bluuebunny/crossref_metadata_2025 huggingface dataset:
Efficacy of a web application for stress management among Iranian college students during COVID-19 outbreak: a study protocol for randomized controlled trials
Authors: Khademian Fatemeh , Aslani Azam , Ravangard Ramin , Bastani Peivand , Nami Mohammad , Jafari Peyman
Published: December 2020

Background

The prevalence of mental health disorders is increasing globally, and the prevalence of COVID-19 has made it worse. Evidence has indicated a major mental health burden and elevated anxiety associated with the new coronavirus outbreak in the general population. This study aims to evaluate an evidence-based web application (Naranj) for stress management among Iranian college students.

Methods and design

This study aims to present a protocol related to a randomized controlled trial among Iranian college students. The study will be conducted on 100 students from two colleges of Shiraz University of Medical Sciences in Iran. The participants will be randomly assigned to the intervention and control groups. The intervention group participants will be provided with a web application, whereas the control group ones will be provided with an app unrelated to stress management. The primary outcome for this study will be the Perceived Stress Scale, and the two groups will be compared with respect to stress level and sleep quality.

Discussion

A web application will be developed according to psychological theories and will be scientifically approved for managing college students’ stress and improving their sleep quality during the COVID-19 outbreak.

Trial registration

Iranian Registry of Clinical TrialsIRCT20160427027647N2. Registered on 14 May 2020
Rewiring of glycerol metabolism in Escherichia coli for effective production of recombinant proteins
Authors: Chiang Chung-Jen , Ho Yi-Jing , Hu Mu-Chen , Chao Yun-Peng
Published: December 2020

Background

The economic viability of a protein-production process relies highly on the production titer and the price of raw materials. Crude glycerol coming from the production of biodiesel is a renewable and cost-effective resource. However, glycerol is inefficiently utilized by Escherichia coli.

Results

This issue was addressed by rewiring glycerol metabolism for redistribution of the metabolic flux. Key steps in central metabolism involving the glycerol dissimilation pathway, the pentose phosphate pathway, and the tricarboxylic acid cycle were pinpointed and manipulated to provide precursor metabolites and energy. As a result, the engineered E. coli strain displayed a 9- and 30-fold increase in utilization of crude glycerol and production of the target protein, respectively.

Conclusions

The result indicates that the present method of metabolic engineering is useful and straightforward for efficient adjustment of the flux distribution in glycerol metabolism. The practical application of this methodology in biorefinery and the related field would be acknowledged.
Robust barcoding and identification of Mycobacterium tuberculosis lineages for epidemiological and clinical studies
Authors: Napier Gary , Campino Susana , Merid Yared , Abebe Markos , Woldeamanuel Yimtubezinash , Aseffa Abraham , Hibberd Martin L. , Phelan Jody , Clark Taane G.
Published: December 2020

Background

Tuberculosis, caused by bacteria in the Mycobacterium tuberculosis complex (MTBC), is a major global public health burden. Strain-specific genomic diversity in the known lineages of MTBC is an important factor in pathogenesis that may affect virulence, transmissibility, host response and emergence of drug resistance. Fast and accurate tracking of MTBC strains is therefore crucial for infection control, and our previous work developed a 62-single nucleotide polymorphism (SNP) barcode to inform on the phylogenetic identity of 7 human lineages and 64 sub-lineages.

Methods

To update this barcode, we analysed whole genome sequencing data from 35,298 MTBC isolates (~ 1 million SNPs) covering 9 main lineages and 3 similar animal-related species (M. tuberculosis var. bovis, M. tuberculosis var. caprae and M. tuberculosis var. orygis). The data was partitioned into training (N = 17,903, 50.7%) and test (N = 17,395, 49.3%) sets and were analysed using an integrated phylogenetic tree and population differentiation (FST) statistical approach.

Results

By constructing a phylogenetic tree on the training MTBC isolates, we characterised 90 lineages or sub-lineages or species, of which 30 are new, and identified 421 robust barcoding mutations, of which a minimal set of 90 was selected that included 20 markers from the 62-SNP barcode. The barcoding SNPs (90 and 421) discriminated perfectly the 86 MTBC isolate (sub-)lineages in the test set and could accurately reconstruct the clades across the combined 35k samples.

Conclusions

The validated 90 SNPs can be used for the rapid diagnosis and tracking of MTBC strains to assist public health surveillance and control. To facilitate this, the SNP markers have now been incorporated into the TB-Profiler informatics platform (https://github.com/jodyphelan/TBProfiler).
Effect of cooking temperature and time on total phenolic content, total flavonoid content and total in vitro antioxidant activity of garlic
Authors: Alide Thandiwe , Wangila Phanice , Kiprop Ambrose
Published: December 2020

Objective

To investigate the effect of cooking temperature and time on the total phenolic content, total flavonoid content and antioxidant activity of aqueous and ethanolic extracts of garlic.

Results

The mean total phenolic content of fresh garlic were 303.07 ± 6.58 mg gallic acid equivalent per 100 g (GAE/100 g) and 638.96 ± 15.30 mg GAE/100 g of plant material for the aqueous and ethanolic extracts respectively. The mean total flavonoid content 109.78 ± 6.78 mg quercetin equivalent per 100 g (QE/100 g) and 258.47 ± 12.37 QE/100 g for aqueous and ethanolic extracts respectively. Fourier transform infrared spectral data showed absorptions in the range for carboxylic acids, hydroxyl group, esters, and alcohols, confirming the presence of phenols and flavonoids in the extracts. Cooking temperature had a significant effect on total phenolic content and total flavonoid content while cooking time did not have a significant effect on the phytochemicals and antioxidant activity.
A plasmid-encoded papB paralogue modulates autoaggregation of Escherichia coli transconjugants
Authors: Monárrez Rubén , Okeke Iruka N.
Published: December 2020

Objective

Plasmids are key to antimicrobial resistance transmission among enteric bacteria. It is becoming increasingly clear that resistance genes alone do not account for the selective advantage of plasmids and bacterial strains that harbor them. Deletion of a 32 Kb fitness-conferring region of pMB2, a conjugative resistance plasmid, produced a hyper-autoaggregation phenotype in laboratory Escherichia coli. This study sought to determine the genetic basis for hyper-autoaggregation conferred by the pMB2-derived mini-plasmid.

Results

The 32 Kb fragment deleted from pMB2 included previously characterized nutrient acquisition genes as well as putative transposase and integrase genes, a 272 bp papB/ pefB-like gene, and several open-reading frames of unknown function. We cloned the papB/ pefB paralogue and found it sufficient to temper the hyper-autoaggregation phenotype. Hyper-autoaggregation conferred by the mini-plasmid did not occur in a fim-negative background. This study has identified and characterized a gene capable of down-regulating host adhesins and has shown that trans-acting papB/pefB paralogues can occur outside the context of an adhesin cluster. This plasmid-mediated modification of a bacterial host’s colonization program may optimize horizontal transfer of the mobile element bearing the genes.
Human multipotent mesenchymal stromal cells cytokine priming promotes RAB27B-regulated secretion of small extracellular vesicles with immunomodulatory cargo
Authors: Cheng Anastasia , Choi Dongsic , Lora Maximilien , Shum-Tim Dominique , Rak Janusz , Colmegna Inés
Published: December 2020

Background

The paracrine effects of multipotent mesenchymal stromal cells (MSCs) are mediated by their secretome composed by soluble factors (i.e., cytokines, growth factors, hormones) and extracellular vesicles (EVs). EVs promote intercellular communication, and the EV cargoes [e.g., proteins, soluble factors, microRNAs (miRNAs), messenger RNA (mRNA), DNA] reflect the molecular and functional characteristics of their parental cells. MSC-derived EVs (MSC-EVs) are currently evaluated as subcellular therapeutics. A key function of the MSC secretome is its ability to promote immune tolerance (i.e., immunopotency), a property that is enhanced by priming approaches (e.g., cytokines, hypoxia, chemicals) and inversely correlates with the age of the MSC donors. We evaluated mechanisms underlying MSC vesiculation and the effects of inflammation and aging on this process.

Methods

We evaluated the effects of interferon gamma (IFN-γ) and tumor necrosis factor alpha (TNF-α) on human adipose-derived MSC: (a) vesiculation (custom RT2Profiler PCR Array), (b) EV profiles (Nanoparticle Tracking Analysis and Nanoparticle Flow Cytometry), (c) EV cargo (proteomic analysis and Western blot analysis), and (d) immunopotency (standard MSC:CD4 T cell proliferation inhibition assay). We confirmed the role of RAB27B on MSC vesiculation (RAB27B siRNA) and assessed its differential contribution to vesiculation in adult and pediatric MSCs (qPCR).

Results

Cytokine priming upregulatedRAB27Bin adipose-derived MSCs increasing their secretion of exosome-like small EVs (sEVs; < 200 nm) containing two key mediators of immunopotency: A20 and TSG-6. These EVs inhibited T cell proliferation in a dose-dependent manner.RAB27BsiRNA inhibited MSC vesiculation. Adipose-derived MSCs isolated from pediatric donors exhibited higher RAB27B expression and secreted more sEVs than adult MSCs.

Conclusions

Cytokine priming is a useful strategy to harvest anti-inflammatory MSC-sEVs for clinical applications. Of relevance, donor age should be considered in the selection of MSC-sEVs for clinical applications.
Quantitative assessment of the impact of cryopreservation on human bone marrow-derived mesenchymal stem cells: up to 24 h post-thaw and beyond
Authors: Bahsoun Soukaina , Coopman Karen , Akam Elizabeth C.
Published: December 2020

Background

The effects of cryopreservation on human bone marrow-derived mesenchymal stem cells (hBM-MSCs) are still ill-defined. In this study, a quantitative approach was adopted to measure several post-thaw cell attributes in order to provide an accurate reflection of the freezing and thawing impact.

Methods

Fresh and cryopreserved passage-matched cells from three different donors were discretely analysed and compared for their viability, apoptosis level, phenotypic marker expression, metabolic activity, adhesion potential, proliferation rate, colony-forming unit ability (CFUF) and differentiation potentials.

Results

The results of this study show that cryopreservation reduces cell viability, increases apoptosis level and impairs hBM-MSC metabolic activity and adhesion potential in the first 4 h after thawing. At 24 h post-thaw, cell viability recovered, and apoptosis level dropped but metabolic activity and adhesion potential remained lower than fresh cells. This suggests that a 24-h period is not enough for a full recovery. Beyond 24 h post-thaw, the observed effects are variable for the three cell lines. While no difference is observed in the pre- and post-cryopreservation proliferation rate, cryopreservation reduced the CFUF ability of two of the cell lines and variably affected the adipogenic and osteogenic differentiation potentials of the three cell lines.

Conclusion

The data collected in this study clearly show that fresh and cryopreserved hBM-MSCs are different, and these differences will inevitably introduce variabilities to the product and process development and subsequently imply financial losses. In order to avoid product divergence pre- and post-cryopreservation, effective strategies to mitigate freezing effects must be developed and implemented.
Repeatability and reproducibility of the wzi high resolution melting-based clustering analysis for Klebsiella pneumoniae typing
Authors: Pasala Ajay Ratan , Perini Matteo , Piazza Aurora , Panelli Simona , Di Carlo Domenico , Loretelli Cristian , Cafiso Alessandra , Inglese Sonia , Gona Floriana , Cirillo Daniela Maria , Zuccotti Gian Vincenzo , Comandatore Francesco
Published: December 2020

High resolution melting (HRM) is a fast closed-tube method for nucleotide variant scanning applicable for bacterial species identification or molecular typing. Recently a novel HRM-based method for Klebsiella pneumoniae typing has been proposed: it consists of an HRM protocol designed on the capsular wzi gene and an HRM-based algorithm of strains clustering. In this study, we evaluated the repeatability and reproducibility of this method by performing the HRM typing of a set of K. pneumoniae strains, on three different instruments and by two different operators. The results showed that operators do not affect melting temperatures while different instruments can. Despite this, we found that strain clustering analysis, performed using MeltingPlot separately on the data from the three instruments, remains almost perfectly consistent. The HRM method under study resulted highly repeatable and thus reliable for large studies, even when several operators are involved. Furthermore, the HRM clusters obtained from the three different instruments were highly conserved, suggesting that this method could be applied in multicenter studies, even if different instruments are used.
An efficient data collection path planning scheme for wireless sensor networks with mobile sinks
Authors: Chang Jau-Yang , Jeng Jin-Tsong , Sheu Yung-Hoh , Jian Z.-Jie , Chang Wei-Yeh
Published: December 2020

Wireless sensor networks with mobile sinks enable a mobile device to move into the sensing area for the purpose of collecting the sensing data. Mobile sinks increase the flexibility and convenience of data gathering in such systems. Taking the energy consumption of the mobile sink into account, the moving distance of the mobile sink must be reduced efficiently. Hence, it is important and necessary to develop an efficient path planning scheme for mobile sinks in large-scale wireless sensor network systems. According to several greedy-based algorithms, we adopt an angle bisector concept to create the moving path for the mobile sink. In this paper, a novel and efficient data collection path planning scheme is proposed to reduce the moving distances and to prolong the lifetimes of mobile sinks in wireless sensor networks. Considering the communication range limitations of sensor nodes and the obstacles within sensing areas, we design an inner center path planning algorithm to reduce the moving distance for the mobile sink. A back-routing avoidance method is included to address the moving path backpropagation problem. We account for the obstacles in sensing area. The reference point of obstacle avoidance is employed to address the obstacle problem. The proposed scheme makes an adaptive decision for creating the moving path of the mobile sink. A suitable moving path planning scheme can be achieved, and the moving distance of the mobile sink can be reduced. The proposed scheme is promising in large-scale wireless sensor networks. When the number of sensor nodes in the sensing area is increased by 50, the proposed scheme yields an average moving distance that is 1.1 km shorter than that of the heuristic tour-planning algorithm, where the sensing area is 5 km × 5 km. Simulation results demonstrate that the proposed data collection path planning scheme outperforms the previously developed greedy-based scheme in terms of the moving paths and moving distances of mobile sinks in wireless sensor networks.
Multiple Kinect based system to monitor and analyze key performance indicators of physical training
Authors: Ryselis Karolis , Petkus Tautvydas , Blažauskas Tomas , Maskeliūnas Rytis , Damaševičius Robertas
Published: December 2020

Using a single Kinect device for human skeleton tracking and motion tracking lacks of reliability required in sports medicine and rehabilitation domains. Human joints reconstructed from non-standard poses such as squatting, sitting and lying are asymmetric and have unnatural lengths while their recognition error exceeds the error of recognizing standard poses. In order to achieve higher accuracy and usability for practical smart health applications we propose a practical solution for human skeleton tracking and analysis that performs the fusion of skeletal data from three Kinect devices to provide a complete 3D spatial coverage of a subject. The paper describes a novel data fusion algorithm using algebraic operations in vector space, the deployment of the system using three Kinect units, provides analysis of dynamic characteristics (position of joints, speed of movement, functional working envelope, body asymmetry and the rate of fatigue) of human motion during physical exercising, and evaluates intra-session reliability of the system using test–retest reliability metrics (intra-class correlation, coefficient of variation and coefficient of determination). Comparison of multi-Kinect system vs single-Kinect system shows an improvement in accuracy of 15.7%, while intra-session reliability is rated as excellent.
A user interest community evolution model based on subgraph matching for social networking in mobile edge computing environments
Authors: Jiang Liang , Liu Lu , Yao Jingjing , Shi Leilei
Published: December 2020

With the rapid development of mobile edge computing, mobile social networks are gradually infiltrating into our daily lives, in which the communities are an important part of social networks. Internet of People such as online social networks is the next frontier for the Internet of Things. The combination of social networking and mobile edge computing has an important application value and is the development trend of future networks. However, how to detect evolutionary communities accurately and efficiently in dynamic heterogeneous social networks remains a fundamental problem. In this paper, a novel User Interest Community Evolution (UICE) model based on subgraph matching is proposed for accurately detecting the corresponding communities in the evolution of the user interest community. The community evolutionary events can be quickly captured including forming, dissolving, evolving and so on with the introduction of core subgraph. A variant of subgraph matching, called Subgraph Matching with Dynamic Weight (SMDW), is proposed to solve the problem of updating the core subgraph due to the change of core user’s interest when tracking evolutionary communities. Finally, the experiments based on the real datasets have been designed to evaluate the performance of the proposed model by comparing it with the state-of-art methods in this area and complete data processing through the local edge computing layer. The experimental results demonstrate that the UICE model presented in this paper has achieved better accuracy, higher efficiency and better scalability against existing methods.
Biological effects of the oxygen molecule in critically ill patients
Authors: Nakane Masaki
Published: December 2020

The medical use of oxygen has been widely and frequently proposed for patients, especially those under critical care; however, its benefit and drawbacks remain controversial for certain conditions. The induction of oxygen therapy is commonly considered for either treating or preventing hypoxia. Therefore, the concept of different types of hypoxia should be understood, particularly in terms of their mechanism, as the effect of oxygen therapy principally varies by the physiological characteristics of hypoxia. Oxygen molecules must be constantly delivered to all cells throughout the human body and utilized effectively in the process of mitochondrial oxidative phosphorylation, which is necessary for generating energy through the formation of adenosine triphosphate. If the oxygen availability at the cellular level is inadequate for sustaining the metabolism, the condition of hypoxia which is characterized as heterogeneity in tissue oxygen tension may develop, which is called dysoxia, a more physiological concept that is related to hypoxia. In such hypoxic patients, repetitive measurements of the lactate level in blood are generally recommended in order to select the adequate therapeutic strategy targeting a reduction in lactate production. Excessive oxygen, however, may actually induce a hyperoxic condition which thus can lead to harmful oxidative stress by increasing the production of reactive oxygen species, possibly resulting in cellular dysfunction or death. In contrast, the human body has several oxygen-sensing mechanisms for preventing both hypoxia and hyperoxia that are employed to ensure a proper balance between the oxygen supply and demand and prevent organs and cells from suffering hyperoxia-induced oxidative stress. Thus, while the concept of hyperoxia is known to have possible adverse effects on the lung, the heart, the brain, or other organs in various pathological conditions of critically ill patients, and no obvious evidence has yet been proposed to totally support liberal oxygen supplementation in any subset of critically ill patients, relatively conservative oxygen therapy with cautious monitoring appears to be safe and may improve the outcome by preventing harmful oxidative stress resulting from excessive oxygen administration. Given the biological effects of oxygen molecules, although the optimal target levels remain controversial, unnecessary oxygen administration should be avoided, and exposure to hyperoxemia should be minimized in critically ill patients.
The diagnostic performance of quantitative mapping in breast cancer patients: a preliminary study using synthetic MRI
Authors: Meng Tiebao , He Ni , He Haoqiang , Liu Kuiyuan , Ke Liangru , Liu Huiming , Zhong Linchang , Huang Chenghui , Yang Anli , Zhou Chunyan , Qian Long , Xie Chuanmiao
Published: December 2020

Background

Previous studies have indicated that quantitative MRI (qMR) is beneficial for diagnosis of breast cancer. As a novel qMR technology, synthetic MRI (syMRI) may be advantageous by offering simultaneous generation of T1 and T2 mapping in one scan within a few minutes and without concern to the deposition of the gadolinium contrast agent in cell nucleus. In this study, the potential of quantitative mapping derived from Synthetic MRI (SyMRI) to diagnose breast cancer was investigated.

Methods

From April 2018 to May 2019, a total of 87 patients with suspicious breast lesions underwent both conventional and SyMRI before treatment. The quantitative metrics derived from SyMRI, including T1 and T2 values, were measured in breast lesions. The diagnostic performance of SyMRI was evaluated with unpaired Student’s t-tests, receiver operating characteristic curve analysis and multivariate logistic regression analysis. The AUCs of quantitative values were compared using Delong test.

Results

Among 77 patients who met the inclusion criteria, 48 were diagnosed with histopathological confirmed breast cancers, and the rest had benign lesions. The breast cancers showed significantly higher T1 (1611.61 ± 215.88 ms) values and lower T2 (80.93 ± 7.51 ms) values than benign lesions. The area under the ROC curve (AUC) values were 0.931 (95% CI: 0.874–0.989) and 0.883 (95% CI: 0.810–0.956) for T1 and T2 maps, respectively, in diagnostic discrimination between breast cancers and benign lesions. A slightly increased AUC of 0.978 (95% CI: 0.915–0.993) was achieved by combining those two relaxation-based quantitative metrics.

Conclusion

In conclusion, our preliminary study showed that the quantitative T1 and T2 values obtained by SyMRI could distinguish effectively between benign and malignant breast lesions, and T1 relaxation time showed the highest diagnostic efficiency. Furthermore, combining the two quantitative relaxation metrics further improved their diagnostic performance.
Automated quantification of baseline imaging PET metrics on FDG PET/CT images of pediatric Hodgkin lymphoma patients
Authors: Weisman Amy J. , Kim Jihyun , Lee Inki , McCarten Kathleen M. , Kessel Sandy , Schwartz Cindy L. , Kelly Kara M. , Jeraj Robert , Cho Steve Y. , Bradshaw Tyler J.
Published: December 2020

Purpose

For pediatric lymphoma, quantitative FDG PET/CT imaging features such as metabolic tumor volume (MTV) are important for prognosis and risk stratification strategies. However, feature extraction is difficult and time-consuming in cases of high disease burden. The purpose of this study was to fully automate the measurement of PET imaging features in PET/CT images of pediatric lymphoma.

Methods

18F-FDG PET/CT baseline images of 100 pediatric Hodgkin lymphoma patients were retrospectively analyzed. Two nuclear medicine physicians identified and segmented FDG avid disease using PET thresholding methods. Both PET and CT images were used as inputs to a three-dimensional patch-based, multi-resolution pathway convolutional neural network architecture, DeepMedic. The model was trained to replicate physician segmentations using an ensemble of three networks trained with 5-fold cross-validation. The maximum SUV (SUVmax), MTV, total lesion glycolysis (TLG), surface-area-to-volume ratio (SA/MTV), and a measure of disease spread (Dmaxpatient) were extracted from the model output. Pearson’s correlation coefficient and relative percent differences were calculated between automated and physician-extracted features.

Results

Median Dice similarity coefficient of patient contours between automated and physician contours was 0.86 (IQR 0.78–0.91). Automated SUVmax values matched exactly the physician determined values in 81/100 cases, with Pearson’s correlation coefficient (R) of 0.95. Automated MTV was strongly correlated with physician MTV (R = 0.88), though it was slightly underestimated with a median (IQR) relative difference of − 4.3% (− 10.0–5.7%). Agreement of TLG was excellent (R = 0.94), with median (IQR) relative difference of − 0.4% (− 5.2–7.0%). Median relative percent differences were 6.8% (R = 0.91; IQR 1.6–4.3%) for SA/MTV, and 4.5% (R = 0.51; IQR − 7.5–40.9%) for Dmaxpatient, which was the most difficult feature to quantify automatically.

Conclusions

An automated method using an ensemble of multi-resolution pathway 3D CNNs was able to quantify PET imaging features of lymphoma on baseline FDG PET/CT images with excellent agreement to reference physician PET segmentation. Automated methods with faster throughput for PET quantitation, such as MTV and TLG, show promise in more accessible clinical and research applications.
Community-based nutrition-sensitive approach to address short-term hunger and undernutrition among primary school children in rural areas in a developing country setting: lessons from North and North-Eastern Uganda
Authors: Elolu Samuel , Ongeng Duncan
Published: December 2020

Background

Undernutrition in childhood is an important factor that greatly impedes the achievement of full human potential at adulthood. Despite increased enrolment of pupils in primary schools in developing countries, short-term hunger and undernutrition continue to impact negatively on school attendance, retention and education outcomes in economically disadvantaged rural areas. This study examined the feasibility of a community-based participatory action research approach building capacity of rural women food vendors to use local food resources to produce nutritionally enhanced food products for primary school feeding in rural localities in a developing country setting.

Methods

Mixed methods approach incorporating focus group discussions (FGDs) to evaluate parents’ and school administrators’ perceptions of the community-based approach, participatory experimental improvement of nutritional quality of an energy-based cassava product (gari) involving community women food vendors, and cross-sectional acceptability assessment of improved products among rural primary school children. Qualitative content analysis, one-way analysis of variance and correlation analysis was used to analyse FGD data, compare nutritional profile and consumer sensory profile of different products, and examine associations between sensory attributes and acceptability of the products, respectively.

Results

The approach of using local food resources to produce nutritious products targeting school feeding was strongly recognised by parents, school administrators, teachers and small scale rural women food vendors as an adoptable nutrition-sensitive means of addressing short-term hunger among primary school children in rural settings. The action research resulted in a highly accepted nutritionally enhanced product (consisting of cassava, soy and silver fish) exhibiting superior nutritional properties (23.29% protein, 90.5 g/100 g calcium, 4.5 g/100 g zinc, 11.6 g/100 g iron, 40.40 g/100 g phosphorus, 61.57 μg/100 g vitamin A) compared to the original energy-dominated cassava product (2.18% Protein, 55.6 g/100 g calcium, 1.2 g/100 g zinc, 4.4 g/100 g iron, 6.6 g/100 g phosphorus, 11.23 μg/100 g vitamin A) (p < 0.05). Nutritional computation revealed that serving 120 g of the new product would suffice to meet 30% of the recommended dietary allowance for essential nutrients that children should receive from school meals.

Conclusion

Community-level nutrition-sensitive innovation using local foods resources offers the opportunity for rural women food vendors to contribute to addressing short-term hunger and undernutrition challenges in primary schools in economically-disadvantaged localities in developing countries.
Investigation of opposition to diagnostic or therapeutic procedures in older people hospitalized in acute geriatric services: the OPTAH pilot study protocol
Authors: Tannou Thomas , Trimaille Hélène , Mathieu-Nicot Florence , Koeberle Séverine , Aubry Régis , Godard-Marceau Aurélie
Published: December 2020

Background

Shared decision-making is a process that involves collaborative discussions between a patient and a care team to ensure informed healthcare decisions. This process becomes more complex when the older person’s decision-making capacities are affected. In these situations, surrogate decision-making processes are used to define a person-centered care plan. Despite these processes, the implementation of the care plan defined in the best interest of the patient may nevertheless be rejected by the patient, particularly in cases of neurocognitive disorders or delirium. This concept of opposition and/or refusal is frequently used in research. This is not yet well understood in the medical literature, and there is a lack of consensus on its definition. We, therefore, explored this concept by defining opposition to diagnostic or therapeutic proposals.

Method

Our pilot study protocol is based on a mixed methodology (epidemiological and qualitative research) to quantify this phenomenon, validate the proposed definition, and explore its core elements. Opposition and refusal of care will be quantified, and semi-structured interviews will be conducted with patients, their relatives, and referring carers. Multidisciplinary meetings that will be associated with these situations will also be observed and analyzed. Methodological approaches that can be used to explore opposition and refusal of care in a scientific, reproducible framework are presented. This methodology considers the specificities of the geriatric, polypathological population with neurocognitive disorders.

Discussion

Opposition and refusal of care are key concepts in clinical research on ethics, particularly in the geriatric field. These concepts are frequently mentioned in studies involving older patients but have not been specifically defined or studied. This study would undoubtedly lead to greater awareness among professional caregivers and relatives of the significance of such opposition, and more respectful interactions in these complex hospitalization cases.

Trial registration

ClinicalTrial.gov, NCT03373838. Registered on 14 December 2017.
COVID-19 knowledge, beliefs, prevention behaviours and misinformation in the context of an adapted seasonal malaria chemoprevention campaign in six northern Nigerian States
Authors: Richardson Sol , Ibinaiye Taiwo , Nikau Jamilu , Oresanya Olusola , Marasciulo Madeleine , Roca-Feltrer Arantxa , Rassi Christian , Adesoro Olatunde
Published: December 2020

Background

Seasonal malaria chemoprevention (SMC) using sulfadoxine-pyrimethamine and amodiaquine is an efficacious intervention for protection of children against Plasmodium falciparum malaria during the rainy season. In response to the global COVID-19 pandemic, Malaria Consortium adapted its SMC delivery model to ensure safety of distributors, data collectors and beneficiaries. We conducted a SMC monitoring survey in July 2020 in the states of Bauchi, Jigawa, Kano, Katsina, Sokoto and Yobe, with questions on COVID-19 prevention behaviours and symptoms, and belief in misinformation. We investigated the associations between receipt of information on COVID-19 by different sources, including from SMC distributors, and these three outcomes using logistic generalised estimating equations. We also considered moderation of effectiveness of message delivery by SMC distributors and adherence to use of face coverings.

Results

We obtained a representative sample of 40,157 caregivers of eligible children aged 3–59 months, of which 36,914 (91.92%) reported knowledge of COVID-19. The weighted proportions of respondents who correctly identified COVID-19 prevention behaviours and symptoms, and who reported belief in COVID-19 misinformation, were 80.52% (95% confidence interval [95% CI] 80.02–81.00), 81.72% (95% CI 81.23–82.20) and 22.90% (95% CI 22.24–23.57). Receipt of information on COVID-19 from SMC distributors during the campaign was significantly associated with higher odds of caregiver knowledge of COVID-19 prevention behaviours (odds ratio [OR] 1.78, 95% CI 1.64–1.94, p < 0.001) and symptoms (OR 1.74, 95% CI 1.59–1.90, p < 0.001) and lower odds of belief in COVID-19 misinformation (OR 0.92, 95% CI 0.85–1.00, p = 0.038). The associations between message delivery by SMC distributors and the three outcomes were moderated by their adherence to face covering use. Receipt of information by other sources used to deliver government public health messages, including radio and health facility workers, was also associated with knowledge of COVID-19.

Conclusions

Malaria Consortium’s SMC programme was successfully adapted in the context of COVID-19 and was a conduit for high-quality public health messages. Standard SMC monitoring and evaluation activities can be adapted to gather evidence on emerging public health issues such as the global COVID-19 pandemic.
Validity of the Egyptian version of Sino-Nasal Outcome Test-22 and its predictive value in evaluation of patients undergoing septoplasty surgery
Authors: Abdelazim M. H. , Alsobky M. E.
Published: December 2020

Background

The purpose of this study is to evaluate the patients undergoing septoplasty surgery via the Egyptian version of Sino-Nasal Outcome Test-22 (SNOT-22). Sixty patients were selected from 77 deviated nasal septum patients who had undergone septoplasty surgery represent the group 1, and another 60 healthy subjects were selected to be the control group 2. All patients as well as the control group were exposed to SNOT-22 questionnaire preoperatively and 3 months postoperatively.

Results

SNOT-22 questionnaire was found to be improved from a mean ± SD of 29.0 ± 10.7 preoperatively to 13.2 ± 3.22 postoperatively; the control group has a mean of 13.8 ± 2.64.

Conclusion

The Egyptian version of SNOT-22 is an effective tool in evaluating the operation results in patients with deviated nasal septum after septoplasty surgery.
Psychotherapy training in Nepal: views of early career psychiatrists
Authors: Rai Yugesh , Karki Utkarsh , Pinto da Costa Mariana
Published: December 2020

Although training in psychotherapy is an integral part of psychiatry training, standards in psychotherapy training have wide variation across and within countries. Post-graduate psychiatry training has been conducted in Nepal for over two decades, but little is known about its psychotherapy training provisions. An online survey was conducted with early career psychiatrists in Nepal. The findings show that the majority recognised psychotherapy training as important and were eager to pursue further training. However, two-thirds had no access to psychotherapy training opportunities. These results highlight the need to improve access to training in different psychotherapy modalities in Nepal.
Cost and health impacts of adherence to the National Institute for Health and Care Excellence schizophrenia guideline recommendations
Authors: Jin Huajie , Tappenden Paul , MacCabe James H. , Robinson Stewart , McCrone Paul , Byford Sarah
Published: December 2020

Background

Discrepancies between the National Institute for Health and Care Excellence (NICE) schizophrenia guideline recommendations and current clinical practice in the UK have been reported.

Aims

We aim to assess whether it is cost-effective to improve adherence to the NICE schizophrenia guideline recommendations, compared with current practice.

Method

A previously developed whole-disease model for schizophrenia, using the discrete event simulation method, was adapted to assess the cost and health impacts of adherence to the NICE recommendations. Three scenarios to improve adherence to the clinical guidelines were modelled: universal provision of cognitive–behavioural therapy for patients at clinical high risk of psychosis, universal provision of family intervention for patients with first-episode psychosis and prompt provision of clozapine for patients with treatment-resistant schizophrenia. The primary outcomes were lifetime costs and quality-adjusted life-years gained.

Results

The results suggest full adherence to the guideline recommendations would decrease cost and improve quality-adjusted life-years. Based on the NICE willingness-to-pay threshold of £20 000–£30 000 per quality-adjusted life-year gained, prompt provision of clozapine for patients with treatment-resistant schizophrenia results in the greatest net monetary benefit, followed by universal provision of cognitive–behavioural therapy for patients at clinical high risk of psychosis, and universal provision of family intervention for patients with first-episode psychosis.

Conclusions

Our results suggest that adherence to guideline recommendations would decrease cost and improve quality-adjusted life-years. Greater investment is needed to improve guideline adherence and therefore improve patient quality of life and realise potential cost savings.
The Epistemic and the Zetetic
Authors: Friedman Jane
Published: December 2020

Call the norms of inquiry zetetic norms. How are zetetic norms related to epistemic norms? At first glance, they seem quite closely connected. Aren't epistemic norms norms that bind inquirers qua inquirers? And isn't epistemology the place to look for a normative theory of inquiry? While much of this thought seems right, this paper argues that the relationship between the epistemic and the zetetic is not as harmonious as one might have thought and liked. In particular, this paper argues that some familiar contemporary epistemic norms are in tension with, and even in conflict with, central zetetic norms.
RET inhibition in novel patient-derived models of RET fusion- positive lung adenocarcinoma reveals a role for MYC upregulation
Authors: Hayashi Takuo , Odintsov Igor , Smith Roger S. , Ishizawa Kota , Liu Allan J. W. , Delasos Lukas , Kurzatkowski Christopher , Tai Huichun , Gladstone Eric , Vojnic Morana , Kohsaka Shinji , Suzawa Ken , Liu Zebing , Kunte Siddharth , Mattar Marissa S. , Khodos Inna , Davare Monika A. , Drilon Alexander , Cheng Emily , de Stanchina Elisa , Ladanyi Marc , Somwar Romel
Published: December 2020

Multi-kinase RET inhibitors, such as cabozantinib and RXDX-105, are active in lung cancer patients with RET fusions; however, the overall response rates to these two drugs are unsatisfactory compared to other targeted therapy paradigms. Moreover, these inhibitors may have different efficacies against RET rearrangements depending on the upstream fusion partner. A comprehensive preclinical analysis of the efficacy of RET inhibitors is lacking due to a paucity of disease models harboring RET rearrangements. Here, we generated two new patient-derived xenograft (PDX) models, one new patient-derived cell line, one PDX-derived cell line, and several isogenic cell lines with RET fusions. Using these models, we re-examined the efficacy and mechanism of action of cabozantinib and found that this RET inhibitor was effective at blocking growth of cell lines, activating caspase 3/7 and inhibiting activation of ERK and AKT. Cabozantinib treatment of mice bearing RET fusion-positive cell line xenografts and two PDXs significantly reduced tumor proliferation without adverse toxicity. Moreover, cabozantinib was effective at reducing growth of a lung cancer PDX that was not responsive to RXDX-105. Transcriptomic analysis of lung tumors and cell lines with RET alterations showed activation of a MYC signature and this was suppressed by treatment of cell lines with cabozantinib. MYC protein levels were rapidly depleted following cabozantinib treatment. Taken together, our results demonstrate that cabozantinib is an effective agent in preclinical models harboring RET rearrangements with three different 5′ fusion partners (CCDC6, KIF5B and TRIM33). Notably, we identify MYC as a protein that is upregulated by RET expression and downregulated by treatment with cabozantinib, opening up potentially new therapeutic avenues for the combinatorial targetin of RET fusion- driven lung cancers. The novel RET fusion-dependent preclinical models described here represent valuable tools for further refinement of current therapies and the evaluation of novel therapeutic strategies.
Determination of Chemical Structure of Bis(dithiolato)iron Nanosheet
Authors: Tan Choon Meng , Horikawa Mami , Fukui Naoya , Maeda Hiroaki , Sasaki Sono , Tsukagoshi Kazuhito , Nishihara Hiroshi
Published: December 2020

Liquid-liquid interfacial reactions between FeSO4 (aq.) and benzenehexathiol (BHT) in chloroform at room temperature and at 45 °C give bis(dithiolato)iron nanosheets 1-RT and 1-H, respectively. Nanosheets were characterized by IR, UV-Vis, SEM-EDS, TEM, XPS and PXRD. 1-H is remarkably more crystalline than 1-RT and its chemical structure resembles not the porous nickel-BHT nanosheet ([Ni3(C6S6)2]n, “Type 1”) but the non-porous copper-BHT nanosheet ([Cu3(C6S6)]n, “Type 2”), evidenced by PXRD data. Electrical conductivity of 1-H is 0.68 S cm−1 with Ea = 270 meV.
High Prevalence of Exercise-induced Laryngeal Obstruction in a Cohort of Elite Cross-country Skiers
Authors: IREWALL TOMMIE , BÄCKLUND CATHARINA , NORDANG LEIF , RYDING MARIE , STENFORS NIKOLAI
Published: December 2020

Introduction

Exercise-induced laryngeal obstruction (EILO) is a differential diagnosis for asthma and prevalent in athletes referred for exercise-induced dyspnea. The aim of this study was to estimate the prevalence of EILO in elite cross-country skiers, known for a high prevalence of asthma.

Method

Elite cross-country skiers were invited for screening of EILO. Screening consisted of clinical assessment, questionnaires, skin prick test, spirometry, eucapnic voluntary hyperventilation test, and continuous laryngoscopy during exercise test. Current asthma was defined as physician-diagnosed asthma and use of asthma medication during the last 12 months. EILO was defined as ≥2 points at the supraglottic or glottic level during exercise at maximal effort, using a visual grade score system.

Result

A total of 89 (51% female) cross-country skiers completed the study. EILO was identified in 27% of the skiers, 83% of whom were female. All skiers with EILO had supraglottic EILO, and there was no glottic EILO. Current asthma was present in 34 (38%) of the skiers, 10 (29%) of whom had concomitant EILO. In the skiers with EILO, a higher proportion reported wheeze or shortness of breath after exercise, compared with skiers without EILO. In skiers with EILO and current asthma, compared with skiers with asthma only, a higher proportion reported wheeze or shortness of breath after exercise. Asthma medication usage did not differ between these groups.

Conclusion

EILO is common in elite cross-country skiers, especially females. Asthma and EILO may coexist, and the prevalence of respiratory symptoms is higher in skiers with both. Testing for EILO should be considered in cross-country skiers with respiratory symptoms.
A prospective review of renewable energy developments in Ethiopia
Authors: Hameer Sameer , Ejigu Netsanet
Published: December 2020

Ethiopia has a vast renewable energy potential in the context of hydro, wind, solar, and geothermal energies. The unsustainable use of biomass coupled with drought has caused a paradigm shift towards wind, geothermal, and solar energies. There have been significant strides by the Government of Ethiopia to actualize these potentials in the context of developing massive projects in these aforementioned areas with the private business sector in the goal of jettisoning the industrial base of Ethiopia in conjunction with increasing the installed power capacity from 4,300 MW to 17,346 MW by 2020. The major challenge still lies in assessing the comprehensive renewable energy resource potential of Ethiopia including the lack of local content development in the context of establishing an industrial base. There have been notable initiatives by the Government of Ethiopia to adhere to the Paris Climate Accord in conjunction with the Green Growth framework and Sustainability Development Goals. However, the top down approach of grand targets to the various regions is not the pragmatic approach to solving the Achilles heel of energy poverty. A more plausible approach is from the bottom up, whereby energy frameworks and policies are generated by conducting a needs assessment of a specified region. The appropriate technology concept needs to be reflected in the innovation aspects of renewable energy technologies. There has to be a framework of translating invention to innovation by actualizing the tripartite structure of Government, Academia, and Industry.
Road traffic injuries in Nepal during COVID-19 lockdown
Authors: Sedain Bhagabati , Pant Puspa Raj
Published: December 2020

Background: As the world is busy addressing COVID-19, road traffic injuries, another major cause of deaths is continuously killing people on the roads. In Nepal, there were frequent media reports of occurrences of road crashes, injuries, and deaths despite nationwide lockdown. This paper aims to describe the situation of road traffic crashes and casualties during the period of complete lockdown.

Methods: This study used secondary data from two sources: Nepal Police and media reports between 24 March and 14 June 2020 (because the government lifted the nationwide lockdown from 15 June 2020). Available details of crashes, deaths, and injuries for this period were extracted from media reports and the summary data that was obtained from the Police.  We have included data from both sources in the results.

Results: Nepal Police recorded 1,801 incidents of road crashes during the 82 days of the COVID-19 lockdown with 256 deaths (on average 3.1 deaths daily) and 1,824 injuries (on average 22.2 injuries daily). Motorcycles comprised over 21% of all vehicles involved in crashes. Ambulances and other vehicles for essential services were also found to be involved in crashes. Speeding itself was the cause for almost a quarter of the incidents during the lockdown.

Conclusions: Even when the movement restrictions were imposed in Nepal, the number of road crashes was not substantially reduced. Media reports were mainly found to be reporting the crashes where deaths occurred, but police records also included nonfatal injuries. The incidence of crashes in this period shows that it is important to work for road safety to save lives from road traffic crashes in Nepal.