bluuebunny/crossref_metadata_2025 huggingface dataset:
2,5‐diketopiperazines mitigate the amount of advanced glycation end products accumulated with age in human dermal fibroblasts
Authors: André A. , Touré A. K. , Stien D. , Eparvier V.
Published: August 2020

Objective

Glycation is a common non‐enzymatic reaction between proteins and sugars, resulting in the formation of advanced glycation end products (AGEs) in the human body. As can be seen in diabetic patients, the accumulation of AGEs in the skin has aesthetic consequences (wrinkles, brown spots and yellowish complexion). Therefore, the objective of this work was to find compounds isolated from natural sources that could eliminate the final AGEs accumulated in the skin with ageing.

Methods and results

A preliminary screening performed on a bank of microbial extracts and pure compounds showed that 2,5‐Diketopiperazines (DKPs), as well as the extract of Sphingobacterium sp (SNB‐CN13), reduced the presence of AGEs in fibroblasts by −28% and −23%, respectively. In this article, we present the dereplication approach used to reveal the presence of 26 different DKPs in the crude extract of Sphingobacterium sp. Bioguided fractionation has led to the isolation of 12 of them, whose identity has been confirmed by HRMS and NMR. A green synthesis approach has been developed to synthesize 3 symmetrical DKPs. The biological activity of all DKPs was evaluated by the development of an in vitro test using immunocytochemistry to reveal the presence of AGE carboxymethyl‐lysine in human dermal fibroblasts.

Conclusion

Our work shows for the first time that DKPs decrease the amount of carboxymethyl‐lysine AGE in elderly human dermal fibroblasts grown in vitro. Therefore, diketopiperazines can be considered as compounds of interest for dermatological and cosmetic applications with an anti‐ageing aim.
Advance care planning in Australia during the COVID‐19 outbreak: now more important than ever
Authors: Sinclair Craig , Nolte Linda , White Ben P. , M. Detering Karen
Published: August 2020

The novel Coronavirus disease 2019 (COVID‐19) outbreak has led to rapid and profound changes in healthcare system delivery and society more broadly. Older adults, and those living with chronic or life‐limiting conditions, are at increased risk of experiencing severe or critical symptoms associated with COVID‐19 infection and are more likely to die. They may also experience non‐COVID‐19 related deterioration in their health status during this period. Advance care planning (ACP) is critical for this cohort, yet there is no coordinated strategy for increasing the low rates of ACP uptake in these groups, or more broadly. This paper outlines a number of key reasons why ACP is an urgent priority, and should form a part of the health system's COVID‐19 response strategy. These include reducing the need for rationing, planning for surges in healthcare demand, respecting human rights, enabling proactive care coordination and leveraging societal change. We conclude with key recommendations for policy and practice in the system‐wide implementation of ACP, to enable a more ethical, coordinated and person‐centred response in the COVID‐19 context.
Early childhood caries and parents’ challenges in implementing oral hygiene practices: a qualitative study
Authors: Suprabha Baranya Shrikrishna , D’Souza Violet , Shenoy Ramya , Karuna Yarmunja Mahabala , Nayak Anupama Panakaje , Rao Arathi
Published: August 2020

Background

Early childhood caries (ECC) is highly prevalent with significant long‐term consequences. Parents are primarily responsible for the oral health practices of their children. Parents’ health beliefs, attitudes, and cultural factors influence oral health practices.

Aim

To explore and understand the perceptions and challenges faced by the parents of the children with ECC in performing routine oral hygiene practices for their children.

Design

We conducted a qualitative description study with the parents of children with ECC. Data were collected through five focus groups using culturally appropriate, semi‐structured, open‐ended questions and probes. Focus groups were audiotaped, and field notes were taken, which were transcribed verbatim after each focus group session. Data were analyzed using content analyses.

Results

A vast majority of the participants were aware of the significance of oral hygiene. However, they faced challenges in implementing proper home hygiene practices at home and lacked knowledge about the type of toothpaste and toothbrush to be used for their children.

Conclusion

The parents of the children with ECC face a severe knowledge gap, which is interfering with the selection of proper oral hygiene aids for their children. They also face barriers in implementing oral hygiene routines for their children, in spite of awareness that tooth brushing is important.
Population genetic structure of turbot (Scophthalmus maximus L., 1758) in the Black Sea
Authors: Firidin Sirin , Ozturk Rafet Cagri , Alemdag Melike , Eroglu Oguzhan , Terzi Yahya , Kutlu Ilyas , Duzgunes Zehra Duygu , Cakmak Eyup , Aydin Ilhan
Published: August 2020

Turbot, Scophthalmus maximus, is a commercially important demersal flatfish species distributed throughout the Black Sea. Several studies performed locally with a limited number of specimens using both mitochondrial DNA (mtDNA) and microsatellite markers evidenced notable genetic variation among populations. However, comprehensive population genetic studies are required to help management of the species in the Black Sea. In the present study eight microsatellite loci were used to resolve the population structure of 414 turbot samples collected from 12 sites across the Black Sea. Moreover, two mtDNA genes, COI and Cyt‐b, were used for taxonomic identification. Microsatellite markers of Smax‐04 and B12‐I GT14 were excluded from analysis due to scoring issues. Data analysis was performed with the remaining six loci. Loci were highly polymorphic (average of 17.8 alleles per locus), indicating high genetic variability. Locus 3/20CA17, with high null allele frequency (>30%), significantly deviated from HW equilibrium. Pairwise comparison of the FST index showed significant differences between most of the surveyed sampling sites (P < 0.01). Cluster analysis evidenced the presence of three genetic groups among sampling sites. Significant genetic differentiation between Northern (Sea of Azov and Crimea) and Southern (Turkish Black Sea Coast) Black Sea sampling sites were detected. The Mantel test supported an isolation by distance model of population structure. These findings are vital for long‐term sustainable management of the species and development of conservation programs. Moreover, generated mtDNA sequences would be useful for the establishment of a database for S. maximus.
Peasant essentialism in GMO debates: Bt cotton in Burkina Faso
Authors: Luna Jessie K.
Published: August 2020

Amidst polarized global debates about genetically modified (GM) crops, much attention has focused on Burkina Faso, where farmers grew Bt cotton from 2008 to 2015 in the first widespread commercial adoption of GM crops by smallholder African farmers. This article draws on ethnographic fieldwork and 125 interviews to analyse the debate accompanying this adoption, contending that both sides employed stock agrarian imaginaries that essentialized rural people. These competing imaginaries—romantic versus modern—reproduced polarized global narratives about GM crops and peasants, while misrepresenting or overlooking the inequalities and constraints shaping rural communities and the specifics of Bt cotton production. Both sides sought to claim the legitimacy and authenticity that comes from representing ‘the peasants’, yet ironically flattened the complexity of rural experiences. This paper demonstrates how each side's adherence to agrarian imaginaries served to produce erroneous knowledge claims. This adherence resulted in part from local resource constraints and dependence on external actors, which produced pressure to conform to polarized global GMO scripts. The paper concludes that GMO debate participants and observers must eschew essentializing imaginaries if they seek to produce more accurate knowledge about farmers' varied experiences with GM crops.
Does Emigration Affect Pro‐environmental Behaviour Back Home? A Long‐Term, Local‐Level Perspective
Authors: Ivlevs Artjoms
Published: August 2020

This study provides novel evidence on the effects of emigration on pro‐environmental behaviour back home. Focusing on the seven successor states of former Yugoslavia, I explore the relationship between people’s present‐day pro‐environmental action and the local‐level intensity of a major guestworker emigration wave that occurred four decades earlier. I find that more intense local‐level emigration is associated with a lower likelihood of pro‐environmental action; the instrumental variable analysis supports the causal nature of this relationship. This finding supports the conjecture that emigration contributes to greater consumerism at home and therefore reduces pro‐environmental behaviour. At the same time, controlling for the intensity of local‐level emigration, a higher proportion of women in the local migrant population is associated with a greater likelihood of pro‐environmental action. As women are generally more likely to undertake pro‐environmental behaviour as well as transfer new norms and practices across borders, this finding supports the hypothesis that migration contributes to a cross‐border transmission of pro‐environmental norms and practices.
Proteinaceous effector discovery and characterization in filamentous plant pathogens
Authors: Kanja Claire , Hammond‐Kosack Kim E.
Published: August 2020

The complicated interplay of plant–pathogen interactions occurs on multiple levels as pathogens evolve to constantly evade the immune responses of their hosts. Many economically important crops fall victim to filamentous pathogens that produce small proteins called effectors to manipulate the host and aid infection/colonization. Understanding the effector repertoires of pathogens is facilitating an increased understanding of the molecular mechanisms underlying virulence as well as guiding the development of disease control strategies. The purpose of this review is to give a chronological perspective on the evolution of the methodologies used in effector discovery from physical isolation and in silico predictions, to functional characterization of the effectors of filamentous plant pathogens and identification of their host targets.
Eosinophilic esophagitis: updates on key unanswered questions
Authors: Fernandez‐Becker Nielsen Q. , Raja Shreya , Scarpignato Carmelo , Lynch Kristle L. , Ahuja Nitin K. , Horsley‐Silva Jennifer L.
Published: August 2020

Eosinophilic esophagitis (EoE) is a clinicopathologic disease characterized by symptoms of esophageal dysfunction and esophageal eosinophilia. In the last decade, there has been a dramatic increase in its prevalence for reasons that are not completely understood. The underlying pathophysiology involves an antigen‐mediated TH2 immune response that draws eosinophils to the esophagus, causing mucosal inflammation, esophageal remodeling, and fibrosis. This ultimately leads to esophageal dysfunction that most commonly manifests as dysphagia. In this review, we will discuss updates on key questions regarding the diagnosis and treatment of EoE.
Policy Process Theory for Rural Studies: Navigating Context and Generalization in Rural Policy
Authors: Peterson Holly L. , McBeth Mark K. , Jones Michael D.
Published: August 2020

Rural studies and policy process literature are ripe for integration due to their interdisciplinary approaches, empirical‐foci, and importance of values, norms, and heuristics. Policy process theory often ignores the important context‐rich variation within the rural and urban distinction, yet offers qualities rural scholars may find useful, like generalizability. This integration would improve both literature by facilitating empirical inquiry. Process theory “lenses” offer internal consistency, a shared research agenda, and applicability in many settings. These qualities encourage sharing and comparing of diverse research findings, thereby advancing common understanding and exploration of the policy process. In illustration of these ideas, this article reviews five policy process frameworks, the Institutional Development and Analysis framework, the Advocacy Coalition Framework, the Social Construction Framework, the Narrative Policy Framework, and the Multiple Streams Approach, extant rural policy process studies, and provides examples of how the literature may be integrated to explore specific research areas and questions.

Related Articles

Crow, Deserai A., Lydia A. Lawhon, John Berggren, Juhi Huda, Elizabeth Koebele, and Adrianne Kroepsch. 2017. “A Narrative Policy Framework Analysis of Wildfire Policy Discussions in two Colorado Communities.”Politics & Policy45 (4): 626‐656.https://doi.org/10.1111/polp.12207

Shortall, Sally, and Margaret Alston. 2016. “To Rural Proof or not to Rural Proof: A Comparative Analysis.”Politics & Policy44 (1): 35‐55.https://doi-org.libproxy.usouthal.edu/10.1111/polp.12144

Smith‐Walter, Aaron, Holly L. Peterson, Michael D. Jones, and Ashley Nicole Reynolds Marshall. 2016. “Gun Stories: How Evidence Shapes Firearm Policy in the United States.”Politics & Policy44 (6): 1053‐1088.https://doi-org.libproxy.usouthal.edu/10.1111/polp.12187
Reputation‐SourcedAuthority and the Prospect of Unchecked Bureaucratic Power
Authors: Bertelli Anthony M. , Busuioc Madalina
Published: August 2020

We explore the democratic implications of a reputational account of bureaucratic authority. While an influential literature has examined the relevance of reputation—and mutual exchange between principals and agents in public organizations generally—the normative implications of these insights have largely escaped scrutiny. We discuss how reputation‐building impacts both the ability and the motivation of principals to oversee administrative policymaking. We argue that reputation‐sourced authority eschews ex ante incentives through the claims‐making and maneuvering of bureaucrats as they develop reputations with audiences. At the same time, it de‐legitimizes ex post oversight because monitoring and compliance must compete both with reputational authority and with resistance from the audiences that are the very sources of such authority.
Effect of Loop Tilting on the Heat Transfer and Pressure Drop in Two-Phase CO2 Based Natural Circulation Loop: An Experimental Study
Authors: Thippeswamy L. R. , Yadav Ajay Kumar
Published: August 2020

The natural circulation loop (NCL) is widely used where the safe and economic heat transfer device is desired. However, the instability associated with the regular change in fluid flow behavior due to the imbalance between friction and buoyant forces is a major disadvantage. One of the erudite solutions to overcome this is to tilt the entire loop by a certain angle, with an inherent penalty in heat transfer and pressure drop. In the present study, experimental studies have been carried out on two-phase carbon dioxide (CO2) based NCL, which has gained popularity because of its compactness and higher heat transfer rate. Pressure drop and heat transfer performance of the loop for various tilt angles (0 deg, 30 deg, and 45 deg) in different planes (XY and YZ planes) have been investigated. Methanol is used as the external fluid in cold and hot heat exchangers in order to maintain low operating temperature in the loop. Results show that the tilting of the loop causes a marginal drop in the heat transfer rate of two-phase CO2 based NCL. Hence, tilting of the loop could be a solution to instability problem without conceding the performance of the loop.
A Novel Anisotropic Failure Criterion With Dispersed Fiber Orientations for Aortic Tissues
Authors: Liu Minliang , Dong Hai , Lou Xiaoying , Iannucci Glen , Chen Edward P. , Leshnower Bradley G. , Sun Wei
Published: August 2020

Accurate failure criteria play a fundamental role in biomechanical analyses of aortic wall rupture and dissection. Experimental investigations have demonstrated a significant difference of aortic wall strengths in the circumferential and axial directions. Therefore, the isotropic von Mises stress and maximum principal stress, commonly used in computational analysis of the aortic wall, are inadequate for modeling of anisotropic failure properties. In this study, we propose a novel stress-based anisotropic failure criterion with dispersed fiber orientations. In the new failure criterion, the overall failure metric is computed by using angular integration (AI) of failure metrics in all directions. Affine rotations of fiber orientations due to finite deformation are taken into account in an anisotropic hyperelastic constitutive model. To examine fitting capability of the failure criterion, a set of off-axis uniaxial tension tests were performed on aortic tissues of four porcine individuals and 18 human ascending thoracic aortic aneurysm (ATAA) patients. The dispersed fiber failure criterion demonstrates a good fitting capability with the off-axis testing data. Under simulated biaxial stress conditions, the dispersed fiber failure criterion predicts a smaller failure envelope comparing to those predicted by the traditional anisotropic criteria without fiber dispersion, which highlights the potentially important role of fiber dispersion in the failure of the aortic wall. Our results suggest that the deformation-dependent fiber orientations need to be considered when wall strength determined from uniaxial tests are used for in vivo biomechanical analysis. More investigations are needed to determine biaxial failure properties of the aortic wall.
Infinite-order perturbative treatment for quantum evolution with exchange
Authors: Lindale Jacob R. , Eriksson Shannon L. , Tanner Christian P. N. , Warren Warren S.
Published: August 2020

A new approach for quantum evolution in dynamic systems converged to all orders in perturbation theory.
Pathogen-induced tissue-resident memory T
H
17 (T
RM
17) cells amplify autoimmune kidney disease
Authors: Krebs Christian F. , Reimers Daniel , Zhao Yu , Paust Hans-Joachim , Bartsch Patricia , Nuñez Sarah , Rosemblatt Mariana V. , Hellmig Malte , Kilian Christoph , Borchers Alina , Enk Leon U. B. , Zinke Michael , Becker Martina , Schmid Joanna , Klinge Stefanie , Wong Milagros N. , Puelles Victor G. , Schmidt Constantin , Bertram Tabea , Stumpf Natascha , Hoxha Elion , Meyer-Schwesinger Catherine , Lindenmeyer Maja T. , Cohen Clemens D. , Rink Michael , Kurts Christian , Franzenburg Sören , Koch-Nolte Friedrich , Turner Jan-Eric , Riedel Jan-Hendrik , Huber Samuel , Gagliani Nicola , Huber Tobias B. , Wiech Thorsten , Rohde Holger , Bono Maria Rosa , Bonn Stefan , Panzer Ulf , Mittrücker Hans-Willi
Published: August 2020

CD4
+
T
RM
17 cells become activated by inflammatory cytokines to produce IL-17A and thereby promote autoimmunity.
Resident T
H
17 cells “break bad” in kidney autoimmunity
Authors: Buggert Marcus
Published: August 2020

Resident memory T
H
17 cells (T
RM
17 cells) are induced by microbial infections in kidneys and amplify renal autoimmunity.
Merging Metagenomics and Spatial Epidemiology To Understand the Distribution of Antimicrobial Resistance Genes from
Enterobacteriaceae
in Wild Owls
Authors: Miller Elizabeth A. , Ponder Julia B. , Willette Michelle , Johnson Timothy J. , VanderWaal Kimberly L.
Published: August 2020

Antimicrobial resistance (AMR) is a multifaceted problem that poses a worldwide threat to human and animal health. Recent reports suggest that wildlife may play an important role in the emergence, dissemination, and persistence of AMR. As such, there have been calls for better integration of wildlife into current research on AMR, including the use of wild animals as biosentinels of AMR contamination in the environment. A One Health approach can be used to gain a better understanding of all AMR sources and pathways, particularly those at the human-animal-environment interface. Our study focuses on this interface in order to assess the effect of human-impacted landscapes on AMR in a wild animal. This work highlights the value of wildlife rehabilitation centers for environmental AMR surveillance and demonstrates how metagenomic sequencing within a spatial epidemiology framework can be used to address questions surrounding AMR complexity in natural ecosystems.
Novel Avian Pathogenic Escherichia coli Genes Responsible for Adhesion to Chicken and Human Cell Lines
Authors: Ali Aamir , Kolenda Rafał , Khan Muhammad Moman , Weinreich Jörg , Li Ganwu , Wieler Lothar H. , Tedin Karsten , Roggenbuck Dirk , Schierack Peter
Published: August 2020

Avian pathogenic
E. coli
is not only pathogenic for commercial poultry but can also cause foodborne infections in humans utilizing the same attachment and virulence mechanisms. Our aim was to identify genes of avian pathogenic
E. coli
involved in adhesion to chicken and human cells in order to understand the colonization and pathogenesis of these bacteria. In contrast to the recent studies based on genotypic and bioinformatics data, we have used a combination of phenotypic and genotypic approaches for identification of novel genes contributing to adhesion in chicken and human cell lines. Identification of adhesion factors remains important, as antibodies elicited against such factors have shown potential to block colonization and ultimately prevent disease as prophylactic vaccines. Therefore, the data will augment the understanding of disease pathogenesis and ultimately in designing strategies against the infections.
Supplemental Material: Stagnant slab front within the mantle transition zone controls the formation of Cenozoic intracontinental high-Mg andesites in northeast Asia
Authors: Xu Wenliang , al. et
Published: August 2020

Analytical methods, and supplemental figures and tables.
Review of response rates over time in registry-based studies using patient-reported outcome measures
Authors: Wang Katherine , Eftang Cathrine N , Jakobsen Rune Bruhn , Årøen Asbjørn
Published: August 2020

Objectives

Gain an overview of expected response rates (RRs) to patient-reported outcome measures (PROMs) in clinical quality registry-based studies and long-term cohorts in order to better evaluate the validity of registries and registry-based studies. Examine the trends of RRs over time and how they vary with study type, questionnaire format, and the use of reminders.

Design

Literature review with systematic search.

Data sources

PubMed, MEDLINE, EMBASE, kvalitetsregistre.no, kvalitetsregister.se and sundhed.dk.

Eligibility criteria

Articles in all areas of medical research using registry-based data or cohort design with at least two follow-up time points collecting PROMs and reporting RRs. Annual reports of registries including PROMs that report RRs for at least two time points.

Primary outcome measure

RRs to PROMs.

Results

A total of 10 articles, 12 registry reports and 6 registry articles were included in the review. The overall RR at baseline was 75%±22.1 but decreased over time. Cohort studies had a markedly better RR (baseline 97%±4.7) compared with registry-based data at all time points (baseline 72%±21.8). For questionnaire formats, paper had the highest RR at 86%±19.4, a mix of electronic and paper had the second highest at 71%±15.1 and the electronic-only format had a substantially lower RR at 42%±8.7. Sending one reminder (82%±16.5) or more than one reminder (76%±20.9) to non-responders resulted in a higher RR than sending no reminders (39%±6.7).

Conclusions

The large variation and downward trend of RRs to PROMs in cohort and registry-based studies are of concern and should be assessed and addressed when using registry data in both research and clinical practice.
Acupuncture for acute non-specific low back pain: a randomised, controlled, multicentre intervention study in general practice—the Acuback study
Authors: Skonnord Trygve , Skjeie Holgeir , Brekke Mette , Klovning Atle , Grotle Margreth , Aas Eline , Mdala Ibrahimu , Fetveit Arne
Published: August 2020

Objectives

The aim of this study was to evaluate whether a single treatment session of acupuncture, when applied in addition to standard treatment for acute low back pain (ALBP), reduces the time to recovery compared with standard treatment alone.

Design

A multicentre, randomised, controlled trial.

Setting

Conducted at 11 Norwegian general practitioners’ (GPs’) offices.

Participants

171 adults aged 20–55 years seeking their GP for ALBP (≤14 days) between March 2014 and March 2017. Patients with secondary back pain and previous sick leave and acupuncture treatment was excluded.

Interventions

The participants were randomised to either the control group (CG) or the acupuncture group (AG) by online software. The CG received standard treatment according to the Norwegian guidelines, while the AG received one session of Western medical acupuncture treatment in addition to standard treatment. The statistician was blinded to group status.

Primary and secondary outcome measures

The primary outcome was median days to recovery. Secondary outcomes were pain intensity, global improvement, back-specific functional status, sick leave, medication and adverse effects.

Results

185 participants were randomised, 95 in the CG and 90 in the AG. 14 participants did not receive the allocated intervention and 4 were excluded from the analysis. Thus, 167 participants were included in the analysis, 86 in the CG and 81 in the AG. The groups were similar according to baseline characteristics. The median time to recovery was 14 days for the CG and 9 days for the AG, HR 1.37 (95% CI 0.95 to 1.96), (p=0.089). No serious adverse effects were reported.

Conclusions

We did not find any statistically significant reduction in time-to-recovery after a single session of acupuncture for ALBP compared with standard care.

Trial registration number

NCT01439412.
Does theory of planned behaviour play a role in predicting uptake of colorectal cancer screening? A cross-sectional study in Hong Kong
Authors: Huang Junjie , Wang Jingxuan , Pang Tiffany Wing-Yin , Chan Maggie Ka-Ying , Leung Sophia , Chen Xiao , Leung Colette , Zheng Zhi-Jie , Wong Martin Chi-Sang
Published: August 2020

Objective

Colorectal cancer (CRC) ranked second in terms of cancer mortality worldwide. It is associated with a substantial global disease burden. We aimed to examine whether the theory of planned behaviour (TPB) could predict the uptake of faecal immunochemical test to inform novel strategies for enhancing CRC screening participation in population-based programmes.

Design

Cross-sectional study.

Settings

A Hong Kong-based and territory-wide telephone survey was conducted during the study period from October 2017 to November 2018.

Participants

4800 asymptomatic individuals aged 61–70 years who can communicate in Cantonese were recruited during the survey period. Those who had a history of CRC, chronic bowel inflammation, two or more first-degree relatives with CRC, and received colonoscopy in the past 10 years or faecal occult blood test in the past 5 years were excluded.

Outcome measures

The association between CRC screening uptake and the factors pertinent to TPB was analysed by univariable and multivariable regression models and the mediating effect of intention. We adjusted for age, gender, educational level, marital and working status, as well as household income.

Results

Multivariable regression analysis showed that high perceived behavioural control (adjusted OR (AOR)=12.35, 95% CI 8.21 to 18.60, p<0.001), high intention for CRC screening (AOR=7.86, 95% CI 6.60 to 9.36, p<0.001) and positive attitude towards CRC screening (accuracy and effectiveness: AOR=1.19, 95% CI 1.03 to 1.38, p<0.05; embarrassment and apprehension: AOR=4.27, 95% CI 3.13 to 5.82, p<0.001) were significantly associated with CRC screening uptake. Mediation analysis found that the effect of social norms on screening behaviour was primarily mediated by intention (83.2%), and this indirect, mediated effect accounted for 21.7% to 24.1% of total effects of other constructs in TPB on screening behaviour.

Conclusions

The variables pertinent to TPB could successfully predict CRC screening uptake. Promotion of CRC screening based on interventions that increase perceived behavioural control and behavioural intention could potentially enhance screening uptake. Further studies are needed to establish the cause and effect relationship among these variables and screening uptake, as well as to evaluate the cost-effectiveness of such interventions.
Prevalence of overweight/obesity among the adult population in Ethiopia: a systematic review and meta-analysis
Authors: Kassie Ayelign Mengesha , Abate Biruk Beletew , Kassaw Mesfin Wudu
Published: August 2020

Background

Overweight and obesity are emerging public health problems in Ethiopia. However, primary study findings on the prevalence of overweight and obesity in Ethiopia are inconsistent. Therefore, this study aimed to estimate the pooled prevalence of overweight and obesity among adults in Ethiopia.

Methods

Studies that looked at overweight and obesity among adults were searched from four international databases. The search involved articles published from 1 January 2010 to 10 March 2020. The Cochran’s Q χ2 and the I2 test statistics were used to check heterogeneity among the studies. The funnel plot and Egger’s regression tests were also used to assess the presence of publication bias. Subgroup analysis was performed by residence, study setting, sample size and year of study. Sensitivity analysis was also done to assess the effect of a single study on the pooled estimates. Data analysis was done using STATA V.14 software program.

Results

A total of 16 studies with 19 527 study participants were included in this systematic review and meta-analysis. The estimated pooled prevalence of overweight among adults in Ethiopia was 20.4%, and after adjustment for publication bias with the trim-and-fill analysis, the estimated prevalence rate was changed to 19%. Besides, the estimated pooled prevalence of obesity was 5.4%. The prevalence of overweight was higher, 22.6% in studies published since 2015, 22.4% in studies conducted only in urban settings and 24.4% in studies with small sample size (≤384 participants). Similarly, the prevalence of obesity was 6.9% in studies published since 2015, 6.2% in studies conducted only in urban settings, 6.4% in institution-based settings and 9.6% in studies with small sample size.

Conclusion

The prevalence of overweight and obesity is high in Ethiopia compared with previous studies. This needs large scale awareness creation campaigns and situation-based and context-specific prevention strategies.
Increasing identification of foot at risk of complications in patients with diabetes: a quality improvement project in an urban primary health centre in India
Authors: Mehndiratta Abha , Mishra Satish Chandra , Bhandarkar Prashant , Chhatbar Kunal , Cluzeau Francoise , PrimaryCareDoctors Team
Published: August 2020

The majority of foot amputations are preventable in people with diabetes. Guidelines recommend that people with diabetes should receive a foot examination for risk assessment, at least annually. In an audit at a primary health centre (PHC) in Mumbai, India, no patient with diabetes was offered preventive foot assessment in preceding 12 months. Problem analysis identified a lack of clinic policy, training and equipment for foot assessment. There was no standardised referral pathway for patients identified with foot at risk of diabetes complications. Furthermore, limited data review, high patient volumes and little time available with healthcare providers were important constraints. A quality improvement project was carried out at the PHC from January to September 2017. The project aimed at increasing compliance to standardised foot assessment in patients with diabetes presenting to the PHC from a baseline of 0% to 100% over 6 months. This would help identify patients having a foot at risk of complications due to diabetes. The Quality Standard on foot assessment was adopted from the Ministry of Health and Family Welfare Diabetic Foot Guideline. The electronic medical record (EMR) was standardised, health providers were trained, PHC processes and referral pathways were redesigned. Plan-Do-Study-Act was used to address barriers with weekly data review. 88.2% (848) of patients with diabetes visiting the PHC during the study period received a foot examination. Out of these, 11% (95) were identified to have a foot at risk and referred to a specialist foot centre. 57% of referred patients followed with specialised foot protection services. Training of healthcare providers, standardisation of processes and regular data feedback can improve diabetic foot care. Integrating quality indicators in the EMR helps monitor compliance. The inability to use doctor’s time efficiently was the biggest challenge and sustaining the change will require organisational changes with suitable task shifting.
Development of a hub and spoke model for quality improvement in rural and urban healthcare settings in India: a pilot study
Authors: Srivastava Sushil , Datta Vikram , Garde Rahul , Singh Mahtab , Sooden Ankur , Pemde Harish , Jain Manish , Shivkumar Poonam , Bang Akash , Kumari Prabha , Makhija Sonia , Ravi Tarun , Mehta Sumita , Garg Bishan Singh , Mehta Rajesh
Published: August 2020

Objective

Hub and spoke model has been used across industries to augment peripheral services by centralising key resources. This exercise evaluated the feasibility of whether such a model can be developed and implemented for quality improvement across rural and urban settings in India with support from a network for quality improvement.

Methods

This model was implemented using support from the state and district administration. Medical colleges were designated as hubs and the secondary and primary care facilities as spokes. Training in quality improvement (QI) was done using WHO’s point of care quality improvement methodology. Identified personnel from hubs were also trained as mentors. Both network mentors (from QI network) and hub-mentors (from medical colleges) undertook mentoring visits to their allotted facilities. Each of the participating facility completed their QI projects with support from mentors.

Results

Two QI training workshops and two experience sharing sessions were conducted for implementing the model. A total of 34 mentoring visits were undertaken by network mentors instead of planned 14 visits and rural hub-mentors could undertake only four visits against planned 18 visits. Ten QI projects were successfully completed by teams, 80% of these projects started during the initial intensive phase of mentoring. The projects ranged from 3 to 10 months with median duration being 5 months.

Discussion

Various components of a health system must work in synergy to sustain improvements in quality of care. Quality networks and collaboratives can play a significant role in creating this synergy. Active participation of district and state administration is a critical factor to produce a culture of quality in the health system.
Utility of CT venography in monitoring stent patency in idiopathic intracranial hypertension: retrospective single-center study
Authors: Shlapak Darya P , Lanzino Giuseppe , Morris Pearse P , Theiler Amy R , Brinjikji Waleed
Published: August 2020

Background

Cerebral venous sinus stenting is an established treatment for patients with idiopathic intracranial hypertension (IIH), refractory to medical management and with stenotic venous sinus on conventional cerebral venography. Currently, there are no clear guidelines on optimal noninvasive imaging modality for routine post-stenting follow-up. We investigated diagnostic yield of CT venography (CTV) for evaluation of stent patency.

Methods

We reviewed our clinical database of patients with a diagnosis of IIH, who underwent stenting of stenotic transverse or transverse/sigmoid sinus junction. Patients who had follow-up CTVs after more than 30 days were included in the final study group. All CTVs were reviewed by two readers for in-stent thrombosis, extrinsic stent compression, juxta-stent stenosis, and new contralateral venous sinus stenosis. Inter-observer agreement and association of stent patency with clinical outcomes (headache and papilledema) were assessed.

Results

In all 36 included patients with 38 cerebral venograms for stenting, follow-up CTVs demonstrated adequate opacifications of the venous sinuses and stents for confident evaluation for in-stent thrombosis, extrinsic stent compression, juxta-stent stenosis, and new contralateral venous sinus stenosis, with inter-observer agreement coefficient of 0.7, 1.0, 0.8, and 1.0 respectively. Association between abnormal CTV and higher rates of persistent headache and lower rates of headache improvement/resolution was statistically significant (P-value of 0.01).

Conclusion

CTV is a reliable noninvasive imaging modality for evaluation of cerebral venous sinuses and stent patency following treatment of idiopathic intracranial hypertension with venous sinus stenting and could be used as a routine follow-up study.
Emergency cricothyrotomy during the COVID-19 pandemic: how to suppress aerosolization
Authors: Issa Nabil , Liddy Whitney E , Samant Sandeep , Conley David B , Kern Robert C , Hungness Eric S , Barsuk Jeffrey H
Published: August 2020

Background

Cricothyrotomy is associated with significant aerosolization that increases the potential risk of infection among healthcare providers. It is important to identify simple yet effective methods to suppress aerosolization and improve the safety of healthcare providers.

Methods

5 ear, nose and throat and general surgeons used a locally developed hybrid cricothyrotomy simulator with a porcine trachea to test three draping methods to suppress aerosolization during the procedure: an X-ray cassette drape, dry operating room (OR) towels and wet OR towels. The three methods were judged based on three categories: effectiveness of suppression, availability in all healthcare systems and ease of handling.

Results

All five surgeons performed the procedure independently using each of the three suppression methods. The wet OR towel drape was found to be an effective method to suppress aerosolization, and it did not hinder the surgeons from performing the procedure accurately. This finding was confirmed by using an atomized fluorescein dye injection into the porcine trachea, representing aerosolized material while performing the procedure.

Conclusions

We present a novel intervention using wet towels to suppress aerosolization during cricothyrotomy. Wet towels are cheap and readily available within any healthcare setting regardless of the financial resources available.
Development of RNA-seq-based molecular markers for characterizing Thinopyrum bessarabicum and Secale introgressions in wheat
Authors: Singh Amit K. , Lo Kitty , Dong Chongmei , Zhang Peng , Trethowan Richard M. , Sharp Peter J.
Published: August 2020

Sequence-based markers have added a new dimension in the efficiency of identifying alien introgressions in wheat. Expressed sequence tag-sequence tagged sites (EST-STS) markers have proved useful in tracing alien chromatin. In this study, we report the development of Thinopyrum bessarabicum- and Secale anatolicum-specific EST-STS markers and their application in tracing respective alien chromatin introgressions in wheat. The parental lines, Chinese Spring (CS), ISR991.1 (CS/Th. bessarabicum amphidiploid), and ISR1049.2 (CS/Secale anatolicum amphidiploid), were used as core experimental materials. Using comparative analysis of RNA-Seq data, 10 903 and 10 660 candidate sequences specific to Th. bessarabicum and S. anatolicum, respectively, were assembled and identified. To validate the genome specificity of these candidate sequences, 68 and 64 EST-STS markers were developed from randomly selected candidate sequences of Th. bessarabicum and S. anatolicum, respectively, and tested on sets of alien addition lines. Fifty-five and 53 markers for Th. bessarabicum and S. anatolicum chromatin, respectively, were assigned to chromosomal location(s), covering all seven chromosomes. Approximately 83% of S. anatolicum-specific markers were transferable to S. cereale. The genome-specific candidate sequences identified and the EST-STS markers developed will be valuable resources for exploitation of Th. bessarabicum and Secale species diversity in wheat and triticale breeding.
An Investigation of Vector Intensity Measures for Seismic Collapse Assessment Under Far-Field Aftershocks
Authors: Meigooni F. Soleiman , Tehranizadeh M.
Published: August 2020

Aftershock records have a considerable effect on the results of collapse assessments conducted on buildings. Thus, they should be selected cautiously. As the number of recorded aftershocks is not sufficient, mainshock records are often utilized instead. In order to increase the correlation between the aftershock time history and the seismic response of a structure, this research intends to investigate several Intensity Measures (IMs). For this study, three RC frames were considered. Forty-four far-field records from FEMAP-695 were selected as main and aftershock. Each building analysis was conducted under 44 mainshock–aftershock chains. According to the results, use of the summation of the first mode spectral acceleration value of aftershocks as the second part of a vector IM can lead to the sufficiency of the IM.
A Cost‐Benefit Methodology for Selecting Analytical Reinforced Concrete Corrosion Onset Models
Authors: Rakotovao Ravahatra N. , de Larrard T. , Duprat F. , Bastidas-Arteaga E. , Schoefs F.
Published: August 2020

This work focuses on predicting corrosion onset induced by concrete carbonation or chloride ingress when using analytical predictive models. The paper proposes a procedure that helps building and infrastructure managers to select an appropriate model depending on the available information and the means granted to auscultation campaigns. The approach proposed combines the costs of input parameters, their relative importance, the benefits brought through obtaining parameters, and the maintenance strategy of the manager. Costs represent the intellectual investment to obtain parameters. This encompasses the time spent to obtain and analyze a result and the required expertise. Relative importance and benefits are obtained from sensitivity analysis. The effect of the maintenance strategy is introduced through a scalar called efficiency of the model. The proposed methodology is illustrated with two case studies where it is supposed that more or less extended information is available. Three concrete qualities are also considered in the case studies. The results highlight that the available data and concrete type have significant impacts on the selection of the most appropriate model.
Assessment of WRF Land Surface Model Performance over West Africa
Authors: Achugbu Ifeanyi C. , Dudhia Jimy , Olufayo Ayorinde A. , Balogun Ifeoluwa A. , Adefisan Elijah A. , Gbode Imoleayo E.
Published: August 2020

Simulations with four land surface models (LSMs) (i.e., Noah, Noah-MP, Noah-MP with ground water GW option, and CLM4) using the Weather Research and Forecasting (WRF) model at 12 km horizontal grid resolution were carried out as two sets for 3 months (December–February 2011/2012 and July–September 2012) over West Africa. The objective is to assess the performance of WRF LSMs in simulating meteorological parameters over West Africa. The model precipitation was assessed against TRMM while surface temperature was compared with the ERA-Interim reanalysis dataset. Results show that the LSMs performed differently for different variables in different land-surface conditions. Based on precipitation and temperature, Noah-MP GW is overall the best for all the variables and seasons in combination, while Noah came last. Specifically, Noah-MP GW performed best for JAS temperature and precipitation; CLM4 was the best in simulating DJF precipitation, while Noah was the best in simulating DJF temperature. Noah-MP GW has the wettest Sahel while Noah has the driest one. The strength of the Tropical Easterly Jet (TEJ) is strongest in Noah-MP GW and Noah-MP compared with that in CLM4 and Noah. The core of the African Easterly Jet (AEJ) lies around 12°N in Noah and 15°N for Noah-MP GW. Noah-MP GW and Noah-MP simulations have stronger influx of moisture advection from the southwesterly monsoonal wind than the CLM4 and Noah with Noah showing the least influx. Also, analysis of the evaporative fraction shows sharp gradient for Noah-MP GW and Noah-MP with wetter Sahel further to the north and further to the south for Noah. Noah-MP-GW has the highest amount of soil moisture, while the CLM4 has the least for both the JAS and DJF seasons. The CLM4 has the highest LH for both DJF and JAS seasons but however has the least SH for both DJF and JAS seasons. The principal difference between the LSMs is in the vegetation representation, description, and parameterization of the soil water column; hence, improvement is recommended in this regard.
Prevalence, Antimicrobial Susceptibility Pattern, and Associated Factors of Urinary Tract Infections among Pregnant and Nonpregnant Women at Public Health Facilities, Harar, Eastern Ethiopia: A Comparative Cross-Sectional Study
Authors: Abate Degu , Marami Dadi , Letta Shiferaw
Published: August 2020

Background. Urinary tract infection is one of the most common health problems worldwide, afflicting many women in reproductive age, especially in developing countries. Increased risk of infection has been attributed to pregnancy and antimicrobial resistance. Objective. To compare the prevalence, antimicrobial susceptibility pattern of the bacteria and associated factors of urinary tract infections among pregnant and nonpregnant women attending public health facilities, Harar, Eastern Ethiopia. Methods. A health facility-based comparative cross-sectional study was conducted among 651 randomly selected women from public health facilities, Harar, Eastern Ethiopia, between February 2017 and December 2017. Pertinent data were collected through a face-to-face interview using a structured questionnaire. The midstream urine specimen was collected and cultured on cysteine-lactose-electrolyte-deficient agar and blood agar. Pure isolates were tested against the ten most prescribed antimicrobials using the Kirby-Bauer disk diffusion method. Data were entered and analysed using Statistical Program for Social Sciences version 21. A p value <0.05 was considered statistically significant. Results. The overall prevalence of significant bacteriuria was 23% (95% CI: 13.6, 26.8). The higher proportion of bacteria were isolated from pregnant women (14.1%) compared to nonpregnant women (8.9%). Escherichia coli (28.8%) and Streptococcus aureus (14.3%) were the most common isolates. E. coli was resistant to amoxicillin (83.3%), trimethoprim-sulfamethoxazole (78.6%), and ciprofloxacin (81%), whereas S. aureus was resistant to chloramphenicol (81%), erythromycin (81%), and amoxicillin (76.2%). Current symptoms, and history of catheterization increase the likelihood of urinary tract infections. Conclusion. Pregnant women were more likely infected with bacterial pathogens than nonpregnant women. Current symptoms, and catheterization increase the odds of urinary tract infections. More than half of the isolates were resistant to the commonly prescribed antimicrobials. Regular assessment of urinary tract infections and antimicrobial resistance are recommended to provide effective therapy and thereby prevent urinary tract complications.