bluuebunny/crossref_metadata_2025 huggingface dataset:
Altered Taste Perception for Sodium Chloride in Patients With Primary Aldosteronism
Authors: Adolf Christian , Görge Veronika , Heinrich Daniel A. , Hoster Eva , Schneider Holger , Handgriff Laura , Künzel Heike , Sturm Lisa , Beuschlein Felix , Reincke Martin
Published: March 2021

Rodents exposed to mineralocorticoid excess have considerably decreased taste sensitivity for sodium chloride (NaCl) and show high dietary sodium intake. A similar shift in NaCl taste perception could be detrimental in humans when aldosterone excess in primary aldosteronism (PA) causes hypertension and favors high sodium consumption. To investigate NaCl taste sensitivity in patients with PA, we studied NaCl taste recognition thresholds as measures of NaCl taste sensitivity in forty patients with PA before and after treatment of aldosterone excess. Forty patients with primary hypertension and 40 healthy normotensive volunteers served as controls. In this context, the subjects compared 10 different NaCl solutions (0.5–256 mmol/L) with distilled water. We also assessed individual NaCl intake using self-reported 24-hour recalls and duplicate determinations of sodium excretion in 24-hour urine. Patients with PA showed significantly higher NaCl taste recognition thresholds (median 32 versus 24 mmol/L in primary hypertension,
P
=0.010, and 16 mmol/l in normotensive control,
P
<0.001). Following specific treatment for PA, the taste recognition threshold for NaCl significantly improved in patients with unilateral PA undergoing adrenalectomy (median 16 versus 32 mmol/L at baseline,
P
=0.017) and in patients on MRA (mineralocorticoid receptor antagonists; median 16 versus 32 mmol/L at baseline,
P
<0.001) but was unaltered in healthy volunteers (median 16 versus 16 mmol/L at baseline,
P
=0.438). Our data show a significantly impaired NaCl taste perception in patients with PA. Surgical as well as medical treatment of PA significantly improved NaCl taste perception in patients with PA.
Impact of the 2003 to 2018 Population Salt Intake Reduction Program in England
Authors: Alonso Sergi , Tan Monique , Wang Changqiong , Kent Seamus , Cobiac Linda , MacGregor Graham A. , He Feng J. , Mihaylova Borislava
Published: March 2021

The United Kingdom was among the first countries to introduce a salt reduction program in 2003 to reduce cardiovascular disease (CVD) incidence risk. Despite its initial success, the program has stalled recently and is yet to achieve national and international targets. We used age- and sex-stratified salt intake of 19 to 64 years old participants in the National Diet and Nutrition Surveys 2000 to 2018 and a multistate life table model to assess the effects of the voluntary dietary salt reduction program on premature CVD, quality-adjusted survival, and health care and social care costs in England. The program reduced population-level salt intake from 9.38 grams/day per adult (SE, 0.16) in 2000 to 8.38 grams/day per adult (SE, 0.17) in 2018. Compared with a scenario of persistent 2000 levels, assuming that the population-level salt intake is maintained at 2018 values, by 2050, the program is projected to avoid 83 140 (95% CI, 73 710–84 520) premature ischemic heart disease (IHD) cases and 110 730 (95% CI, 98 390–112 260) premature strokes, generating 542 850 (95% CI, 529 020–556 850) extra quality-adjusted life-years and £1640 million (95% CI, £1570–£1660) health care cost savings for the adult population of England. We also projected the gains of achieving the World Health Organization target of 5 grams/day per adult by 2030, which by 2050 would avert further 87 870 (95% CI, 82 050–88 470) premature IHD cases, 126 010 (95% CI, 118 600–126 460) premature strokes and achieve £1260 million (95% CI, £1180–£1260) extra health care savings compared with maintaining 2018 levels. Strengthening the salt reduction program to achieve further reductions in population salt intake and CVD burden should be a high priority.
Adapting Family Size and Composition: Childhood Mortality and Fertility in Rural Spain, 1750–1949
Authors: Marco-Gracia Francisco J.
Published: March 2021

An event-history analysis of ten rural villages in Spain from 1750 to 1949 indicates that the likelihood of parents having additional children was influenced by the number of their surviving children and the children’s sex composition. Parents whose children had a low survival rate had more children than parents whose children generally survived. Exclusively having daughters during the pre-transitional period also reflected, to a limited degree, the likelihood of new conception. The results suggest that some families adapted their reproductive behavior to their desired objectives. In the pre-transitional period, as well as during the transition itself, decisions to control or encourage fertility often appear to have been based on family size and composition.
Tritodynamia bengalensis n. sp., a new species of brachyuran crab from West Bengal state, India (Decapoda: Brachyura: Macrophthalmidae)
Authors: TRIVEDI JIGNESHKUMAR N. , MITRA SANTANU , NG PETER K. L.
Published: March 2021

Tritodynamia bengalensis n. sp. is described on the basis of a male specimen dredged from the shallow coastal waters of West Bengal state, India. The new species is morphologically similar to T. bidentata Yang & Tang, 2005 and T. serratipes Anker & Ng, 2014, but can be distinguished by the carapace shape, dentition of the pollex, relative length of the dactylus of the third maxilliped, proportions of the propodus of the third pereopod, and structure of the male left gonopod. This is the first record of the genus Tritodynamia from India.
Note on the heart-shaped modified basal antenna in the genus Marshiella Shaw (Hymenoptera: Braconidae: Euphorinae), with description of a new species
Authors: LI JUN , VAN ACHTERBERG CORNELIS , ZHENG MIN-LIN , CHEN JIA-HUA
Published: March 2021

The euphorine braconid genus Marshiella is quite rare and enigmatic (Shaw and Marsh 2000). Shaw (1985) named this genus for two species previously included the genera Streblocera and Microctonus. Both species share the unusually heart-shaped modified, densely setose basal flagellomeres (as in Fig. 3) and are included in the tribe Townesilitini by Stigenberg et al. (2015) together with Townesilitus, Streblocera and Proclithrophorus, but the placement of the latter is controversial. Very little is known about the species of Marshiella, including their biology and diversity. They are presumed to be koinobiont endoparasitoids of adult Coleoptera; only one species, M. plumicornis (Ruthe) has been reared from a host, the anthicid beetle Notozus monceros L. They probably orient themselves to their hosts using chemical cues (Shaw and Marsh 2000). Their heart-shaped modified basal antenna are apparently modified for grasping the pronotal horn of their aggressive adult host during oviposition. Only nine species of Marshiella are currently known, two of them are from Oriental China (Yu et al. 2016).
Health and Care of an Ageing Population: Alignment of Health and Social Systems to Address the Need
Authors: Thinley Sangay
Published: March 2021

Population ageing is both an achievement and challenge, an achievement as longevity is the result of successful prevention and control of diseases, decreasing fertility rates and overall socio-economic development. It is at the same time a challenge as the increasing number of older people and the resultant demographic shift are accompanied by the need to adjust and scale up the social and health care systems. The challenges are of particular relevance to the developing world where the demographic shift is occurring much faster.

Comprehensive efforts based on country contexts are required in the following areas: (a) older persons and development, (b) health and well-being and (c) enabling and supportive environments to address population ageing needs. This article, however, focuses only on three most crucial issues, that is, livelihood, health care systems and care of the older dependent people. Measures to sustain the livelihood of older people, to align the health systems to provide care and to develop long-term care systems are highlighted. Person-centred care, integration and functional capacity are advocated. Further, ageing in place or living in one’s own home, community or a place with the closest fit with the person’s needs and preferences is considered very important for healthy ageing.

In terms of enhancing livelihood, major policy changes and reforms to improve the social security systems and expanding coverage as well as increasing the amounts to minimum subsistence levels are highlighted. Another area which needs to be strengthened is the tradition of existing family support systems.

The health systems alignment required are reflected for each health system building block, and focuses mainly on (a) developing and ensuring access to services that provide older-person-centred care; (b) shifting the clinical focus from disease to intrinsic capacity; and (c) developing or reorienting the health workforce to provide care as per alignment.

Long-term care systems would best meet the needs of dependent older people if families, communities, civil society organisations and private sector are equally involved while governments play leadership roles in setting up and monitoring quality.
Mn-bearing purplish-red tourmaline from the Anjanabonoina pegmatite, Madagascar
Authors: Bosi Ferdinando , Celata Beatrice , Skogby Henrik , Hålenius Ulf , Tempesta Gioacchino , Ciriotti Marco E. , Bittarello Erica , Marengo Alessandra
Published: March 2021

A gem-quality purplish-red tourmaline sample of alleged liddicoatitic composition from the Anjanabonoina pegmatite, Madagascar, has been fully characterised using a multi-analytical approach to define its crystal-chemical identity. Single-crystal X-ray diffraction, chemical and spectroscopic analysis resulted in the formula: X(Na0.41□0.35Ca0.24)Σ1.00Y(Al1.81Li1.00Fe3+0.04Mn3+0.02Mn2+0.12Ti0.004)Σ3.00ZAl6 [T(Si5.60B0.40)Σ6.00O18] (BO3)3 (OH)3W[(OH)0.50F0.13O0.37]Σ1.00 which corresponds to the tourmaline species elbaite having the typical space group R3m and relatively small unit-cell dimensions, a = 15.7935(4) Å, c = 7.0860(2) Å and V = 7.0860(2) Å3.

Optical absorption spectroscopy showed that the purplish-red colour is caused by minor amounts of Mn3+ (Mn2O3 = 0.20 wt.%). Thermal treatment in air up to 750°C strongly intensified the colour of the sample due to the oxidation of all Mn2+ to Mn3+ (Mn2O3 up to 1.21 wt.%). Based on infrared and Raman data, a crystal-chemical model regarding the electrostatic interaction between the X cation and W anion, and involving the Y cations as well, is proposed to explain the absence or rarity of the mineral species ‘liddicoatite’.
Reliability and validity of the Patient Benefit Assessment Scale for Hospitalised Older Patients (P-BAS HOP)
Authors: van der Kluit Maria Johanna , Dijkstra Geke J. , de Rooij Sophia E.
Published: March 2021

Background

The Patient Benefit Assessment Scale for Hospitalised Older Patients (P-BAS HOP) is a tool which is capable of both identifying the priorities of the individual patient and measuring the outcomes relevant to him/her, resulting in a Patient Benefit Index (PBI) with range 0–3, indicating how much benefit the patient had experienced from the admission. The aim of this study was to evaluate the reliability, validity, responsiveness and interpretability of the P-BAS HOP.

Methods

A longitudinal study among hospitalised older patients with a baseline interview during hospitalisation and a follow-up by telephone 3 months after discharge. Test-retest reliability of the baseline and follow-up questionnaire were tested. Percentage of agreement, Cohen’s kappa with quadratic weighting and maximum attainable kappa were calculated per item. The PBI was calculated for both test and retest of baseline and follow-up and compared with Intraclass Correlation Coefficient (ICC). Construct validity was tested by evaluating pre-defined hypotheses comparing the priority of goals with experienced symptoms or limitations at admission and the achievement of goals with progression or deterioration of other constructs. Responsiveness was evaluated by correlating the PBI with the anchor question ‘How much did you benefit from the admission?’. This question was also used to evaluate the interpretability of the PBI with the visual anchor-based minimal important change distribution method.

Results

Reliability was tested with 53 participants at baseline and 72 at follow-up. Mean weighted kappa of the baseline items was 0.38. ICC between PBI of the test and retest was 0.77.

Mean weighted kappa of the follow-up items was 0.51. ICC between PBI of the test and retest was 0.62.

For the construct validity, tested in 451 participants, all baseline hypotheses were confirmed. From the follow-up hypotheses, tested in 344 participants, five of seven were confirmed.

The Spearman’s correlation coefficient between the PBI and the anchor question was 0.51.

The optimal cut-off point was 0.7 for ‘no important benefit’ and 1.4 points for ‘important benefit’ on the PBI.

Conclusions

Although the concept seems promising, the reliability and validity of the P-BAS HOP appeared to be not yet satisfactory. We therefore recommend adapting the P-BAS HOP.
Construction of the optimization prognostic model based on differentially expressed immune genes of lung adenocarcinoma
Authors: Zhai Yang , Zhao Bin , Wang Yuzhen , Li Lina , Li Jingjin , Li Xu , Chang Linhan , Chen Qian , Liao Zijun
Published: March 2021

Background

Lung adenocarcinoma (LUAD) is the most common pathology subtype of lung cancer. In recent years, immunotherapy, targeted therapy and chemotherapeutics conferred a certain curative effects. However, the effect and prognosis of LUAD patients are different, and the efficacy of existing LUAD risk prediction models is unsatisfactory.

Methods

The Cancer Genome Atlas (TCGA) LUAD dataset was downloaded. The differentially expressed immune genes (DEIGs) were analyzed with edgeR and DESeq2. The prognostic DEIGs were identified by COX regression. Protein-protein interaction (PPI) network was inferred by STRING using prognostic DEIGs with p value< 0.05. The prognostic model based on DEIGs was established using Lasso regression. Immunohistochemistry was used to assess the expression of FERMT2, FKBP3, SMAD9, GATA2, and ITIH4 in 30 cases of LUAD tissues.

Results

In total,1654 DEIGs were identified, of which 436 genes were prognostic. Gene functional enrichment analysis indicated that the DEIGs were involved in inflammatory pathways. We constructed 4 models using DEIGs. Finally, model 4, which was constructed using the 436 DEIGs performed the best in prognostic predictions, the receiver operating characteristic curve (ROC) was 0.824 for 3 years, 0.838 for 5 years, 0.834 for 10 years. High levels of FERMT2, FKBP3 and low levels of SMAD9, GATA2, ITIH4 expression are related to the poor overall survival in LUAD (p < 0.05). The prognostic model based on DEIGs reflected infiltration by immune cells.

Conclusions

In our study, we built an optimal prognostic signature for LUAD using DEIGs and verified the expression of selected genes in LUAD. Our result suggests immune signature can be harnessed to obtain prognostic insights.
Reduced level of physical activity during COVID-19 pandemic is associated with depression and anxiety levels: an internet-based survey
Authors: Puccinelli Paulo José , da Costa Taline Santos , Seffrin Aldo , de Lira Claudio Andre Barbosa , Vancini Rodrigo Luiz , Nikolaidis Pantelis T. , Knechtle Beat , Rosemann Thomas , Hill Lee , Andrade Marilia Santos
Published: March 2021

Background

The coronavirus disease 2019 (COVID-19) pandemic has resulted in a strong negative impact on economic and social life worldwide. It has also negatively influenced people’s general health and quality of life.The aim of the present study was to study the impact of social distancing on physical activity level, and the association between mood state (depression and anxiety level) or sex with actual physical activity levels, the change in physical activity caused by social distancing period, the adhesion level to social distancing, the adoption time of social distancing, family income and age.

Methods

A self-administered questionnaire with personal, quarantine, physical activity, and mood state disorders information’s was answered by 2140 Brazilians of both sex who were recruited through online advertising.

Results

The physical activity level adopted during the period of social distancing (2.9 ± 1.1) was lower than that adopted prior to the pandemic period (3.5 ± 0.8,p < 0.001). Thirty percent of the participants presented symptoms of moderate/severe depression and 23.3% displayed moderate/severe anxiety symptoms. A greater presence of symptoms related to anxiety and depression were associated with low physical activity levels, low family monthly income, and younger age. A higher percentage of men who had no mood disorders was observed among those who were very active than among those less active.

Conclusion

The COVID-19 pandemic has a negative impact on physical activity. Those who reduced their level of physical activity had the highest levels of mood disorders. Therefore, physical activity programs should be encouraged, while respecting the necessary social distancing to prevent the spread of Severe Acute Respiratory Syndrome Coronavirus 2.
Optimizing antiviral treatment for seasonal influenza in the USA: a mathematical modeling analysis
Authors: Yechezkel Matan , Ndeffo Mbah Martial L. , Yamin Dan
Published: March 2021

Background

Seasonal influenza remains a major cause of morbidity and mortality in the USA. Despite the US Centers for Disease Control and Prevention recommendation promoting the early antiviral treatment of high-risk patients, treatment coverage remains low.

Methods

To evaluate the population-level impact of increasing antiviral treatment timeliness and coverage among high-risk patients in the USA, we developed an influenza transmission model that incorporates data on infectious viral load, social contact, and healthcare-seeking behavior. We modeled the reduction in transmissibility in treated individuals based on their reduced daily viral load. The reduction in hospitalizations following treatment was based on estimates from clinical trials. We calibrated the model to weekly influenza data from Texas, California, Connecticut, and Virginia between 2014 and 2019. We considered in the baseline scenario that 2.7–4.8% are treated within 48 h of symptom onset while an additional 7.3–12.8% are treated after 48 h of symptom onset. We evaluated the impact of improving the timeliness and uptake of antiviral treatment on influenza cases and hospitalizations.

Results

Model projections suggest that treating high-risk individuals as early as 48 h after symptom onset while maintaining the current treatment coverage level would avert 2.9–4.5% of all symptomatic cases and 5.5–7.1% of all hospitalizations. Geographic variability in the effectiveness of earlier treatment arises primarily from variabilities in vaccination coverage and population demographics. Regardless of these variabilities, we found that when 20% of the high-risk individuals were treated within 48 h, the reduction in hospitalizations doubled. We found that treatment of the elderly population (> 65 years old) had the highest impact on reducing hospitalizations, whereas treating high-risk individuals aged 5–19 years old had the highest impact on reducing transmission. Furthermore, the population-level benefit per treated individual is enhanced under conditions of high vaccination coverage and a low attack rate during an influenza season.

Conclusions

Increased timeliness and coverage of antiviral treatment among high-risk patients have the potential to substantially reduce the burden of seasonal influenza in the USA, regardless of influenza vaccination coverage and the severity of the influenza season.
Responsiveness and interpretability of commonly used outcome assessments of mobility capacity in older hospital patients with cognitive spectrum disorders
Authors: Braun Tobias , Thiel Christian , Schulz Ralf-Joachim , Grüneberg Christian
Published: March 2021

Background

In older hospital patients with cognitive spectrum disorders (CSD), mobility should be monitored frequently with standardised and psychometrically sound measurement instruments. This study aimed to examine the responsiveness, minimal important change (MIC), floor effects and ceiling effects of commonly used outcome assessments of mobility capacity in older patients with dementia, delirium or other cognitive impairment.

Methods

In a cross-sectional study that included acute older hospital patients with CSD (study period: 02/2015–12/2015), the following mobility assessments were applied: de Morton Mobility Index (DEMMI), Hierarchical Assessment of Balance and Mobility (HABAM), Performance Oriented Mobility Assessment, Short Physical Performance Battery, 4-m gait speed test, 5-times chair rise test, 2-min walk test, Timed Up and Go test, Barthel Index mobility subscale, and Functional Ambulation Categories. These assessments were administered shorty after hospital admission (baseline) and repeated prior to discharge (follow-up). Global rating of mobility change scales and a clinical anchor of functional ambulation were used as external criteria to determine the area under the curve (AUC). Construct- and anchor-based approaches determined responsiveness. MIC values for each instrument were established from different anchor- and distribution-based approaches.

Results

Of the 63 participants (age range: 69–94 years) completing follow-up assessments with mild (Mini Mental State Examination: 19–24 points; 67%) and moderate (10–18 points; 33%) cognitive impairment, 25% were diagnosed with dementia alone, 13% with delirium alone, 11% with delirium superimposed on dementia and 51% with another cognitive impairment. The follow-up assessment was performed 10.8 ± 2.5 (range: 7–17) days on average after the baseline assessment. The DEMMI was the most responsive mobility assessment (all AUC > 0.7). For the other instruments, the data provided conflicting evidence of responsiveness, or evidence of no responsiveness. MIC values for each instrument varied depending on the method used for calculation. The DEMMI and HABAM were the only instruments without floor or ceiling effects.

Conclusions

Most outcome assessments of mobility capacity seem insufficiently responsive to change in older hospital patients with CSD. The significant floor effects of most instruments further limit the monitoring of mobility alterations over time in this population. The DEMMI was the only instrument that was able to distinguish clinically important changes from measurement error.

Trial registration

German Clinical Trials Register (DRKS00005591). Registered February 2, 2015.
It’s a woman’s thing: gender roles sustaining the practice of female genital mutilation among the Kassena-Nankana of northern Ghana
Authors: Akweongo Patricia , Jackson Elizabeth F. , Appiah-Yeboah Shirley , Sakeah Evelyn , Phillips James F.
Published: March 2021

Introduction

The practice of female genital mutilation (FGM/C) in traditional African societies is grounded in traditions of patriarchy that subjugate women. It is widely assumed that approaches to eradicating the practice must therefore focus on women’s empowerment and changing gender roles.

Methods

This paper presents findings from a qualitative study of the FGM/C beliefs and opinions of men and women in Kassena-Nankana District of northern Ghana. Data are analyzed from 22 focus group panels of young women, young men, reproductive age women, and male social leaders.

Results

The social systemic influences on FGM/C decision-making are complex. Men represent exogenous sources of social influence on FGM/C decisions through their gender roles in the patriarchal system. As such, their FGM/C decision influence is more prominent for uncircumcised brides at the time of marriage than for FGM/C decisions concerning unmarried adolescents. Women in extended family compounds are relatively prominent as immediate sources of influence on FGM/C decision-making for both brides and adolescents. Circumcised women are the main source of social support for the practice, which they exercise through peer pressure in concert with co-wives. Junior wives entering a polygynous marriage or a large extended family are particularly vulnerable to this pressure. Men are less influential and more open to suggestions of eliminating the practice of FGM/C than women.

Conclusion

Findings attest to the need for social research on ways to involve men in the promotion of FGM/C abandonment, building on their apparent openness to social change. Investigation is also needed on ways to marshal women’s social networks for offsetting their extended family familial roles in sustaining FGM/C practices.
Asymptotic behavior of Clifford-valued dynamic systems with D-operator on time scales
Authors: Aouiti Chaouki , Ben Gharbia Imen , Cao Jinde , Li Xiaodi
Published: March 2021

In this paper, a general class of Clifford-valued neutral high-order neural network (HNN) withD-operator on time scales is investigated. In this model, time-varying delays and continuously distributed delays are taken into account. As an extension of the real-valued neural network, the Clifford-valued neural network, which includes a familiar complex-valued neural network and a quaternion-valued neural network as special cases, has been an active research field recently. By utilizing this novel method, which incorporates the differential inequality techniques and the fixed point theorem and time-scale theory of computation, we derive a few sufficient conditions to ensure the existence, uniqueness, and exponential stability of the pseudo almost periodic () solution of the considered model. The results in this paper are new, even if time scale$\mathbb{T}=\mathbb{R}$T=Ror$\mathbb{T}=\mathbb{Z}$T=Z, and complementary to the previously existing works. Furthermore, an example and its numerical simulations are included to demonstrate the validity and advantage of the obtained results.
Solving nonlinear third-order three-point boundary value problems by boundary shape functions methods
Authors: Lin Ji , Zhang Yuhui , Liu Chein-Shan
Published: March 2021

For nonlinear third-order three-point boundary value problems (BVPs), we develop two algorithms to find solutions, which automatically satisfy the specified three-point boundary conditions. We construct a boundary shape function (BSF), which is designed to automatically satisfy the boundary conditions and can be employed to develop new algorithms by assigning two different roles of free function in the BSF. In the first algorithm, we let the free functions be complete functions and the BSFs be the new bases of the solution, which not only satisfy the boundary conditions automatically, but also can be used to find solution by a collocation technique. In the second algorithm, we let the BSF be the solution of the BVP and the free function be another new variable, such that we can transform the BVP to a corresponding initial value problem for the new variable, whose initial conditions are given arbitrarily and terminal values are determined by iterations; hence, we can quickly find very accurate solution of nonlinear third-order three-point BVP through a few iterations. Numerical examples confirm the performance of the new algorithms.
Landscape structure and suitable habitat analysis for effective restoration planning in semi-arid mountain forests
Authors: Piri Sahragard Hossein , Ajorlo Majid , Karami Peyman
Published: March 2021

Background

Suitable habitat and landscape structure play a pivotal role in the success of forest restoration projects. This study aimed to model the habitat suitability of wild almond (Amygdalus scopariaSpach) using three individual species distribution models (SDMs), i.e., backpropagation artificial neural network (BP-ANN), maximum entropy (MaxEnt), generalized linear model (GLM), as well as the ensemble technique along with measuring the landscape metrics and analyzing the relationship between the distribution of the suitable habitat of the species in different landform classes in Fars Province, southern Iran.

Results

There was no clear difference in the prediction performance of the models. The BP-ANN had the highest accuracy (AUC = 0.935 andk= 0.757) in modeling habitat suitability ofA. scoparia, followed by the ensemble technique, GLM, and MaxEnt models with the AUC values of 0.890, 0.887, and 0.777, respectively. The highest discrimination capacity was associated to the BP-ANN model, and the highest reliability was related to the ensemble technique. Moreover, evaluation of variable importance showed that the occurrence ofA. scopariawas strongly dependent on climatic variables, particularly isothermality (Bio 3), temperature seasonality (Bio 4), and precipitation of driest quarter (Bio 17). Analysis of the distribution of species habitat in different landform classes revealed that the canyon, mountain top, upland drainage, and hills in valley classes had the highest suitability for the species establishment.

Conclusions

Considering the importance of landform in the establishment of plant habitats, the combination of the outputs of the SDMs, landform, and the use of landscape metrics could provide both a clear view of habitat conditions and the possibility of analyzing habitat patches and their relationships that can be very useful in managing the remaining forests in semi-arid regions. The canyon, mountain top, and upland drainage classes were found to be the most important landforms to provide the highest suitable environmental conditions for the establishment ofA. scoparia. Therefore, such landforms should be given priority in restoration projects of forest in the study area.
Bridging the health inequality gap: an examination of South Africa’s social innovation in health landscape
Authors: de Villiers Katusha
Published: March 2021

Background

Despite the end of apartheid in the early 1990s, South Africa remains racially and economically segregated. The country is beset by persistent social inequality, poverty, unemployment, a heavy burden of disease and the inequitable quality of healthcare service provision. The South African health system is currently engaged in the complex project of establishing universal health coverage that ensures the system’s ability to deliver comprehensive care that is accessible, affordable and acceptable to patients and families, while acknowledging the significant pressures to which the system is subject. Within this framework, the Bertha Centre for Social Innovation & Entrepreneurship works to pursue social impact towards social justice in Africa with a systems lens on social innovation within innovative finance, health, education and youth development. The aim of this study is to demonstrate the capacity for social innovation in health with respect for South Africa, and to highlight some current innovations that respond to issues of health equity such as accessibility, affordability, and acceptability.

Methods

Different data types were collected to gain a rich understanding of the current context of social innovation in health within South Africa, supported by mini-case studies and examples from across the African continent, including: primary interviews, literature reviews, and organisational documentation reviews. Key stakeholders were identified, to provide the authors with an understanding of the context in which the innovations have been developed and implemented as well as the enablers and constraints. Stakeholders includes senior level managers, frontline health workers, Ministry of Health officials, and beneficiaries. A descriptive analysis strategy was adopted.

Results

South Africa’s health care system may be viewed, to a large extent, as a reflection of the issues facing other Southern African countries with a similar disease burden, lack of systemic infrastructure and cohesiveness, and societal inequalities. The evolving health landscape in South Africa and the reforms being undertaken to prepare for a National Healthcare Insurance presents the opportunity to understand effective models of care provision as developed in other African contexts, and to translate these models as appropriate to the South African environment.

Conclusions

After examining the cases of heath innovation, it is clear that no one actor, no matter how innovative, can change the system alone. The interaction and collaboration between the government and non-state actors is critical for an integrated and effective delivery system for both health and social care.
Melanopsin-mediated pupillary responses in bipolar disorder—a cross-sectional pupillometric investigation
Authors: Madsen Helle Østergaard , Ba-Ali Shakoor , Heegaard Steffen , Hageman Ida , Knorr Ulla , Lund-Andersen Henrik , Martiny Klaus , Kessing Lars Vedel
Published: March 2021

Background

Visible light, predominantly in the blue range, affects mood and circadian rhythm partly by activation of the melanopsin-containing intrinsically photosensitive retinal ganglion cells (ipRGCs). The light-induced responses of these ganglion cells can be evaluated by pupillometry. The study aimed to assess the blue light induced pupil constriction in patients with bipolar disorder (BD).

Methods

We investigated the pupillary responses to blue light by chromatic pupillometry in 31 patients with newly diagnosed bipolar disorder, 22 of their unaffected relatives and 35 healthy controls. Mood state was evaluated by interview-based ratings of depressive symptoms (Hamilton Depression Rating Scale) and (hypo-)manic symptoms (Young Mania Rating Scale).

Results

The ipRGC-mediated pupillary responses did not differ across the three groups, but subgroup analyses showed that patients in remission had reduced ipRGC-mediated responses compared with controls (9%, p = 0.04). Longer illness duration was associated with more pronounced ipRGC-responses (7% increase/10-year illness duration, p = 0.02).

Conclusions

The ipRGC-mediated pupil response to blue light was reduced in euthymic patients compared with controls and increased with longer disease duration. Longitudinal studies are needed to corroborate these potential associations with illness state and/or progression.
Single-cell map of diverse immune phenotypes in the acute myeloid leukemia microenvironment
Authors: Guo Rongqun , Lü Mengdie , Cao Fujiao , Wu Guanghua , Gao Fengcai , Pang Haili , Li Yadan , Zhang Yinyin , Xing Haizhou , Liang Chunyan , Lyu Tianxin , Du Chunyan , Li Yingmei , Guo Rong , Xie Xinsheng , Li Wei , Liu Delong , Song Yongping , Jiang Zhongxing
Published: March 2021

Background

Knowledge of immune cell phenotypes, function, and developmental trajectory in acute myeloid leukemia (AML) microenvironment is essential for understanding mechanisms of evading immune surveillance and immunotherapy response of targeting special microenvironment components.

Methods

Using a single-cell RNA sequencing (scRNA-seq) dataset, we analyzed the immune cell phenotypes, function, and developmental trajectory of bone marrow (BM) samples from 16 AML patients and 4 healthy donors, but not AML blasts.

Results

We observed a significant difference between normal and AML BM immune cells. Here, we defined the diversity of dendritic cells (DC) and macrophages in different AML patients. We also identified several unique immune cell types including T helper cell 17 (TH17)-like intermediate population, cytotoxic CD4+T subset, T cell: erythrocyte complexes, activated regulatory T cells (Treg), and CD8+memory-like subset. Emerging AML cells remodels the BM immune microenvironment powerfully, leads to immunosuppression by accumulating exhausted/dysfunctional immune effectors, expending immune-activated types, and promoting the formation of suppressive subsets.

Conclusion

Our results provide a comprehensive AML BM immune cell census, which can help to select pinpoint targeted drug and predict efficacy of immunotherapy.
Neuronal hibernation following hippocampal demyelination
Authors: Baltan Selva , Jawaid Safdar S. , Chomyk Anthony M. , Kidd Grahame J. , Chen Jacqueline , Battapady Harsha D. , Chan Ricky , Dutta Ranjan , Trapp Bruce D.
Published: March 2021

Cognitive dysfunction occurs in greater than 50% of individuals with multiple sclerosis (MS). Hippocampal demyelination is a prominent feature of postmortem MS brains and hippocampal atrophy correlates with cognitive decline in MS patients. Cellular and molecular mechanisms responsible for neuronal dysfunction in demyelinated hippocampi are not fully understood. Here we investigate a mouse model of hippocampal demyelination where twelve weeks of treatment with the oligodendrocyte toxin, cuprizone, demyelinates over 90% of the hippocampus and causes decreased memory/learning. Long-term potentiation (LTP) of hippocampal CA1 pyramidal neurons is considered to be a major cellular readout of learning and memory in the mammalian brain. In acute slices, we establish that hippocampal demyelination abolishes LTP and excitatory post-synaptic potentials of CA1 neurons, while pre-synaptic function of Schaeffer collateral fibers is preserved. Demyelination also reduced Ca2+-mediated firing of hippocampal neurons in vivo. Using three-dimensional electron microscopy, we investigated the number, shape (mushroom, stubby, thin), and post-synaptic densities (PSDs) of dendritic spines that facilitate LTP. Hippocampal demyelination did not alter the number of dendritic spines. Surprisingly, dendritic spines appeared to be more mature in demyelinated hippocampi, with a significant increase in mushroom-shaped spines, more perforated PSDs, and more astrocyte participation in the tripartite synapse. RNA sequencing experiments identified 400 altered transcripts in demyelinated hippocampi. Gene transcripts that regulate myelination, synaptic signaling, astrocyte function, and innate immunity were altered in demyelinated hippocampi. Hippocampal remyelination rescued synaptic transmission, LTP, and the majority of gene transcript changes. We establish that CA1 neurons projecting demyelinated axons silence their dendritic spines and hibernate in a state that may protect the demyelinated axon and facilitates functional recovery following remyelination.
Strengthening multisectoral coordination on antimicrobial resistance: a landscape analysis of efforts in 11 countries
Authors: Joshi Mohan P. , Hafner Tamara , Twesigye Gloria , Ndiaye Antoine , Kiggundu Reuben , Mekonnen Negussu , Kusu Ndinda , Berthé Safoura , Lusaya Edgar Peter , Acho Alphonse , Tuala Robert Tuala , Siddiqua Ayasha , Kaboré Henri , Aidara Soukeyna Sadiya , Guzman Javier
Published: March 2021

Background

Increasingly, there has been recognition that siloed approaches focusing mainly on human health are ineffective for global antimicrobial resistance (AMR) containment efforts. The inherent complexities of AMR containment warrant a coordinated multisectoral approach. However, how to institutionalize a country’s multisectoral coordination across sectors and between departments used to working in silos is an ongoing challenge. This paper describes the technical approach used by a donor-funded program to strengthen multisectoral coordination on AMR in 11 countries as part of their efforts to advance the objectives of the Global Health Security Agenda and discusses some of the challenges and lessons learned.

Methods

The program conducted a rapid situational analysis of the Global Health Security Agenda and AMR landscape in each country and worked with the governments to identify the gaps, priorities, and potential activities in multisectoral coordination on AMR. Using the World Health Organization (WHO) Joint External Evaluation tool and the WHO Benchmarks for International Health Regulations (2005) Capacities as principal guidance, we worked with countries to achieve key milestones in enhancing effective multisectoral coordination on AMR.

Results

The program’s interventions led to the achievement of key benchmarks recommended actions, including the finalization of national action plans on AMR and tools to guide their implementation; strengthening the leadership, governance, and oversight capabilities of multisectoral governance structures; establishing and improving the functions of technical working groups on infection prevention and control and antimicrobial stewardship; and coordinating AMR activities within and across sectors.

Conclusion

A lot of learning still needs to be done to identify best practices for building mutual trust and adequately balancing the priorities of individual ministries with cross-cutting issues. Nevertheless, this paper provides some practical ideas for countries and implementing partners seeking to improve multisectoral coordination on AMR. It also demonstrates that the WHO benchmark actions, although not intended as an exhaustive list of recommendations, provide adequate guidance for increasing countries’ capacity for effective multisectoral coordination on AMR in a standardized manner.
History taking and response to an adult diarrheal case among community drug retail outlets in Gondar town, north-west Ethiopia: a simulated-client survey
Authors: Wondimsigegn Dawit , Woldegerima Berhanemeskel , Taddese Asefa Adimasu
Published: March 2021

Background

Self-care is one of the growing tasks of community pharmacy professionals. They are highly engaged in consultations in response to specific drug request (product-based presentation) or symptoms clients describe (symptom-based presentation).

Purpose

This study was aimed at assessing the appropriateness of patient assessment and response to an adult diarrheal case among community drug retail outlets in Gondar town, north-west Ethiopia.

Methods

A descriptive cross-sectional study design based on simulated-client method of visit was conducted from 03 August to 21 September, 2020. An adult female diarrheal case scenario was developed and used to guide data collectors to interact with professionals in a standardized and consistent way. All 60 dispensaries in the town during the data collection were included in the study. A pretested data collection tool was used to record the conversation between simulated clients and providers. The data were analyzed using SPSS version 20.

Results

With regard to patient history, age of the patient, whether diarrhea is watery or bloody and onset and duration of diarrhea were the three most commonly requested questions with 59 (98.3%), 55 (91.7%) and 46 (76.7%), respectively. Past-medical and medication history are enquired in none of the visits. Medication was dispensed in 57 (95%) of the visits and no referral to a health facility was recommended in majority (90%) of cases. The most commonly recommended medications were ciprofloxacin 30 (52.6%) and metronidazole 20 (35.1%). ORS was considered in only 6 (10.5%) dispensaries.

Conclusion

Patient assessment, final decisions and treatment recommendations for an adult diarrheal case are inadequate, irrational and illegal. Educational interventions coupled with incentive mechanisms for cognitive pharmaceutical service and strict regulatory enforcement are needed to reduce the problem.
Soil-vegetation relationships in Mediterranean forests after fire
Authors: Fernández-García Víctor , Marcos Elena , Huerta Sara , Calvo Leonor
Published: March 2021

Background

Wildfires are one of the major environmental concerns in Mediterranean ecosystems. Thus, many studies have addressed wildfire impacts on soil and vegetation in Mediterranean forests, but the linkages between these ecosystem compartments after fire are not well understood. The aim of this work is to analyze soil-vegetation relationships in Mediterranean burned forests as well as the consistency of these relationships among forests with different environmental conditions, at different times after fire, and among vegetation with different functional traits.

Results

Our results indicate that study site conditions play an important role in mediating soil-vegetation relationships. Likewise, we found that the nature of soil-vegetation relationships may vary over time as fire effects are less dominant in both ecosystem compartments. Despite this, we detected several common soil-vegetation relationships among study sites and times after fire. For instance, our results revealed that available P content and stoichiometry (C:P and N:P) were closely linked to vegetation growth, and particularly to the growth of trees. We found that enzymatic activities and microbial biomass were inversely related to vegetation growth rates, whereas the specific activities of soil enzymes were higher in the areas with more vegetation height and cover. Likewise, our results suggest that resprouters may influence soil properties more than seeders, the growth of seeders being more dependent on soil status.

Conclusions

We provide pioneer insights into how vegetation is influenced by soil, and vice-versa, in Mediterranean burned areas. Our results reflect variability in soil-vegetation relationships among study sites and time after fire, but consistent patterns between soil properties and vegetation were also detected. Our research is highly relevant to advance in forest science and could be useful to achieve efficient post-fire management.
Effectiveness of protocol-based pharmacotherapy management collaboration between hospital and community pharmacists to address capecitabine-related hand–foot syndrome in cancer patients: a retrospective study
Authors: Nakamura Nobuhiko , Shiraiwa Hiroki , Haruna Yasuhiro , Ichijima Tomoki , Takeda Tomoko , Hasegawa Koji , Kusumoto Masaaki , Yano Yoshitaka
Published: March 2021

Background

Pharmaceutical care of capecitabine-related hand–foot syndrome (HFS) is extremely important to avoid the progression of the syndrome. Protocol-based pharmacotherapy management (PBPM) of HFS by community pharmacists has been introduced in our community, whereby the community pharmacist instructs patients to use steroid creams if they develop HFS of grade 2 or higher. This study aimed to evaluate the effectiveness of PBPM in cancer patients with HFS by comparing it to conventional pharmaceutical care using monitoring reports for pharmacotherapy management by community pharmacists.

Methods

From September 2017 to August 2019, we retrospectively investigated the medical records of 396 cancer patients who received capecitabine adjuvant chemotherapy. Before PBPM implementation, conventional pharmaceutical care was administered from September 2017 to August 2018; these patients served as the control group. Care was switched to PBPM in September 2018, and PBPM was applied from September 2018 to August 2019; these patients served as the PBPM group. We excluded patients who received both conventional pharmaceutical care and PBPM. We categorized all cases into two groups: age ≤ 69 years and age ≥ 70 years.

Results

In all, 396 cases were included, of which 227 were ineligible, such as those of cancer patients who received both conventional pharmaceutical care and PBPM. Among patients aged higher than 70 years, the incidence and severity of HFS associated with PBPM were significantly lower than those associated with conventional care (grade 0: 59.5% [44/74] vs. 30.6% [11/36], grade 1: 33.8% [25/74] vs. 63.9% [23/36]). All patients continued to receive the capecitabine, HFS severity improved to grade 1 during the study period, and treatment of HFS was not stopped.

Conclusion

Our findings suggest that PBPM is effective for addressing capecitabine-related HFS among cancer patients aged higher than 70 years, in that it helps prevent an increase in HFS severity.