantly. Studying the field profile variation in the output side of the ZRIM lattice, we have considered two separate cascaded 2D PC-based ZRIM lattices in a THz waveguide with the same conditions and computed spatial phase shifts, and also the transmission and reflection coefficients versus the displacement between the two ZRIM lattices. This small limited distance led us to an almost 34° phase shift tuning between THz waves in two (multiple) THz waveguide systems.
High-frequency characterization of electro-optic modulation chips based on photonic down-conversion sampling and microwave fixture de-embedding
Authors: He Yutong , Xu Ying , Zou Xinhai , Zhang Yali , Zhang Zhiyao , Zhang Shangjian , Liu Yong , Zhu Ninghua
Published: October 2022

A self-reference and on-chip method for extracting the intrinsic frequency responses including modulation index and half-wave voltage of electro-optic modulator (EOM) chips is proposed based on photonic down-conversion sampling and microwave fixture de-embedding. The photonic down-conversion sampling is firstly employed to extract the combined response of the source network SxN, the adapter network SAN and the EOM chip. Then the Open-Short-Load (OSL) calibration is exploited to realize the on-chip microwave de-embedding of SxN and SAN in terms of the transmission attenuation and the impedance mismatch. Finally, the power leveling technique is used to track the incident microwave power to obtain the intrinsic half-wave voltage of the EOM chip. Our method features self-reference and on-chip capability, which is applicable for the EOM chips even without a good impedance match, and is free of any extra optical/electrical (O/E) transducer standard, which will be helpful to chip evaluation and packaging optimization.
High brightness and broad modulation bandwidth InGaN-based red micro-LEDs integrated with plasmonic gratings
Authors: Zhang Guogang , Zhang Lijun , Ren Fang-Fang , Li Yi , Wang Yongjin
Published: October 2022

We propose red micro-LEDs integrated with plasmonic gratings, which demonstrate high efficiency and broad modulation bandwidth. The Purcell factor and external quantum efficiency (EQE) for an individual device can be improved up to 5.1 and 11%, respectively, due to the strong coupling between surface plasmons and multiple quantum wells. The cross talk effect between adjacent micro-LEDs can be efficiently alleviated as well, thanks to the high-divergence far-field emission pattern. Moreover, the 3-dB modulation bandwidth of the designed red micro-LEDs is predicted to be ∼ 528 MHz. Our results can be used to design high-efficiency and high-speed micro-LEDs for the applications of advanced light display and visible light communication.
Emerging Optical Materials, Devices and Systems for Photonic Neuromorphic Computing: introduction to special issue
Authors: Hurtado Antonio , Romeira Bruno , Buckley Sonia , Cheng Zengguang , Shastri Bhavin J.
Published: October 2022

This is an introduction to the feature issue of Optical Materials Express on Emerging Optical Materials, Devices and Systems for Photonic Neuromorphic Computing.
Efficient Bayesian inference for stochastic agent-based models
Authors: Jørgensen Andreas Christ Sølvsten , Ghosh Atiyo , Sturrock Marc , Shahrezaei Vahid
Published: October 2022

The modelling of many real-world problems relies on computationally heavy simulations of randomly interacting individuals or agents. However, the values of the parameters that underlie the interactions between agents are typically poorly known, and hence they need to be inferred from macroscopic observations of the system. Since statistical inference rests on repeated simulations to sample the parameter space, the high computational expense of these simulations can become a stumbling block. In this paper, we compare two ways to mitigate this issue in a Bayesian setting through the use of machine learning methods: One approach is to construct lightweight surrogate models to substitute the simulations used in inference. Alternatively, one might altogether circumvent the need for Bayesian sampling schemes and directly estimate the posterior distribution. We focus on stochastic simulations that track autonomous agents and present two case studies: tumour growths and the spread of infectious diseases. We demonstrate that good accuracy in inference can be achieved with a relatively small number of simulations, making our machine learning approaches orders of magnitude faster than classical simulation-based methods that rely on sampling the parameter space. However, we find that while some methods generally produce more robust results than others, no algorithm offers a one-size-fits-all solution when attempting to infer model parameters from observations. Instead, one must choose the inference technique with the specific real-world application in mind. The stochastic nature of the considered real-world phenomena poses an additional challenge that can become insurmountable for some approaches. Overall, we find machine learning approaches that create direct inference machines to be promising for real-world applications. We present our findings as general guidelines for modelling practitioners.
Prevalence and factors associated with anaemia among pregnant women attending reproductive and child health clinics in Mbeya region, Tanzania
Authors: Abdallah Fatma , John Sauli E. , Hancy Adam , Paulo Heavenlight A. , Sanga Abraham , Noor Ramadhan , Lankoande Fatoumata , Chimanya Kudakwashe , Masumo Ray M. , Leyna Germana H.
Published: October 2022

Anaemia is a global public health issue, disproportionately affecting vulnerable populations such as pregnant women. The aim of this study was to assess the prevalence of anaemia and to identify factors associated with the condition among pregnant women attending antenatal clinics in the Mbeya Region of Tanzania. A cross sectional study was conducted with 420 pregnant women (<28 weeks of gestation) attending antenatal visits in the 7 districts of the Mbeya Region. A structured questionnaire was used to collect demographic information and eating habits using a 24hours dietary recall. A blood sample was collected and tested for hemoglobin content using the HemoCue 201+. Multivariate analysis was performed using standard logistic regression to explore the association between anaemia status with socio-demographic, reproductive and nutritional factors.

Overall prevalence of anaemia in pregnant women was 25.5%. Out of 107 pregnant women diagnosed with anaemia and, sixty six had mild anaemia. In a multivariate logistical regression analysis anaemic women was associated with pregnant women coming from lower socio-economic status [adjusted OR = 2.40, 95%CI (1.05, 5.48)]. Moreover, anaemia was less associated with pregnant women who were living in Mbeya district council [adjusted OR = 0.28, 95%CI (0.11, 0.72)], consume at least once a day dark green leafy vegetables [adjusted OR = 0.53, 95% CI (0.30, 0.94)], and vegetable liquid cooking oil [adjusted OR = 0.56, 95% CI (0.34, 0.98)]. The prevalence of anaemia among the pregnant women falls in the category of moderate public health problem according to the WHO classification. Low socio-economic status, consumption of green leafy vegetables and vegetable liquid cooking oil were significantly and independently associated with anaemia during pregnancy. Thus, special attention should be given to pregnant women who are in lower socio-economic status and those not consuming vegetables. Interventions that integrate health and nutrition education in reproductive and child health clinics are needed to combat anaemia.
Built environment as a risk factor for adult overweight and obesity: Evidence from a longitudinal geospatial analysis in Indonesia
Authors: Dev Alka , Brite Jennifer , Heiland Frank W. , Balk Deborah
Published: October 2022

Indonesia has nearly doubled its urban population in the past three decades. In this period, the prevalence of overweight and obesity in Indonesia has also nearly doubled. We examined 1993–2014 panel data from the Indonesian Family Life Survey (IFLS) to determine the extent to which the increase in one’s built environment contributed to a corresponding increase in adult overweight and obesity during this period. We estimated longitudinal regression models for body mass index (BMI) and being overweight or obese using novel matched geospatial measures of built-up land area. Living in a more built-up area was associated with greater BMI and risk of being overweight or obese. The contribution of the built environment was estimated to be small but statistically significant even after accounting for individuals’ initial BMI. We discuss the findings considering the evidence on nutritional and technological transitions affecting food consumption patterns and physical activity levels in urban and rural areas.
Prevalence of elevated blood lead levels and risk factors among children living in Patna, Bihar, India 2020
Authors: Brown M. J. , Patel P. , Nash E. , Dikid T. , Blanton C. , Forsyth J. E. , Fontaine R. , Sharma P. , Keith J. , Babu B. , Vaisakh T. P. , Azarudeen M. J. , Riram B. , Shrivastava A.
Published: October 2022

Childhood lead exposure remains a key health concern for officials worldwide, contributing some 600,000 new cases of intellectually disabled children annually. Most children affected by high exposure to lead live in low- and middle-income countries. The leaded gasoline phase out in India was completed in 2000. Yet, in 2020, an estimated 275 million children aged 0 to 9 years had blood lead levels (BLLs) ≥ 5 μg/dL known to adversely affect intelligence and behavior. Lead sources reported in India include spices, cookware, paint, traditional medicines and cosmetics, and lead-acid battery recycling and repair. However, their relative contribution has not been characterized. More than 200 lead pollution sites related to battery recycling and repair activities were identified in Bihar and Jharkhand, India. Ninety percent of the recycling sites had soil lead concentrations exceeding the US Environmental Protection Agency’s standards. We compared blood and environmental lead levels in two groups of children in Patna, Bihar. Households in proximity to battery recycling operations (Proximal n = 67) versus households distal to these operations (Distal n = 68). The average age of children was 40 months; 46% were female. Overall, the geometric mean (GM) BLL was 11.6 μg/dL. GM BLLs of children in Proximal and Distal households were not significantly different (10.2 μg/dL vs. 13.1 μg/dL respectively; p≤0.07). About 87% children, 56 Proximal and 62 Distal had BLLs ≥5 μg/dl. Lead concentrations in environmental samples were significantly higher in Proximal households (soil mean 9.8 vs. 1.6 μg/ft2; dust mean 52.9 vs. 29.9 μg/ft2 p<0.001; Proximal vs. Distal respectively) whereas concentrations in all spices were higher in Distal households (mean 46.8 vs 134.5 ppm p<0.001; Proximal vs. Distal respectively), and turmeric (mean 59.4 vs. 216.9 ppm Proximal vs. Distal respectively). In multivariate analyses for all children lead in spices and turmeric and number of rooms in the house were significant while for the Proximal group only lead in spices remained in the model. The predictive value of these models was poor. For the Distal group, a model with lead concentration in spices, turmeric and soil and number of rooms in the house was a much better fit. Of the 34 water samples collected, 7 were above the Indian standard of 10 ppb for lead in drinking water (2 in the Proximal area, 5 in the Distal area). Children in Patna, Bihar, India are exposed to multiple sources of lead, with lead levels in house dust and loose, locally sourced spices the most likely to increase blood lead levels. A holistic approach to blood lead testing and source identification and remediation are necessary to prevent lead exposure.
Instruments to identify risk factors associated with adverse childhood experiences for vulnerable children in primary care in low- and middle-income countries: A systematic review and narrative synthesis
Authors: Mwashala Winfrida , Saikia Udoy , Chamberlain Diane
Published: October 2022

Vulnerable children exposed to Adverse Childhood Experiences (ACEs) are lacking visibility in healthcare and social welfare support systems, particularly in countries where there are delays in integrating biopsychosocial care into traditional medical care. This review seeks to identify, evaluate, and summarise existing screening instruments used in measuring risks factors related to Adverse Childhood Experiences (ACEs) in vulnerable children in Primary Health Care (PHC) settings in low- and middle-income countries (LMICs). The target population in this research is children from age (05–18 years) living in poverty and extreme social disadvantage. First, a systematic review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) approach. A mixed-methods narrative synthesis analyzed the studies and instruments used to assess vulnerable children exposed to ACEs. Each instrument was scrutinized for quality, validity, and feasibility for use with vulnerable children in frontline clinical settings. There is a lack of suitable risk assessment instruments to identify biopsychosocial risk factors from exposure to ACEs in vulnerable children in LMIC primary healthcare settings. Among nine identified instruments from the reviewed studies, none were found suitable for rapidly identifying the effects of ACEs. This was due to issues on the reviewed instruments which could hinder their application in the rapid screening of ACEs in frontline clinical settings. This included the, retrospective nature of the instruments, decisional capacity of the rater, institutional capacity in implementation of the instruments and instruments capacity to assess individual risk factors in biopsychosocial dimensions. Therefore, currently, there is lack of instruments that can be used to identify biopsychosocial risk factors of ACEs in vulnerable children in primary care in limited-resource settings. Further development of an instrument for the rapid identification of ACEs in vulnerable children is required for an early recognition and referred for preventive care, treatment, and social support services.
Changes in the salt content of packaged foods sold in supermarkets between 2015–2020 in the United Kingdom: A repeated cross-sectional study
Authors: Bandy Lauren K. , Hollowell Sven , Jebb Susan A. , Scarborough Peter
Published: October 2022

Background

Excess consumption of salt is linked to an increased risk of hypertension and cardiovascular disease. The United Kingdom has had a comprehensive salt reduction programme since 2003, setting a series of progressively lower, product-specific reformulation targets for the food industry, combined with advice to consumers to reduce salt. The aim of this study was to assess the changes in the sales-weighted mean salt content of grocery foods sold through retail between 2015 and 2020 by category and company.

Methods and findings

Information for products, including salt content (g/100 g), was collected online from retailer websites for 6 consecutive years (2015 to 2020) and was matched with brand-level retail sales data from Euromonitor for 395 brands. The sales-weighted mean salt content and total volume of salt sold were calculated by category and company. The mean salt content of included foods fell by 0.05 g/100 g, from 1.04 g/100 g in 2015 to 0.90 g/100 g in 2020, equivalent to −4.2% (p = 0.13). The categories with the highest salt content in 2020 were savoury snacks (1.6 g/100 g) and cheese (1.6 g/100 g), and the categories that saw the greatest reductions in mean salt content over time were breakfast cereals (−16.0%, p = 0.65); processed beans, potatoes, and vegetables (−10.6%, p = 0.11); and meat, seafood, and alternatives (−9.2%, p = 0.56). The total volume of salt sold fell from 2.41 g per person per day to 2.25 g per person per day, a reduction of 0.16 g or 6.7% (p = 0.54). The majority (63%) of this decrease was attributable to changes in mean salt content, with the remaining 37% accounted for by reductions in sales. Across the top 5 companies in each of 9 categories, the volume of salt sold decreased in 26 and increased in 19 cases. This study is limited by its exclusion of foods purchased out of the home, including at restaurants, cafes, and takeaways. It also does not include salt added at the table, or that naturally occurring in foods, meaning the findings underrepresent the population’s total salt intake. The assumption was also made that the products matched with the sales data were entirely representative of the brand, which may not be the case if products are sold exclusively in convenience stores or markets, which are not included in this database.

Conclusions

There has been a small decline in the salt content of foods and total volume of salt sold between 2015 and 2020, but observed changes were not statistically significant so could be due to random variations over time. We suggest that mandatory reporting of salt sales by large food companies would increase the transparency of how individual businesses are progressing towards the salt reduction targets.
Exploring the association between precipitation and population cases of ocular toxoplasmosis in Colombia
Authors: Boada-Robayo Laura , Cruz-Reyes Danna Lesley , Cifuentes-González Carlos , Rojas-Carabali William , Vargas-Largo Ángela Paola , de-la-Torre Alejandra
Published: October 2022

Background

Previous studies suggest a relationship between precipitation and ocular toxoplasmosis (OT) reactivation and congenital toxoplasmosis infection. We aimed to investigate the relationship between precipitation and the frequency of new OT cases in Colombia from 2015 to 2019.

Methodology

This retrospective cohort study analyzed data obtained from a claims-based database created by the Colombian Ministry of Health and national registries of precipitation of the Institute of Hydrology, Meteorology, and Environmental Studies. We estimated the daily number of OT cases, interpolating data from the average number of annual cases from 2015 to 2019. Then, we compared exposures (mean daily precipitation) in the case period in which the events (interpolated OT new cases) occurred by a quasi-Poisson regression, combined with a distributed lag non-linear model to estimate the non-linear and lag–response curve.

Principal findings

In the 5-year analysis, there were 1,741 new OT cases. Most of the cases occurred in 2019, followed by 2015 and 2018. New OT cases among departments were significantly different (P< 0.01). The cumulative exposure-response curve was decreasing for most departments. Nevertheless, in Chocó, Bogotá, Cesar, Cauca, and Guajira, when a certain amount of precipitation accumulates, the relative risk (RR) increases, which was contrary to the pattern observed in the other regions. The response curves to the one-day lag showed that precipitation influences the RR; however, the trends vary by department. Finally, an increasing trend in the number of cases was directly proportional to precipitation in Guajira, Atlántico, Norte de Santander, Santander, Caquetá and Quindío (r = 0.84; P< 0.05).

Conclusions

Precipitation influenced the RR for new OT cases. However, varying trends among geographical regions (departments) lead us to hypothesize that other sociodemographic, behavioral, and environmental variables, such as wind and water contamination, could influence the RR.
Comparison of coproprevalence and seroprevalence to guide decision-making in national soil-transmitted helminthiasis control programs: Ethiopia as a case study
Authors: Roose Sara , Leta Gemechu Tadesse , Vlaminck Johnny , Getachew Birhanu , Mekete Kalkidan , Peelaers Iris , Geldhof Peter , Levecke Bruno
Published: October 2022

Background

WHO recommends periodical assessment of the prevalence of any soil-transmitted helminth (STH) infections to adapt the frequency of mass drug administration targeting STHs. Today, detection of eggs in stool smears (Kato-Katz thick smear) remains the diagnostic standard. However, stool examination (coprology) has important operational drawbacks and impedes integrated surveys of multiple neglected tropical diseases. Therefore, the aim of the present study was to assess the potential of applying serology instead of coprology in STH control program decision-making.

Methodology

An antibody-ELISA based on extract of Ascaris lung stage larvae (AsLungL3-ELISA) was applied in ongoing monitoring activities of the Ethiopian national control program against schistosomiasis and soil-transmitted helminthiasis. Blood and stool samples were collected from over 6,700 students (median age: 11) from 63 schools in 33 woredas (districts) across the country. Stool samples of two consecutive days were analyzed applying duplicate Kato-Katz thick smear.

Principal findings

On woreda level, qualitative (seroprevalence) and quantitative (mean optical density ratio) serology results were highly correlated, and hence seroprevalence was chosen as parameter. For 85% of the woredas, prevalence based on serology was higher than those based on coprology. The results suggested cross-reactivity of the AsLungL3-ELISA with Trichuris. When extrapolating the WHO coproprevalence thresholds, there was a moderate agreement (weighted κ = 0.43) in program decision-making. Using the same threshold values would predominantly lead to a higher frequency of drug administration.

Significance

This is the first time that serology for soil-transmitted helminthiasis is applied on such large scale, thereby embedded in a control program context. The results underscore that serology holds promise as a tool to monitor STH control programs. Further research should focus on the optimization of the diagnostic assay and the refinement of serology-specific program decision-making thresholds.
Locomotion control during curb descent: Bilateral ground reaction variables covary consistently during the double support phase regardless of future foot placement constraints
Authors: Cui Chuyi , Kulkarni Ashwini , Rietdyk Shirley , Ambike Satyajit
Published: October 2022

During community ambulation, anticipatory adaptations in gait are key for navigating built, populated and natural environments. It has been argued that some instability in gait can be functionally beneficial in situations demanding high maneuverability, and while the mechanisms utilized to maintain locomotor balance are well understood, relatively less is known about how the control of gait stability changes to facilitate upcoming maneuvers in challenging environments. The double support phase may be important in this regard; since both feet can push off the ground simultaneously, there is greater control authority over the body’s movement during this phase. Our goal was to identify how this control authority is exploited to prepare for upcoming maneuvers in challenging environments. We used synergy indices to quantify the degree of coordination between the ground reaction forces and moments under the two feet for stabilizing the resultant force and moment on the body during the double support phase of curb descent. In contrast to our expectations, we observed that the kinetic synergy indices during curb descent were minimally influenced by expected foot targeting maneuvers for the subsequent step. Only the resultant moment in the frontal plane showed reduced stability when targeting was required, but the synergy index was still high, indicating that the resultant moment was stable. Furthermore, the synergy indices indicated that the main function of the ground reaction variables is to maintain stability of whole-body rotations during double support, and this prerogative was minimally influenced by the subsequent foot targeting tasks, likely because the cost of losing balance while descending a curb would be higher than the cost of mis-stepping on a visual target. Our work demonstrates the salience of stabilizing body rotations during curb negotiation and improves our understanding of locomotor control in challenging environments.