bluuebunny/crossref_metadata_2025 huggingface dataset:
Four in ten married women demands satisfied by modern contraceptives in high fertility sub-Saharan Africa countries: a multilevel analysis of demographic and health surveys
Authors: Negash Wubshet Debebe , Belachew Tadele Biresaw , Asmamaw Desale Bihonegn , Bitew Desalegn Anmut
Published: November 2022

Background

Demand satisfied with modern contraceptive can be seen on both a health and economic level. Additionally, family planning helps to regulate fertility, prevent unintended pregnancies and their consequences. Thus, the aim of this study was to identify the magnitude of demand satisfied with modern contraceptive among married/in-union women in ten high fertility sub Saharan African countries.

Methods

Recent Demographic and Health Surveys that included a weighted sample of 43,745 women of reproductive age provided the data for this study. All statistical analyses were conducted once the data had been weighted, and Stata version 16.0 was used. A multilevel mixed-effect binary logistic regression model was fitted. To determine statistically significant individual and community-level factors associated with demand satisfied for modern contraceptive, odds ratios with a 95% confidence interval was generated. A p-value less than 0.05 was declared as statistical significance.

Results

Overall, demand satisfied to use modern contraceptive in high fertility sub-Saharan Africa countries was 39.53% (95%CI: 39.06, 39.98). Women aged 25–34 (AOR: 1.34, 95%CI: 1.26, 1.42) and 35–49 (AOR: 1.28, 95%CI: 1.20, 1.38), women education: primary (AOR: 1.35, 95%CI: 1.27, 1.44) and secondary (AOR: 2.05, 95%CI: 1.90, 2.21), husband education: primary (AOR: 1.26, 95%CI: 1.18, 1.35) and secondary (AOR: 1.54, 95%CI: 1.43, 1.66), husband residence (AOR: 1.75, 95%CI: 1.60, 1.91), media exposure (AOR: 1.22, 95%CI: 1.15, 1.29), wealth index: poorer (AOR: 1.1, 95%CI: 1.02, 1.19), middle (AOR: 1.18, 95%CI: 1.08, 1.28), richer (AOR: 1.37, 95%CI: 1.26, 1.49) and richest (AOR: 1.34, 95%CI: 1.56, 1.89), number of children: 4–6 (AOR: 0.48, 95%CI: 0.43, 0.55) and above 6 (AOR: 0.39, 95%CI: 0.29, 0.59), perceived distance to the health facility not big problem (AOR: 1.11, 95%CI: 1.04, 1.15), urban residence (AOR: 1.18, 95%CI: 1.10, 1.27), high community level poverty (AOR: 0.85, 95%CI: 0.74, 0.97) were significantly associated with demand satisfied for modern contraceptives.

Conclusion

Only four in ten married reproductive age women demands satisfied with modern contraceptives in high fertility Sub Saharan African countries. Modern contraceptives should therefore be more widely available, especially in rural areas and for those living away from health facilities. Also, increasing media exposure and education, providing financial support, and making contraceptive access easier for married women from poor households are important interventions that need to be put in place.
CircRNA/miRNA/mRNA axis participates in the progression of partial bladder outlet obstruction
Authors: Zhu Baoyi , Gao Jun , Zhang Yuying , Liao Baojian , Zhu Sihua , Li Chunling , Liao Junhao , Liu Jianjia , Jiang Chonghe , Zeng Jianwen
Published: November 2022

Background

More and more evidence showed that circRNA/miRNA/mRNA axis played a vital role in the pathogenesis of some diseases. However, the role of circRNA/miRNA/mRNA axis in partial bladder outlet obstruction (pBOO) remains unknown. Our study aimed to explore the complex regulatory mechanism of circRNA/miRNA/mRNA axis in pBOO.

Methods

The pBOO rat model was established, and the bladder tissues were collected for mRNA sequencing. The differentially expressed mRNAs were analyzed by high-throughput sequencing, and the GO and KEGG analysis of the differentially expressed mRNAs were performed. Competing endogenous RNAs (ceRNAs) analysis identified the potential regulation function of circRNA/miRNA/mRNA axis in pBOO. qRT-PCR detected the expression of circRNA/miRNA/mRNA. miRanda software was performed to predict the relationship between circRNA and miRNA, miRNA and mRNA.

Results

Compared with the sham group, a total of 571 mRNAs were differentially expressed in the pBOO group, of which 286 were up-regulated and 285 were down-regulated. GO analysis showed that the mRNAs were mainly involved in cellular process, single-organism process, and cell, etc. KEGG analysis showed that the enriched signaling pathways were metabolic pathways, cell adhesion molecules (CAMs), and HTLV-I infection, etc. Based on the previous transcriptome data and differentially expressed circRNAs, we drew the ceRNA network regulation diagram. qRT-PCR results confirmed that chr3:113195876|113197193/rno-miR-30c-1-3p/Gata4, chr1:126188351|126195625/rno-miR-153-5p/Diaph3, and chr9:81258380|81275269/rno-miR-135b-5p/Pigr axis may have ceRNA function. miRanda confirmed there have the binding sites of circRNA/miRNA/mRNA axis.

Conclusions

CircRNA/miRNA/mRNA axis was involved in the progression of pBOO. Our research on the circRNA/miRNA/mRNA axis revealed new pathogenesis and treatment strategies for pBOO.
Prevalence and clinical characteristics of patients with Advanced Chronic Illness and Palliative Care needs, identified with the NECPAL CCOMS-ICO© Tool at a Tertiary Care Hospital
Authors: Calsina-Berna Agnès , Amblàs Novellas Jordi , González-Barboteo Jesús , Bardés Robles Ignasi , Beas Alba Elba , Martínez-Muñoz Marisa , Madariaga Sánchez Rafael , Gómez Batiste Alentorn Xavier
Published: November 2022

Background

The identification of patients with advanced chronic conditions and palliative care needs is essential since their care represents one of the main challenges for public health systems. The study aimed to determine the prevalence and characteristics of inpatients with palliative care needs in different services of a tertiary care hospital using the NECPAL CCOMS-ICO© tool.

Methods

A descriptive, cross-sectional cohort study was conducted in a tertiary hospital.

The NECPAL tool identifies patients who require palliative care. Any patient with the Surprise Question with the answer “NO” and at least another question of the tool with a positive answer is considered a positive identification.

Patients were classified as Non-NECPAL, NECPAL I-II, and NECPAL III, depending on the NECPAL tool criteria they met. The presence of physical symptoms, emotional distress, and social risk factors was assessed.

Results

Of the 602 inpatients, 236 (39.2%) were enrolled. Of them, 34 (14.4%) non-NECPAL, 202 (85.6%) NECPAL+ [105 (44.5%) NECPAL I-II, and 97 (41.1%) NECPAL III]. Physical symptom burden was high (pain intensity ≥ 1 in 68.3% of patients; tiredness ≥ 1 in 83.5%; somnolence ≥ 1 in 50.6%; dyspnea ≥ 1 in 37.9%; anorexia ≥ 1 in 59.5%). 64.1% had emotional distress, and 83.6% had social risk factors. The NECPAL-III group contained a higher percentage of cancer patients, higher demand for palliative care, and greater need for palliative care (p < 0.001). In 50.8% of cases, no referrals were made to psychology, social work, or hospital palliative and supportive care teams. The three services with the higher number of patients with palliative care needs were: Palliative Care Unit (100%), Oncology (54.54%), and Emergency Short-stay Unit (54.16%).

Conclusion

A high percentage of patients admitted to tertiary care hospitals presented palliative care needs, with multiple unmet physical, emotional, and social needs. Less than 50% are referred to specialized care teams, such as hospital palliative and supportive care teams.
Patient-reported outcomes among patients undergoing total hip replacement in an integrated care system and in a standard care system in Region Stockholm, Sweden
Authors: Agerholm J. , Teni F. S. , Sundbye J. , Rolfson O. , Burström K.
Published: November 2022

Background

Coordination, cooperation and efficient use of resources is vital for the health- and social care sector if it is to meet the needs of an aging population. Integrated care is a patient-centred approach to provision of care aiming to improve quality of care and overcome fragmented care through co-productive partnerships and may positively affect quality of care and health outcomes, especially among those in need of highly coordinated care services.

Aim

To compare patient-reported outcomes (PROs) among patients undergoing total hip replacement (THR) in the integrated care system in Norrtälje Municipality and in the standard care system in other municipalities in Region Stockholm, Sweden.

Methods

Swedish Hip Arthroplasty Register PRO data during 2008–2015 were compared 1 year after THR among patients (≥50 years) in integrated care (n = 407) and standard care (n = 3501) systems using linear (EQ VAS score), logistic (EQ-5D-3L dimensions) and negative binomial (hip pain VAS score) regressions. Analyses were adjusted for the preoperative factors age, sex, BMI, ASA class and type of incision.

Results

1-year postoperatively, patients in the integrated care system did not report their health significantly different from patients receiving standard care. Exceptions: Female patients in integrated care reported less problems with self-care (OR:0.52; 0.29–0.96) and patients above 70 years reported more problems with mobility (OR: 1.37; 1.01–1.87).

Conclusion

No significant differences were found between the two care systems for postoperative PROs. A longer follow-up time and analyses by socioeconomic groups would be valuable.
IL-6/STAT3 signaling in tumor cells restricts the expression of frameshift-derived neoantigens by SMG1 induction
Authors: Meraviglia-Crivelli Daniel , Villanueva Helena , Zheleva Angelina , Villalba-Esparza María , Moreno Beatriz , Menon Ashwathi Puravankara , Calvo Alfonso , Cebollero Javier , Barainka Martin , de los Mozos Igor Ruiz , Huesa-Berral Carlos , Pastor Fernando
Published: November 2022

Background

The quality and quantity of tumor neoantigens derived from tumor mutations determines the fate of the immune response in cancer. Frameshift mutations elicit better tumor neoantigens, especially when they are not targeted by nonsense-mediated mRNA decay (NMD). For tumor progression, malignant cells need to counteract the immune response including the silencing of immunodominant neoantigens (antigen immunoediting) and promoting an immunosuppressive tumor microenvironment. Although NMD inhibition has been reported to induce tumor immunity and increase the expression of cryptic neoantigens, the possibility that NMD activity could be modulated by immune forces operating in the tumor microenvironment as a new immunoediting mechanism has not been addressed.

Methods

We study the effect of SMG1 expression (main kinase that initiates NMD) in the survival and the nature of the tumor immune infiltration using TCGA RNAseq and scRNAseq datasets of breast, lung and pancreatic cancer. Different murine tumor models were used to corroborate the antitumor immune dependencies of NMD. We evaluate whether changes of SMG1 expression in malignant cells impact the immune response elicited by cancer immunotherapy. To determine how NMD fluctuates in malignant cells we generated a luciferase reporter system to track NMD activity in vivo under different immune conditions. Cytokine screening, in silico studies and functional assays were conducted to determine the regulation of SMG1 via IL-6/STAT3 signaling.

Results

IL-6/STAT3 signaling induces SMG1, which limits the expression of potent frameshift neoantigens that are under NMD control compromising the outcome of the immune response.

Conclusion

We revealed a new neoantigen immunoediting mechanism regulated by immune forces (IL-6/STAT3 signaling) responsible for silencing otherwise potent frameshift mutation-derived neoantigens.
Does severe hypoxia during irradiation of Aedes aegypti pupae improve sterile male performance?
Authors: Tussey Dylan A. , Linthicum Kenneth J. , Hahn Daniel A.
Published: November 2022

Background

The yellow fever mosquito, Aedes aegypti, vectors several pathogens responsible for human diseases. As a result, this mosquito species is a priority for control by mosquito control districts in Florida. With insecticide resistance development becoming a concern, alternative control strategies are needed for Ae. aegypti. Sterile insect technique (SIT) is an increasingly popular option that is being explored as a practical area-wide control method. However, questions about sterile male performance persist. The objectives of this study were to determine the extent to which hypoxia exposure prior to and during irradiation effects the longevity, activity and mating competitiveness of sterile male Ae. aegypti.

Methods

Male longevity was monitored and analyzed using Cox regression. Mosquito activity was recorded by an infrared beam sensor rig that detected movement. Competing models were created to analyze movement data. Fecundity and fertility were measured in females mated with individual males by treatment and analyzed using one-way ANOVAs. Mating competition studies were performed to compare both hypoxia and normoxia treated sterile males to fertile males. Competitiveness of groups was compared using Fried’s competitiveness index.

Results

First, we found that subjecting Ae. aegypti pupae to 1 h of severe hypoxia (< 1 kPa O2) did not directly increase mortality. One hour of hypoxia was found to prevent decreases in longevity of irradiated males compared to males irradiated in normoxic conditions. Exposure to hypoxia prior to irradiation did not significantly improve activity of sterile males except at the highest doses of radiation. Hypoxia did significantly increase the required dose of radiation to achieve > 95% male sterility compared to males irradiated under normoxic conditions. Males sterilized after an hour in hypoxic conditions were significantly more competitive against fertile males compared to males irradiated under normoxic conditions despite requiring a higher dose of radiation to achieve sterility.

Conclusions

Hypoxia was found to greatly improve key performance metrics in sterile male Ae. aegypti without any significant drawbacks. Little work other than increasing the target dose for sterility needs to be conducted to incorporate hypoxia into SIT programs. These results suggest that SIT programs should consider including hypoxia in their sterile male production workflow.

Graphical Abstract
Role of anti-Giardia recombinant cyst wall protein IgG polyclonal antibodies in diagnosis and protection
Authors: Maher Ahmed , Atallah Donia , Hassan Mahmoud , Hammad Mariam , Galal Mohaned , Mohamed Saif-Eldin , Abdelkafy Yara , Farid Alyaa
Published: November 2022

Giardia duodenalis(G. duodenalis) is an infectious protozoan that has a global distribution especially in the hot climate. Around 200 million people are infected worldwide annually byGiardia, but infection is not always accompanied by symptoms, especially in endemic countries. Using traditional microscopy techniques in diagnosis, both in stool and water samples were less sensitive when compared to immunological methods; and the need for new diagnostic methods was necessary. Also, protection from infection is required in endemic areas. Therefore, the study aimed to produce anti-G. duodenalisIgG polyclonal antibodies (pAbs) by immunizing rabbit byG. duodenaliscyst recombinant protein. The produced antibodies were evaluated in the detection ofG. duodenalisantigens in patients’ stool and water samples from endemic areas across River Nile; where pAbs were used as a coating and a peroxidase conjugate antibody in sandwich ELISA. Moreover, pAbs were tested for the protection of mice from giardiasis. Sandwich ELISA using pAb has succeeded in the detection ofG. duodenaliscoproantigens in stool samples by a sensitivity of 97% and a specificity of 92.72%. Moreover,G. duodenaliscyst was detected in only seven water samples by ordinary microscopy; while sandwich ELISA revealed nineteen positive results. IgG pAb (1/200 µg/ml) protected mice from giardiasis; which was evident from the reduction in cysts and trophozoites numbers. We recommended the use of sandwich ELISA to monitor water quality, investigate environmental contamination and diagnosis in patients' stools. The pAbs can be prepared in large amount and used in field diagnosis and protection. This will help in the early diagnosis ofG. duodenalisin water, which in turn can control outbreaks in rural areas.
Insights into the antimicrobial effects of ceritinib against Staphylococcus aureus in vitro and in vivo by cell membrane disruption
Authors: Liu Shasha , She Pengfei , Li Zehao , Li Yimin , Yang Yifan , Li Linhui , Zhou Linying , Wu Yong
Published: November 2022

According to a 2019 report from the Centers of Disease Control and Prevention (CDC), methicillin-resistant Staphylococcus aureus (MRSA) was listed as one of the “serious threats” that had become a global public challenge in hospitals and community. Biofilm-associated infections and refractory persisters of S. aureus also impede the effectiveness of conventional antibiotics that have greatly increased difficulty in clinical therapy. There is an urgent need to develop new antimicrobials with antibiofilm and anti-persister capacities, and drug repurposing is the most effective and most economical solution to the problem. The present study profiles the antimicrobial activity of ceritinib, a tyrosine kinase inhibitor, against S. aureus in vitro and in vivo. We investigated the antimicrobial efficacy of ceritinib against planktonic and persistent S. aureus by a time-killing kinetics assay. Then, antibiofilm effect of ceritinib was assessed by crystal violet staining and laser confocal microscope observation. Ceritinib showed biofilm inhibition and mature biofilm eradication, and possesses robust bactericidal activity against S. aureus persisters. We also evaluated antimicrobial efficacy in vivo using a subcutaneous abscess infection model. Ceritinib ameliorated infection in a subcutaneous abscess mouse model and only showed negligible systemic toxicity in vivo. Mechanism exploration was conducted by transmission electron microscopy, fluorescently labeled giant unilamellar vesicle assays, and a series of fluorescent dyes. In conclusion, we find ceritinib represents potential bactericidal activity against MRSA by disrupting cell membrane integrity and inducing reactive oxygen species production, suggesting ceritinib has the potential to treat MRSA-related infections.
A computational method based on the generalized Lucas polynomials for fractional optimal control problems
Authors: Karami Sh. , Fakharzadeh Jahromi A. , Heydari M. H.
Published: November 2022

Nonorthogonal polynomials have many useful properties like being used as a basis for spectral methods, being generated in an easy way, having exponential rates of convergence, having fewer terms and reducing computational errors in comparison with some others, and producing most important basic polynomials. In this regard, this paper deals with a new indirect numerical method to solve fractional optimal control problems based on the generalized Lucas polynomials. Through the way, the left and right Caputo fractional derivatives operational matrices for these polynomials are derived. Based on the Pontryagin maximum principle, the necessary optimality conditions for this problem reduce into a two-point boundary value problem. The main and efficient characteristic behind the proposed method is to convert the problem under consideration into a system of algebraic equations which reduces many computational costs and CPU time. To demonstrate the efficiency, applicability, and simplicity of the proposed method, several examples are solved, and the obtained results are compared with those obtained with other methods.
Design and implementation of a metaverse platform for traditional culture: the chime bells of Marquis Yi of Zeng
Authors: Wu Lingyi , Yu Riji , Su Wei , Ye Shishu
Published: November 2022

Metaverse platforms have become increasingly prevalent for collaboration in virtual environments. Metaverse platforms, as opposed to virtual reality, augmented reality, and mixed reality, expand with enhanced social meanings within virtual worlds. The research object in this study is the chime bells of Marquis Yi of Zeng, one of China's most treasured cultural heritage sites. We aimed to create a metaverse platform for the chime bells of Marquis Yi of Zeng to provide visitors with a highly immersive and interactive experience. First, we collected the materials and data of the chime bells and other exhibits, as well as historical information. Then, the data were processed and integrated for 3D model reconstruction. In addition, we designed the virtual roaming system through which visitors could interact with the exhibits to obtain multimedia information and even knock to ring the chime bells. Finally, we built our system to connect multiple visitors in different geographic locations and encourage them to collaborate and communicate within the virtual space. This platform helps users visualize cultural heritage, simulates real-life tour experiences with intuitive manners of interaction, and motivates visitors’ interest in traditional culture. This research also reveals the potential use of metaverse-related techniques in cultural heritage sectors.
Factors affecting provision of female family planning commodities in public health facilities in Kajiado county, Kenya
Authors: Githinji Fredrick , Maru Shital M. , Karimi Peter N. , Rutungwa Eugene , Kayitare Egide
Published: November 2022

Background

Family planning involves the use of traditional or modern methods to prevent maternal and infant mortality associated with unintended pregnancies and negative economic outcomes. In sub-Saharan Africa, the unmet need for modern family planning is approximately 66%. However, information on factors affecting utilization of female family planning commodities is limited. Therefore, this research was conducted to bridge this gap.

Methods

Health facility-based descriptive cross-sectional research design was conducted and involved the public health facilities offering family planning, targeting respondents who handle the commodities and service providers themselves. A semi-structured questionnaire was used to collect data about availability of the commodities, knowledge of service providers and barriers affecting provision of the service. Data were coded and analyzed via Microsoft Excel 2019 and SPSS version 20.

Results

The study showed that shorter term methods were more readily available, 60–75% than the long-term methods, 20–60%. Approximately 60% of the service providers did not comprehensively utilize the recommended World Health Organization Medicine Eligibility Criteria (WHO MEC) during service provision. Stock outs, myths and misconceptions, male interference and culture were the major barriers identified.

Conclusion

Provision of family planning commodities in public health facilities in Kajiado county is affected by stock levels at the national program, and provider knowledge on WHO MEC. The key factors affecting provision of family planning were stock outs, myths and misconceptions on the contraceptives, inadequate male involvement and inadequate community engagement on potential benefits of the service. These challenges need to be part of the solutions to bridging the gap identified.
Factors determining membership in community-based health insurance in West Africa: a scoping review
Authors: Conde Kaba Kanko , Camara Aboubacar Mariama , Jallal Manar , Khalis Mohamed , Zbiri Saad , De Brouwere Vincent
Published: November 2022

Background

In many low-income countries, households bear most of the health care costs. Community-based health insurance (CBHI) schemes have multiplied since the 1990s in West Africa. They have significantly improved their members’ access to health care. However, a large proportion of users are reluctant to subscribe to a local CBHI. Identifying the major factors affecting membership will be useful for improving CBHI coverage. The objective of this research is to obtain a general overview of existing evidence on the determinants of CBHI membership in West Africa.

Methods

A review of studies reporting on the factors determining membership in CBHI schemes in West Africa was conducted using guidelines developed by the Joanna Briggs Institute. Several databases were searched (PubMed, ScienceDirect, Global Health database, Embase, EconLit, Cairn.info, BDPS, Cochrane database and Google Scholar) for relevant articles available by August 15, 2022, with no methodological or linguistic restrictions in electronic databases and grey literature.

Results

The initial literature search resulted in 1611 studies, and 10 studies were identified by other sources. After eliminating duplicates, we reviewed the titles of the remaining 1275 studies and excluded 1080 irrelevant studies based on title and 124 studies based on abstracts. Of the 71 full texts assessed for eligibility, 32 additional papers were excluded (not relevant, outside West Africa, poorly described results) and finally 39 studies were included in the synthesis. Factors that negatively affect CBHI membership include advanced age, low education, low household income, poor quality of care, lack of trust in providers and remoteness, rules considered too strict or inappropriate, low trust in administrators and inadequate information campaign.

Conclusions

This study shows many lessons to be learned from a variety of countries and initiatives that could make CBHI an effective tool for increasing access to quality health care in order to achieve universal health coverage. Coverage through CBHI schemes could be improved through communication, improved education and targeted financial support.
Developing a conceptual framework for the health protection of United Nations peacekeepers against the COVID-19 pandemic from global health perspectives
Authors: Yuan Quan , Chen Yong , Wan Jiqing , Zhang Rui , Liao Miaomiao , Li Zhaogang , Zhou Jiani , Li Ying
Published: November 2022

The coronavirus disease 2019 (COVID-19) pandemic has posed particular health risks to United Nations peacekeepers, which require prompt responses and global attention. Since the health protection of United Nations peacekeepers against the COVID-19 pandemic is a typical global health problem, strategies from global health perspectives may help address it. From global health perspectives, and referring to the successful health protection of the Chinese Anti-Ebola medical team in Liberia, a conceptual framework was developed for the health protection of United Nations peacekeepers against the COVID-19 pandemic. Within this framework, the features include multiple cross-borders (cross-border risk factors, impact, and actions); multiple risk factors (Social Determinants of Health), multiple disciplines (public health, medicine, politics, diplomacy, and others), and extensive interdepartmental cooperation. These strategies include multiple phases (before-deployment, during-deployment, and post-deployment), multi-level cooperation networks (the United Nations, host countries, troop-contributing countries, the United Nations peacekeeping team, and United Nations peacekeepers), and concerted efforts from various dimensions (medical, psychological, and social).
A postmortem study of unexpected natural pediatric deaths in Egypt
Authors: Fnon Nora Fawzy , Ismael Nour El-Hoda Sayed , Hassan Hanan Hosney , El-Sheikh Samar Abd-Elmonem , Sobh Zahraa Khalifa
Published: November 2022

Background

Identifying the causes of unexpected pediatric deaths is a clinical, medicolegal, and humanitarian requirement. This study included autopsied children aged < 18 years who suddenly died due to natural causes and excluded nonnatural deaths. The study was performed over 5 years in the Egyptian Forensic Medical Authority.

Results

The study included 244 cases, consisting of 51.6% of neonates (< 1 month), 18% of infants (1–12 months), and 30.3% of children (1–18 years). The cause of death in neonates and children was “explained natural diseases” in 73.8% and 91.9%, respectively, while it was only 45.5% in infants. Infection-related deaths account for 30.4% of all explained natural deaths. Infections were responsible for 11.8% of explained deaths in neonates, while 55% and 48.5% were in infants and children, respectively. Of the fatal infections, 60% occurred at the age of > 1 year. Pneumonia accounted for 61.8% of infection-related deaths, followed by myocarditis (12.7%) and septicemia (12.7%). Regarding systems that had fatal pathologies, respiratory causes were responsible for 64% of explained natural deaths, whereas cardiovascular and central nervous system diseases accounted for 11% and 7.7% of explained natural deaths, respectively. Considering prodromes, alarming symptoms were reported before death in 51.2% of cases, whereas death occurred without alarming manifestations in 29.9% of cases. The rest of the cases (18.9%) were abandoned children with unavailable antemortem data.

Conclusions

Present results serve as a valuable reference dataset for deaths in developmental stages in Egypt that guides forensic practitioners in managing child deaths.
Antagonist activities of native rhizosphere micro-flora against groundnut stem rot pathogen, Sclerotium rolfsii Sacc.
Authors: Akash A. U. , Ramya V. , Uma Devi G. , Pushpavalli S. N. C. V. L. , Triveni S.
Published: November 2022

Background

Stem rot caused bySclerotium rolfsiiSacc. is a major nuisance in groundnut production, causing substantial yield losses in almost all groundnut-growing areas around the world. Biological control is regarded as a sustainable choice over the currently popular management strategy i.e., chemical control, as later has a negative influence on the environment. The present study evaluated the antagonistic effect of native rhizosphere micro-flora against groundnut stem rot pathogenS. rolfsii.

Results

A total of 111 bacterial isolates and 9Trichodermaisolates isolated from groundnut rhizosphere soil were evaluated for their antagonist activity againstS. rolfsiiin vitro. Eight isolates (seven bacterial and oneTrichoderma) were chosen as prospective biocontrol candidates based on the findings of the dual culture assay. Molecular characterization of these isolates by 16S rDNA and ITS rDNA sequencing confirmed the identity of bacterial isolates asBacillusspp. (sixB. subtilisand oneB. amyloliquefaciens) and fungal isolate asTrichoderma asperellum. Also, the selected seven bacterial isolates recorded favourable results for antagonism-promoting biochemical traits.

Conclusion

The results of the current study suggested that the native groundnut rhizosphere micro-flora can be exploited for biological control of groundnut stem rot pathogenS. rolfsii. Further research may enable the use of the isolated rhizosphere biocontrol agents as single organisms or in a consortium for sustainable management of the groundnut stem rot pathogen.
Sustainability in interventional radiology: are we doing enough to save the environment?
Authors: Shum Pey Ling , Kok Hong Kuan , Maingard Julian , Zhou Kevin , Van Damme Vivienne , Barras Christen D. , Slater Lee-Anne , Chong Winston , Chandra Ronil V. , Jhamb Ashu , Brooks Mark , Asadi Hamed
Published: November 2022

Background

Healthcare waste contributes substantially to the world’s carbon footprint. Our aims are to review the current knowledge of Interventional Radiology (IR) waste generation and ways of reducing waste in practice, to quantify the environmental and financial impact of waste generated and address green initiatives to improve IR waste management.

Methods

A systematic literature search was conducted in July 2022 using the Medline and Embase literature databases. The scope of the search included the field of IR as well as operating theatre literature, where relevant to IR practice.

Results

One-hundred articles were reviewed and 68 studies met the inclusion criteria. Greening initiatives include reducing, reusing and recycling waste, as well as strict waste segregation. Interventional radiologists can engage with suppliers to reformulate procedure packs to minimize unnecessary items and packaging. Opened but unused equipment can be prevented if there is better communication within the team and increased staff awareness of wasted equipment cost. Incentives to use soon-to-expire equipment can be offered. Power consumption can be reduced by powering down operating room lights and workstations when not in use, changing to Light Emitting Diode (LED) and motion sensor lightings. Surgical hand wash can be replaced with alcohol-based hand rubs to reduce water usage. Common barriers to improving waste management include the lack of leadership, misconceptions regarding infectious risk, lack of data, concerns about increased workload, negative staff attitudes and resistance to change. Education remains a top priority to engage all staff in sustainable healthcare practices.

Conclusion

Interventional radiologists have a crucial role to play in improving healthcare sustainability. By implementing small, iterative changes to our practice, financial savings, greater efficiency and improved environmental sustainability can be achieved.
The current status and history of AFLAS
Authors: Kasai Noriyuki
Published: November 2022

The Asian federation of laboratory animal science associations (AFLAS) was established on November 29, 2003, and will celebrate its 20th anniversary in 2023. During this time, the number of AFLAS member associations and societies increased from six founders to eleven, and eight AFLAS congresses and 19 council meetings were held. In addition, the education and training system of laboratory animal science and technology funding program to support the activities of AFLAS member associations or societies started in 2015. Unfortunately, the COVID-19 pandemic had a great impact on the activities of AFLAS, and the 10th Congress which was scheduled to be held in Thailand in 2021 had to be canceled. AFLAS must have its members work together to overcome this difficult situation and further develop.
Optimization of the iron-enriched extruded snack containing jackfruit seed flour, mung bean flour and ferrous ammonium phosphate by using response surface methodology
Authors: Kumari Aparna , Gupta Aditya , Chauhan Anil Kumar
Published: November 2022

The Food and Agriculture Organization (State of food and agriculture. Moving forward on food loss and waste reduction, 2019) stated that approximately 1.3 billion tons of food wasted every year caused the emission of around 4.4 gigatons of greenhouse gas. World Health Organization highlights that iron deficiency affects billions of people worldwide and remains the leading cause of anemia. With the growth of healthy and sustainable diets and consumers’ better understanding of the relationship between diet, health, and the environment, there is an opportunity to develop novel healthy extruded snacks. The present study was carried out using response surface methodology to investigate the effects of varying proportions of jackfruit seed flour, mung bean flour, and ferrous ammonium phosphate on physical and functional properties of extruded snacks. Experiments were carried out using a central composite rotatable design with three independent parameters such as jackfruit seed flour(%), mung bean flour(%), and ferrous ammonium phosphate (%), and five responses such as bulk density (BD), expansion ratio (ER), hardness, color difference (ΔE), and iron content. It was found that ferrous ammonium phosphate significantly increased the iron content. Bulk density, expansion ratio, and hardness were significantly affected by jackfruit seed flour and mung bean flour. All independent variables significantly influenced colour value. The optimized iron-enrich extruded snacks were obtained at 24.87% jackfruit seed flour, 20.95% mung bean flour, and 0.021% ferrous ammonium phosphate. The optimized extruded snack contained 15.32 g/100 g protein and 22.03 mg/100 g iron content. Results of the study indicate that the optimized extruded snack could be used as a protein and iron source to mitigate malnutrition and anemia.

Graphical Abstract
Robot-assisted ipsilateral partial nephrectomy with distal ureterectomy for synchronous renal and ureteric tumors—a case report
Authors: Murugesan Anandan
Published: November 2022

Background

Ipsilateral synchronous renal and ureteric tumor is uncommon. Nephron sparing surgery is the standard for small renal masses. Ureteric tumors can be selectively managed with nephron sparing surgery, especially in renal dysfunction. This case report details the management of double malignancy by nephron sparing surgery with robot-assisted approach.

Case report

A 63-year-old gentleman with diabetes presented with history of intermittent gross hematuria for 2 weeks. He was clinically normal. On evaluation, he had grade 4 renal dysfunction (Se. creatinine 4.5 mg%) with mild proteinuria. Magnetic resonance imaging revealed right renal upper polar Bosniak III lesion and right hydroureteronephrosis due to 2 cm ureteric tumor near the vessel crossing. Renogram showed overall GFR of 22 ml/min with 31% (6 ml/min) contribution from the right side. He underwent robot-assisted right partial nephrectomy with distal ureterectomy and Boari flap ureteric reimplantation. Histopathology revealed margins free T2 clear cell carcinoma (kidney) and high-grade T3 transitional cell carcinoma (ureter). His nadir creatinine at 1 year follow-up was 3.3 mg% and no recurrence on MRI, cystoscopy, and ureteroscopy at 1 year.

Conclusion

Minimally invasive nephron sparing surgery is feasible and reasonable option with satisfactory oncological control even in ipsilateral synchronous renal and ureteric tumors in selected patients with renal dysfunction.
Alterations of the fecal microbiota in relation to acute COVID-19 infection and recovery
Authors: Yin Yue Sandra , Minacapelli Carlos D. , Parmar Veenat , Catalano Carolyn C. , Bhurwal Abhishek , Gupta Kapil , Rustgi Vinod K. , Blaser Martin J.
Published: November 2022

People with acute COVID-19 due to SARS-CoV-2 infection experience a range of symptoms, but major factors contributing to severe clinical outcomes remain to be understood. Emerging evidence suggests associations between the gut microbiome and the severity and progression of COVID-19. To better understand the host-microbiota interactions in acute COVID-19, we characterized the intestinal microbiome of patients with active SARS-CoV-2 infection in comparison to recovered patients and uninfected healthy controls. We performed 16S rRNA sequencing of stool samples collected between May 2020 and January 2021 from 20 COVID-19-positive patients, 20 COVID-19-recovered subjects and 20 healthy controls. COVID-19-positive patients had altered microbiome community characteristics compared to the recovered and control subjects, as assessed by both α- and β-diversity differences. In COVID-19-positive patients, we observed depletion of Bacteroidaceae, Ruminococcaceae, and Lachnospiraceae, as well as decreased relative abundances of the genera Faecalibacterium, Adlercreutzia, and the Eubacterium brachy group. The enrichment of Prevotellaceae with COVID-19 infection continued after viral clearance; antibiotic use induced further gut microbiota perturbations in COVID-19-positive patients. In conclusion, we present evidence that acute COVID-19 induces gut microbiota dysbiosis with depletion of particular populations of commensal bacteria, a phenomenon heightened by antibiotic exposure, but the general effects do not persist post-recovery.
How can we obtain truly translational mouse models to improve clinical outcomes in schizophrenia?
Authors: Clapcote Steven J.
Published: November 2022

Schizophrenia is a serious mental illness affecting 0.7% of the world’s population. Despite over 50 years of schizophrenia drug identification and development, there have been no fundamental advances in the treatment of schizophrenia since the 1980s. Complex genetic aetiology and elusive pathomechanisms have made it difficult for researchers to develop models that sufficiently reflect pathophysiology to support effective drug discovery. However, recent large-scale, well-powered genomic studies have identified risk genes that represent tractable entry points to decipher disease mechanisms in heterogeneous patient populations and develop targeted treatments. Replicating schizophrenia-associated gene variants in mouse models is an important strategy to start understanding their pathogenicity and role in disease biology. Furthermore, longitudinal studies in a wide range of genetic mouse models from early postnatal life are required to assess the progression of this disease through developmental stages to improve early diagnostic strategies and enable preventative measures. By expanding and refining our approach to schizophrenia research, we can improve prevention strategies and treatment of this debilitating disease.
Standard Lymphadenectomy for Esophageal and Lung Cancer: Variability in the Number of Examined Lymph Nodes Among Pathologists and Its Survival Implication
Authors: Uimonen Mikko , Helminen Olli , Böhm Jan , Mrena Johanna , Sihvo Eero
Published: November 2022

Aim

We compared variability in number of examined lymph nodes between pathologists and analyzed survival implications in lung and esophageal cancer after standardized lymphadenectomy.

Methods

Outcomes of 294 N2 dissected lung cancer patients and 132 2-field dissected esophageal cancer patients were retrospectively examined. The primary outcome was difference in reported lymph node count among pathologists. Secondary outcomes were overall and disease-specific survival related to this count and survival related to the 50% probability cut-off value of detecting metastasis based on the number of examined lymph nodes.

Results

The median number of examined lymph nodes in lung cancer was 13 (IQR 9–17) and in esophageal cancer it was 22 (18–29). The pathologist with the highest median number of examined nodes had > 50% higher lymph node yield compared with the pathologist with the lowest median number of nodes in lung (15 vs. 9.5,p= 0.003), and esophageal cancer (28 vs. 17,p= 0.003). Survival in patients stratified by median reported lymph node count in both lung (adjusted RMST ratio < 14 vs. ≥ 14 lymph nodes 0.99, 95% CI 0.88–1.10;p= 0.810) and esophageal cancer (adjusted RMST ratio < 25 vs. ≥ 25 lymph nodes 0.95, 95% CI 0.79–1.15,p= 0.612) was similar. The cut-off value for 50% probability of detecting metastasis by number of examined lymph nodes in lung cancer was 15.7 and in esophageal cancer 21.8. When stratified by this cut-off, no survival differences were seen.

Conclusion

The quality of lymphadenectomy based on lymph node yield is susceptible to error due to detected variability between pathologists in the number of examined lymph nodes. This variability in yield did not have any survival effect after standardized lymphadenectomy.
Dynamic Matching in Overloaded Waiting Lists
Authors: Leshno Jacob D.
Published: November 2022

This paper introduces a stylized model to capture distinctive features of waiting list allocation mechanisms. First, agents choose among items with associated expected wait times. Waiting times serve a similar role to that of monetary prices in directing agents' choices and rationing items. Second, the expected wait for an item is endogenously determined and randomly fluctuates over time. We evaluate welfare under these endogenously determined waiting times and find that waiting time fluctuations lead to misallocation and welfare loss. A simple randomized assignment policy can reduce misallocation and increase welfare. (JEL C78, D61, D82, D83)
Frontier model of the environmental inefficiency effects on livestock bioeconomy
Authors: Zuniga Gonzalez C. A. , Jaramillo-Villanueva J. L.
Published: November 2022

Background: This work was focused on measuring environmental inefficiency in Mexican dairy farms, considering climate change variables related to the emission of greenhouse gases (GHG) and planetary geomagnetic activity.

Methods: The applied methodology measures the eco-efficiency of Mexican dairy farms using the empirical application of a stochastic frontier model of the bioeconomy. The productive sector of the bioeconomy studied was the eco-intensification of the livestock production system (dairies). The environmental inefficiency effect was assumed to be a distribution-independent truncation of a normal distribution with constant variance, while the mean was a linear environmental function of the observable variable.

Results: The results showed that the coefficients of the frontier model were highly significant, highlighting the investment in livestock (50%). The inefficiency model had an impact on climate variation with greenhouse gas emissions CH4 (1.96%). The results of the environmental technical efficiency in geometric average were 81.28%. The producers that reached the border with a technical efficiency equal to 1 are the references for the rest, marking the relative technical efficiency.

Conclusions: It was concluded that the coefficients in the model were very significant, showing the level of investment in livestock (50%). The low-performance model estimates the impact of climate change on GHG emissions CH4 (1.96%) explaining the trend of increasing GHG emissions, keeping in view that the management of food and cattle during the study period were affected by summer feeding, which allowed considering the activity of GHG emissions. According to the results, the geometric mean environmental performance of engineering is 81.28%.
What’s Wrong with Democracy? The Peculiar Power of Kratos
Authors: McGuire John
Published: November 2022

In this paper, I reconstruct the notion of kratos as a unique and distinguishable mode of political power. My claim will be that kratos encapsulates a specific problem for democracy, in both ancient and modern contexts. Using examples from 5th- and 4th- century Attic tragedy, Old Comedy, and forensic oratory, I show how kratos was used in Athenian cultural and political discourse to convey the irrefutability of a claim, the recognition of prevailing over another, and the sense of having the last word, all of which makes kratic power dependent upon its continued demonstrability. Although the agency of the dēmos is now largely mediated through representative mechanisms, the peculiarly kratic drive towards ‘winning,’ with all its inherent instability and vacuity, remains indispensable for democratic legitimacy. In focusing critical attention on kratos and the pathology of winning, I hope to shift discussion from what divides ‘elites’ from the ‘masses,’ to a problem shared in common.