bluuebunny/crossref_metadata_2025 huggingface dataset:
Designing low-cost, accurate cervical screening strategies that take into account COVID-19: a role for self-sampled HPV typing
Authors: Ajenifuja Kayode Olusegun , Belinson Jerome , Goldstein Andrew , Desai Kanan T. , de Sanjose Silvia , Schiffman Mark
Published: October 2020

Background

We propose an economical cervical screening research and implementation strategy designed to take into account the typically slow natural history of cervical cancer and the severe but hopefully temporary impact of COVID-19. The commentary introduces the practical validation of some critical components of the strategy, described in three manuscripts detailing recent project results in Asia and Africa.

The main phases of a cervical screening program are 1) primary screening of women in the general population, 2) triage testing of the small minority of women that screen positive to determine need for treatment, and 3) treatment of triage-positive women thought to be at highest risk of precancer or even cancer. In each phase, attention must now be paid to safety in relation to SARS-CoV-2 transmission. The new imperatives of the COVID-19 pandemic support self-sampled HPV testing as the primary cervical screening method. Most women can be reassured for several years by a negative test performed on a self-sample collected at home, without need of clinic visit and speculum examination. The advent of relatively inexpensive, rapid and accurate HPV DNA testing makes it possible to return screening results from self-sampling very soon after specimen collection, minimizing loss to follow-up. Partial HPV typing provides important risk stratification useful for triage of HPV-positive women. A second “triage” test is often useful to guide management. In lower-resource settings, visual inspection with acetic acid (VIA) is still proposed but it is inaccurate and poorly reproducible, misclassifying the risk stratification gained by primary HPV testing. A deep-learning based approach to recognizing cervical precancer, adaptable to a smartphone camera, is being validated to improve VIA performance. The advent and approval of thermal ablation permits quick, affordable and safe, immediate treatment at the triage clinic of the majority of HPV-positive, triage-positive women.

Conclusions

Overall, only a small percentage of women in cervical screening programs need to attend the hospital clinic for a surgical procedure, particularly when screening is targeted to the optimal age range for detection of precancer rather than older ages with decreased visual screening performance and higher risks of hard-to-treat outcomes including invasive cancer.
AAV9-Retro mediates efficient transduction with axon terminal absorption and blood–brain barrier transportation
Authors: Lin Kunzhang , Zhong Xin , Li Lei , Ying Min , Yang Tian , Zhang Zhijian , He Xiaobin , Xu Fuqiang
Published: October 2020

Recombinant adeno-associated viruses (rAAVs), particularly those that permit efficient gene transfer to neurons from axonal terminals or across the blood–brain barrier, are useful vehicles for structural and functional studies of the neural circuit and for the treatment of many gene-deficient brain diseases that need to compensate for the correct genes in every cell in the whole brain. However, AAVs with these two advantages have not been reported. Here, we describe a new capsid engineering method, which exploits the combination of different capsids and aims to yield a capsid that can provide more alternative routes of administration that are more suitable for the wide-scale transduction of the central nervous system (CNS). A new AAV variant, AAV9-Retro, was developed by inserting the 10-mer peptide fragment from AAV2-Retro into the capsid of AAV9, and the biodistribution properties were evaluated in mice. By intracranial and intravenous injection in the mice, we found that AAV9-Retro can retrogradely infect projection neurons with an efficiency comparable to that of AAV2-Retro and retains the characteristic of AAV9, which can be transported across the nervous system. Our strategy provides a new tool for the manipulation of neural circuits and future preclinical and clinical treatment of some neurological and neurodegenerative disorders.
Clinical and imaging features of pediatric COVID-19
Authors: Zhang Yu , Xie Ru-Ming , He Yu-Lin , Xing Li-Hong , Dong Li , Zhang Jian-Zhong , Xing Wei-Hong , Lv Xiao-Yan , Lu Yi-Bo , Liu Qiang , Lin Ling-Bo , Liu Gui-Zeng , Li Li , Li Pan , Xie Yuan-Zhong , Ni Zhi-Yu , Yin Xiao-Ping , Li Hong-Jun , Gao Bu-Lang
Published: October 2020

Background

Pediatric COVID-19 is relatively mild and may vary from that in adults. This study was to investigate the epidemic, clinical, and imaging features of pediatric COVID-19 pneumonia for early diagnosis and treatment.

Methods

Forty-one children infected with COVID-19 were analyzed in the epidemic, clinical and imaging data.

Results

Among 30 children with mild COVID-19, seven had no symptoms, fifteen had low or mediate fever, and eight presented with cough, nasal congestion, diarrhea, headache, or fatigue. Among eleven children with moderate COVID-19, nine presented with low or mediate fever, accompanied with cough and runny nose, and two had no symptoms. Significantly (P < 0.05) more children had a greater rate of cough in moderate than in mild COVID-19. Thirty children with mild COVID-19 were negative in pulmonary CT imaging, whereas eleven children with moderate COVID-19 had pulmonary lesions, including ground glass opacity in ten (90.9%), patches of high density in six (54.5%), consolidation in three (27.3%), and enlarged bronchovascular bundles in seven (63.6%). The lesions were distributed along the bronchus in five patients (45.5%). The lymph nodes were enlarged in the pulmonary hilum in two patients (18.2%). The lesions were presented in the right upper lobe in two patients (18.1%), right middle lobe in one (9.1%), right lower lobe in six (54.5%), left upper lobe in five (45.5%), and left lower lobe in eight (72.7%).

Conclusions

Children with COVID-19 have mild or moderate clinical and imaging presentations. A better understanding of the clinical and CT imaging helps ascertaining those with negative nucleic acid and reducing misdiagnosis rate for those with atypical and concealed symptoms.
Cancer predictive studies
Authors: Amelio Ivano , Bertolo Riccardo , Bove Pierluigi , Candi Eleonora , Chiocchi Marcello , Cipriani Chiara , Di Daniele Nicola , Ganini Carlo , Juhl Hartmut , Mauriello Alessandro , Marani Carla , Marshall John , Montanaro Manuela , Palmieri Giampiero , Piacentini Mauro , Sica Giuseppe , Tesauro Manfredi , Rovella Valentina , Tisone Giuseppe , Shi Yufang , Wang Ying , Melino Gerry
Published: October 2020

The identification of individual or clusters of predictive genetic alterations might help in defining the outcome of cancer treatment, allowing for the stratification of patients into distinct cohorts for selective therapeutic protocols. Neuroblastoma (NB) is the most common extracranial childhood tumour, clinically defined in five distinct stages (1–4 & 4S), where stages 3–4 define chemotherapy-resistant, highly aggressive disease phases. NB is a model for geneticists and molecular biologists to classify genetic abnormalities and identify causative disease genes. Despite highly intensive basic research, improvements on clinical outcome have been predominantly observed for less aggressive cancers, that is stages 1,2 and 4S. Therefore, stages 3–4 NB are still complicated at the therapeutic level and require more intense fundamental research. Using neuroblastoma as a model system, here we herein outline how cancer prediction studies can help at steering preclinical and clinical research toward the identification and exploitation of specific genetic landscape. This might result in maximising the therapeutic success and minimizing harmful effects in cancer patients.
Doppler radar rainfall prediction and gauge data
Authors: Lansford Jesse W. , Walsh Tyson H. , Hromadka T. V. , Rao P.
Published: October 2020

Objective

The data herein represents multiple gauge sets and multiple radar sites of like-type Doppler data sets combined to produce populations of ordered pairs. Publications spanning decades yet specific to Doppler radar sites contain graphs of data pairs of Doppler radar precipitation estimates versus rain gauge precipitation readings.

Data description

Taken from multiple sources, the data set represents several radar sites and rain gauge sites combined for 8830 data points. The data is relevant in various applications of hydrometeorology and engineering as well as weather forecasting. Further, the importance of accuracy in radar and precipitation estimates continues to increase, necessitating the incorporation of as much data as possible.
Rebelled epigenome: histone H3S10 phosphorylation and H3S10 kinases in cancer biology and therapy
Authors: Komar Dorota , Juszczynski Przemyslaw
Published: October 2020

Background

With the discovery that more than half of human cancers harbor mutations in chromatin proteins, deregulation of epigenetic mechanisms has been recognized a hallmark of malignant transformation. Post-translational modifications (PTMs) of histone proteins, as main components of epigenetic regulatory machinery, are also broadly accepted as therapeutic target. Current “epigenetic” therapies target predominantly writers, erasers and readers of histone acetylation and (to a lesser extent) methylation, leaving other types of PTMs largely unexplored. One of them is the phosphorylation of serine 10 on histone H3 (H3S10ph).

Main body

H3S10ph is emerging as an important player in the initiation and propagation of cancer, as it facilitates cellular malignant transformation and participates in fundamental cellular functions. In normal cells this histone mark dictates the hierarchy of additional histone modifications involved in the formation of protein binding scaffolds, transcriptional regulation, blocking repressive epigenetic information and shielding gene regions from heterochromatin spreading. During cell division, this mark is essential for chromosome condensation and segregation. It is also involved in the function of specific DNA–RNA hybrids, called R-loops, which modulate transcription and facilitate chromosomal instability. Increase in H3S10ph is observed in numerous cancer types and its abundance has been associated with inferior prognosis. Many H3S10-kinases, including MSK1/2, PIM1, CDK8 and AURORA kinases, have been long considered targets in cancer therapy. However, since these proteins also participate in other critical processes, including signal transduction, apoptotic signaling, metabolic fitness and transcription, their chromatin functions are often neglected.

Conclusions

H3S10ph and enzymes responsible for deposition of this histone modification are important for chromatin activity and oncogenesis. Epigenetic-drugs targeting this axis of modifications, potentially in combination with conventional or targeted therapy, provide a promising angle in search for knowledge-driven therapeutic strategies in oncology.
Aiming for a shorter time to diagnosis: pediatric eosinophilic esophagitis in British Columbia
Authors: Jia Jocelyn , Chan Edmond S. , Avinashi Vishal , Hsu Elaine , Ko Hin Hin , Soller Lianne
Published: October 2020

Longer time to diagnosis for patients with eosinophilic esophagitis can lead to adverse patient outcomes, but the length of diagnostic delay has not been quantified for patients with eosinophilic esophagitis in Canada. Our study defines the time to diagnosis (TTD) for pediatric patients with eosinophilic esophagitis in British Columbia and identifies factors that predict increased time to diagnosis. The median TTD was 21 months (1.75 years; IQR = 7, 45) with a median age at EoE diagnosis of 105 months (8.75 years; IQR = 44, 156). Caucasians experienced significantly longer TTD compared to other ethnicities (24 months (IQR = 7, 52) and 12 months (IQR = 4.5, 23) respectively, p = 0.008). Caucasian ethnicity (p = 0.037) and older age at the time of diagnosis (p = 0.006) predicted increased TTD. Our model explained 7.9% (Adjusted R2 = 0.079) of the total variance for our cohort.
Stochastic mathematical model for the spread and control of Corona virus
Authors: Hussain Sultan , Zeb Anwar , Rasheed Akhter , Saeed Tareq
Published: October 2020

This work is devoted to a stochastic model on the spread and control of corona virus (COVID-19), in which the total population of a corona infected area is divided into susceptible, infected, and recovered classes. In reality, the number of individuals who get disease, the number of deaths due to corona virus, and the number of recovered are stochastic, because nobody can tell the exact value of these numbers in the future. The models containing these terms must be stochastic. Such numbers are estimated and counted by a random process called a Poisson process (or birth process). We construct an SIR-type model in which the above numbers are stochastic and counted by a Poisson process. To understand the spread and control of corona virus in a better way, we first study the stability of the corresponding deterministic model, investigate the unique nonnegative strong solution and an inequality managing of which leads to control of the virus. After this, we pass to the stochastic model and show the existence of a unique strong solution. Next, we use the supermartingale approach to investigate a bound managing of which also leads to decrease of the number of infected individuals. Finally, we use the data of the COVOD-19 in USA to calculate the intensity of Poisson processes and verify our results.
Consumption smoothing and price enhancement motives for grain storage: empirical perspectives from rural Ethiopia
Authors: Tesfaye Wondimagegn , Gebremariam Gebrelibanos
Published: October 2020

Consumption smoothing and temporal price arbitrage are the two main economic motives for grain storage in semi-subsistence economies. Nonetheless, little has been documented on the determinants of households’ grain storage behavior. Using a rich panel data from maize producing households in Ethiopia, this paper investigates the determinants of households’ decision to store grain for consumption and/or for the market. We found that grain storage is mainly determined by climatic factors, technological innovations, and shocks. Grain storage for consumption and for the markets are not mutually exclusive decisions. While the decisions made by the households to store maize for consumption and for the markets are influenced by a host of similar factors, the effects of climatic factors and infrastructure are found to be heterogeneous.
Weekly group tummy time classes are feasible and acceptable to mothers with infants: a pilot cluster randomized controlled trial
Authors: Hewitt Lyndel , Stephens Samantha , Spencer Abbe , Stanley Rebecca M. , Okely Anthony D.
Published: October 2020

Background

The World Health Organization recommends 30 min of tummy time daily for improved motor development and reduced likelihood of plagiocephaly. As only 30% of infants meet this recommendation, parents require strategies and support to increase this proportion.

Methods

The aim of this study was to determine the feasibility, acceptability, and potential efficacy of a group intervention to promote tummy time. The design is a cluster randomized controlled trial with concealed allocation, assessor blinding, and intention-to-treat analysis. Five groups of healthy infants (N = 35, baseline mean (SD) age 5.9 (2.8) weeks) and their mothers attending local mother’s groups (Australia) were randomly allocated to the intervention or control group. The intervention group received group tummy time classes in addition to usual care. The control group received usual care with their child and family health nurse. Primary outcomes were intervention feasibility and acceptability. Secondary outcomes were tummy time duration (accelerometry), adherence to physical activity guidelines, head shape, and motor development. Measures were taken at baseline, post-intervention, and when infants were 6 months of age. Analyses were by linear mixed models and Cohen’s d statistic.

Results

Recruitment, retention, and collection of objective data met feasibility targets. Acceptability was also met with intervention mothers reporting the information, goal planning, and handouts significantly more useful and relevant than control group mothers (p < 0.01). Moderate effect sizes were also found at post-intervention for tummy time duration, adherence to physical activity guidelines and infant ability in prone and supine favoring the intervention group (intervention infants had a mean of 30 min and 30% adherence to guidelines (95% CI 0 to 60.6 min) compared to the control infants who had a mean of 16.6 min and 13% adherence to the guidelines (95% CI 0 to 42.1 min, Cohen’s d = 0.5). Limitations were the small sample size, 4-week intervention, limited accelerometer use, and a homogenous sample of participants.

Conclusion

Group tummy time classes delivered in a mother’s group setting were shown to be feasible and acceptable. A larger randomized controlled trial is warranted.

Trial registration

ANZCTR, ACTRN12617001298303p. Registered 11 September 2017
High serum uric acid within the normal range is a useful predictor of hypertension among Japanese community-dwelling elderly women
Authors: Kawamoto Ryuichi , Ninomiya Daisuke , Akase Taichi , Asuka Kikuchi , Kumagi Teru
Published: October 2020

Background

The risk associated with serum uric acid (SUA) levels when within the normal range is unknown. This study aims to examine whether SUA within the normal range is a predictor of hypertension.

Methods

The subjects comprised 704 men aged 71 ± 9 (mean ± standard deviation) years and 946 women aged 70 ± 8 years recruited for a survey at the community based annual medical check-up. The main outcome was the presence of hypertension (antihypertensive medication and/or having SBP ≥140 mmHg and/or DBP ≥90 mmHg).

Results

At baseline, 467 (66.3%) men and 608 (64.3%) women had hypertension. Comparing to lowest quartile in women (SUA-1, uric acid < 4.1 mg/dL), the unadjusted odds ratios (ORs) [95% confidence interval (CI)] for hypertension of SUA-2 (4.1 to 4.7 mg/dL), SUA-3 (4.8 to 5.4 mg/dL), and SUA-4 (≥5.5 mg/dL) were 1.11 (0.78–1.59), 1.75 (1.20–2.55), and 1.89 (1.30–2.77), respectively. These associations were apparent even after adjustments for age, but ORs were attenuated after adjusting for all confounding factors. During a follow-up of 3.0 years, there were 35 (24.0%) hypertension cases in men and 51 (20.8%) in women. In women only, a significant association between increased SUA categories and incidence of hypertension was observed, and the multivariate-ORs (95% (CI) for incident hypertension of SUA-3 (4.5–5.2 mg/dL) and SUA-4 (≥5.3 mg/dL) were 2.23 (0.81–6.11) and 3.84 (1.36–10.8), respectively.

Conclusions

These results suggest that baseline SUA within the normal range could be an important predictor for incidence of hypertension in Japanese community-dwelling elderly women.
Partnering with patients to get better outcomes with chimeric antigen receptor T-cell therapy: towards engagement of patients in early phase trials
Authors: Foster Madison , Fergusson Dean A , Hawrysh Terry , Presseau Justin , Kekre Natasha , Schwartz Stuart , Castillo Gisell , Asad Sarah , Fox Grace , Atkins Harold , Thavorn Kednapa , Montroy Joshua , Holt Robert A , Monfaredi Zarah , Lalu Manoj M
Published: October 2020

Aim

Though patient engagement in clinical research is growing, recent reports suggest few clinical trials report on such activities. To address this gap, we describe our approach to patient engagement in the development of a clinical trial protocol to assess a new immunotherapy for blood cancer (chimeric antigen receptor T-cell therapy, CAR-T cell therapy).

Methods

Our team developed a clinical trial protocol by working with patient partners from inception. Two patient partners with lived blood cancer experience were identified through referrals from our team’s professional network and patient organization contacts. Our patient partners were onboarded to the team and engaged in several studies conducted to develop the clinical trial protocol, including a systematic review of the existing literature on the therapy, patient interviews and a survey to obtain perspectives on barriers and enablers to participating in the trial, an early economic analysis, and a retrospective cohort study.

Results

Engaging patient partners enhanced our research in ways that would not have otherwise occurred. By selecting patient important outcomes for data collection, our partners helped flag that quality of life and health utility measures have not been reported in previous CAR-T cell therapy trials for blood cancer. Our partners also co-developed a non-technical summary of the systematic review that summarized results in an accessible manner. Our patient partners reviewed interview and survey questions, to improve the language and appropriateness; provided recruitment suggestions; and provided a patient perspective on the results, thereby confirming the importance of findings. Input was also obtained on costs for the early economic analysis. Our patient partners identified costs that may be a burden to both patients and caregivers during a trial and helped to confirm that the overall structure of the economic model reflected the patient care pathway. Our patient partners also shared their diagnosis and treatment stories, which helped to provide the research team with insight into this experience.

Conclusions

Contributions by our patient partners were invaluable to each component study, as well as the overall development of the trial protocol. We plan to use this approach in the future in order to meaningfully engage patients in the development of other clinical trials; we also hope that by reporting our methods this will help other research teams to do the same.

Trial registration

Affiliated with the development of NCT03765177.
A competitive analysis of EU ports by fixing spatial and economic dimensions
Authors: Quintano Claudio , Mazzocchi Paolo , Rocca Antonella
Published: October 2020

The purpose of this paper is to evaluate the efficiencies of ten of the leading European ports. The motivation of the research refers to the relevant topic of selection of indicators that can be involved in the comparative analysis. Concerning the theoretical model, the authors’ efforts are especially directed towards the usage of the stochastic frontier analysis (SFA) and of the data envelopment analysis (DEA). These techniques have been widely adopted for benchmarking and performance evaluation by involving indicators based on data from National Accounts. If one of these indicators, such as labour force consistency, is not available at a specific level of aggregation, detailed assumptions are needed to address this complication. The present study proposes an additive model in order to provide an estimation of ports’ economic activities by fixing the port activity boundaries and the spatial perimeter of the firms investigated. Several NUTS (Nomenclature of Territorial Units for Statistics) levels and NACE (EU Statistical Classification of Economic Activities) codes are fixed to offer a useful comparable labour indicator. Empirical results reveal that each port area presents a combination of the NACE categories which significantly impact the efficiency that can reach very high performance values through both the SFA and DEA techniques. Since the managers can choose which sectors to improve, which particular improvement strategies to support, which specific service to add, their decisions impact this performance evaluation, and their performance can be verified through the approaches proposed.
Pathogenicity of indigenous Beauveria bassiana (Balsamo) against Ceratitis capitata Wiedemann (Diptera: Tephritidae) under laboratory conditions
Authors: Chergui Sabrina , Boudjemaa Khadidja , Benzehra Abdelmadjid , Karaca Ismail
Published: October 2020

Background

The Mediterranean fruit fly, Ceratitis capitata (Wiedemann) (Diptera: Tephritidae), is the major insect pest of fruit production worldwide. Chemical control of this pest has induced the selection of resistant medflies populations and negative environmental impact. In addition, the use of pesticides has become an obstacle to the fresh agricultural products exported to many countries that restrict pesticides residues. The aim of this study was to propose alternatives based on the use of microbiological products for the control of C. capitata.

Main body

The pathogenicity of the Turkish isolate Beauveria bassiana BMAUM M6-4 was evaluated against immature stages and adult of C. capitata under laboratory conditions at a concentration of 107 conidia/ml via different routes of exposure. Conidial treatment was applied by spraying soil and filter paper against 3rd instar larvae and pupae. In contrast, the treatment was administered to adult males and females by contact and ingestion. The percentage of mortality was recorded on the 3rd, 7th, 12th and 15th day after inoculation. Obtained results showed that B. bassiana was very effective against the adult’s fly, where males were more susceptible than females in both treatments (contact and ingestion). This isolate was tested against 3rd instar larvae. It achieved an infection rate of 33.33 and 43.5% of the larvae treated on filter paper and in the soil, respectively. Application of conidial preparations to soil reduced insect emergence and CAN represent a promising strategy for fruit fly integrated management (57.33 and 56.66% emergence from the treatments in soil and filter paper).

Conclusion

Entomopathogenic fungi are promising as a biocontrol agent that can be used under different modes of ground application against larvae, prepupae and pupae, and/or as a bait spraying or contact against adults.
Development of anti-phishing browser based on random forest and rule of extraction framework
Authors: HR Mohith Gowda , MV Adithya , S Gunesh Prasad , S Vinay
Published: October 2020

Phishing is a technique under Social Engineering attacks which is most widely used to get user sensitive information, such as login credentials and credit and debit card information, etc. It is carried out by a person masquerading as an authentic individual. To protect web users from these attacks, various anti-phishing techniques are developed, but they fail to protect the user from these attacks in various ways. In this paper, we propose a novel technique to identify phishing websites effortlessly on the client side by proposing a novel browser architecture. In this system, we use the rule of extraction framework to extract the properties or features of a website using the URL only. This list consists of 30 different properties of a URL, which will later be used by the Random Forest Classification machine learning model to detect the authenticity of the website. A dataset consisting of 11,055 tuples is used to train the model. These processes are carried out on the client-side with the help of a redesigned browser architecture. Today Researches have come up with machine learning frameworks to detect phishing sites, but they are not in a state to be used by individuals having no technical knowledge. To make sure that these tools are accessible to every individual, we have improvised and introduced detection methods into the browser architecture named as ‘Embedded Phishing Detection Browser’ (EPDB), which is a novel method to preserve the existing user experience while improving the security. The newly designed browser architecture introduces a special segment to perform phishing detection operations in real-time. We have prototyped this technique to ensure maximum security, better accuracy of 99.36% in the identification of phishing websites in real-time.
Wave-equation time migration
Authors: Fomel Sergey , Kaur Harpreet
Published: October 2020

Time migration, as opposed to depth migration, suffers from two well-known shortcomings: (1) approximate equations are used for computing Green’s functions inside the imaging operator and (2) in case of lateral velocity variations, the transformation between the image-ray coordinates and the Cartesian coordinates is undefined in places where the image rays cross. We have found that the first limitation can be removed entirely by formulating time migration through wave propagation in image-ray coordinates. Our approach constructs a time-migrated image without relying on any kind of traveltime approximation by formulating an appropriate geometrically accurate acoustic wave equation in the time-migration domain. The advantage of this approach is that the propagation velocity in image-ray coordinates does not require expensive model building and can be approximated by quantities that are estimated in conventional time-domain processing. Synthetic and field data examples demonstrate the effectiveness of the proposed approach and show that the proposed imaging workflow leads to a significant uplift in terms of image quality and can bridge the gap between time and depth migrations. The image obtained by the proposed algorithm is correctly focused and mapped to depth coordinates; it is comparable to the image obtained by depth migration.
Primary care mental health services in Qatar
Authors: Wadoo Ovais , Ahmed Mohamed Ali Siddig , Reagu Shuja , Al Abdulla Samya Ahmad , Al Abdulla Majid Ali Y. A.
Published: October 2020

With rapid growth and development in recent decades, the State of Qatar has been redefining strategies and policies towards building a world-class healthcare system. Mental health has emerged as a priority area for development. As a result, mental health services in the region are being redefined and expanded, and this was realised with the launching of the ambitious National Mental Health Strategy in 2013. Traditionally, mental healthcare in Qatar had been considered to be the remit of psychiatrists within secondary care. The new strategy supported the transition towards community-based care. It outlined a plan to design and build a comprehensive and integrated mental health system, offering treatment in a range of settings. In this article, we provide an overview of the advent of primary care mental health services in Qatar. We discuss the historical aspects of psychiatric care and development of primary care mental health services in Qatar.
Metabolomics of Lean/Overweight Insulin-Resistant Females Reveals Alterations in Steroids and Fatty Acids
Authors: Diboun Ilhame , Al-Mansoori Layla , Al-Jaber Hend , Albagha Omar , Elrayess Mohamed A
Published: October 2020

Background

The global diabetes epidemic is largely attributed to obesity-triggered metabolic syndrome. However, the impact of insulin resistance (IR) prior to obesity on the high prevalence of diabetes and the molecular mediators remain largely unknown. This study aims to compare the metabolic profiling of apparently healthy lean/overweight participants with IR and insulin sensitivity (IS), and identify the metabolic pathways underlying IR.

Methods

In this cross-sectional study, clinical and metabolic data for 200 seemingly healthy young female participants (100 IR and 100 IS) was collected from Qatar Biobank. Orthogonal partial least square analysis was performed to assess the extent of separation between individuals from the 2 groups based on measured metabolites. Classical linear models were used to identify the metabolic signature of IR, followed by elastic-net-regularized generalized linear model (GLMNET) and receiver operating characteristic (ROC) analysis to determine top metabolites associated with IR.

Results

Compared to lean/overweight participants with IS, those with IR showed increased androgenic steroids, including androsterone glucuronide, in addition to various microbiota byproducts, such as the phenylalanine derivative carboxyethylphenylalanine. On the other hand, participants with IS had elevated levels of long-chain fatty acids. A ROC analysis suggested better discriminatory performance using 20 metabolites selected by GLMNET in comparison to the classical clinical traits (area under curve: 0.93 vs 0.73, respectively).

Conclusion

Our data confirm the multifactorial mechanism of IR with a diverse spectrum of emerging potential biomarkers, including steroids, long-chain fatty acids, and microbiota metabolites. Further studies are warranted to validate these markers for diagnostic and therapeutic applications.
Genotype-Phenotype Features of Germline Variants of the TMEM127 Pheochromocytoma Susceptibility Gene: A 10-Year Update
Authors: Armaiz-Pena Gustavo , Flores Shahida K , Cheng Zi-Ming , Zhang Xhingyu , Esquivel Emmanuel , Poullard Natalie , Vaidyanathan Anusha , Liu Qianqian , Michalek Joel , Santillan-Gomez Alfredo A , Liss Michael , Ahmadi Sara , Katselnik Daniel , Maldonado Enrique , Salgado Sarimar Agosto , Jimenez Camilo , Fishbein Lauren , Hamidi Oksana , Else Tobias , Lechan Ron , Tischler Art S , Benn Diana E , Dwight Trisha , Clifton-Bligh Rory , Sanso Gabriela , Barontini Marta , Vincent Deepa , Aronin Neil , Biondi Bernadette , Koops Maureen , Bowhay-Carnes Elizabeth , Gimenez-Roqueplo Anne-Paule , Alvarez-Eslava Andrea , Bruder Jan M , Kitano Mio , Burnichon Nelly , Ding Yanli , Dahia Patricia L M
Published: October 2020

Purpose

This work aimed to evaluate genotype-phenotype associations in individuals carrying germline variants of transmembrane protein 127 gene (TMEM127), a poorly known gene that confers susceptibility to pheochromocytoma (PHEO) and paraganglioma (PGL).

Design

Data were collected from a registry of probands with TMEM127 variants, published reports, and public databases.

Main Outcome Analysis

Clinical, genetic, and functional associations were determined.

Results

The cohort comprised 110 index patients (111 variants) with a mean age of 45 years (range, 21-84 years). Females were predominant (76 vs 34, P < .001). Most patients had PHEO (n = 94; 85.5%), although PGL (n = 10; 9%) and renal cell carcinoma (RCC, n = 6; 5.4%) were also detected, either alone or in combination with PHEO. One-third of the cases had multiple tumors, and known family history was reported in 15.4%. Metastatic PHEO/PGL was rare (2.8%). Epinephrine alone, or combined with norepinephrine, accounted for 82% of the catecholamine profiles of PHEO/PGLs. Most variants (n = 63) occurred only once and 13 were recurrent (2-12 times). Although nontruncating variants were less frequent than truncating changes overall, they were predominant in non-PHEO clinical presentations (36% PHEO-only vs 69% other, P < .001) and clustered disproportionately within transmembrane regions (P < .01), underscoring the relevance of these domains for TMEM127 function. Integration of clinical and previous experimental data supported classification of variants into 4 groups based on mutation type, localization, and predicted disruption.

Conclusions

Patients with TMEM127 variants often resemble sporadic nonmetastatic PHEOs. PGL and RCC may also co-occur, although their causal link requires further evaluation. We propose a new classification to predict variant pathogenicity and assist with carrier surveillance.
Η εφαρμογή του μοντέλου της ανεστραμμένης τάξης (flipped Classroom) στη Τριτοβάθμια Εκπαίδευση: ο λόγος στους φοιτητές
Authors: Ρακιτζή Καρολίνα , Μπότσογλου Καφένια , Ρουσσάκης Γιάννης
Published: October 2020

Οι διδάσκοντες της Τριτοβάθμιας Εκπαίδευσης αντιμετωπίζουν την πρόκληση της οργάνωση της διδασκαλίας και της μάθησης  κατά τρόπο που θα ανταποκρίνεται τις εκπαιδευτικές ανάγκες και τις εμπειρίες των φοιτητών τους, που τα τελευταία χρόνια έχουν κυρίως ψηφιακό υπόβαθρο. Η παραδοσιακή διδασκαλία με διάλεξη φαίνεται να μην τις καλύπτει·, αντιθέτως, εμφανίζεται να έχει ως αποτέλεσμα τόσο την ελλιπή επικοινωνία και αλληλεπίδραση μεταξύ των φοιτητών αλλά και μεταξύ φοιτητών – διδασκόντων, όσο και την αδυναμία ένταξης συνεργατικών μεθόδων εργασίας. Στο πλαίσιο αυτό, επιχειρήθηκε η εφαρμογή του καινοτόμου μοντέλου της ανεστραμμένης τάξης (flipped classroom). Η εργασία παρουσιάζει  όψεις αυτής της εφαρμογής, η οποία είχε τη μορφή έρευνας δράσης που διήρκησε ένα εξάμηνο και εφαρμόστηκε στο μάθημα «Σύγχρονες Παιδαγωγικές Προσεγγίσεις», στο Παιδαγωγικό Τμήμα Ειδικής Αγωγής του Πανεπιστημίου Θεσσαλίας με συμμετέχοντες 131 φοιτητές. Η θεματική ανάλυση περιεχομένου των εργασιών των συμμετεχόντων σε δύο φάσεις κωδικοποίησης οδηγούν σε συμπεράσματα ικανά να τροφοδοτήσουν τον στοχασμό της Πανεπιστημιακής Εκπαίδευσης. Σκιαγραφείται μια αισιόδοξη εικόνα τόσο σε διδακτικό επίπεδο με το αυξημένο ενδιαφέρον των φοιτητών να επιθυμούν να συμμετέχουν ενεργά στην εκπαιδευτική διαδικασία καθορίζοντας σε σημαντικό βαθμό της πορεία της, όσο και σε κοινωνικό συμβάλλοντας στην αλληλεπίδραση, τη συνεργασία και κατ’ επέκταση τη κοινωνικοποίησή τους εντός και εκτός της πανεπιστημιακής αίθουσας.
Δημιουργία Πολυμορφικού Εκπαιδευτικού Περιβάλλοντος με τη μέθοδο της ΕξΑΕ στην ενότητα «Ερευνώ και Ανακαλύπτω» της Στ’ τάξης: «Αναπνευστικό σύστημα»
Authors: Νιανιούρης Αντώνης , Καλογιαννάκης Μιχαήλ
Published: October 2020

Η παρούσα έρευνα αφορά τη δημιουργία και αποτίμηση του Πολυμορφικού Εκπαιδευτικού Περιβάλλοντος (ΠΕΠ) «Αναπνευστικό σύστημα», βασιζόμενο στην αντίστοιχη ενότητα του μαθήματος «Ερευνώ και Ανακαλύπτω» της Στ’ τάξης Δημοτικού σχολείου. Υλοποιήθηκε στηριζόμενο στις προδιαγραφές μεθοδολογίας υλικού εξ αποστάσεως εκπαίδευσης (εξΑΕ) και στις αρχές σχεδιασμού πολυμεσικών περιβαλλόντων. Σκοπός του υλικού είναι να λειτουργήσει ως επικουρικό εργαλείο για τον εκπαιδευτικό για τη διδασκαλία αυτής της ενότητας, αλλά και ως μέσο για τους μαθητές, διευκολύνοντάς τους κατά την επεξεργασία, κατανόηση και εμπέδωση του γνωστικού αντικειμένου στην πράξη.Αρχικά, αναλύεται το θεωρητικό πλαίσιο πάνω στο οποίο στηρίχθηκε τόσο η δημιουργία του ΠΕΠ, όσο και η ερευνητική αποτίμησή του. Στη συνέχεια, περιγράφονται τα δομικά μέρη του, καθώς και η μεθοδολογία και οι εφαρμογές για την ανάπτυξή του. Το «Αναπνευστικό σύστημα» διαρθρώνεται από τέσσερα μέρη: (1) την Εισαγωγή, (2) το κεφάλαιο της Αναπνοής, (3) το κεφάλαιο της Αναπνοής και Υγείας και την (4) Εμπέδωση. Το πολυμορφικό υλικό εμπεριέχει ένα πλήθος ψηφιακών δεδομένων πολλαπλών μορφών, όπως: κείμενα, εικόνες, κινούμενες εικόνες, ήχους και διαδραστικά βίντεο δίνοντας προτεραιότητα στην ενεργητική και συνεργατική μάθηση, αξιοποιώντας τα ενδιαφέροντα, τις ιδέες και τις εμπειρίες των μαθητών και προωθώντας τεχνικές διαφοροποιημένης διδασκαλίας όπως: τον καταιγισμό ιδεών, την υποστηρικτική μάθηση, τη φθίνουσα καθοδήγηση, την εργασία σε ομάδες, τα σχέδια δράσης, τη συγγραφή άρθρου, τη δημιουργία αφίσας, κ.α.Η μελέτη μας ολοκληρώνεται με μία ποιοτική αποτίμηση του υλικού για το αναπνευστικό σύστημα από δέκα εκπαιδευτικούς οι οποίοι αφού το μελέτησαν, κλήθηκαν μέσω ημιδομημένης συνέντευξης να το αξιολογήσουν. Από την ανάλυση περιεχομένου των συνεντεύξεων προέκυψαν ενδιαφέροντα στοιχεία για την παρουσίαση – δομή του, τη μεθοδολογική του επάρκεια και την ευχρηστία του περιεχομένου του. Επιπρόσθετα, επισημάνθηκαν οι προϋποθέσεις αξιοποίησής του στη διδακτική πράξη καθώς και προτάσεις - υποδείξεις για περαιτέρω βελτίωσή του.
Οπτικοακουστική Μάθηση και Τηλεδιάσκεψη στην εξΑΕ
Authors: Κανελλόπουλος Αθανάσιος , Κουτσούμπα Μαρία Ι. , Γκιόσος Ιωάννης
Published: October 2020

Η τηλεδιάσκεψη αποτελεί ένα επικοινωνιακό μέσο που δημιουργεί συνθήκες για την εξ αποστάσεως διδασκαλία πολύ κοντινές προς αυτές της δια ζώσης, ενώ δεν έχει μελετηθεί ιδιαίτερα ως προς τις παιδαγωγικές αρχές της εξΑΕ αλλά ούτε και ως προς τη λειτουργία της μάθησης. Σκοπός της παρούσας εργασίας είναι η διερεύνηση της σχέσης θεωριών, αρχών και γνωστικών προσεγγίσεων της οπτικοακουστικής μάθησης και αντίληψης με τη μαθησιακή διαδικασία μέσω τηλεδιάσκεψης στην εξΑΕ. Πρόκειται για μια θεωρητική εργασία που στηρίζεται στη βιβλιογραφική ανασκόπηση χωρίς, όμως, να συνιστά μία τυπική έρευνα βιβλιογραφικής ανασκόπησης. Οι κοινωνικο-συναισθηματικές σχέσεις μιας τηλε-κοινότητας διερεύνησης επηρεάζονται από τα οπτικοακουστικά μηνύματα (λεκτικά και μη) που εκπέμπονται, τα οποία και επιδρούν στην τηλε-γνωστική, στην τηλε-διδακτική και στην τηλε-κοινωνική παρουσία. Με την τηλεδιάσκεψη να αποτελεί ένα πολυμεσικό εργαλείο επικοινωνίας, η γνώση των οπτικοακουστικών θεωριών μάθησης είναι σημαντική. Η μάθηση μέσω τηλεδιάσκεψης στηρίζεται στην αισθητηριακή, και κυρίως στην οπτική, αντίληψη. Έτσι, οι αισθήσεις και οι δράσεις του σώματος των συμμετεχόντων στην τηλεδιάσκεψη θα πρέπει να οδηγούν σε μία αίσθηση «πραγματικότητας» στο συγκεκριμένο ηλεκτρονικό μαθησιακό περιβάλλον. Η επίδραση της οπτικοακουστικής αντίληψης και μάθησης στη μαθησιακή διαδικασία μέσω τηλεδιάσκεψης στην εξΑΕ αναδεικνύει, επίσης, τη σημασία της προσέγγισης της τελευταίας υπό το πρίσμα ενός νέου θεωρητικού πλαισίου, δεδομένου και των νέων συνθηκών που υπάρχουν στον χώρο της εκπαίδευσης στην Ελλάδα λόγω της υγειονομικής κρίσης που βιώνει η χώρα.
Bimodal distribution and set point HBV DNA viral loads in chronic infection: retrospective analysis of cohorts from the UK and South Africa
Authors: Downs Louise O. , Vawda Sabeehah , Bester Phillip Armand , Lythgoe Katrina A. , Wang Tingyan , McNaughton Anna L. , Smith David A. , Maponga Tongai , Freeman Oliver , Várnai Kinga A. , Davies Jim , Woods Kerrie , Fraser Christophe , Barnes Eleanor , Goedhals Dominique , Matthews Philippa C.
Published: October 2020

Hepatitis B virus (HBV) viral load (VL) is used as a biomarker to assess risk of disease progression, and to determine eligibility for treatment. While there is a well recognised association between VL and the expression of the viral e-antigen protein, the distributions of VL at a population level are not well described. We here present cross-sectional, observational HBV VL data from two large population cohorts in the UK and in South Africa, demonstrating a consistent bimodal distribution. The right skewed distribution and low median viral loads are different from the left-skew and higher viraemia in seen in HIV and hepatitis C virus (HCV) cohorts in the same settings. Using longitudinal data, we present evidence for a stable ‘set-point’ VL in peripheral blood during chronic HBV infection. These results are important to underpin improved understanding of HBV biology, to inform approaches to viral sequencing, and to plan public health interventions.
Case Report: Application of hepatitis B virus (HBV) deep sequencing to distinguish between acute and chronic infection
Authors: Downs Louise O. , McNaughton Anna L. , de Cesare Mariateresa , Ansari M. Azim , Martin Jacqueline , Woodrow Charles , Bowden Rory , Collier Jane , Barnes Eleanor , Matthews Philippa C.
Published: October 2020

Deep sequencing of the full-length hepatitis B virus (HBV) genome provides the opportunity to determine the extent to which viral diversity, genotype, polymorphisms, insertions and deletions may influence presentation and outcomes of disease. Increasing experience with analysis of HBV genomic data opens up the potential for using these data to inform insights into pathophysiology of infection and to underpin decision making in clinical practice. We here set out to undertake whole genome HBV sequencing from an adult who presented acutely unwell with a new diagnosis of HBV infection, and tested positive for both HBV anti-core IgM and IgG, possibly representing either acute hepatitis B infection (AHB) or chronic hepatitis B with an acute reactivation (CHB-AR). The distinction between these two scenarios may be important in predicting prognosis and underpinning treatment decisions, but can be challenging based on routine laboratory tests. Through application of deep whole-genome sequencing we typed the isolate as genotype-D1, and identified several minority variants including G1764A and G1986A substitutions in the pre-core promoter and pre-core regions, which support CHB-AR rather than AHB. In the longer term, enhanced deep sequencing data for HBV may provide improved evidence to distinguish between acute and chronic infection, to predict outcomes and to stratify treatment.
From “business continuity” to “back to business” for orthopaedic surgeons during the COVID-19 pandemic
Authors: Liow Ming Han Lincoln , Tay Kenny Xian Khing , Yeo Nicholas Eng Meng , Tay Darren Keng Jin , Goh Seo Kiat , Koh Joyce Suang Bee , Howe Tet Sen , Tan Andrew Hwee Chye
Published: October 2020

The coronavirus disease 2019 (COVID-19) pandemic has led to unprecedented challenges to healthcare systems worldwide. Orthopaedic departments have adopted business continuity models and guidelines for essential and non-essential surgeries to preserve hospital resources as well as protect patients and staff. These guidelines broadly encompass reduction of ambulatory care with a move towards telemedicine, redeployment of orthopaedic surgeons/residents to the frontline battle against COVID-19, continuation of education and research through web-based means, and cancellation of non-essential elective procedures. However, if containment of COVID-19 community spread is achieved, resumption of elective orthopaedic procedures and transition plans to return to normalcy must be considered for orthopaedic departments. The COVID-19 pandemic also presents a moral dilemma to the orthopaedic surgeon considering elective procedures. What is the best treatment for our patients and how does the fear of COVID-19 influence the risk-benefit discussion during a pandemic? Surgeons must deliberate the fine balance between elective surgery for a patient’s wellbeing versus risks to the operating team and utilization of precious hospital resources. Attrition of healthcare workers or Orthopaedic surgeons from restarting elective procedures prematurely or in an unsafe manner may render us ill-equipped to handle the second wave of infections. This highlights the need to develop effective screening protocols or preoperative COVID-19 testing before elective procedures in high-risk, elderly individuals with comorbidities. Alternatively, high-risk individuals should be postponed until the risk of nosocomial COVID-19 infection is minimal. In addition, given the higher mortality and perioperative morbidity of patients with COVID-19 undergoing surgery, the decision to operate must be carefully deliberated. As we ramp-up elective services and get “back to business” as orthopaedic surgeons, we have to be constantly mindful to proceed in a cautious and calibrated fashion, delivering the best care, while maintaining utmost vigilance to prevent the resurgence of COVID-19 during this critical transition period.

Cite this article: Bone Joint Open 2020;1-6:222–228.
Polarization state dependence of laser-induced domain nucleation in lithium niobate crystals investigated by digital holography
Authors: Zhi Yanan , Shen Yanting , Zhu Yongjian , Tian Kehan
Published: October 2020

This paper systematically investigates the influences of polarization states on laser-induced domain nucleation in z-cut

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crystals. The real-time 2D and 3D phase distributions at the focus during laser-induced domain nucleation were reconstructed by digital holography. The different

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samples, including undoped congruent

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, Mg-doped congruent

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, Hf-doped congruent

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, and stoichiometric

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, were tested. The systematical comparisons of phase mapping and nucleation fields with different polarization states, including linear polarization, circular polarization, and elliptical polarization, have been carried out. The polarization states proved to be a key influence factor for the laser-induced domain nucleation. It was demonstrated that the generated bulk photovoltaic field along the

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direction was an important mechanism for laser-induced preferential domain nucleation. This work is of great significance for the future development of ferroelectric domain engineering of

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crystals.