bluuebunny/crossref_metadata_2025 huggingface dataset:
Tenofovir disoproxil fumarate in pregnancy for prevention of mother to child transmission of hepatitis B in a rural setting on the Thailand-Myanmar border: a cost-effectiveness analysis
Authors: Bierhoff Marieke , Angkurawaranon Chaisiri , Rijken Marcus J. , Sriprawa Kanlaya , Kobphan Pachinee , Nosten Francois N. , van Vugt Michèle , McGready Rose , Devine Angela
Published: February 2021

Background

Hepatitis B Virus (HBV) is transmitted from mother to child which can be prevented via birth dose vaccine combined with three follow up hepatitis B vaccines, hepatitis B immunoglobulins (HBIG), and maternal antiviral treatment with Tenofovir Disoproxil Fumarate (TDF). This study evaluates the cost effectiveness of six strategies to prevent perinatal HBV transmission in a resource limited setting (RLS) on the Thailand-Myanmar border.

Methods

The cost effectiveness of six strategies was tested by a decision tree model in R. All strategies included birth and follow up vaccinations and compared cost per infection averted against two willingness to pay thresholds: one-half and one gross domestic product (GDP) per capita. Strategies were: 1) Vaccine only, 2) HBIG after rapid diagnostic test (RDT): infants born to HBsAg+ are given HBIG, 3) TDF after RDT: HBsAg+ women are given TDF, 4) TDF after HBeAg test: HBeAg+ women are given TDF, 5) TDF after high HBV DNA: women with HBV DNA > 200,000 are given TDF, 6) HBIG & TDF after high HBV DNA: women with HBV DNA > 200,000 are given TDF and their infants are given HBIG. One-way and probabilistic sensitivity analyses were conducted on the cost-effective strategies.

Results

Vaccine onlywas the least costly option withTDF after HBeAg teststrategy as the only cost-effective alternative.TDF after HBeAg testhad an incremental cost-effectiveness ratio of US$1062; which would not be considered cost-effective with the lower threshold of one-half GDP per capita. The one-way sensitivity analysis demonstrated that the results were reasonably robust to changes in single parameter values. The PSA showed thatTDF after HBeAg testhad an 84% likelihood of being cost effective at a willingness to pay threshold of one GDP per capita per infection averted.

Conclusions

We found thatTDF after HBeAg testhas the potential to be cost-effective if TDF proves effective locally to prevent perinatal HBV transmission. The cost of TDF treatment and reliability of the RDT could be barriers to implementing this strategy. WhileTDF after RDTmay be a more feasible strategy to implement in RLS,TDF after HBeAg testis a less costly option.
High-intensity interval training in breast cancer survivors: a systematic review
Authors: Tsuji Katsunori , Matsuoka Yutaka J. , Ochi Eisuke
Published: February 2021

Background

To review the settings and outcomes of high-intensity interval training (HIIT) interventions for breast cancer survivors, and to explore the feasibility of prescribing exercise for breast cancer survivors.

Methods

A systematic search of electronic databases was conducted for studies published up to May 31, 2020. Eligibility criteria included randomized controlled trials of HIIT intervention in breast cancer survivors. Studies were grouped by whether the intervention was conducted during or after breast cancer treatment, and intervention methods and outcomes were reviewed within each group.

Results

Twenty-six studies were identified, and 13 satisfied the inclusion criteria. Intervention was conducted during treatment in 8 studies, and after treatment in 5. Intervention duration ranged from 3 to 16 weeks, with 2 or 3 sessions per week, for a total of 9 to 36 sessions. All interventions were supervised; 12 were lab-based, and 1 was community-based. One of most promising outcomes was improvement of cardiorespiratory fitness by HIIT.

Conclusion

This review found that all studies on HIIT for breast cancer survivors investigated lab-based, supervised interventions, but not home-based or unsupervised. HIIT is a time-efficient method for increasing cardiovascular function in breast cancer survivors, but further research is necessary to determine its effects on other outcomes.
Comparison of risk allele frequencies of single nucleotide polymorphisms associated with age-related macular degeneration in different ethnic groups
Authors: Shin Hyun-Tae , Yoon Byung Woo , Seo Je Hyun
Published: February 2021

Background

The prevalence of age-related macular degeneration (AMD) varies from 6.8 to 18.3% for all forms of AMD and from 0.6 to 2.6% for late AMD according to race, suggesting the existence of genetic differences among races. The purpose of this study was to determine the genetic causes of differences in the prevalence of AMD among individuals of different races.

Methods

We collected 138 AMD-associated single nucleotide polymorphisms (SNPs) from a genome-wide association studies catalog. Their population-level allele frequencies were derived based on the 1000 Genomes Project and Korean Reference Genome Database. We used Fisher’s exact tests to assess whether the effect allele at a given SNP was significantly enriched or depleted in the database.

Results

European, American, and South Asian populations showed similar heatmap patterns, whereas East Asian, and Korean populations had distinct patterns. Korean populations exhibited patterns that were different from those of the other groups; rs5754227 (SYN3), rs1626340 (TGFBR1/COL15A1), rs3750846(ARMS2/HTRA1), and rs9564692 (B3GALTL) were enriched, whereas rs2230199 (C3) and rs73036519 (EXOC3L2/MARK4) were depleted in Koreans; these SNPs are associated with late AMD. The genetic risk score calculated from allele frequencies was not less in East Asians than in Europeans.

Conclusion

The prevalence of AMD is lower in Asians than in Europeans. However, our study showed that genetic risk scores in East Asians were similar to those in Europeans, which may explain why the global projected number of people with AMD by 2040 is in largest for East Asians, including Koreans.
Prevalence, median time, and associated factors with the likelihood of initial antidepressant change: a cross-sectional study in Qatar
Authors: Elbakary Nervana , Ouanes Sami , Riaz Sadaf , Abdallah Oraib , Mahran Islam , Al-Khuzaei Noriya , Eltorki Yassin
Published: February 2021

Background

Major Depressive Disorder (MDD) requires therapeutic interventions during the initial month after being diagnosed for better disease outcomes. International guidelines recommend a duration of 4–12 weeks for an initial antidepressant (IAD) trial at an optimized dose to get a response. If depressive symptoms persist after this duration, guidelines recommend switching, augmenting, or combining strategies as the next step. Premature discontinuation of IAD due to ineffectiveness can cause unfavorable consequences. We aimed to determine the prevalence and the patterns of strategies applied after an IAD was changed because of a suboptimal response as a primary outcome. Secondary outcomes included the median survival time on IAD before any change; and the predictors that were associated with IAD change.

Methods

This was a retrospective study conducted in Mental Health Services in Qatar. A dataset between January 1, 2018, and December 31, 2019, was extracted from the electronic health records. Inclusion and exclusion criteria were defined and applied. The sample size was calculated to be at least 379 patients. Descriptive statistics were reported as frequencies and percentages, in addition, to mean and standard deviation. The median time of IAD to any change strategy was calculated using survival analysis. Associated predictors were examined using several cox regression models.

Results

A total of 487 patients met the inclusion criteria of the study, 431 (88%) of them had an occurrence of IAD change to any strategy before end of the study. Almost half of the sample (212 (49%); 95% CI [44–53%]) had their IAD changed less than or equal to 30 days. The median time to IAD change was 43 days with 95% CI [33.2–52.7]. The factors statistically associated with higher hazard of IAD change were: younger age, un-optimization of the IAD dose before any change, and comorbid anxiety.

Conclusions

Because almost half of the patients in this study changed their IAD as early as within the first month, efforts to avoid treatment failure are needed to ensure patient-treatment targets are met. Our findings offered some clues to help clinicians identify the high-risk predictors of short survival and subsequent failure of IAD.
Perception of menopause among women of Sarawak, Malaysia
Authors: Syed Alwi S. A. R. , Brohi I. B. , Awi I.
Published: February 2021

Background

Various factors, including menopausal status, educational and social background, culture, and physical and emotional health, may influence women’s perceptions of menopause. This study documents the elements influencing attitudes towards menopause among women in Sarawak, Malaysia.

Methods

A face-to-face interview using a validated questionnaire was conducted with 324 Sarawakian women aged 40–65 to determine the mean age of menopause and perceptions and experiences of menopause among these women.

Results

The mean age ± standard deviation of the women was 51.37 ± 5.91 years. Ninety (27.8%) participants were premenopausal, 124 (38.5%) perimenopausal and 110 (33.7%) postmenopausal. The majority of these women (228; 70.4%) were local indigenous inhabitants of Sarawak. The findings show that 22.5% of the participants agreed that problems during menopause are a natural process. While 21.9% of the participants suggested that menopause should be treated medically, 32.3% argued that natural approaches for menopause symptoms are better than hormonal treatments. Seventy-five per cent of the women agreed that the absence of menses after menopause is a relief; meanwhile, 61.2% stated that menopause causes unpleasant symptoms. Notably, 51.7% were not sure whether women become less sexually attractive after menopause, and 51.1% were uncertain as to whether they feel less of a woman following menopause. Finally, 81.7% of participants were unsure if sexual activity is more enjoyable after menopause, and 71.9% were uncertain whether changes in life during menopause are more stressful. Among the different menopausal stages, the premenopausal group of women were noted to have more positive perceptions of menopause compared to the peri- and postmenopausal women. The study also observed that women with a better educational background generally had more positive perceptions of menopause.

Conclusions

The women’s perceptions of menopause in this study were found to correspond to those in other studies on Asian women. Women with higher levels of education and premenopausal women comparatively expressed more positive opinions regarding menopause. Lastly, most of the women noted that menopausal symptoms are unpleasant, but that the absence of menses after menopause is a relief.
Chemical composition, in vitro antioxidant, anticholinesterase, and antidiabetic potential of essential oil of Elaeagnus umbellata Thunb
Authors: Nazir Nausheen , Zahoor Muhammad , Uddin Faheem , Nisar Mohammad
Published: February 2021

Background

Elaeagnus umbellata Thunb. (autumn olive) is a high valued medicinal plant. It belongs to Elaeagnaceae family and is widely distributed in Himalayan regions of Pakistan. In the present study essential oil were extracted from the fruit of this plant and their antioxidant, anticholinesterase and antidiabetic potentials were also evaluated.

Methods

Essential oils were extracted from the fruit of E. umbellata using hydro-distillation method and were characterized by GC-MS. The extracted oil were tested for its antioxidant, anticholinesterase, and antidiabetic potentials using standard protocols.

Results

About 68 compounds were identified by GC-MS. The extracted oil exhibited a fairly high free radical scavenging activities against DPPH and ABTS radicals with IC50 values of 70 and 105 μg/mL respectively (for ascorbic acid, used as standard, the IC50 values were 32 and 29 μg/mL, respectively against the mentioned radicals). The essential oil also exhibited anticholinesterase activities with IC50 values of 48 and 90 μg/mL respectively against AChE and BChE (for galantamine used as standard, the IC50 values were 25 and 30 μg/mL respectively). The essential oil also exhibited antidiabetic potential with IC50 values of 120 and 110 μg/mL respectively against α-glucosidase and α-amylase (IC50 values for standard acarbose = 28 and 30 μg/mL respectively).

Conclusion

Essential oil extracted from the fruits of E. umbellata exhibited reasonable antioxidant, anticholinesterase, and antidiabetic potentials that could be used as alternative medicine in treating diabetes and neurodegenerative disorders. However, further studies are needed to isolate responsible compounds and evaluate the observed potential in animal models.

Graphical abstract
Medical student remote eConsult participation during the COVID-19 pandemic
Authors: Kopp Adam R. , Rikin Sharon , Cassese Todd , Berger Matthew A. , Raff Amanda C. , Gendlina Inessa
Published: February 2021

Background

Undergraduate medical education was severely impacted by the COVID-19 pandemic. As traditional clinical rotations were suspended, medical students quickly began alternative, novel educational experiences. Third-year medical students at an academic medical center were given the opportunity to join inpatient eConsult teams within the department of medicine. This study describes the development and implementation of this program as well as the experiences of student and faculty participants.

Methods

Student eConsult participation was rapidly developed and implemented within medical subspecialty teams in either infectious diseases (ID) or nephrology. Twelve third-year medical students and 15 subspecialty attendings participated in this program during an eight-week period from April 6 through May 29, 2020. Breadth of student clinical experience was assessed via review of clinical documentation and surveys. Participating students and attending physicians completed surveys to reflect upon their impressions of the program. Surveys were returned by nine students and eight faculty members. Survey responses were summarized with descriptive statistics.

Results

Over an eight-week period, student consultants wrote 126 notes on 100 patients; 74 of these patients (74%) were hospitalized with COVID-19. Student experiences were largely positive with most strongly agreeing that attendings promoted interactive and engaged learning (N = 8 of 8, 100%), that the experience helped to expand their knowledge about consultant roles (N = 6, 75%), and that they would participate in a remote eConsult program again if given the opportunity (N = 6, 75%). Faculty also were largely positive about the experience with most agreeing or strongly agreeing with the importance of teaching medical students about telehealth (N = 7 of 8, 88%) and eConsults (N = 6, 75%). In narrative responses, students and faculty agreed that teaching was a strength of the program whereas lack of in-person contact was a challenge.

Conclusions

Rapid development of an inpatient eConsult-based educational experience for third-year medical students was feasible and successful. Student-consultants saw a range of pathology including COVID-19 and related complications. Students were satisfied with the program. They were able to develop a strong relationship with attendings while learning about the role of a consultant. Faculty agreed with the importance of teaching students about telehealth and eConsults specifically.
Relation of severe COVID-19 to polypharmacy and prescribing of psychotropic drugs: the REACT-SCOT case-control study
Authors:   on behalf of Public Health Scotland COVID-19 Health Protection Study Group, McKeigue Paul M. , Kennedy Sharon , Weir Amanda , Bishop Jen , McGurnaghan Stuart J. , McAllister David , Robertson Chris , Wood Rachael , Lone Nazir , Murray Janet , Caparrotta Thomas M. , Smith-Palmer Alison , Goldberg David , McMenamin Jim , Guthrie Bruce , Hutchinson Sharon , Colhoun Helen M.
Published: February 2021

Background

The objective of this study was to investigate the relation of severe COVID-19 to prior drug prescribing.

Methods

Severe cases were defined by entry to critical care or fatal outcome. For this matched case-control study (REACT-SCOT), all 4251 cases of severe COVID-19 in Scotland since the start of the epidemic were matched for age, sex and primary care practice to 36,738 controls from the population register. Records were linked to hospital discharges since June 2015 and dispensed prescriptions issued in primary care during the last 240 days.

Results

Severe COVID-19 was strongly associated with the number of non-cardiovascular drug classes dispensed. This association was strongest in those not resident in a care home, in whom the rate ratio (95% CI) associated with dispensing of 12 or more drug classes versus none was 10.8 (8.8, 13.3), and in those without any of the conditions designated as conferring increased risk of COVID-19. Of 17 drug classes postulated at the start of the epidemic to be “medications compromising COVID”, all were associated with increased risk of severe COVID-19 and these associations were present in those without any of the designated risk conditions. The fraction of cases in the population attributable to exposure to these drug classes was 38%. The largest effect was for antipsychotic agents: rate ratio 4.18 (3.42, 5.11). Other drug classes with large effects included proton pump inhibitors (rate ratio 2.20 (1.72, 2.83) for = 2 defined daily doses/day), opioids (3.66 (2.68, 5.01) for = 50 mg morphine equivalent/day) and gabapentinoids. These associations persisted after adjusting for covariates and were stronger with recent than with non-recent exposure.

Conclusions

Severe COVID-19 is associated with polypharmacy and with drugs that cause sedation, respiratory depression, or dyskinesia; have anticholinergic effects; or affect the gastrointestinal system. These associations are not easily explained by co-morbidity. Measures to reduce the burden of mortality and morbidity from COVID-19 should include reinforcing existing guidance on reducing overprescribing of these drug classes and limiting inappropriate polypharmacy.

Registration

ENCEPP number https://EUPAS35558
Immune infiltrating cells in cholangiocarcinoma may become clinical diagnostic markers: based on bioinformatics analysis
Authors: Zhang Yongwei , Chen Sihan , Li Jun , Dai Wei , Qian Yeben
Published: February 2021

Background

Intrahepatic cholangiocarcinoma (ICC) is a malignant tumor originating from the secondary bile duct and its branch epithelium. Among primary liver tumors, the incidence of ICC is second only to hepatocellular carcinoma. Tumor microenvironment can regulate the occurrence and development of tumors. This study is dedicated to finding more markers that can diagnose ICC by finding the differential tumor microenvironment cells between ICC and normal tissues.

Methods

We wanted to study the infiltration of immune cells between the cholangiocarcinoma of the same patient and its paired non-tumor tissues, to explore the difference of immune cells in the tumor microenvironment and adjacent non-tumor tissues in the same organism. So, we searched the relevant data of patients with ICC from the GEO database and found that the GSE45001 data set meets our research needs. CIBERSORT database is used to calculate immune cell composition. Finally, perform visual analysis and data statistics to find out the differentially expressed immune cells.

Results

We found that the expression levels of dendritic cells activated, macrophages M2, and T cells regulatory (Tregs) in ICC were higher than normal tissues, and the expression levels of macrophages M1, monocytes, and T cells follicular helper in ICC were lower than normal tissues.

Conclusion

These 6 types of immune cells are expected to become molecular markers for clinical diagnosis of ICC.
Correction to: Characterization of speed adaptation while walking on an omnidirectional treadmill
Authors: Soni Smit , Lamontagne Anouk
Published: February 2021

An amendment to this paper has been published and can be accessed via the original article.
A cross-country core strategy comparison in China, Japan, Singapore and South Korea during the early COVID-19 pandemic
Authors: Chen Haiqian , Shi Leiyu , Zhang Yuyao , Wang Xiaohan , Sun Gang
Published: February 2021

Background

The study aimed to analyze the effectiveness of COVID-19 strategies adopted by China, Japan, Singapore, and South Korea.

Methods

We extracted publicly available data from various official websites, summarized the strategies implemented in these four countries, and assessed the effectiveness of the prevention and control measures adopted by these countries.

Results

As of October 28, 2020, the growth of daily new confirmed cases has stabilized in China, Singapore, and South Korea. In Japan, the daily new confirmed cases increased sharply since it lifted a state of emergency, but case-fatality maintains at a lower level. The growth of total cases is near stagnant in China and Singapore, with a case-fatality of 5.39 and 0.05% respectively. The case-fatality rate between Japan and South Korea is identical at 1.76%, however, Japan’s growth rate of cases has increased more rapidly than South Korea.

Conclusion

This study found that China, Japan, Singapore, and South Korea accessed the situation within their own borders and implemented different intervention strategies to curb the spread of COVID-19 and maintain lower rates of case-fatality. China, Singapore, and South Korea adopted the containment strategy, while Japan adopted the mitigation strategy. Although Japan’s case-fatality maintained at a low level, daily new cases increased faster than the other three countries. This result indicated that a mitigation strategy could be inferior to a containment strategy.
Megabase-scale methylation phasing using nanopore long reads and NanoMethPhase
Authors: Akbari Vahid , Garant Jean-Michel , O’Neill Kieran , Pandoh Pawan , Moore Richard , Marra Marco A. , Hirst Martin , Jones Steven J. M.
Published: February 2021

The ability of nanopore sequencing to simultaneously detect modified nucleotides while producing long reads makes it ideal for detecting and phasing allele-specific methylation. However, there is currently no complete software for detecting SNPs, phasing haplotypes, and mapping methylation to these from nanopore sequence data. Here, we present NanoMethPhase, a software tool to phase 5-methylcytosine from nanopore sequencing. We also present SNVoter, which can post-process nanopore SNV calls to improve accuracy in low coverage regions. Together, these tools can accurately detect allele-specific methylation genome-wide using nanopore sequence data with low coverage of about ten-fold redundancy.
Gender-related variables for health research
Authors: Nielsen Mathias W. , Stefanick Marcia L. , Peragine Diana , Neilands Torsten B. , Ioannidis John P. A. , Pilote Louise , Prochaska Judith J. , Cullen Mark R. , Einstein Gillian , Klinge Ineke , LeBlanc Hannah , Paik Hee Young , Schiebinger Londa
Published: February 2021

Background

In this paper, we argue for Gender as a Sociocultural Variable (GASV) as a complement to Sex as a Biological Variable (SABV). Sex (biology) and gender (sociocultural behaviors and attitudes) interact to influence health and disease processes across the lifespan—which is currently playing out in the COVID-19 pandemic. This study develops a gender assessment tool—the Stanford Gender-Related Variables for Health Research—for use in clinical and population research, including large-scale health surveys involving diverse Western populations. While analyzing sex as a biological variable is widely mandated, gender as a sociocultural variable is not, largely because the field lacks quantitative tools for analyzing the influence of gender on health outcomes.

Methods

We conducted a comprehensive review of English-language measures of gender from 1975 to 2015 to identify variables across three domains: gender norms, gender-related traits, and gender relations. This yielded 11 variables tested with 44 items in three US cross-sectional survey populations: two internet-based (N= 2051;N= 2135) and a patient-research registry (N= 489), conducted between May 2017 and January 2018.

Results

Exploratory and confirmatory factor analyses reduced 11 constructs to 7 gender-related variables: caregiver strain, work strain, independence, risk-taking, emotional intelligence, social support, and discrimination. Regression analyses, adjusted for age, ethnicity, income, education, sex assigned at birth, and self-reported gender identity, identified associations between these gender-related variables and self-rated general health, physical and mental health, and health-risk behaviors.

Conclusion

Our new instrument represents an important step toward developing more comprehensive and precise survey-based measures of gender in relation to health. Our questionnaire is designed to shed light on how specific gender-related behaviors and attitudes contribute to health and disease processes, irrespective of—or in addition to—biological sex and self-reported gender identity. Use of these gender-related variables in experimental studies, such as clinical trials, may also help us understand if gender factors play an important role as treatment-effect modifiers and would thus need to be further considered in treatment decision-making.
MAIP: a web service for predicting blood‐stage malaria inhibitors
Authors: Bosc Nicolas , Felix Eloy , Arcila Ricardo , Mendez David , Saunders Martin R. , Green Darren V. S. , Ochoada Jason , Shelat Anang A. , Martin Eric J. , Iyer Preeti , Engkvist Ola , Verras Andreas , Duffy James , Burrows Jeremy , Gardner J. Mark F. , Leach Andrew R.
Published: February 2021

Malaria is a disease affecting hundreds of millions of people across the world, mainly in developing countries and especially in sub-Saharan Africa. It is the cause of hundreds of thousands of deaths each year and there is an ever-present need to identify and develop effective new therapies to tackle the disease and overcome increasing drug resistance. Here, we extend a previous study in which a number of partners collaborated to develop a consensus in silico model that can be used to identify novel molecules that may have antimalarial properties. The performance of machine learning methods generally improves with the number of data points available for training. One practical challenge in building large training sets is that the data are often proprietary and cannot be straightforwardly integrated. Here, this was addressed by sharing QSAR models, each built on a private data set. We describe the development of an open-source software platform for creating such models, a comprehensive evaluation of methods to create a single consensus model and a web platform called MAIP available at https://www.ebi.ac.uk/chembl/maip/. MAIP is freely available for the wider community to make large-scale predictions of potential malaria inhibiting compounds. This project also highlights some of the practical challenges in reproducing published computational methods and the opportunities that open-source software can offer to the community.
Blind signal separation based on widely linear complex autoregressive process of order one
Authors: Li Jiong , Qin Yuan , Fan Menglan , Tang Xiaogang , Gao Lijuan , Chen Long , Feng Junhao
Published: February 2021

In this paper, the blind signal separation problem of complex baseband signal is addressed. A widely linear complex autoregressive process of order one is employed to represent the temporal structure of complex sources. We formulate a new contrast function by a convex combination of generalized autocorrelations and the statistics of the innovation. And the proposed contrast function is optimized by gradient method. Simulation results show that the proposed algorithm is better than the comparison algorithm in convergence speed and convergence accuracy.
Vitamin D status and blood pressure in children and adolescents: a systematic review of observational studies
Authors: Abboud Myriam , Al Anouti Fatme , Papandreou Dimitrios , Rizk Rana , Mahboub Nadine , Haidar Suzan
Published: February 2021

Background

Childhood hypertension is a growing public health problem. Simultaneously, hypovitaminosis D is widespread in this population and could be associated with hypertension. This study systematically reviewed the literature on the relationship between vitamin D status and blood pressure (BP) in children and adolescents.

Methods

Following the PRISMA guidelines, PUBMED, MEDLINE, CINAHL, EMBASE, Cochrane Library, and ClinicalTrials.gov and the gray literature without language or time restrictions were searched. We included observational studies, assessed their risk of bias, and extracted data on population characteristics, vitamin D status and BP measurements, and the association between the two variables. A narrative analysis of the studies was performed.

Results

In total, 85 studies were included. Prospective cohort studies showed no association between vitamin D and BP, and generally, they were flawed. Also, the majority of non-prospective cohort studies (cross-sectional, retrospective, case-control) did not report an association between vitamin D and BP. They were mostly flawed regarding BP measurement and adjusting to potential confounders.

Conclusion

The results on the relationship between vitamin D status and BP in children and adolescents varied between the studies, and mainly pointed towards lack of association.
Fractional calculus in the sky
Authors: Baleanu Dumitru , Agarwal Ravi P.
Published: February 2021

Fractional calculus was born in 1695 on September 30 due to a very deep question raised in a letter of L’Hospital to Leibniz. The prophetical answer of Leibniz to that deep question encapsulated a huge inspiration for all generations of scientists and is continuing to stimulate the minds of contemporary researchers. During 325 years of existence, fractional calculus has kept the attention of top level mathematicians, and during the last period of time it has become a very useful tool for tackling the dynamics of complex systems from various branches of science and engineering. In this short manuscript, we briefly review the tremendous effect that the main ideas of fractional calculus had in science and engineering and briefly present just a point of view for some of the crucial problems of this interdisciplinary field.
Container orchestration on HPC systems through Kubernetes
Authors: Zhou Naweiluo , Georgiou Yiannis , Pospieszny Marcin , Zhong Li , Zhou Huan , Niethammer Christoph , Pejak Branislav , Marko Oskar , Hoppe Dennis
Published: February 2021

Containerisation demonstrates its efficiency in application deployment in Cloud Computing. Containers can encapsulate complex programs with their dependencies in isolated environments making applications more portable, hence are being adopted in High Performance Computing (HPC) clusters.Singularity, initially designed for HPC systems, has become theirde factostandard container runtime. Nevertheless, conventional HPC workload managers lack micro-service support and deeply-integrated container management, as opposed to container orchestrators. We introduce a Torque-Operator which serves as a bridge between HPC workload manager (TORQUE) and container orchestrator (Kubernetes). We propose a hybrid architecture that integrates HPC and Cloud clusters seamlessly with little interference to HPC systems where container orchestration is performed on two levels.
The effect of household storage tanks/vessels and user practices on the quality of water: a systematic review of literature
Authors: Manga Musa , Ngobi Timothy G. , Okeny Lawrence , Acheng Pamela , Namakula Hidaya , Kyaterekera Elizabeth , Nansubuga Irene , Kibwami Nathan
Published: February 2021

Background

Household water storage remains a necessity in many communities worldwide, especially in the developing countries. Water storage often using tanks/vessels is envisaged to be a source of water contamination, along with related user practices. Several studies have investigated this phenomenon, albeit in isolation. This study aimed at developing a systematic review, focusing on the impacts of water storage tank/vessel features and user practices on water quality.

Methods

Database searches for relevant peer-reviewed papers and grey literature were done. A systematic criterion was set for the selection of publications and after scrutinizing 1106 records, 24 were selected. These were further subjected to a quality appraisal, and data was extracted from them to complete the review.

Results and discussion

Microbiological and physicochemical parameters were the basis for measuring water quality in storage tanks or vessels. Water storage tank/vessel material and retention time had the highest effect on stored water quality along with age, colour, design, and location. Water storage tank/vessel cleaning and hygiene practices like tank/vessel covering were the user practices most investigated by researchers in the literature reviewed and they were seen to have an impact on stored water quality.

Conclusions

There is evidence in the literature that storage tanks/vessels, and user practices affect water quality. Little is known about the optimal tank/vessel cleaning frequency to ensure safe drinking water quality. More research is required to conclusively determine the best matrix of tank/vessel features and user practices to ensure good water quality.
Role of forest provisioning services to local livelihoods: based on relative forest income (RFI) approach in southwest Ethiopia coffee forest
Authors: Fekadu Ayehu , Soromessa Teshome , Warkineh Dullo Bikila
Published: February 2021

Background

This study provides empirical evidence, for the contribution of forest provisioning ecosystem services to the local communities done on the Afromontum rainforest of southwest Ethiopia which is endowed with many Fauna and Flora. The study may give some representative evidence for policy-maker on behalf of conservation of the area.

Methodology

This study was done with the approach of focus group discussion and in-depth interviews of the rural community in southwest Ethiopia coffee forest. The role of forest provisioning services analysis was made by relative forest income (RFI) procedure based on the stratification category of the local ethnics and newcomers.

Results

The overall result indicated that seventeen forest provisioning services collected by the community from natural forest, however income were varied in relation to demographic features, the income from forest for local communities shown too high to which contributes 90.85% of the total income and have a long history of the link between this livelihood and forest. While forest also provides a considerable income for the new resettled community coming from elsewhere in the area but we observed non- forest income were the main source of revenue for this community.

Conclusions

The traditional and the indigenous communities used for access to a finite resource and considered the resource harvested from the forest are the central part of their economy and the relationships between forests and people’s livelihoods particularly for this remote community were complementary. Then planning should take into conceder, in policy perceptive, for supporting this remote community for livelihood improvement and conservation of this natural forest.
Goal oriented error estimation in multi-scale shell element finite element problems
Authors: Bonney Matthew S. , Evans Richard , Rouse James , Jones Arthur , Kerfriden Pierre , Hamadi Maxime
Published: February 2021

A major challenge with modern aircraft design is the occurrence of structural features of varied length scales. Structural stiffness can be accurately represented using homogenisation, however aspects such as the onset of failure may require information on more refined length scale for both metallic and composite components. This work considers the errors encountered in the coarse global models due to the mesh size and how these are propagated into detailed local sub-models. The error is calculated by a goal oriented error estimator, formulated by solving dual problems and Zienkiewicz-Zhu smooth field recovery. Specifically, the novel concept of this work is applying the goal oriented error estimator to shell elements and propagating this error field into the continuum sub-model. This methodology is tested on a simplified aluminium beam section with four different local feature designs, thereby illustrating the sensitivity to various local features with a common global setting. The simulations show that when the feature models only contained holes on the flange section, there was little sensitivity of the von Mises stress to the design modifications. However, when holes were added to the webbing section, there were large stress concentrations that predicted yielding. Despite this increase in nominal stress, the maximum error does not significantly change. However, the error field does change near the holes. A Monte Carlo simulation utilising marginal distributions is performed to show the robustness of the multi-scale analysis to uncertainty in the global error estimation as would be expected in experimental measurements. This shows a trade-off between Saint-Venant’s principle of the applied loading and stress concentrations on the feature model when investigating the response variance.
The incidence of pulmonary thromboembolism in COVID-19 patients admitted to the intensive care unit: a meta-analysis and meta-regression of observational studies
Authors: Ng Jun Jie , Liang Zhen Chang , Choong Andrew M. T. L.
Published: February 2021

Objectives

Coronavirus disease 2019 (COVID-19) infection is associated with a prothrombotic state. We performed a meta-analysis of proportions to estimate the weighted average incidence of pulmonary thromboembolism (PTE) in COVID-19 patients who were admitted to the intensive care unit (ICU).

Methods

We searched various medical databases for relevant studies from 31 December 2019 till 30 September 2020. We included observational studies that reported the incidence of PTE in COVID-19 patients admitted to the ICU. We extracted data related to study characteristics, patient demographics, and the incidence of PTE. Risk of bias was assessed by using the ROBINS-I tool. Statistical analysis was performed with R 3.6.3.

Results

We included 14 studies with a total of 1182 patients in this study. Almost all patients in this meta-analysis received at least prophylactic anticoagulation. The weighted average incidence of PTE was 11.1% (95% CI 7.7% to 15.7%,I2= 78%, Cochran’sQtestP< 0.01). We performed univariate and multivariate meta-regression, which identified the proportion of males as a significant source of heterogeneity (P= 0.03, 95% CI 0.00 to − 0.09)

Conclusion

The weighted average incidence of PTE remains high even after prophylactic anticoagulation. PTE is a significant complication of COVID-19 especially in critically ill patients in the ICU.
A feasibility study to assess Imbrasia belina (mopane worm) sensitisation and related respiratory health outcomes in a rural community in Gwanda district, Zimbabwe
Authors: Ndlovu Vuyelwa , Chimbari Moses , Sibanda Elopy , Ndarukwa Pisirai
Published: February 2021

Background

Allergic diseases are considered to be some of the fastest growing chronic conditions in Africa. Of concern is the paucity of knowledge about the local environment and its role in allergic disease development. In response to this, we explored whether Imbrasia belina, a popular indigenous edible insect commonly known as mopane worm, is a potential allergen of clinical and public health significance in Zimbabwe. This study was intended to assess the plausibility and feasibility of this hypothesis with a view to evaluate the insect’s health impact in a larger study.

Methods

The study participants included male and female villagers aged 10 years and above in Gwanda district, Zimbabwe. Eligible participants who completed the household questionnaire were referred to the local clinic for skin prick tests and to measure lung function and allergic airway inflammation. Allergen sensitisation patterns were evaluated using 10 different inhalant allergen extracts including an in-house preparation of mopane worm. Lung function was measured with a Koko Legend spirometer, and fractional exhaled nitric oxide levels (FeNO) (NIOX VERO) were measured in participants with at least one abnormal spirometric parameter. Data was analysed using Stata version 13 software.

Results

Of the 46 eligible participants that completed the household questionnaire, 17 went to the clinic giving a response rate of 37%. The majority who completed the questionnaire were adults (91%) and the children (9%) were all female. The prevalence of sensitisation to Imbrasia belina was 50%, and the prevalence ranged from 22 to 72% for the other allergens including cockroach, mosquito and house dust mites. The data collection tools were safe and well tolerated by participants with no adverse events reported. Self-reported respiratory symptoms, abnormal lung function and elevated FeNO were recorded amongst participants sensitised to mopane worm.

Conclusion

Pre-defined feasibility criteria were met with the exception of a lower than expected response rate for clinic data collection in this pilot study. For the main study, modifying the sampling strategy and applying more consistent community engagement will improve the response rates.
Importance of immunoglobulin therapy for COVID-19 patients with lymphocytopenia
Authors: Nabih Heba K.
Published: February 2021

Background

The global coronavirus disease 2019 (COVID-19) was announced as pandemic by the World Health Organization (WHO). With the increased number of infected and dead victims daily all over the world, it becomes necessary to stop or overcome its rapid spread.

Main body

Although the production of vaccine or even specified effective anti-virus may take about six months to a year, intravenous immunoglobulin (IVIg) may be clinically used as a safe treatment to save and improve the quality of life of patients with a variety of immunodeficiency diseases such as lymphocytopenia, which is a common clinical feature in COVID-19.

Conclusion

Through the current review, it was concluded that this passive immunization may promote the immunity to better fight against the virus, so the survival of the patients could be kept longer. The efficacy of immunotherapy with IVIg would be greater if the immune IgG antibodies were collected from convalescent plasma therapy.
Diagnostic efficiency of PET/CT in patients with cancer of unknown primary with brain metastasis as initial manifestation and its impact on overall survival
Authors: Mohamed Dina Moghazy , Kamel Hanaa Ahmed
Published: February 2021

Background

Carcinoma of unknown primary (CUP) is a diagnostic and therapeutic challenge; correct diagnostic approach results in better outcomes in patients with brain metastasis. Whole body 18 F-FDG PET/CT is a helpful modality to detect the origin of primary tumor and assess metastasis in the rest of the body. We assessed the value of PET/CT in detection of unknown primary in 39 patients with brain metastases as initial presentation and detected its impact on their overall survival.

Results

PET/CT could correctly detected the primary tumor in 49% of patients which occurred mainly in the lung, 63% of patients had additional extracerebral metastatic sites mostly in lymph nodes. Specificity, sensitivity, and accuracy of PET/CT in CUP patients were 95%, 79%, and 87%, respectively. No significant difference was noticed in estimated overall survival time between patients with an identified primary tumor and patients with unidentified primary tumor.

Conclusion

PET–CT was a helpful non-invasive imaging modality in detecting primary in CUP patients with metastatic brain lesion. It helped in the diagnosis of unexpected extracerebral metastatic lesions. However, the identification of the primary tumor by PET/CT has no significant prognostic effect on patient overall survival.
Breast cancer in dense breasts: comparative diagnostic merits of contrast-enhanced mammography and diffusion-weighted breast MRI
Authors: Anwar Reham , Farouk Mohamed Amr , Abdel Hamid Wafaa Raafat , Abu El Maati Amal Amin , Eissa Hanan
Published: February 2021

Background

The study was done to compare the value of contrast-enhanced mammography and diffusion-weighted breast MRI in dense breast screening and accurate detection of the breast cancer with correlation of the findings to the histopathological results.

The study included 32 female patients having suspicious breast lesions and underwent digital mammography then scheduled for CESM and MRI DW imaging technique. The imaging findings were correlated to the histopathological findings.

Results

The study was conducted on 40 breast lesions in 32 female patients having dense breasts; they were classified by the digital mammography into ACR C (59.4%) and ACR D (40.6%). By CESM, there were twenty three lesions (57.5%) as mass lesions and thirteen lesions (32.5%) as non-mass lesions. Four lesions (10%) showed no contrast enhancement. According to the lesion characteristics in diffusion-weighted imaging, the breast lesions were classified into thirty three lesions (82.5%) with restricted diffusion and seven lesions (17.5%) with non-restricted diffusion. The study showed a cutoff ADC value to detect the malignant lesions in the dense breasts ≤ 1.1 × 10-3 s/mm2 at b value of 1000 s/mm2 with a sensitivity of 96.77%, specificity of 66.67%, PPV of 96.77%, NPV of 55.55%, and an overall total accuracy of 92.5%.

On comparing the diagnostic accuracy of the CESM to that of the DW MRI, the sensitivity of DW MRI (96.77%) was higher than that of CESM (90.32%). The specificity of DW MRI (66.67%) was higher than that of CESM (33.33%). Total accuracy of DW MRI was higher than that of CESM; they were 90% and 77.5%, respectively. Also, PPV and NPV of DW MRI were 90.91 and 85.71% as compared with 82.35 and 50.00% in CESM, respectively. When comparing the sensitivity of CESM to DW MRI in the detection of multiple breast lesions, they were 88.8 and 100%, respectively.

Conclusion

CESM is a useful technique in identification of hidden lesions in mammographically dense breasts. DW MRI is a fast, unenhanced modality that can be used as a breast cancer screening modality. CESM and DWI demonstrated good overall diagnostic accuracy in dense breast patients; however, DW MRI has a higher diagnostic accuracy than CESM for the detection of malignant breast lesions and their multiplicity.
Pulmonary veno-occlusive disease: a rare and enigmatic cause of pulmonary hypertension—a case report
Authors: Karmakar Angan , Bhakat Biva
Published: February 2021

Background

Pulmonary veno-occlusive disease (PVOD) is a rare form of pulmonary hypertension characterized by remodelling of the pulmonary venules. PVOD and pulmonary arterial hypertension share similar clinical presentation. It is important to differentiate between these two conditions as PVOD carries a worse prognosis and life-threatening pulmonary oedema may occur following the initiation of conventional therapy.

Case presentation

We are reporting a case of pulmonary hypertension in a middle-aged lady who presented with hemoptysis and features of right heart failure. After extensive work up, no definite aetiology of pulmonary hypertension could be found out. Standard therapy did not cause any symptomatic improvement. After right heart catheterization, we got pre capillary pulmonary hypertension and along with typical findings in HRCT scan of thorax we established PVOD. We did not try lung biopsy as the procedure often lands up with complications. As we could not arrange for lung transplant we eventually lost the patient.

Conclusions

High suspicion and thorough systematic evaluation helped us to diagnose PVOD in this case. Thus, early diagnosis should be the primary aim in suspected cases of PVOD so that we can prepare for lung transplant at the earliest.