bluuebunny/crossref_metadata_2025 huggingface dataset:
Reflexivity in Health Promotion: A Typology for Training
Authors: Alexander Stephanie A. , Jones Catherine M. , Tremblay Marie-Claude , Beaudet Nicole , Rod Morten Hulvej , Wright Michael T.
Published: April 2020

Reflexivity has emerged as a key concept in the field of health promotion (HP). Yet it remains unclear how diverse forms of reflexivity are specifically relevant to HP concerns, and how these “reflexivities” are interconnected. We argue that frameworks are needed to support more systematic integration of reflexivity in HP training and practice. In this article, we propose a typology of reflexivity in HP to facilitate the understanding of reflexivity in professional training. Drawing from key theories and models of reflexivity, this typology proposes three reflexive positions (ideal-types) with specific purposes for HP: reflexivity in, on, and underlying action. This article illustrates our typology’s ideal-types with vignettes collected from HP actors working with reflexivity in North America and Europe. We suggest that our typology constitutes a conceptual device to organize and discuss a variety of experiences of engaging with reflexivity for HP. We propose the typology may support integrating reflexivity as a key feature in training a future cadre of health promoters and as a means for building a responsible HP practice.
The association of Helicobacter pylori CagA EPIYA motifs and vacA genotypes with homologous recombination repair markers during the gastric precancerous cascade
Authors: Mi Yang , Dong Haibin , Sun Xiangdong , Ren Feifei , Tang Youcai , Zheng Pengyuan
Published: April 2020

Background:

Helicobacter pylori-induced DNA damage and impaired homologous recombination repair are vital molecular mechanisms for gastric cancer, which mainly count on its virulence factors cytotoxic-associated gene A (CagA) and vacuolating cytotoxin A (VacA). However, the relationship between H. pylori CagA EPIYA motifs and vacA genotypes with DNA damage and homologous recombination repair markers is still not clear.

Methods:

H. pylori positive and negative gastric biopsies were taken from 165 subjects with different gastric precancerous pathologic stages, and DNA damage marker γH2AX and key homologous recombination repair proteins (CtIP and Rad51) were investigated for their association with H. pylori CagA EPIYA motifs and vacAs-, m-, i-, and d-region genotypes and histology (Sydney classification).

Results:

Out of 165 patients, 78 were identified as H. pylori-positive. CagA EPIYA motifs were identified as AB, ABC, and ABD in 2 (3.3%), 21 (35%), and 37 (61.7%) patients, respectively, while vacA alleles were identified as: s1, s2, m1, m2, i1, i2, d1, and d2 in 50 (89.3%), 6 (10.7%), 24 (42.9%), 32 (57.1%), 45 (80.4%), 11 (19.6%), 40 (71.4%), and 16 (28.6%) patients, respectively. vacAs1m1i1d1, s1m2i1d1, and s1m2i2d2 were the most prevailing genotypes. γH2AX was highly localized in H. pylori-positive tissues with corresponding CagA EPIYA motifs and vacA genotypes, while Rad51 and CtIP signals were weak.

Conclusion:

H. pylori were positively correlated with the DNA damage marker in precancerous lesions, but were negatively correlated with the key homologous recombination repair proteins, which may be due to the specific CagA EPIYA motifs and vacA genotypes.
Inhibition of the Wnt/β-catenin pathway enhances antitumor immunity in ovarian cancer
Authors: Doo David W. , Meza-Perez Selene , Londoño Angelina I. , Goldsberry Whitney N. , Katre Ashwini A. , Boone Jonathan D. , Moore Dylana J. , Hudson Cindy T. , Betella Ilaria , McCaw Tyler R. , Gangrade Abhishek , Bao Riyue , Luke Jason J. , Yang Eddy S. , Birrer Michael J. , Starenki Dmytro , Cooper Sara J. , Buchsbaum Donald J. , Norian Lyse A. , Randall Troy D. , Arend Rebecca C.
Published: April 2020

Background:

The Wnt/β-catenin pathway is linked to tumorigenesis in a variety of tumors and promotes T cell exclusion and resistance to checkpoint inhibitors. We sought to determine whether a small molecule inhibitor of this pathway, WNT974, would impair tumor growth, affect gene expression patterns, and improve the immune response in human and murine ovarian cancer models.

Methods:

Human ovarian cancer cells were treated with WNT974 in vitro. RNAseq libraries were constructed and differences in gene expression patterns between responders and nonresponders were compared to The Cancer Genome Atlas (TCGA). Mice with subcutaneous or intraperitoneal ID8 ovarian cancer tumors were treated with WNT974, paclitaxel, combination, or control. Tumor growth and survival were measured. Flow cytometry and β-TCR repertoire analysis were used to determine the immune response.

Results:

Gene expression profiling revealed distinct signatures in responders and nonresponders, which strongly correlated with T cell infiltration patterns in the TCGA analysis of ovarian cancer. WNT974 inhibited tumor growth, prevented ascites formation, and prolonged survival in mouse models. WNT974 increased the ratio of CD8+ T cells to T regulatory cells (Tregs) in tumors and enhanced the effector functions of infiltrating CD4+ and CD8+ T cells. Treatment also decreased the expression of inhibitory receptors on CD8+ T cells. Combining WNT974 with paclitaxel further reduced tumor growth, prolonged survival, and expanded the T cell repertoire.

Conclusions:

These findings suggest that inhibiting the Wnt/β-catenin pathway may have a potent immunomodulatory effect in the treatment of ovarian cancer, particularly when combined with paclitaxel.
Farmers’ Knowledge and Attitudes Toward Pollination and Bees in a Maize-Producing Region of Zimbabwe: Implications for Pollinator Conservation
Authors: Tarakini Gugulethu , Chemura Abel , Musundire Robert
Published: April 2020

Pollination ecosystem service contributes tremendously to food security; however, little is known about the farmers’ awareness of the ecosystem service to ensure conservation of pollinators. This study determined farmers’ perceptions, knowledge, attitudes toward bees, and pollination in a maize-producing region of Zimbabwe using semistructured questionnaires ( N = 828). Generalized linear model and logit regressions were used to determine factors influencing farmers’ ability to identify bees, knowledge of pollination, and fear toward bees, respectively. Identification of bees was positively related to education, years in farming, and negatively related to fear toward bees ( p < .001). Fear toward bees was influenced by gender, knowledge of bee attack fatalities, and perception of the importance of bees ( p < .001). The majority of respondents (67%) confirmed knowledge of pollination (χ2 = 96.043, p < .001), and the probability of knowing pollination was higher for those who depended on media compared with extension and school education as a source of farming information ( p < .001). Our findings suggest that to improve bee conservation, farmers should be made more aware of the diverse bee fauna, specifically regarding their benefits as pollinators compared with the few dangers (resulting from stings) in order to reduce fear and increase willingness to conserve bees. Bee awareness programs need to be accessible to women, youth, and those with less formal education as they exhibited the least knowledge. Our findings also support evidence showing that extension officers should consider various media options for the effective dissemination of information to the different target audiences.
Religious Overclaiming and Support for Religious Aggression
Authors: Jones Daniel N. , Neria Adon L. , Helm Farzad A. , Sahlan Reza N. , Carré Jessica R.
Published: April 2020

Agentic self-enhancement consists of self-protective and self-advancing tendencies that can lead to aggression, especially when challenged. Because self-enhancers often endorse aggression to defend or enhance the self-concept, religious self-enhancement should lead to endorsing aggression to defend or enhance one’s religion. We recruited three samples ( N = 969) from Mechanical Turk ( n = 409), Iran ( n = 351), and the U.S.–Mexico border region ( n = 209). We found that religious (but not secular) self-enhancement in the form of religious overclaiming predicted support for, and willingness to engage in, religious aggression. In contrast, accuracy in religious knowledge had mostly negative associations with aggression-relevant outcomes. These results emerged across two separate religions (Christianity and Islam) and across three different cultures (the United States, Iran, and the U.S.–Mexico border region). Thus, religious overclaiming is a promising new direction for studying support for religious aggression and identifying those who may become aggressive in the name of God.
Extended Commentary
Authors: Yengde Suraj
Published: April 2020

Gidla Sujatha, Ants Among Elephants: An Untouchable Family and the Making of Modern India. New York, NY: FSG, 2017, 306 pp., $28.00 (hardback). ISBN: 9780865478114.
DOACs vs LMWHs in hospitalized medical patients: a systematic review and meta-analysis that informed 2018 ASH guidelines
Authors: Neumann Ignacio , Izcovich Ariel , Zhang Yuqing , Rada Gabriel , Kahn Susan R. , Spencer Frederick , Rezende Suely , Dentali Franchesco , Bauer Kenneth , Morgano Gian Paolo , Yepes-Nuñez Juan J. , Nieuwlaat Robby , Wiercioch Wojtek , Lu Liming , Wu Jiaming , Cushman Mary , Schunemann Holger
Published: April 2020

Venous thromboembolism (VTE) is a relatively frequent complication in hospitalized patients, especially in those with risk factors. The benefit of using direct oral anticoagulants (DOACs) for prevention is controversial. This systematic review was performed as part of the American Society of Hematology (ASH) guidelines on VTE, developed in partnership with McMaster University. MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, and Epistemonikos were used as data sources from date of inception to November 2019. We included randomized trials in patients hospitalized for an acute medical disease, evaluating any DOACs vs other pharmacological prophylaxis, and included 3 trials with low risk of bias. We analyzed the effects of DOACs vs low-molecular-weight heparins (LMWHs) at 2 different time points: at the end of the short-term treatment phase (both drugs given for the same period of time) and at the end of the extended prophylaxis period (extended DOACs vs a shorter course of LMWHs). We observed that the use of DOACs did not reduce the risk of pulmonary embolism or symptomatic deep venous thrombosis (DVT) in comparison with LMWHs. However, the risk of major bleeding was slightly increased. Additionally, we observed that the benefit of DOACs previously reported was largely based on the reduction of asymptomatic DVT and was not apparent when only symptomatic events were considered. The use of DOACs in hospitalized medical patients slightly increases the risk of major bleeding with no appreciable benefit over LMWHs.
Thrombolytics for venous thromboembolic events: a systematic review with meta-analysis
Authors: Izcovich Ariel , Criniti Juan M. , Popoff Federico , Lu Liming , Wu Jiaming , Ageno Walter , Witt Daniel M. , Jaff Michael R. , Schulman Sam , Manja Veena , Verhamme Peter , Rada Gabriel , Zhang Yuqing , Nieuwlaat Robby , Wiercioch Wojtek , Schünemann Holger J. , Neumann Ignacio
Published: April 2020

Thrombolytic therapy might reduce venous thromboembolism–related mortality and morbidity, but it could also increase the risk of major bleeding. We systematically reviewed the literature to evaluate the effectiveness and safety of thrombolytics in patients with pulmonary embolism (PE) and/or deep venous thrombosis (DVT). We searched Medline, Embase, and Cochrane databases for relevant randomized controlled trials up to February 2019. Multiple investigators independently screened and collected data. We included 45 studies (4740 participants). Pooled estimates of PE studies indicate probable reduction in mortality with thrombolysis (risk ratio [RR], 0.61; 95% confidence interval [CI], 0.40-0.94) (moderate certainty) and possible reduction in nonfatal PE recurrence (RR, 0.56; 95% CI, 0.35-0.89) (low certainty). Pooled estimates of DVT studies indicate the possible absence of effects on mortality (RR, 0.77; 95% CI, 0.26-2.28) (low certainty) and recurrent DVT (RR, 0.99; 95% CI, 0.56-1.76) (low certainty), but possible reduction in postthrombotic syndrome (PTS) with thrombolytics (RR, 0.70; 95% CI, 0.59-0.83) (low certainty). Pooled estimates of the complete body of evidence indicate increases in major bleeding (RR, 1.89; 95% CI, 1.46-2.46) (high certainty) and a probable increase in intracranial bleeding (RR, 3.17; 95% CI 1.19-8.41) (moderate certainty) with thrombolytics. Our findings indicate that thrombolytics probably reduce mortality in patients with submassive- or intermediate-risk PE and may reduce PTS in patients with proximal DVT at the expense of a significant increase in major bleeding. Because the balance between benefits and harms is profoundly influenced by the baseline risks of critical outcomes, stakeholders involved in decision making would need to weigh these effects to define which clinical scenarios merit the use of thrombolytics.
Longer shared parental leave is associated with longer duration of breastfeeding: a cross-sectional study among Swedish mothers and their partners
Authors: Grandahl Maria , Stern Jenny , Funkquist Eva-Lotta
Published: April 2020

Background

Breastfeeding is associated with health benefits for both the mother and infant and is therefore important to support; moreover, parental leave is a beneficial factor for breastfeeding. The Swedish parental leave is generous, allowing each parent to take 90 days; additionally, a further 300 days can be taken by either parent. Generally, mothers take 70% of the parental leave days, mainly during the first year. However, breastfeeding duration has declined in the last decade, and it is not known how shared parental leave is associated with the duration of breastfeeding.

Aim

To investigate how parental leave is associated with the duration of exclusive and partial breastfeeding of the infant during the first 12 months after birth. An additional aim was to describe infants’ and parents’ characteristics and mode of birth in association with the duration of exclusive and partial breastfeeding.

Methods

This cross-sectional study was part of the Swedish Pregnancy Planning Study, conducted in Sweden in 2012–2015. The parents were recruited at 153 antenatal clinics in nine counties. In total, 813 couples completed a follow-up questionnaire 1 year after birth. Linear regression models were used to analyse the association between parental leave and the duration of breastfeeding.

Results

Infants were exclusively breastfed for, on average, 2.5 months (range 0–12 months) and partially breastfed, on average, 7 months (range 0–12 months). Most of the parental leave was taken by the mother (mean = 10.9 months) during the infant’s first 12 months, while the partner took 3 months, on average. The parental leave (used and planned) during the infant’s first 24 months were, on average, 21 months. In the multivariate linear regression analysis, mothers’ and partners’ high level of education (p < 0.001, p = 0.044, respectively), mothers’ higher age (p = 0.049), non-instrumental vaginal birth (p = 0.004) and longer parental leave for the first 24 months (p < 0.001) were associated with longer duration of partial breastfeeding.

Conclusion

The duration of partial breastfeeding was associated with higher parental educational level, higher age, non-instrumental vaginal birth and longer parental leave.
“From good hearted community members we get volunteers” – an exploratory study of palliative care volunteers across Africa
Authors: Loth Carolin Clara , Namisango Eve , Powell Richard Antony , Pabst Katharina Henny , Leng Mhoira , Hamada Mohamed , Radbruch Lukas
Published: April 2020

Background

Volunteers play a significant role in supporting hospice and palliative care in Africa, but little is known about the types of volunteers, their motivations and roles in service delivery.

Methods

Palliative care experts from 30 African countries were invited to participate in an online survey, conducted in English and French, that consisted of 58 questions on: socio-demographics, the activities, motivation and coordination of volunteers, and an appraisal of recent developments in volunteering. The questionnaire was pre-tested in Uganda. Quantitative data was analysed descriptively with SPSS v22; answers on open-ended questions were analysed using content analysis.

Results

Twenty-five respondents from 21 countries replied to the questionnaire. The typical volunteer was reported to be a female aged between 30 and 50 years. Volunteer roles included, among others: direct patient assistance, providing psychosocial / spiritual support, and assisting patients’ families. Respondents considered altruism, civic engagement and personal gain (for a professional career) as volunteers’ most significant motivational drivers. One in two respondents noted that recruiting volunteers is easy, and cooperation with the communities was often mentioned as helpful. Trainings mostly occurred before the first assignment, with topics covering the palliative care concept, care, psychosocial support and team work. Half of respondents described recent overall volunteering developments as positive, while the other half described problems primarily with financing and motivation. Most volunteers received transportation allowances or bicycles; some received monetary compensation.

Conclusions

The findings show a wide range of volunteering in palliative care. We identified volunteers as typically 30–50 years old, non-professional females, motivated by altruism, a sense of civic engagement and personal gain. Palliative care services benefit from volunteers who take on high workloads and are close to the patients. The main challenges for volunteer programmes are funding and the long-term motivation of volunteers.
Association between organizational citizenship behavior and patient safety culture from nurses’ perspectives: a descriptive correlational study
Authors: Jafarpanah Marzyeh , Rezaei Behrooz
Published: April 2020

Background

Nurses play a key role in providing patient safety. It is known that patient safety requires the improvement of patient safety culture, which can be a difficult process. One of the current challenges of hospitals is to explore the ways to improve patient safety culture. Organizational citizenship behaviors are one of the factors, which can develop organizational culture including safety culture; however, its role is not well established.

Methods

In this cross-sectional study, a stratified random sample of 214 nurses was selected from a largest teaching hospital in west of Iran. The institutional research board approved the study protocol. Data were collected using three self-report questionnaires: demographic information; hospital survey on patient safety culture (HSPSC); and organizational citizenship behaviors questionnaire. Data were analyzed using Spearman’s correlation coefficient test in SPSS (α < 0.05).

Results

Organizational citizenship behaviors were found to be at an intermediate level (56.84 ± 16.22). However, some of its dimensions, including sportsmanship, civic virtue, and courtesy, were at weak levels (< 50%). The mean percentage of positive responses to the patient safety culture was 49.00 ± 14.01. The patient safety culture had significant positive correlations with organizational citizenship behaviors (r = 0.349, P = 0.001) and dimensions of altruism (r = 0.255, P = 0.001), civic virtue (r = 0.434, P = 0.001), and courtesy (r = 0.214, P = 0.001).

Conclusion

Our findings proposed the hypothesis that OCB has a statistical significant impact on PSC. Low levels of civic virtue, sportsmanship and courtesy behaviors may be indicative low nurses’ interest in participating in organizational affairs and nurses’ low attention to measures that prevent harm to their organization. It is recommended that nursing managers focus more on these dimensions, identifying influintioal factors and taking appropriate management measures to promote these behaviors. If our findings are confirmed in future studies, nursing managers can consider the development of organizational citizenship behaviors as one of the managerial approaches for promoting a patient safety culture.
An agent-based model to investigate microbial initiation of Alzheimer’s via the olfactory system
Authors: Sundar Shalini , Battistoni Carly , McNulty Ryan , Morales Fernando , Gorky Jonathan , Foley Henry , Dhurjati Prasad
Published: April 2020

Background

Alzheimer’s disease (AD) is a degenerative brain disease. A novel agent-based modelling framework was developed in NetLogo 3D to provide fundamental insights into the potential mechanisms by which a microbe (eg. Chlamydia pneumoniae) may play a role in late-onset AD. The objective of our initial model is to simulate one possible spatial and temporal pathway of bacterial propagation via the olfactory system, which may then lead to AD symptoms. The model maps the bacteria infecting cells from the nasal cavity and the olfactory epithelium, through the olfactory bulb and into the olfactory cortex and hippocampus regions of the brain.

Results

Based on the set of biological rules, simulated randomized infection by the microbe led to the formation of beta-amyloid (Aβ) plaque and neurofibrillary (NF) tangles as well as caused immune responses. Our initial simulations demonstrated that breathing in C. pneumoniae can result in infection propagation and significant buildup of Aβ plaque and NF tangles in the olfactory cortex and hippocampus. Our model also indicated how mucosal and neural immunity can play a significant role in the pathway considered. Lower immunities, correlated with elderly individuals, had quicker and more Aβ plaque and NF tangle formation counts. In contrast, higher immunities, correlated with younger individuals, demonstrated little to no such formation.

Conclusion

The modelling framework provides an organized visual representation of how AD progression may occur via the olfactory system to better understand disease pathogenesis. The model confirms current conclusions in available research but can be easily adjusted to match future evidence and be used by researchers for their own individual purposes. The goal of our initial model is to ultimately guide further hypothesis refinement and experimental testing to better understand the dynamic system interactions present in the etiology and pathogenesis of AD.
Inference of single-cell phylogenies from lineage tracing data using Cassiopeia
Authors: Jones Matthew G , Khodaverdian Alex , Quinn Jeffrey J , Chan Michelle M , Hussmann Jeffrey A , Wang Robert , Xu Chenling , Weissman Jonathan S , Yosef Nir
Published: April 2020

The pairing of CRISPR/Cas9-based gene editing with massively parallel single-cell readouts now enables large-scale lineage tracing. However, the rapid growth in complexity of data from these assays has outpaced our ability to accurately infer phylogenetic relationships. First, we introduce Cassiopeia—a suite of scalable maximum parsimony approaches for tree reconstruction. Second, we provide a simulation framework for evaluating algorithms and exploring lineage tracer design principles. Finally, we generate the most complex experimental lineage tracing dataset to date, 34,557 human cells continuously traced over 15 generations, and use it for benchmarking phylogenetic inference approaches. We show that Cassiopeia outperforms traditional methods by several metrics and under a wide variety of parameter regimes, and provide insight into the principles for the design of improved Cas9-enabled recorders. Together, these should broadly enable large-scale mammalian lineage tracing efforts. Cassiopeia and its benchmarking resources are publicly available at www.github.com/YosefLab/Cassiopeia.
Toward risk adjustment in mental health in Israel: calculation of risk adjustment rates from large outpatient and inpatient databases
Authors: Kohn Yoav , Shmueli Amir
Published: April 2020

Background

In 2015, mental health services were added to the Israeli National Health Insurance package of services. As such, these services are financed by the budget which is allocated to the Health Plans according to a risk adjustment scheme. An inter-ministerial team suggested a formula by which the mental health budget should be allocated among the Health Plans. Our objective in this study was to develop alternative rates based on individual data, and to evaluate the ones suggested.

Methods

The derivation of the new formula is based on our previous study of all psychiatric inpatients in Israel in the years 2012–2013 (n = 27,446), as well as outpatients in one psychiatric clinic in the same period (n = 6115). Based on Ministry of Health and clinic data we identified predictors of mental health services consumption. Age, gender, marital status and diagnosis were used as risk adjusters to calculate the capitation rates for outpatient care and inpatient care, respectively. All prices of services were obtained from the Ministry of Health tariffs. These rates were modified to include non-users using restricted models.

Results

The mental health capitation scales are typically “humped” with regard to age. The rates for ambulatory care varied from a minimum 0.19 of the average consumption for males above the age of 85 to a maximum of 1.93 times the average for females between the ages of 45–54. For inpatient services the highest rate was 409.25 times the average for single, male patients with schizophrenia spectrum diagnoses, aged 45–54. The overall mental health scale ranges from 2.347 times the average for men aged 45–54, to 0.191 for women aged 85+. The modified scale for the entire post-reform package of benefits (including both mental health care and physical health care) is increasing with age to 4.094 times the average in men aged over 85. The scale is flatter than the pre-reform scale.

Conclusions

The risk adjustment rates calculated for outpatient care are substantially different from the ones suggested by the inter-ministerial team. The inpatient rates are new, and indicate that for patients with schizophrenia, a separate risk-sharing arrangement might be desirable. Adopting the rates developed in this analysis would decrease the budget shares of Clalit and Leumit with their relatively older populations, and increase Maccabi and Meuhedet’s shares. Future research should develop a risk-adjustment scheme which covers directly both mental and physical care provided by the Israeli Health Plans, using their data.
Impact of a multidisciplinary intervention on physical fitness, physical activity habits and the association between aerobic fitness and components of metabolic syndrome in adults diagnosed with metabolic syndrome
Authors: Tremblay Angelo , Bélanger Marie-Pier , Dhaliwal Rupinder , Brauer Paula , Royall Dawna , Mutch David M. , Rhéaume Caroline
Published: April 2020

Background

Metabolic syndrome (MetS) is a health disorder characterized by metabolic abnormalities that predict an increased risk to develop cardiovascular disease (CVD) and type 2 diabetes (T2DM). It can be resolved, and its complications reduced, by lifestyle interventions offered in primary care. The objectives of this study were to evaluate the impact of the exercise program of the CHANGE feasibility study on physical fitness and physical activity habits, and assess associations between changes in MetS components and cardiorespiratory fitness (CRF).

Methods

In this analysis of 192 of the 293 adults with MetS in the overall study, the impact on physical fitness [aerobic capacity, muscular fitness and flexibility], and non-supervised physical activities was investigated over 12 months. In the CHANGE program, aerobic capacity, muscular fitness and flexibility were assessed at baseline, after 3 months of weekly supervised exercise, and following 9 additional months during which participants had one monthly session of supervised exercise. Additionally, CRF response was also examined in relation to changes in MetS components [fasting glucose, high-density lipoprotein (HDL) cholesterol, triglycerides, blood pressure, waist circumference (WC)].

Results

Fitness variables were significantly increased at 12 months with most of the improvements reached by 3 months (estimated VO2 max: 6 and 12%; partial curl-ups: 55 and 80%; push-ups: 50 and 100%; flexibility: 22 and 10% in men and women, respectively, p <  0.001). As expected, the duration and intensity of supervised aerobic physical activity increased during the first 3 months of supervision in both men and women, and remained unchanged for the duration of the program. The duration of non-supervised physical activities did not change during the program in men whereas an increase in manual work of moderate intensity was recorded in women between 3 and 12 months. In women, mean changes in WC were significantly greater among high VO2 max responders than low responders, between 0 and 12 months, as well as between 3 and 12 months (− 3.42 cm and − 4.32 cm, respectively, p <  0.05). No associations were seen with MetS components in men. Higher intensity activities were maintained by both sexes at one year.

Conclusion

Patients with MetS participating in the CHANGE lifestyle program improved physical fitness and physical activity habits by three months and maintained these gains over one year. Women who achieved a greater VO2 max increase had greater reductions in WC compared to low VO2max responders.
A sustainable biomass network design model for bioenergy production by anaerobic digestion technology: using agricultural residues and livestock manure
Authors: Bijarchiyan Mohadeseh , Sahebi Hadi , Mirzamohammadi Saeed
Published: April 2020

Scarcity of fossil fuels and their emissions have led energy policymakers to look for alternative renewable and clean energy sources. In line with this target, biomass is a promising alternative source for the generation of clean energy and the development of a sustainable society. The use of animal and agricultural wastes is one of the very promising renewable energy alternatives paving the way for a more sustainable energy network. Animal and agricultural wastes as biomass sources do not endanger food security and mitigate environmental impacts and may therefore considerably contribute to an appropriate waste management. As a result, converting animal and agricultural wastes to energy is a challenging issue that has attracted the attention of academic and industrial researchers. A multi-echelon multi-objective model is developed to design a sustainable supply chain for bioenergy generation through the anaerobic digestion process. The model maximizes economic and social objective functions, representing direct economic profits and positive social externalities such as job creation and economic development, respectively. Factors affecting the international supply chain include imports of intermediate production equipment, exports of a final product, international business terms applied, customs duties, and foreign exchange rates. Bioenergy and fertilizers are outputs considered in this study; the former to be converted to electricity in a biogas plant to meet domestic demands, and the latter to be exported. A case study for the Golestan province is used to evaluate the efficiency of the proposed model. The results support the potential for three biogas power plants in Gonbad-e-Kavoos, with an annual production capacity of about 1000 tons of fertilizer and an electricity supply for 101,556 households per month. There is still a broad field of promising avenues for future research. Studying uncertainty in different supply chain parameters and using robust optimization to deal with uncertainties are recommended approaches.
Integrated vector control of Chagas disease in Guatemala: a case of social innovation in health
Authors: Castro-Arroyave Diana , Monroy Maria Carlota , Irurita Maria Isabel
Published: April 2020

Background

Improved access to health care and quality of services require integrated efforts and innovations, including community empowerment and participation in transformation processes. Chagas disease is a neglected tropical disease that is generally controlled by insecticide spraying. To achieve community empowerment in a health program, actions for social innovations may include: community-based research, interdisciplinary and intersectoral participation, community perception of direct benefits and participation in health or environmental improvements. The aim of this study was to describe and analyze the processes by which an interdisciplinary team, in collaboration with communities of Comapa, Guatemala, developed an effective solution to address the risk for Chagas disease.

Methods

A qualitative study involving interviews semi-structured and direct observation was conducted using a case study approach to describe and understand the community-based research and intervention process developed by researchers from the Laboratory of Applied Entomology and Parasitology of the Universidad de San Carlos of Guatemala (Laboratorio de Entomologia y Parasitologia Aplicada). Nine interviews were conducted with the investigators, innovators, members of the community in which the intervention had been implemented. NVivo software (version 12) was used for the emergent coding and analysis of the interviews.

Results

Processes of social transformation were evident within households, and the communities that transcended the mere improvement of walls and floors. New social dynamics that favored the household economy and conditions of hygiene and home care that positively impacted the health of the community. We describe how the integration of criteria of social innovation into a home improvement strategy for Chagas disease control, can generate processes of transformation in health by considering sociocultural conditions, encouraging dialogue between public health approaches and traditional practices. We identify and discuss processes for Social Innovations in Health and identify their potential in improving community health in Latin America.

Conclusions

When social innovation criteria are included in a health control initiative, the community-based research and the interdisciplinary and intersectoral participation facilitate the implementation of the control strategy, the perceived benefits by the community and its empowerment to sustain and share the strategy. The case study provided understanding of the intersectoral and interdisciplinary dynamics in particular contexts, and documented the relevance of innovation criteria in health processes.
Fighting and burial: the production of bronze weapons in the Shu state based on a case study of Xinghelu cemetery, Chengdu, China
Authors: Li Haichao , Zhou Zhiqing , Liu Yang , Wang Yi , Wang Zhankui , Wang Lin , Tian Jianbo , Cui Jianfeng
Published: April 2020

This article discusses the bronze weapons discovered in the Xinghelu cemetery of Chengdu, China in order to study the production of bronze weapons in the Shu state. Metallographic microscopy, inductively coupled plasma atomic emission spectroscopy (ICP-AES) and multi-collector inductively coupled plasma mass spectrometry (MC-ICP-MS) were used to analyze 56 bronze samples. The results show that normal size weapons contain more lead or tin than the equivalent small weapons. Some normal size weapons were made from the same lead sources as the small ones; others, such as the dagger-axe and scabbards, might be imported products. To match the imported scabbards, swords of comparable size were cast or chosen. Most of the small weapons may have been produced by type, while the variable alloying composition and size for each weapon suggests multiple casting processes.
A protocol for a pilot cluster randomized control trial of e-vouchers and mobile phone application to enhance access to maternal health services in Cameroon
Authors: Nkangu Miriam N. , Okwen Patrick M. , Mbuagbaw Lawrence , Weledji Donald K. , Roberts Janet Hatcher , Yaya Sanni
Published: April 2020

Background

Cameroon still has relatively high maternal mortality rate (MMR) of 596/100,000 live births. Approximately 40% of births are unattended by skilled healthcare personnel with high out-of-pocket expenditures. Poor resource allocation, poorly functioning referral systems, long trekking distances to health facilities, all of which lead to low rates of use of maternal health services.

Objectives

The aim of this pilot study is to explore perception and acceptability of mobile health (mhealth) and e-voucher and to determine the feasibility of conducting a large cluster randomized trial to determine the effects of combining e-vouchers and a mobile application compared with usual care in improving access to and use of maternal health services.

Methods

This is a multimethod study that comprises two phases. The first phase is the development of the mobile phone app, which includes a qualitative formative study through in-depth key informant interviews and focus group discussions. The second phase is a cluster randomized control trial assessing the combination of e-vouchers and a mobile application compared with usual care in improving access to and use of maternal health services. Feasibility will be determined based on evaluating randomization, contamination, enrollment rate, complete follow up, compliance rate, success in matching data from different sources, and data completeness.

Ethics and discussion

Ethics approval has been granted, and the trial has been registered in the Pan-African Clinical Trials Registry. We will disseminate our findings through peer-reviewed manuscripts and conference presentations. Findings from this study will inform the design and conduct of a larger randomized trial.

Trial registration

PACTR201808703097367. The trial on the Pan African Clinical Trials Registry.
Meckel Gruber syndrome – a case report
Authors: Raj Marquess , Dhanuka Sujata , Agarwal Prerna , Reddy Suresh Lakki , Vivekananthan Sethuramalingam
Published: April 2020

Background

Meckel Gruber Syndrome (MKS) is a rare autosomal recessive malformation syndrome characterized by multiple congenital anomalies ultimately leading to the death of fetus in utero or shortly after birth. It is characterized by classical triad of occipital encephalocele, infantile polycystic kidneys and postaxial polydactyly. Diagnosis of MKS is made on the basis of ultrasonography, gross morphology & histopathological findings. Here, we describe a case of MKS presenting with the classical triad.

Case presentation

A 25 year old lady presented with missed abortion at 17 weeks of gestation on her first conception. There was no history of previous fetal demise or any congenital anomaly. History of consanguineous marriage was not present. Ultra sonogram revealed death of the fetus in utero. Planned termination of pregnancy was performed & the products of conception were sent for study to the laboratory for autopsy, histopathological examination & genetic studies.

Conclusion

Rare genetic anomalies can present with missed abortion & an understanding of the same is important considering the clinical as well as psychological strain it can have on the pregnant mother. The case moreover should be reported for it being a genetic anomaly which results in death at a young age & also for its historical value.
Composition and co-occurrence patterns of the microbiota of different niches of the bovine mammary gland: potential associations with mastitis susceptibility, udder inflammation, and teat-end hyperkeratosis
Authors: Derakhshani Hooman , Plaizier Jan C. , De Buck Jeroen , Barkema Herman W. , Khafipour Ehsan
Published: April 2020

Background

Within complex microbial ecosystems, microbe-microbe interrelationships play crucial roles in determining functional properties such as metabolic potential, stability and colonization resistance. In dairy cows, microbes inhabiting different ecological niches of the udder may have the potential to interact with mastitis pathogens and therefore modulate susceptibility to intramammary infection. In the present study, we investigated the co-occurrence patterns of bacterial communities within and between different niches of the bovine mammary gland (teat canal vs. milk) in order to identify key bacterial taxa and evaluate their associations with udder health parameters and mastitis susceptibility.

Results

Overall, teat canal microbiota was more diverse, phylogenetically less dispersed, and compositionally distinct from milk microbiota. This, coupled with identification of a large number of bacterial taxa that were exclusive to the teat canal microbiota suggested that the intramammary ecosystem, represented by the milk microbiota, acts as a selective medium that disfavors the growth of certain environmental bacterial lineages. We further observed that the diversity of milk microbiota was negatively correlated with udder inflammation. By performing correlation network analysis, we identified two groups of phylogenetically distinct hub species that were either positively (unclassified Bacteroidaceae and Phascolarctobacterium) or negatively (Sphingobacterium) correlated with biodiversity metrics of the mammary gland (MG). The latter group of bacteria also showed positive associations with the future incidence of clinical mastitis.

Conclusions

Our results provide novel insights into the composition and structure of bacterial communities inhabiting different niches of the bovine MG. In particular, we identified hub species and candidate foundation taxa that were associated with the inflammatory status of the MG and/or future incidences of clinical mastitis. Further in vitro and in vivo interrogations of MG microbiota can shed light on different mechanisms by which commensal microbiota interact with mastitis pathogens and modulate udder homeostasis.
Hydroclathrus clathratus as anti-damaging agent against lung injury in male albino rats
Authors: Alharbi Reem Mohammed
Published: April 2020

Background

The present investigation is designed to evaluate the antioxidant and protective efficacy of the brown alga, Hydroclathrus clathratus (C.Agardh) M. Howe, against copper-induced lung injury in male albino rats. The present study was carried out on 24 adult male albino rats, they were randomly divided into four groups (n = 6) (A group, control rats; B group, rats received 100 mg/kg body weight of H. clathratus ethanolic extract; C group, rats augmented with 100 mg/kg body weight of CuSO4; and D group, rats were supplemented with 100 mg/kg of CuSO4 and 100 mg/kg of H. clathratus ethanolic extract). All the experimental treatments were given orally and daily for 28 days.

Results

It was showing that Cu treatment was found to induce lung toxicity, histopathologically, Cu revealed severe degenerative and necrotic lesions in the lung. Also, Cu caused a significant decrease in glutathione-S-transferase (GST) count and glutathione (GSH); meanwhile, malondialdehyde (MDA) content was increased. Consistently, mRNA and protein expression levels of proapoptotic (caspase-3 and Bax) marker showed a significant upregulation, whereas the anti-apoptotic (Bcl-2) level was significantly downregulated in lung tissues of CuSO4-intubated groups. Moreover, H. clathratus plus CuSO4-treated group showed improvement in the histopathological changes of lung injury. The bronchi and bronchioles appeared like those of the control, where the alveoli showed thin septa in some parts and thickened septa in other parts.

Conclusion

Findings revealed that the natural antioxidant activity of H. clathratus could protect the lung tissue from the damage produced by CuSO4.
Depression-related anterior cingulate prefrontal resting state connectivity normalizes following cognitive behavioral therapy
Authors: Pantazatos Spiro P. , Yttredahl Ashley , Rubin-Falcone Harry , Kishon Ronit , Oquendo Maria A. , John Mann J. , Miller Jeffrey M.
Published: April 2020

Background.

Aberrant activity of the subcallosal cingulate (SCC) is a common theme across pharmacologic treatment efficacy prediction studies. The functioning of the SCC in psychotherapeutic interventions is relatively understudied, as are functional differences among SCC subdivisions. We conducted functional connectivity analyses (rsFC) on resting-state functional magnetic resonance imaging (fMRI) data, collected before and after a course of cognitive behavioral therapy (CBT) in patients with major depressive disorder (MDD), using seeds from three SCC subdivisions.

Methods.

Resting-state data were collected from unmedicated patients with current MDD (Hamilton Depression Rating Scale-17 > 16) before and after 14-sessions of CBT monotherapy. Treatment outcome was assessed using the Beck Depression Inventory (BDI). Rostral anterior cingulate (rACC), anterior subcallosal cingulate (aSCC), and Brodmann’s area 25 (BA25) masks were used as seeds in connectivity analyses that assessed baseline rsFC and symptom severity, changes in connectivity related to symptom improvement after CBT, and prediction of treatment outcomes using whole-brain baseline connectivity.

Results.

Pretreatment BDI negatively correlated with pretreatment rACC ~ dorsolateral prefrontal cortex and aSCC ~ lateral prefrontal cortex rsFC. In a region-of-interest longitudinal analysis, rsFC between these regions increased post-treatment (p < 0.05FDR). In whole-brain analyses, BA25 ~ paracentral lobule and rACC ~ paracentral lobule connectivities decreased post-treatment. Whole-brain baseline rsFC with SCC did not predict clinical improvement.

Conclusions.

rsFC features of rACC and aSCC, but not BA25, correlated inversely with baseline depression severity, and increased following CBT. Subdivisions of SCC involved in top-down emotion regulation may be more involved in cognitive interventions, while BA25 may be more informative for interventions targeting bottom-up processing. Results emphasize the importance of subdividing the SCC in connectivity analyses.