bluuebunny/crossref_metadata_2025 huggingface dataset:
Prevalence of suicidal ideation and attempted suicide in the general population of Ethiopia: a systematic review and meta-analysis
Authors: Bifftu Berhanu Boru , Tiruneh Bewket Tadesse , Dachew Berihun Assefa , Guracho Yonas Deressa
Published: March 2021

Background

In Ethiopia, in spite of the high burden of suicide related-adverse effect, substantial variability in the reported prevalence of individual studies about suicidal ideation and attempted suicide; there is no national level epidemiological evidence. Thus, the present study aimed to determine the pooled prevalence of suicide ideation and suicidal attempt in the general population.

Methods

We followed the PRISMA Guidelines to report the results of the finding. Databases including: PubMed/Medline, SCOPUS, CINAHL (EBSCOhost), African Journal Online (AJOL) and African Indexed Medicus (AIM) were searched. Heterogeneity was assessed by Cochrane chi-square (χ2) and quantified by I2 statistics test. Sensitivity test and subgroup analysis performed. Publication bias was tested by funnel plots and Egger’s test. Effect size was calculated by random effects model.

Results

A total of 12 studies for suicidal ideation and 10 studies for attempted suicide were included in the study. The prevalence of suicidal ideation and attempted suicide were ranged from 1 to 55% and 0.6% to 14% respectively. The 12-month pooled prevalence of suicidal ideation and suicidal attempt were 9% (5–16%), I2 = 99.64%, p < 0.001 and 4% (1–8%), I2 = 98.11%, p < 0.001] respectively. The lifetime pooled prevalence of attempted suicide was found to be 4% (3–6%). We found evidence of significant heterogeneity for suicidal ideation [I2 = 99.64%, p < 0.001] and attempted suicide [I2 = 98.11%, p < 0.001]. The subgroup analysis could not identified source of heterogeneity. The sensitivity analysis showed that none of the point estimates was outside of the overall 95%CI for suicidal ideation and attempted suicide. No evidence of publication bias from the visual inspection of the funnel plot for suicidal ideation and [Egger’s test (P = 0.174)] and attempted suicide [Egger’s test (P = 0.318)].

Conclusion

High prevalence of suicidal ideation and attempted suicide were observed in the general population of Ethiopia. These suggest the need of strengthening the awareness of suicidal behaviours and evaluate the effectiveness of the national health strategy in addressing the issues of suicidal behaviours.
Pediatric routine vaccinations in the COVID 19 lockdown period: the survey of the Italian Pediatric Society
Authors: Russo Rocco , Bozzola Elena , Palma Paolo , Corsello Giovanni , Villani Alberto
Published: March 2021

Background

COVID-19 pandemic was responsible for disrupting routine immunization activities all over the world. Aim of the study was to investigate the reduced adherence to the national children vaccination schedule during the lockdown period in Italy.

Materials and methods

Through social channels, the Italian Pediatric Society conducted a survey among Italian families on children vaccination during lockdown period.

Results

In the study period, 1474 responders were collected. More than one third (34%) of them skipped the vaccine appointment as they were afraid of SARS-CoV-2-virus (44%), vaccination services postponed the appointment (42%) or was closed to public (13%).

Discussion

Reduction in routine immunization coverage may represent a serious life-threating problem for unvaccinated or under-vaccinated children.

Conclusions

Information on national and local preventive measures including physical distancing, handwashing, and proper coughing/sneezing hygiene should be spread among families in order to contrast vaccine hesitancy and maintain adequate coverage levels during COVID19 pandemic period.
CACTUS: integrating clonal architecture with genomic clustering and transcriptome profiling of single tumor cells
Authors: Shafighi Shadi Darvish , Kiełbasa Szymon M. , Sepúlveda-Yáñez Julieta , Monajemi Ramin , Cats Davy , Mei Hailiang , Menafra Roberta , Kloet Susan , Veelken Hendrik , van Bergen Cornelis A.M. , Szczurek Ewa
Published: March 2021

Background

Drawing genotype-to-phenotype maps in tumors is of paramount importance for understanding tumor heterogeneity. Assignment of single cells to their tumor clones of origin can be approached by matching the genotypes of the clones to the mutations found in RNA sequencing of the cells. The confidence of the cell-to-clone mapping can be increased by accounting for additional measurements. Follicular lymphoma, a malignancy of mature B cells that continuously acquire mutations in parallel in the exome and in B cell receptor loci, presents a unique opportunity to join exome-derived mutations with B cell receptor sequences as independent sources of evidence for clonal evolution.

Methods

Here, we propose CACTUS, a probabilistic model that leverages the information from an independent genomic clustering of cells and exploits the scarce single cell RNA sequencing data to map single cells to given imperfect genotypes of tumor clones.

Results

We apply CACTUS to two follicular lymphoma patient samples, integrating three measurements: whole exome, single-cell RNA, and B cell receptor sequencing. CACTUS outperforms a predecessor model by confidently assigning cells and B cell receptor-based clusters to the tumor clones.

Conclusions

The integration of independent measurements increases model certainty and is the key to improving model performance in the challenging task of charting the genotype-to-phenotype maps in tumors. CACTUS opens the avenue to study the functional implications of tumor heterogeneity, and origins of resistance to targeted therapies. CACTUS is written in R and source code, along with all supporting files, are available on GitHub (https://github.com/LUMC/CACTUS).
Diverting less urgent utilizers of emergency medical services to primary care: is it feasible? Patient and morbidity characteristics from a cross-sectional multicenter study of self-referring respiratory emergency department consulters
Authors: Holzinger Felix , Oslislo Sarah , Resendiz Cantu Rebecca , Möckel Martin , Heintze Christoph
Published: March 2021

Objective

Diversion of less urgent emergency medical services (EMS) callers to alternative primary care (PC) is much debated. Using data from the EMACROSS survey of respiratory ED patients, we aimed to characterize self-referred EMS patients, compare these with non-EMS patients, and assess scope and acceptability of a potential redirection to alternative PC.

Results

Of n = 292 self-referred patients, n = 99 were transported by EMS. Compared to non-EMS patients, these were older, triaged more urgently and arrived out-of-hours more frequently. The share of chronically and severely ill patients was greater. Out-of-hours ED visit, presence of a chronic pulmonary condition as well as a hospital diagnosis of respiratory failure were identified as determinants of EMS utilization in a logistic model, while consultation for access and quality motives as well as migrant status decreased the probability. EMS-transported lower urgency outpatients visiting during regular physicians’ hours were defined as potential PC cases and evaluated descriptively (n = 9). As a third was medically complex and potentially less suitable for PC, redirection potential could be estimated at only 6% of EMS cases. This would be reduced to 2% if considering patients’ judgment concerning the appropriate setting. Overall, the scope for PC diversion of respiratory EMS patients seems limited.
16S rRNA sequencing of samples from universal stool bank donors
Authors: Santiago Marina , Olesen Scott W.
Published: March 2021

Objectives

Universal stool banks provide stool to physicians for use in treating recurrent Clostridioides difficile infection via fecal microbiota transplantation. Stool donors providing the material are rigorously screened for diseases and disorders with a potential microbiome etiology, and they are likely healthier than the controls in most microbiome datasets. 16S rRNA sequencing was performed on samples from a selection of stool donors at a large stool bank, OpenBiome, to characterize their gut microbial community and to compare samples across different timepoints and sequencing runs.

Data description

16S rRNA sequencing was performed on 200 samples derived from 170 unique stool donations from 86 unique donors. Samples were sequenced on 11 different sequencing runs. We are making this data available because rigorously screened, likely very healthy stool donors may be useful for characterizing and understanding microbial community differences across different populations and will help shed light into the how the microbiome community promotes health and disease.
Seronegative limbic encephalitis manifesting as subacute amnestic syndrome: a case report and review of the literature
Authors: Ismail Ismail Ibrahim , Alnaser Fahad , Al-Hashel Jasem Y.
Published: March 2021

Background

Limbic encephalitis (LE), a variant of autoimmune encephalitis, is inflammation of the limbic system of the brain. The disorder presents with subacute impairment of short-term memory, psychiatric manifestations, confusion and seizures. “Seronegative LE” is a challenging diagnosis in the absence of well-characterized autoantibodies.

Case presentation

A 33-year-old Kuwaiti woman with no relevant past history presented with subacute progressive amnesia of 6-month duration. Magnetic resonance imaging (MRI) showed bilateral hyperintensity of the limbic structures. An extensive workup of the blood and cerebrospinal fluid (CSF) failed to identify paraneoplastic or autoimmune antibodies. The diagnosis of seronegative LE was made, and immunotherapy was initiated, with improvement in cognitive function.

Conclusion

Seronegative LE is a challenging diagnosis. Inability to detect autoantibodies, especially early in the disease course, should not rule out the diagnosis of autoimmune encephalitis. Early diagnosis and treatment with immunotherapy may prevent irreversible brain damage.
Analysis of the effects of related fingerprints on molecular similarity using an eigenvalue entropy approach
Authors: Kuwahara Hiroyuki , Gao Xin
Published: March 2021

Two-dimensional (2D) chemical fingerprints are widely used as binary features for the quantification of structural similarity of chemical compounds, which is an important step in similarity-based virtual screening (VS). Here, using an eigenvalue-based entropy approach, we identified 2D fingerprints with little to no contribution to shaping the eigenvalue distribution of the feature matrix as related ones and examined the degree to which these related 2D fingerprints influenced molecular similarity scores calculated with the Tanimoto coefficient. Our analysis identified many related fingerprints in publicly available fingerprint schemes and showed that their presence in the feature set could have substantial effects on the similarity scores and bias the outcome of molecular similarity analysis. Our results have implication in the optimal selection of 2D fingerprints for compound similarity analysis and the identification of potential hits for compounds with target biological activity in VS.
Negative selection—a new performance measure for automated order execution
Authors: Kumaresan Miles , Krejić Nataša , Lončar Sanja
Published: March 2021

Automated Order Execution is the dominant way of trading at stock markets. Performance of numerous execution algorithms is measured through slippage from some benchmark. But measuring true slippage in algorithmic execution is a difficult task since the execution as well as benchmarks are function of market activity. In this paper, we propose a new performance measure for execution algorithms. The measure, named Negative Selection, takes a posterior look at the trading window and allows us to determine what would have been the optimal order placement if we knew in advance, before the actual trading, the complete market information during the trading window. We define the performance measure as the difference between the hypothetical optimal trading position and the actual execution. This difference is calculated taking into account all prices and traded quantities within the considered time window. Thus, we are capturing the impact caused by our own trading as a cost that affects all trades. Properties of Negative Selection, which make it well defined and objective are discussed. Some empirical results on real trade data are presented.
Suicide rates and risk factors for suicide among Israeli immigrants from Ethiopia (1985–2017)
Authors: Youngmann Rafael , Zilber Nelly , Haklai Ziona , Goldberger Nehama
Published: March 2021

Background

Suicide rates among Ethiopian immigrants to Israel (EI) are relatively high. This study sought to identify suicide-risk factors in this population in order to suggest some potentially preventive measures to mental health policymakers who are struggling to prevent suicide among EI.

Method

Nationwide age-adjusted suicide rates were calculated for EI, Former Soviet Union immigrants (FSUI) and Israeli-born (IB) Jews by age, gender, and year of death and, for EI, by marital status and immigration period in the years 1985–2017 (1990–2017 for FSUI).

Results

Age-adjusted suicide rates for the period 1990–2017 confirmed the significantly higher rate among EI––3.1 times higher than for FSUI and 4.1 times higher than for IB. Similar rates were obtained for both genders, within each age group, and in all study years. Comparable male/female rate ratios were found among EI and IB (3.3, 3.6, respectively). Over the years of the study, only among the Ethiopian immigrants were there large fluctuations in suicide rates: a decrease (1992–2001), followed by an increase (2001–2006), and then a progressive decrease (from 2006). The secular changes differed greatly according to age. Among females, these fluctuations were smaller, the decrease began earlier and was greater, and the subsequent increase was much smaller. Marriage was found to be less protective for Ethiopian immigrants than for the other surveyed populations.

Conclusions

The considerable gap between the EI’s and FSUI’s suicide rates highlights the critical role of immigrants’ integration difficulties. These difficulties among EI lead to ongoing conflict within the family, which may explain why marriage is less protective for EI. Nevertheless, progressive integration is occurring as indicated by the decline in suicide rates since 2006. The fluctuations in EI suicide rates over time seem to be associated with modifications in social welfare allowances, which are crucial for EI of low socioeconomic status. Groups at risk, particularly EI men facing socioeconomic challenges and EI with considerable family conflict, typically identified by HMOs and welfare services, should be screened for suicide risk, and those identified as at risk referred to tailored workshops sensitive to Ethiopian culture.
Theoretical and numerical analysis for transmission dynamics of COVID-19 mathematical model involving Caputo–Fabrizio derivative
Authors: Thabet Sabri T. M. , Abdo Mohammed S. , Shah Kamal
Published: March 2021

This manuscript is devoted to a study of the existence and uniqueness of solutions to a mathematical model addressing the transmission dynamics of the coronavirus-19 infectious disease (COVID-19). The mentioned model is considered with a nonsingular kernel type derivative given by Caputo–Fabrizo with fractional order. For the required results of the existence and uniqueness of solution to the proposed model, Picard’s iterative method is applied. Furthermore, to investigate approximate solutions to the proposed model, we utilize the Laplace transform and Adomian’s decomposition (LADM). Some graphical presentations are given for different fractional orders for various compartments of the model under consideration.
Caputo SIR model for COVID-19 under optimized fractional order
Authors: Alshomrani Ali S. , Ullah Malik Z. , Baleanu Dumitru
Published: March 2021

Everyone is talking about coronavirus from the last couple of months due to its exponential spread throughout the globe. Lives have become paralyzed, and as many as 180 countries have been so far affected with 928,287 (14 September 2020) deaths within a couple of months. Ironically, 29,185,779 are still active cases. Having seen such a drastic situation, a relatively simple epidemiological SIR model with Caputo derivative is suggested unlike more sophisticated models being proposed nowadays in the current literature. The major aim of the present research study is to look for possibilities and extents to which the SIR model fits the real data for the cases chosen from 1 April to 15 March 2020, Pakistan. To further analyze qualitative behavior of the Caputo SIR model, uniqueness conditions under the Banach contraction principle are discussed and stability analysis with basic reproduction number is investigated using Ulam–Hyers and its generalized version. The best parameters have been obtained via the nonlinear least-squares curve fitting technique. The infectious compartment of the Caputo SIR model fits the real data better than the classical version of the SIR model (Brauer et al. in Mathematical Models in Epidemiology 2019). Average absolute relative error under the Caputo operator is about 48% smaller than the one obtained in the classical case ($\nu =1$ν=1). Time series and 3D contour plots offer social distancing to be the most effective measure to control the epidemic.
Socioeconomic status, well-being and mortality: a comprehensive life course analysis of panel data, Germany, 1984-2016
Authors: Montano Diego
Published: March 2021

Background

This study seeks to explore potential causal mechanisms involved in the observed associations between several socioeconomic status (SES) indicators, well-being and mortality, by taking a life course perspective focusing on (i) the trajectory of income and domain-specific well-being indicators, (ii) the influence of different SES indicators on well-being and mortality, (iii) the interactions between those trajectories, and (iv) the associations of the income and domain-specific well-being trajectories with all-cause mortality.

Methods

Socioeconomic status is operationalised by net household income, education, employment and marital status. Well-being is measured with two indicators: life satisfaction and satisfaction with health. Data from the German Socio-Economic Panel, collected between 1984 and 2016 and comprising more than 55,000 individuals, are analysed by means of longitudinal k-means cluster analysis, simultaneous equation systems and parametric time-to-death regressions.

Results

The analyses indicate the presence of large reciprocal effects of the trajectories of income and well-being on each other. However, the results suggest that well-being has a larger influence on income than the opposite, namely, income on well-being. The mortality analysis, on the other hand, revealed that the history of satisfaction with health is a much stronger predictor of longevity than the individual’s income history. Mortality risk was found lower among married individuals and those with tertiary education. In contrast, unemployment was associated with lower income and well-being levels. The findings provide support to the notion that education is a superior SES indicator than income in the investigation of the social determinants of well-being and mortality.

Conclusion

The present study provides evidence of large reciprocal effects of income and well-being and emphasises the importance of taking a life course approach in the investigation of the social determinants of health. Several SES indicators and both well-being indicators were found to be highly predictive of all-cause mortality and indicate the presence of cumulative effects related to one’s income and well-being trajectories.
Genetic relatedness of multidrug resistant Escherichia coli isolated from humans, chickens and poultry environments
Authors: Aworh Mabel Kamweli , Kwaga Jacob K. P. , Hendriksen Rene S. , Okolocha Emmanuel C. , Thakur Siddhartha
Published: March 2021

Background

Inappropriate use of antimicrobial agents in animal production has led to the development of antimicrobial resistance (AMR) in foodborne pathogens. Transmission of AMR foodborne pathogens from reservoirs, particularly chickens to the human population does occur. Recently, we reported that occupational exposure was a risk factor for multidrug-resistant (MDR)Escherichia coli (E. coli)among poultry-workers. Here we determined the prevalence and genetic relatedness among MDRE. coliisolated from poultry-workers, chickens, and poultry environments in Abuja, Nigeria. This study was conducted to address the gaps identified by the Nigerian AMR situation analysis.

Methods

We conducted a cross-sectional study among poultry-workers, chickens, and poultry farm/live bird market (LBM) environments. The isolates were tested phenotypically for their antimicrobial susceptibility profiles, genotypically characterized using whole-genome sequencing (WGS) and in silico multilocus sequence types (MLST). We conducted a phylogenetic single nucleotide polymorphism (SNPs) analysis to determine relatedness and clonality among the isolates.

Results

A total of 115 (26.8%) out of 429 samples were positive forE. coli.Of these, 110 isolates were viable for phenotypic and genotypic characterization. The selection comprised 47 (42.7%) isolates from poultry-workers, 36 (32.7%) from chickens, and 27 (24.5%) from poultry-farm or LBM environments. Overall, 101 (91.8%) of the isolates were MDR conferring resistance to at least three drug classes.High frequency of resistance was observed for tetracycline (n = 102; 92.7%), trimethoprim/sulfamethoxazole (n = 93; 84.5%), streptomycin (n = 87; 79.1%) and ampicillin (n = 88; 80%). Two plasmid-mediated colistin genes—mcr-1.1harboured on IncX4 plasmids were detected in environmental isolates. The most prevalent sequence types (ST) were ST-155 (n = 8), ST-48 (n = 8) and ST-10 (n = 6). Two isolates of human and environmental sources with a SNPs difference of 6161 originating from the same farm shared a novel ST. The isolates had similar AMR genes and plasmid replicons.

Conclusion

MDRE.coliisolates were prevalent amongst poultry-workers, poultry, and the poultry farm/LBM environment. The emergence of MDRE. coliwith novel ST in two isolates may be plasmid-mediated. Competent authorities should enforce AMR regulations to ensure prudent use of antimicrobials to limit the risk of transmission along the food chain.
Opportunistic bacteria with reduced genomes are effective competitors for organic nitrogen compounds in coastal dinoflagellate blooms
Authors: Han Yu , Jiao Nianzhi , Zhang Yao , Zhang Fan , He Chen , Liang Xuejiao , Cai Ruanhong , Shi Quan , Tang Kai
Published: March 2021

Background

Phytoplankton blooms are frequent events in coastal areas and increase the production of organic matter that initially shapes the growth of opportunistic heterotrophic bacteria. However, it is unclear how these opportunists are involved in the transformation of dissolved organic matter (DOM) when blooms occur and the subsequent impacts on biogeochemical cycles.

Results

We used a combination of genomic, proteomic, and metabolomic approaches to study bacterial diversity, genome traits, and metabolic responses to assess the source and lability of DOM in a spring coastal bloom of Akashiwo sanguinea. We identified molecules that significantly increased during bloom development, predominantly belonging to amino acids, dipeptides, lipids, nucleotides, and nucleosides. The opportunistic members of the bacterial genera Polaribacter, Lentibacter, and Litoricola represented a significant proportion of the free-living and particle-associated bacterial assemblages during the stationary phase of the bloom. Polaribacter marinivivus, Lentibacter algarum, and Litoricola marina were isolated and their genomes exhibited streamlining characterized by small genome size and low GC content and non-coding densities, as well as a smaller number of transporters and peptidases compared to closely related species. However, the core proteomes identified house-keeping functions, such as various substrate transporters, peptidases, motility, chemotaxis, and antioxidants, in response to bloom-derived DOM. We observed a unique metabolic signature for the three species in the utilization of multiple dissolved organic nitrogen compounds. The metabolomic data showed that amino acids and dipeptides (such as isoleucine and proline) were preferentially taken up by P. marinivivus and L. algarum, whereas nucleotides and nucleosides (such as adenosine and purine) were preferentially selected by L. marina.

Conclusions

The results suggest that the enriched DOM in stationary phase of phytoplankton bloom is a result of ammonium depletion. This environment drives genomic streamlining of opportunistic bacteria to exploit their preferred nitrogen-containing compounds and maintain nutrient cycling.
GLUT5 (SLC2A5) enables fructose-mediated proliferation independent of ketohexokinase
Authors: Liang Roger J. , Taylor Samuel , Nahiyaan Navid , Song Junho , Murphy Charles J. , Dantas Ezequiel , Cheng Shuyuan , Hsu Ting-Wei , Ramsamooj Shakti , Grover Rahul , Hwang Seo-Kyoung , Ngo Bryan , Cantley Lewis C. , Rhee Kyu Y. , Goncalves Marcus D.
Published: March 2021

Background

Fructose is an abundant source of carbon and energy for cells to use for metabolism, but only certain cell types use fructose to proliferate. Tumor cells that acquire the ability to metabolize fructose have a fitness advantage over their neighboring cells, but the proteins that mediate fructose metabolism in this context are unknown. Here, we investigated the determinants of fructose-mediated cell proliferation.

Methods

Live cell imaging and crystal violet assays were used to characterize the ability of several cell lines (RKO, H508, HepG2, Huh7, HEK293T (293T), A172, U118-MG, U87, MCF-7, MDA-MB-468, PC3, DLD1 HCT116, and 22RV1) to proliferate in fructose (i.e., the fructolytic ability). Fructose metabolism gene expression was determined by RT-qPCR and western blot for each cell line. A positive selection approach was used to “train” non-fructolytic PC3 cells to utilize fructose for proliferation. RNA-seq was performed on parental and trained PC3 cells to find key transcripts associated with fructolytic ability. A CRISPR-cas9 plasmid containingKHK-specific sgRNA was transfected in 293T cells to generateKHK-/-cells. Lentiviral transduction was used to overexpress empty vector, KHK, or GLUT5 in cells. Metabolic profiling was done with seahorse metabolic flux analysis as well as LC/MS metabolomics. Cell Titer Glo was used to determine cell sensitivity to 2-deoxyglucose in media containing either fructose or glucose.

Results

We found that neither the tissue of origin nor expression level of any single gene related to fructose catabolism determine the fructolytic ability. However, cells cultured chronically in fructose can develop fructolytic ability.SLC2A5, encoding the fructose transporter, GLUT5, was specifically upregulated in these cells. Overexpression of GLUT5 in non-fructolytic cells enabled growth in fructose-containing media across cells of different origins. GLUT5 permitted fructose to flux through glycolysis using hexokinase (HK) and not ketohexokinase (KHK).

Conclusions

We show that GLUT5 is a robust and generalizable driver of fructose-dependent cell proliferation. This indicates that fructose uptake is the limiting factor for fructose-mediated cell proliferation. We further demonstrate that cellular proliferation with fructose is independent of KHK.
How to design a national genomic project—a systematic review of active projects
Authors: Kovanda Anja , Zimani Ana Nyasha , Peterlin Borut
Published: March 2021

An increasing number of countries are investing efforts to exploit the human genome, in order to improve genetic diagnostics and to pave the way for the integration of precision medicine into health systems. The expected benefits include improved understanding of normal and pathological genomic variation, shorter time-to-diagnosis, cost-effective diagnostics, targeted prevention and treatment, and research advances.

We review the 41 currently active individual national projects concerning their aims and scope, the number and age structure of included subjects, funding, data sharing goals and methods, and linkage with biobanks, medical data, and non-medical data (exposome). The main aims of ongoing projects were to determine normal genomic variation (90%), determine pathological genomic variation (rare disease, complex diseases, cancer, etc.) (71%), improve infrastructure (59%), and enable personalized medicine (37%). Numbers of subjects to be sequenced ranges substantially, from a hundred to over a million, representing in some cases a significant portion of the population. Approximately half of the projects report public funding, with the rest having various mixed or private funding arrangements. 90% of projects report data sharing (public, academic, and/or commercial with various levels of access) and plan on linking genomic data and medical data (78%), existing biobanks (44%), and/or non-medical data (24%) as the basis for enabling personal/precision medicine in the future.

Our results show substantial diversity in the analysed categories of 41 ongoing national projects. The overview of current designs will hopefully inform national initiatives in designing new genomic projects and contribute to standardisation and international collaboration.
Psychological experiences of healthcare professionals in Sri Lanka during COVID-19
Authors: Perera Bilesha , Wickramarachchi Bimba , Samanmalie Champika , Hettiarachchi Manjula
Published: March 2021

Background

The upsurge of COVID-19 has caused numerous psycho-social challenges for healthcare professionals because of its ability to spread rapidly in the community and high mortality rate. The seriousness of the disease has led many healthcare professionals plagued by stigma as well as discrimination. In this study, depressive symptomatology, levels of anxiety, and related psychosocial and occupational factors experienced by healthcare professionals in Sri Lanka during COVID -19 were investigated.

Methods

A total of 512 healthcare professionals were surveyed using an online survey. The Generalized Anxiety Disorder 7-item scale, the Center for Epidemiologic Studies Depression Scale-Revised-10, and psychosocial and occupational factors predictive of depression and anxiety were included in the survey questionnaire. Logistic regression determined the factors associated with the presence of depressive symptoms and anxiety.

Results

Results showed that elevated depressive symptoms and anxiety were experienced by 53.3% and 51.3%, respectively, of the participants. No differences in the prevalence of elevated depressive symptoms and anxiety were found between those who were exposed and non-exposed to COVID-19 confirmed or suspected patients. Having a fear of being infected with COVID-19 and spreading it among family members were associated with increased risk of depression. Among those exposed to COVID-19 confirmed or suspected patients, poor occupational safety (OR = 2.06, 95% CI 1.25–3.39), stigmatization (OR = 2.19, 95% CI 1.29–3.72), and heavy workload (OR = 2.45, 95% CI 1.53–3.92) were associated with increased risk of elevated depressive symptoms, whilst poor self-confidence (OR = 2.53, 95% CI 1.56–4.09) and heavy workload (OR = 1.94. 95% CI 1.22–3.12) were associated with increased risk of anxiety.

Conclusions

Fear of being infected and distress caused by fear of spreading it among family members, stigmatization, poor self-confidence, poor occupational safety and heavy workload are vital risk factors that need to be considered in future psychological support services designed for the healthcare professionals in unprecedented outbreaks like COVID-19.
Chronically altered NMDAR signaling in epilepsy mediates comorbid depression
Authors: Sadeghi Mohammad Amin , Hemmati Sara , Mohammadi Sina , Yousefi-Manesh Hasan , Vafaei Ali , Zare Meysam , Dehpour Ahmad Reza
Published: March 2021

Depression is the most common psychiatric comorbidity of epilepsy. However, the molecular pathways underlying this association remain unclear. The NMDA receptor (NMDAR) may play a role in this association, as its downstream signaling has been shown to undergo long-term changes following excitotoxic neuronal damage. To study this pathway, we used an animal model of fluoxetine-resistant epilepsy-associated depression (EAD). We determined the molecular changes associated with the development of depressive symptoms and examined their response to various combinations of fluoxetine and a selective neuronal nitric oxide synthase inhibitor, 7-nitroindazole (NI). Depressive symptoms were determined using the forced swim test. Furthermore, expression and phosphorylation levels of markers in the ERK/CREB/ELK1/BDNF/cFOS pathway were measured to determine the molecular changes associated with these symptoms. Finally, oxidative stress markers were measured to more clearly determine the individual contributions of each treatment. While chronic fluoxetine (Flxc) and NI were ineffective alone, their combination had a statistically significant synergistic effect in reducing depressive symptoms. The development of depressive symptoms in epileptic rats was associated with the downregulation of ERK2 expression and ELK1 and CREB phosphorylation. These changes were exactly reversed upon Flxc + NI treatment, which led to increased BDNF and cFOS expression as well. Interestingly, ERK1 did not seem to play a role in these experiments. NI seemed to have augmented Flxc’s antidepressant activity by reducing oxidative stress. Our findings suggest NMDAR signaling alterations are a major contributor to EAD development and a potential target for treating conditions associated with underlying excitotoxic neuronal damage.
Effect of groundwater forced seepage on heat transfer characteristics of borehole heat exchangers
Authors: Ma Jiuchen , Jiang Qian , Zhang Qiuli , Xie Yacheng , Wang Yahui , Yi Feiyu
Published: March 2021

A system of borehole heat exchangers (BHEs) combined with pumping–injection wells is established in areas where the groundwater is shallow and the seepage velocity is weak. The pumping and injection wells are set on both sides of the BHEs. According to the three-dimensional unsteady-state heat transfer model in the aquifer, the convection–dispersion analytical solution of excess temperature is derived that considers groundwater-forced seepage and thermal dispersion effects and axial effect of the BHEs. Then, we use the dimensional analysis method and similarity criteria to build a controllable forced seepage sandbox. The software FEFLOW 7.1 is adopted and the simulation results are validated by the theoretical analysis and the indoor experiment test. On this basis, the numerical simulation is used to explore the influence of different pumping–injection flow volume on the Darcy flow velocity of the aquifer where the BHEs are located, as well as the average heat transfer efficiency and the heat transfer rates with borehole depth. The results show that when the pumping flow volume increases from 200 m3 day−1 to 1200 m3 day−1, the Darcy velocity correspondingly increases to about 10 times. The average heat efficiency coefficient of the BHEs is increased by 11.5% in cooling stage, and by 7.5% in heating stage. When the pumping–injection flow volume is 400–600 m3 day−1, the increment of heat transfer rates of the BHEs reaches 12.8–17.9 W m−1 and 3.6–4.2 W m−1 per unit of borehole depth during the cooling stage and heating stage, respectively, and then decreases as the flow volume increases gradually.
Early stage nonclinical pulmonary disorder in COVID-19 may present asymptomatic and fuel the contagion
Authors: Adedokun Kamoru Ademola
Published: March 2021

Evidence shows that pulmonary problems in coronavirus disease 2019 (COVID-19) may set off from vascular injury that progresses to physiological disturbances through a compromised gas exchange, following an infection with the severe acute respiratory syndrome coronavirus 2. In this process, inefficient gas exchange in the alveolar could precipitate silent nonclinical hypoxemia. Unfortunately, patients with “silent hypoxemia” do not necessarily experience any breathing difficulty (dyspnea) at the early stage of COVID-19 while the disease progresses. As a result, several asymptomatic, presymptomatic and patients with mild symptoms may escape quarantine measure and thus continue to spread the virus through contacts. Therefore, early diagnosis of “silent hypoxemia”, which attracts no clinical warnings, could be an important diagnostic measure to prevent acute respiratory distress syndrome from the risk of pulmonary failure among the presymptomatic and as a screening tool in the asymptomatic who are hitherto potential spreaders of the virus.
Feasibility of using a biofeedback device in mindfulness training - a pilot randomized controlled trial
Authors: Lin Brenna , Prickett Christopher , Woltering Steven
Published: March 2021

Background

Stress can negatively impact an individual’s health and well-being and high levels of stress are noted to exist among college students today. While traditional treatment methods are plagued with stigma and transfer problems, newly developed wearable biofeedback devices may offer unexplored possibilities. Although these products are becoming commonplace and inexpensive, scientific evidence of the effectiveness of these products is scarce and their feasibility within research contexts are relatively unexplored. Conversely, companies are not required, and possibly reluctant, to release information on the efficacy of these products against their claims. Thus, in the present pilot, we assess the feasibility of using a real-time respiratory-based biofeedback device in preparation for a larger study. Our main aims were to assess device-adherence and collaboration with the company that develops and sells the device.

Method

Data were collected from 39 college students who self-identified as experiencing chronic stress at a Southwestern university in the USA. Students were randomized into either a mindfulness-only control group without a biofeedback device (n= 21), or an experimental group with biofeedback device (n= 18). Both groups received mindfulness meditation training. Pre-test and post-test procedures were conducted 2 weeks apart. Further, both participant compliance and company compliance were assessed and collaboration with the company was evaluated.

Results

Participant device-adherence as well as the company’s collaboration necessary for a full-scale study was determined to be low. This may also have affected our results which showed a strong main effect for time for all outcome variables, suggesting all groups showed improvement in their levels of stress after the intervention period. No group by time effects were identified, however, indicating no added benefit of the biofeedback device.

Conclusions

Our findings suggest feasibility of future studies requires full collaboration and detailed and agreed upon data sharing procedures with the biofeedback company. The particular device under investigation added no value to the intervention outcomes and it was not feasible to continue a larger-scale study. Further, as the technology sector is innovating faster than it can validate products, we urge for open science collaborations between public and private sectors to properly develop evidence-based regulations that can withstand technological innovation while maintaining product quality, safety, and effectiveness.

Trial registration

NCT02837016. Registered 19 July 2016.
Physical activity intervention for rural middle-aged and older Australian adults: a pilot implementation study of the ecofit program delivered in a real-world setting
Authors: Wilczynska Magdalena , Jansson Anna K. , Lubans David R. , Smith Jordan J. , Robards Sara L. , Plotnikoff Ronald C.
Published: March 2021

Background

ecofit is an evidence-based multi-component physical activity intervention that integrates smartphone technology, the outdoor environment, and social support. In a previous efficacy trial, significant improvements were found across several clinical, fitness, and mental health outcomes among adults at risk of (or with) type 2 diabetes.

Methods

The aim of the present pilot study was to evaluate a number of patient-centered and feasibility outcomes of the ecofit intervention in a “real-world” setting, using a scalable implementation model. ecofit was adapted and implemented by a rural municipal council in the Upper Hunter Shire, New South Wales, Australia, and evaluated using a single-group pre-post design. Inactive middle-aged and older adults (N=59) were recruited and assessed at 6 (primary time-point) and 20 weeks (follow-up).

Results

Improvements were found in this predominantly overweight and obese sample for aerobic fitness, functional mobility, upper and lower body muscular fitness, systolic blood pressure, and waist circumference at 6 weeks. At 20 weeks, effects were found for aerobic fitness, functional mobility, upper and lower body muscular fitness, and systolic blood pressure. Overall, participants were satisfied with the ecofit program. Participants attended the 6-week primary time-point (66.1%) and follow-up at 20 weeks (41.6%).

Conclusions

Our findings support the preliminary effectiveness and feasibility of the ecofit intervention delivered by municipal council staff following a brief training from the research team. This study provides valuable preliminary evidence to support a larger implementation trial.
Therapeutic effects of non-invasive, individualized, transcranial neuromodulation treatment for voiding dysfunction in multiple sclerosis patients: study protocol for a pilot clinical trial
Authors: Tran Khue , Shi Zhaoyue , Karmonik Christof , John Blessy , Rajab Hamida , Helekar Santosh A. , Boone Timothy , Khavari Rose
Published: March 2021

Background

Voiding dysfunction (VD) is a common neurogenic lower urinary tract dysfunction (NLUTD) in multiple sclerosis (MS) patients. Currently, the only effective management for VD and urinary retention in MS patients is catheterization, prompting us to look for novel therapeutic options beyond the bladder, such as the brain. Transcranial rotating permanent magnet stimulator (TRPMS) is a non-invasive, portable, multifocal neuromodulator that simultaneously modulates multiple cortical regions, enhancing or attenuating strengths of functional connections between these regions. The objective of this pilot clinical trial is to evaluate the feasibility of a TRPMS trial to address lower urinary tract symptoms in MS patients, through investigating the therapeutic effects of TRPMS in modulating brain regions during voiding initiation and mitigating VD in female MS individuals.

Methods

Ten adult female MS patients with VD (defined as having %post-void residual/bladder capacity (%PVR/BC) ≥ 40% or Liverpool nomogram percentile < 10%) will be recruited for this study. Concurrent urodynamic and functional MRI evaluation with a bladder filling/emptying task repeated three to four times will be performed at baseline and post-treatment. Predetermined regions of interest and their blood-oxygen-level-dependent (BOLD) activation at voiding initiation will be identified on each patient’s baseline anatomical and functional MRI scan, corresponding to the microstimulators placement on their individualized TRPMS treatment cap to either stimulate or inhibit these regions. Patients will receive 10 40-min treatment sessions. Non-instrumented uroflow and validated questionnaires will also be collected at baseline and post-treatment to evaluate clinical improvement.

Discussion

Despite the crucial role of the central nervous system in urinary control and its sensitivity to MS, there has been no treatment for urinary dysfunction targeting the brain centers that are involved in proper bladder function. This trial, to our knowledge, will be the first of its kind in humans to consider non-invasive and individualized cortical modulation for treating VD in MS patients. Results from this study will provide a better understanding of the brain control of neurogenic bladders and lay the foundation for a potential alternative therapy for VD in MS patients and other NLUTD in a larger neurogenic population in the future.

Trial registration

This trial is registered at ClinicalTrials.Gov (NCT03574610, 2 July 2018.) and Houston Methodist Research Institute IRB (PRO00019329)
Routine surveillance of patients post Fontan palliation: lessons learnt from cardiac catheterisation
Authors: Ordonez Maria Victoria , Biglino Giovanni , Bedair Radwa
Published: March 2021

Background

There is no consensus on the clinical utility of ‘routine’ diagnostic cardiac catheterisation in patients with Fontan palliation in the absence of symptoms or haemodynamic lesions.

Objective

We sought to evaluate whether diagnostic cardiac catheterisation for a variety of indications led to a change in the clinical management of patients with a Fontan circulation.

Methods

All adult patients (≥16 years) with Fontan palliation undergoing diagnostic cardiac catheterisation at our institution from 2016 to 2019 were included retrospectively. Patients undergoing electrophysiological studies were excluded as haemodynamic measurements were not taken. Routine cardiac catheterisation at our institution is considered in adult patients who have not had a diagnostic cardiac catheter for more than 5 years.

Results

Thirty-eight patients, mean age 27 ± 7 years, 60% NYHA I, 31% NYHA II, 8% NYHA III, at mean duration post Fontan of 20 ± 6 years, lateral tunnel (LT) n = 20, extracardiac (EC) n = 14 and atriopulmonary (AP) n = 4, underwent 41 diagnostic cardiac catheterisation procedures. Indication for cardiac catheterisation was as follows: haemodynamic lesion identified on cross-sectional imaging in 12; routine catheterisation in 9; cyanosis in 8; dyspnoea in 8; significant liver stiffness on ultrasound hepatic elastography in 2; and arrhythmia in 2. Of the 9 patients undergoing routine diagnostic catheterisation, 3 had not had any diagnostic catheterisation since their Fontan completion and, in the remaining six, the mean time lapsed since the last diagnostic catheter was 8 ± 3 years. The diagnostic catheterisation led to a recommended change in clinical management on 24 occasions (59%): catheter intervention in 17 (40%); surgery in 4 (10%); medication change in 3 (17%); and transplant referral in 2 (5%). The clinical indications that led to changes in clinical management were: cyanosis (8/8), dyspnoea (7/8), haemodynamic lesions on cross-sectional imaging (8/11) and arrhythmia (1/2). None of the 9 patients listed for routine diagnostic catheterisation or as a result of findings on ultrasound hepatic elastography had a recommended change in clinical management.

Conclusion

Diagnostic cardiac catheterisation frequently leads to changes in the clinical management of patients with Fontan palliation presenting with dyspnoea, cyanosis, and for further evaluation of potential haemodynamic lesions identified on cross-sectional imaging. Routine cardiac catheterisation in the absence of the above indications had limited impact on clinical management in our cohort.