bluuebunny/crossref_metadata_2025 huggingface dataset:
Performance improvement of machine learning techniques predicting the association of exacerbation of peak expiratory flow ratio with short term exposure level to indoor air quality using adult asthmatics clustered data
Authors: Bae Wan D. , Kim Sungroul , Park Choon-Sik , Alkobaisi Shayma , Lee Jongwon , Seo Wonseok , Park Jong Sook , Park Sujung , Lee Sangwoon , Lee Jong Wook
Published: January 2021

Large-scale data sources, remote sensing technologies, and superior computing power have tremendously benefitted to environmental health study. Recently, various machine-learning algorithms were introduced to provide mechanistic insights about the heterogeneity of clustered data pertaining to the symptoms of each asthma patient and potential environmental risk factors. However, there is limited information on the performance of these machine learning tools. In this study, we compared the performance of ten machine-learning techniques. Using an advanced method of imbalanced sampling (IS), we improved the performance of nine conventional machine learning techniques predicting the association between exposure level to indoor air quality and change in patients’ peak expiratory flow rate (PEFR). We then proposed a deep learning method of transfer learning (TL) for further improvement in prediction accuracy. Our selected final prediction techniques (TL1_IS or TL2-IS) achieved a balanced accuracy median (interquartile range) of 66(56~76) % for TL1_IS and 68(63~78) % for TL2_IS. Precision levels for TL1_IS and TL2_IS were 68(62~72) % and 66(62~69) % while sensitivity levels were 58(50~67) % and 59(51~80) % from 25 patients which were approximately 1.08 (accuracy, precision) to 1.28 (sensitivity) times increased in terms of performance outcomes, compared to NN_IS. Our results indicate that the transfer machine learning technique with imbalanced sampling is a powerful tool to predict the change in PEFR due to exposure to indoor air including the concentration of particulate matter of 2.5 μm and carbon dioxide. This modeling technique is even applicable with small-sized or imbalanced dataset, which represents a personalized, real-world setting.
Setting a research agenda to improve community health: An inclusive mixed-methods approach in Northern Uganda
Authors: Dowhaniuk Nicholas , Ojok Susan , McKune Sarah L.
Published: January 2021

Background

The United Nations Sustainable Development Goals stress the importance of equitable partnerships in research and practice that integrate grass-roots knowledge, leadership, and expertise. However, priorities for health research in low-and-middle income countries are set almost exclusively by external parties and priorities, while end-users remain "researched on" not "researched with". This paper presents the first stage of a Community-Based Participatory Research-inspired project to engage communities and public-health end-users in setting a research agenda to improve health in their community.

Methods

Photovoice was used in Kuc, Gulu District, Uganda to engage community members in the selection of a research topic for future public health research and intervention. Alcohol-Use Disorders emerged from this process the health issue that most negatively impacts the community. Following identification of this issue, a cross-sectional survey was conducted using the Alcohol Use Disorder Identification Test (n = 327) to triangulate Photovoice findings and to estimate the prevalence of Alcohol-Use Disorders in Kuc. Logistic regression was used to test for associations with demographic characteristics and Alcohol-Use Disorders.

Results

Photovoice generated four prominent themes, including alcohol related issues, sanitation and compound cleanliness, water quality and access, and infrastructure. Alcohol-Use Disorders were identified by the community as the most important driver of poor health. Survey results indicated that 23.55% of adults in Kuc had a probable Alcohol Use Disorder, 16.45 percentage points higher than World Health Organization estimates for Uganda.

Conclusions

Community members engaged in the participatory, bottom-up approach offered by the research team to develop a research agenda to improve health in the community. Participants honed in on the under-researched and underfunded topic of Alcohol-Use Disorders. The findings from Photovoice were validated by survey results, thereby solidifying the high prevalence of Alcohol-Use Disorders as the health outcome that will be targeted through future long-term research and partnership.
Social networks influence farming practices and agrarian sustainability
Authors: Albizua Amaia , Bennett Elena M. , Larocque Guillaume , Krause Robert W. , Pascual Unai
Published: January 2021

The social-ecological effects of agricultural intensification are complex. We explore farmers’ perceptions about the impacts of their land management and the impact of social information flows on their management through a case study in a farming community in Navarra, Spain, that is undergoing agricultural intensification due to adoption of large scale irrigation. We found that modern technology adopters are aware that their management practices often have negative social-ecological implications; by contrast, more traditional farmers tend to recognize their positive impacts on non-material benefits such as those linked with traditions and traditional knowledge, and climate regulation. We found that farmers’ awareness about nature contributions to people co-production and their land management decisions determine, in part, the structure of the social networks among the farming community. Since modern farmers are at the core of the social network, they are better able to control the information flow within the community. This has important implications, such as the fact that the traditional farmers, who are more aware of their impacts on the environment, rely on information controlled by more intensive modern farmers, potentially jeopardizing sustainable practices in this region. We suggest that this might be counteracted by helping traditional farmers obtain information tailored to their practices from outside the social network.
COVID-19 and the public response: Knowledge, attitude and practice of the public in mitigating the pandemic in Addis Ababa, Ethiopia
Authors: Desalegn Zelalem , Deyessa Negussie , Teka Brhanu , Shiferaw Welelta , Hailemariam Damen , Addissie Adamu , Abagero Abdulnasir , Kaba Mirgissa , Abebe Workeabeba , Nega Berhanu , Ayele Wondimu , Haile Tewodros , Gebrehiwot Yirgu , Amogne Wondwossen , Kantelhardt Eva Johanna , Abebe Tamrat
Published: January 2021

Background

The COVID-19 pandemic is impacting the global community in many ways. Combating the COVID-19 pandemic requires a coordinated effort through engaging public and service providers in preventive measures. The government of Ethiopia had already announced prevention guidelines for the public. However, there is a scarcity of evidence-based data on the public knowledge, attitude, and practice (KAP) and response of the service providers regarding COVID-19.

Objective

This study aimed to assess the public KAP and service providers’ preparedness towards the pandemic in Addis Ababa, Ethiopia.

Methods

A community-based cross-sectional study was conducted in Addis Ababa, Ethiopia, from late March to the first week of April 2020. Participants were conveniently sampled from 10 different city sites. Data collection was performed using a self-administered questionnaire and observational assessment using a checklist. All statistical analysis was performed using SPSS version Descriptive statistics, correlation coefficient and chi-square tests were performed.

Result

A total of 839 public participants and 420 service providers enrolled in the study. The mean age was 30.30 (range = 18–72) years. The majority of the respondents (58.6%) had moderate knowledge about COVID-19, whereas 37.2% had good knowledge. Moreover, 60.7% and 59.8% of the participants had a positive attitude towards preventive measures and good practice to mitigate the pandemic, respectively. There was a moderate positive correlation between knowledge and attitude, whereas the correlations between knowledge and practice and attitude and practice were weak. With regard to service providers’ preparedness, 70% have made hand-washing facilities available. A large majority of the respondents (84.4%) were using government-owned media followed by social media (46.0%) as a main source of information.

Conclusion

The public in Addis Ababa had moderate knowledge, an optimistic attitude and descent practice. The information flow from government and social media seemed successful seeing the majority of the respondents identifying preventive measures, signs and symptoms and transmission route of SARS-CoV-2. Knowledge and attitude was not associated with practice, thus, additional innovative strategies for practice changes are needed. Two thirds of the service provider made available hand washing facilities which seems a first positive step. However, periodic evaluation of the public KAP and assessment of service providers’ preparedness is mandatory to combat the pandemic effectively.
The effects of viewing a winter forest landscape with the ground and trees covered in snow on the psychological relaxation of young Finnish adults: A pilot study
Authors: Bielinis Ernest , Janeczko Emilia , Takayama Norimasa , Zawadzka Anna , Słupska Alicja , Piętka Sławomir , Lipponen Maija , Bielinis Lidia
Published: January 2021

Forest bathing is an outdoor activity, and it might be a promising preventive treatment for social problems involving stress. A vast number of studies confirm the positive effects of this activity on people’s health. Nevertheless, little is known about the influence of winter forest bathing when conducted in an environment with snow cover on the ground and trees. Thus, a crossover experiment was designed in this study, with the participation of twenty-two healthy university students from Finland. During the experiment, a short exposition by a forest environment or landscape with buildings (as a control) was applied. Participants self-reported their psychological relaxation before and after the exposition, and the results were analyzed and compared. The mood, emotions, restorativeness, and subjective vitality were recorded as indices reflecting the psychological relaxation effect. The negative mood indices decreased significantly after exposition by the snow-covered environment, but the positive ‘vigor’ indices did not increase or decrease significantly. The level of negative emotions increased after the exposition with the control environment. Likewise, positive emotions decreased after the interaction with the control. Restorativeness was significantly increased after the exposition by the experimental forest but decreased after the viewing of the control buildings. The size of the effect in terms of restorativeness was the highest in this experiment. The subjective vitality was lowered as affected by the control, but it did not increase or decrease after the exposition with the experimental forest. There is probably an effect from the slight interruption in the process from the influence of the forest greens on participants because their vigor and vitality did not increase after the exposition with this environment in the study. However, snow might influence the participants as a calming and emotion-lowering component of the environment, but this idea needs to be further explored with the involvement of participants from other countries who would be viewing forest environments with snow cover and whose psychological relaxation could be measured.
Acute stress does not affect economic behavior in the experimental laboratory
Authors: Veszteg Róbert F. , Yamakawa Kaori , Matsubayashi Tetsuya , Ueda Michiko
Published: January 2021

We report statistical results from a laboratory experiment in which participants were required to make decisions with monetary consequences in several solitary and interactive situations under acute stress. Our study follows the tradition of behavioral and experimental economics in selecting the experimental situations and incorporates elements from medical and psychological research in the way stress is induced and measured. It relies on a larger sample, with 192 volunteers, than previous studies to achieve higher statistical power. The main conclusion, drawn from binary comparisons between the treatment and reference groups, is that acute stress does not have a significant impact on cognitive skills, strategic sophistication, risk attitudes, altruism, cooperativeness, or nastiness. Regression analysis, controlling for psycho-social characteristics, corroborates these findings, while also suggesting that acute stress significantly decreases men’s risk aversion (as measured by a lottery-choice risk-elicitation task).
The influence of teacher-student proximity, teacher feedback, and near-seated peer groups on classroom engagement: An agent-based modeling approach
Authors: Dong Zhe , Liu Haiyan , Zheng Xinqi
Published: January 2021

Fostering students’ classroom engagement is a research hotspot in classroom teaching management. Enhancing classroom engagement requires consideration of the interactive effects of physical and interpersonal environments. Considering the characteristics of physical space, the teacher gives feedback on student engagement in terms of different seating positions. Further, near-seated peer group engagement has an impact, though previous research has found this to be inconsistent. The teacher and near-seated peer groups have different paths of influence on classroom engagement, and there is interplay between them. However, based on realistic classroom scenarios, it is difficult for traditional research methods to reveal how spatially heterogeneous and non-linear micro-interactions among teachers, students, and near-seated peer groups evolve into dynamic changes in macro-classroom engagement. Hence, this study utilized agent-based simulation to explore the non-linear dynamic mechanism underlying how teacher-student proximity, teacher feedback, and near-seated peer groups affect classroom engagement, thereby shedding light on the evolutionary features of classroom engagement. According to the results, the teacher’s positive feedback promoted an S-shaped increase in classroom engagement, and the closer a student sat to the teacher, the greater the increase was. The level and homogeneity of near-seated peer group engagement were predictors of changes in classroom engagement. Moreover, the proximity of students to the teacher, teacher feedback, and near-seated peer groups had a joint effect on student engagement. The compensation effect of the teacher’s positive feedback on the impact of low-engagement, near-seated peer groups was weaker than that of highly engaged, near-seated peer groups on the effects of the teacher’s negative feedback. This suggests that the model of teacher-student proximity and teacher feedback effects differed from that of near-seated peer group influence, and the two interacted and showed asymmetry.
A data-sharing scheme that supports multi-keyword search for electronic medical records
Authors: Niu Shufen , Liu Wenke , Han Song , Fang Lizhi
Published: January 2021

As cloud storage technology develops, data sharing of cloud-based electronic medical records (EMRs) has become a hot topic in the academia and healthcare sectors. To solve the problem of secure search and sharing of EMR in cloud platforms, an EMR data-sharing scheme supporting multi-keyword search is proposed. The proposed scheme combines searchable encryption and proxy re-encryption technologies to perform keyword search and achieve secure sharing of encrypted EMR. At the same time, the scheme uses a traceable pseudo identity to protect the patient’s private information. Our scheme is proven secure based on the modified Bilinear Diffie-Hellman assumption and Quotient Decisional Bilinear Diffie-Hellman assumption under the random oracle model. The performance of our scheme is evaluated through theoretical analysis and numerical simulation.
Temporal patterns of hospitalizations for diabetic ketoacidosis in children and adolescents
Authors: Kalla Vyas Arpita , Oud Lavi
Published: January 2021

Objectives

To examine the temporal patterns of hospitalizations with diabetic ketoacidosis (DKA) in the pediatric population and their associated fiscal impact.

Methods

The Texas Inpatient Public Use Data File was used to identify hospitalizations of state residents aged 1month-19 years with a primary diagnosis of DKA during 2005–2014. Temporal changes of population-adjusted hospitalization rates and hospitalization volumes were examined for the whole cohort and on stratified analyses of sociodemographic attributes. Changes in the aggregate and per-hospitalization charges were assessed overall and on stratified analyses.

Results

There were 24,072 DKA hospitalizations during the study period. The population-adjusted hospitalization rate for the whole cohort increased from 31.3 to 35.9 per 100,000 between 2005–2006 and 2013–2014. Hospitalization volume increased by 30.2% over the same period, driven mainly by males, ethnic minorities, those with Medicaid insurance and uninsured patients. The aggregate hospital charges increased from approximately $69 million to $130 million between 2005–2006 and 2013–2014, with 66% of the rise being due to increased per-hospitalization charges.

Conclusions

There was progressive rise in pediatric DKA hospitalizations over the last decade, with concurrent near-doubling of the associated fiscal footprint. Marked disparities were noted in the increasing hospitalization burden of DKA, born predominantly by racial and ethnic minorities, as well as by the underinsured and the uninsured. Further studies are needed to identify scalable preventive measures to achieve an equitable reduction of pediatric DKA events.
An immunotoxin targeting Ebola virus glycoprotein inhibits Ebola virus production from infected cells
Authors: Cai Yingyun , Yu Shuiqing , Chi Xiaoli , Radoshitzky Sheli R. , Kuhn Jens H. , Berger Edward A.
Published: January 2021

Ebola virus (EBOV), a member of the mononegaviral family Filoviridae, causes severe disease associated with high lethality in humans. Despite enormous progress in development of EBOV medical countermeasures, no anti-EBOV treatment has been approved. We designed an immunotoxin in which a single-chain variable region fragment of the EBOV glycoprotein-specific monoclonal antibody 6D8 was fused to the effector domains of Pseudomonas aeruginosa exotoxin A (PE38). This immunotoxin, 6D8-PE38, bound specifically to cells expressing EBOV glycoproteins. Importantly, 6D8-PE38 targeted EBOV-infected cells, as evidenced by inhibition of infectious EBOV production from infected cells, including primary human macrophages. The data presented here provide a proof of concept for immunotoxin-based targeted killing of infected cells as a potential antiviral intervention for Ebola virus disease.
Motor control characteristics of upper limbs in response to assistive forces during bilateral tasks
Authors: Wang Yuanyuan , Loh Ping Yeap , Muraki Satoshi
Published: January 2021

Most research on power assist suits (PASs) that concerned PAS-human interactions has used human physical reactions as criteria to evaluate the mechanical function, however, with minimal emphasis on human reactions in response to PASs. In this study, we focused on the physiological responses of the upper limbs including muscle activity of the biceps brachii and the triceps brachii, co-activation, force steadiness (CV) and rated perceived exertion (RPE) to various patterns of bilateral assistive force, such as unilateral assistance (L0% & R67% [% = percentage of workload force, L = left arm, R = right arm], L67% & R0%, L0% & R33%, L33% & R0%), symmetrical (L0% & R0%, L33% & R33%, L67% & R67%) and asymmetrical bilateral assistance (L33% & R67%, L67% & R33%), during bilateral isometric force-matching tasks. The results showed a similar muscular response of the two arms to bilateral assistive conditions, and the muscle activity of the arm that was being observed decreased only when the assistive force that applied on itself increased, indicating that both arms may have adopted similar but independent motor control mechanisms to acclimate to the bilateral assistive forces. Comparison between the two unilateral assistances (L0% & R33% and L33% & R0%) and the two asymmetrical bilateral assistances (L33% & R67%, L67% & R33%) showed no significant differences in muscular responses, CV and RPE, indicating that bilateral assistances with bilateral interchanged assistive levels may be equally effective regardless of which arm the higher assistive force is applied to. Comparison between unilateral and symmetrical assistive conditions that have similar overall workloads (L67% & R0%, L33% & R33%, L0% & R67%) showed a lower CV and RPE score at symmetrical assistance compared with unilateral assistance, suggesting that assisting both arms with the same level simultaneously improves task performances compared with applying the assistive force to only one arm.
The use of health geography modeling to understand early dispersion of COVID-19 in São Paulo, Brazil
Authors: Fortaleza Carlos Magno Castelo Branco , Guimarães Raul Borges , Catão Rafael de Castro , Ferreira Cláudia Pio , Berg de Almeida Gabriel , Nogueira Vilches Thomas , Pugliesi Edmur
Published: January 2021

Public health policies to contain the spread of COVID-19 rely mainly on non-pharmacological measures. Those measures, especially social distancing, are a challenge for developing countries, such as Brazil. In São Paulo, the most populous state in Brazil (45 million inhabitants), most COVID-19 cases up to April 18th were reported in the Capital and metropolitan area. However, the inner municipalities, where 20 million people live, are also at risk. As governmental authorities discuss the loosening of measures for restricting population mobility, it is urgent to analyze the routes of dispersion of COVID-19 in São Paulo territory. We hypothesize that urban hierarchy is the main responsible for the disease spreading, and we identify the hotspots and the main routes of virus movement from the metropolis to the inner state. In this ecological study, we use geographic models of population mobility to check for patterns for the spread of SARS-CoV-2 infection. We identify two patterns based on surveillance data: one by contiguous diffusion from the capital metropolitan area, and the other hierarchical with long-distance spread through major highways that connects São Paulo city with cities of regional relevance. This knowledge can provide real-time responses to support public health strategies, optimizing the use of resources in order to minimize disease impact on population and economy.
Efficient association mapping from k-mers—An application in finding sex-specific sequences
Authors: Mehrab Zakaria , Mobin Jaiaid , Tahmid Ibrahim Asadullah , Rahman Atif
Published: January 2021

Genome wide association studies (GWAS) attempt to map genotypes to phenotypes in organisms. This is typically performed by genotyping individuals using microarray or by aligning whole genome sequencing reads to a reference genome. Both approaches require knowledge of a reference genome which hinders their application to organisms with no or incomplete reference genomes. This caveat can be removed by using alignment-free association mapping methods based on k-mers from sequencing reads. Here we present an improved implementation of an alignment free association mapping method. The new implementation is faster and includes additional features to make it more flexible than the original implementation. We have tested our implementation on an E. Coli ampicillin resistance dataset and observe improvement in execution time over the original implementation while maintaining accuracy in results. We also demonstrate that the method can be applied to find sex specific sequences.
How to account for the uncertainty from standard toxicity tests in species sensitivity distributions: An example in non-target plants
Authors: Charles Sandrine , Wu Dan , Ducrot Virginie
Published: January 2021

This research proposes new perspectives accounting for the uncertainty on 50% effective rates (ER50) as interval input for species sensitivity distribution (SSD) analyses and evaluating how to include this uncertainty may influence the 5% Hazard Rate (HR5) estimation. We explored various endpoints (survival, emergence, shoot-dry-weight) for non-target plants from seven standard greenhouse studies that used different experimental approaches (vegetative vigour vs. seedling emergence) and applied seven herbicides at different growth stages. Firstly, for each endpoint of each study, a three-parameter log-logistic model was fitted to experimental toxicity test data for each species under a Bayesian framework to get a posterior probability distribution for ER50. Then, in order to account for the uncertainty on the ER50, we explored two censoring criteria to automatically censor ER50 taking the ER50 probability distribution and the range of tested rates into account. Secondly, based on dose-response fitting results and censoring criteria, we considered input ER50 values for SSD analyses in three ways (only point estimates chosen as ER50 medians, interval-censored ER50 based on their 95% credible interval and censored ER50 according to one of the two criteria), by fitting a log-normal distribution under a frequentist framework to get the three corresponding HR5 estimates. We observed that SSD fitted reasonably well when there were at least six distinct intervals for the ER50 values. By comparing the three SSD curves and the three HR5 estimates, we shed new light on the fact that both propagating the uncertainty from the ER50 estimates and including censored data into SSD analyses often leads to smaller point estimates of HR5, which is more conservative in a risk assessment context. In addition, we recommend not to focus solely on the point estimate of the HR5, but also to look at the precision of this estimate as depicted by its 95% confidence interval.
Application and effect evaluation of nursing quality target management in free flap transplantation for hand injury
Authors: Zhao Lili , Yang Jianing , Liu Weiwei
Published: January 2021

To explore application and effect of nursing quality target management in free flap transplantation for hand injury. 140 patients with free skin flap transplantation for hand injury admitted to the hand and foot surgery ward of the hospital from January 2017 to December 2019 were selected as the research objects. They were randomly divided into observation group and control group. There were 70 patients in each group, and both groups of patients received microscopic free flap transplantation. The observation group adopted traditional nursing mode and nursing quality target management mode to carry out nursing, while the control group adopted traditional nursing mode to carry out nursing. The treatment compliance, skin flap survival, occurrence of vascular crisis, occurrence of complications, VAS and Barthel comparison score of the two groups were compared. The treatment compliance of patients in the observation group was significantly higher than that in the control group (P < 0.05). The survival rate of skin flap in the observation group was higher than that in the control group (P < 0.05). The incidence of vascular crisis in the observation group was lower than that in the control group (P < 0.05). The postoperative pain in the observation group was better than that in the control group (P < 0.05). There was no significant difference in Barthel score between the observation group and the control group at admission (P > 0.05), but the improvement range of Barthel score in the observation group was higher than that in the control group at discharge (P < 0.05), The satisfaction of patients in the observation group to nurses was higher than that in the control group (p < 0.05). The application of nursing quality target management can improve the treatment compliance of patients, improve the survival rate of free skin flap transplantation for hand injury, reduce the incidence of vascular crisis within 48 hours after operation, reduce the occurrence of postoperative complications, relieve the pain of patients, improve self-care ability and ensure the quality of life.
Rapid detection of Clostridium perfringens in food by loop-mediated isothermal amplification combined with a lateral flow biosensor
Authors: Sridapan Thanawat , Tangkawsakul Wanida , Janvilisri Tavan , Kiatpathomchai Wansika , Dangtip Sirintip , Ngamwongsatit Natharin , Nacapricha Duangjai , Ounjai Puey , Chankhamhaengdecha Surang
Published: January 2021

Clostridium perfringens is a key anaerobic pathogen causing food poisoning. Definitive detection by standard culture method is time-consuming and labor intensive. Current rapid commercial test kits are prohibitively expensive. It is thus necessary to develop rapid and cost-effective detection tool. Here, loop-mediated isothermal amplification (LAMP) in combination with a lateral-flow biosensor (LFB) was developed for visual inspection of C. perfringens-specific cpa gene. The specificity of the developed test was evaluated against 40 C. perfringens and 35 other bacterial strains, which showed no cross-reactivity, indicating 100% inclusivity and exclusivity. LAMP-LFB detection limit for artificially contaminated samples after enrichment for 16 h was 1–10 CFU/g sample, which was comparable to the commercial real-time PCR kit. The detection performance of LAMP-LFB was also compared to culture-based method using 95 food samples, which revealed the sensitivity (SE), specificity (SP) and Cohen's kappa coefficient (κ) of 88.0% (95% CI, 75.6%-95.4%), 95.5% (95% CI, 84.8%-99.4%) and 0.832 (95% CI, 0.721–0.943), respectively. Area under the receiver operating characteristic (ROC) curve was 0.918 (95% CI, 0.854–0.981), indicating LAMP-LFB as high relative accuracy test. In conclusion, LAMP-LFB assay is a low-cost qualitative method and easily available for routine detection of C. perfringens in food samples, which could serve as an alternative to commercial test kit.
Mental health literacy in Arab states of the Gulf Cooperation Council: A systematic review
Authors: Elyamani Rowaida , Naja Sarah , Al-Dahshan Ayman , Hamoud Hamed , Bougmiza Mohammed Iheb , Alkubaisi Noora
Published: January 2021

Background

Mental health literacy (MHL) has been relatively neglected, despite the increase of mental health illnesses worldwide, as well as within the Middle East region. A low level of MHL may hinder public acceptance of evidence-based mental health care.

Aim

This systematic review aims to identify and appraise existing research, focusing on MHL among adults in the Gulf Cooperation Council (GCC) countries.

Methods

A systematic search of electronic databases (PubMed, PsychInfo, and Medline) was carried out from database inception to July 2019, in order to identify peer-reviewed journal articles that investigated MHL in the GCC countries. Studies were eligible for inclusion if they were: cross-sectional studies, reported in English, targeted adults (aged 18 and above), conducted in any of the GCC countries, include at least one outcome measure of the main components of MHL: knowledge of mental illnesses and their treatment, stigmatizing attitudes towards mental illnesses, and seeking help for self and offering help.

Results

A total of 27 studies (16,391 participants) were included. The outcome across studies varied due to disparity in the tested populations. Findings show that limited MHL was observed among participants, even health care professionals. Results also show a high cumulative level of stigma and negative attitude towards mental health illness in the public. Negative beliefs and inappropriate practices are common, as well. The majority of studies yielded a moderate to high risk of bias.

Conclusion

This work indicates that research on MHL must be tackled through well-designed large-scale studies of the public. Campaigns to promote early identification and treatment of mental illness is also encouraged to improve overall level of MHL in the general population of the GCC region.

Registration number:PROSPERO 2018 CRD42018104492.
Social isolation stress facilitates chemically induced oral carcinogenesis
Authors: Verza Flávia Alves , Valente Vitor Bonetti , Oliveira Lia Kobayashi , Kayahara Giseli Mitsuy , Crivelini Marcelo Macedo , Furuse Cristiane , Biasoli Éder Ricardo , Miyahara Glauco Issamu , Oliveira Sandra Helena Penha , Bernabé Daniel Galera
Published: January 2021

Social isolation has affected a large number of people and may lead to impairment of physical and mental health. Although stress resulting from social isolation may increase cancer progression, its interference on tumorigenesis is poorly known. In this study, we used a preclinical model to evaluate the effects of social isolation stress on chemically induced oral carcinogenesis. Sixty-two 21-day-old male Wistar rats were divided into isolated and grouped groups. After 90 days of age, the rats from both groups underwent oral carcinogenesis with 4-nitroquinoline 1-oxide (4NQO) for 20 weeks. All rats were assessed for depressive-like behavior and euthanized for oral squamous cell carcinoma (OSCC) diagnosis and measurement of inflammatory mediators in the tumor microenvironment. Social isolation stress increased the OSCC occurrence by 20.4% when compared to control. Isolated rats also showed higher tumor volume and cachexia than the grouped rats. Social isolation did not induce changes in the depressive-like behavior after carcinogenic induction. Tumors from stressed rats had increased levels of the inflammatory mediators, TNF-alpha, IL1-beta and MCP-1. The concentrations of TNF-alpha and MCP-1 were significantly increased in the large tumors from isolated animals. Higher tumor levels of TNF-alpha, IL-6, IL1-beta and MCP-1 were positively correlated with OSCC growth. This study provides the first evidence that social isolation stress may facilitate OSCC occurrence and tumor progression, an event accompanied by increased local levels of inflammatory mediators.
Trajectories of sickness absence and disability pension before and after colorectal cancer: A Swedish longitudinal population-based matched cohort study
Authors: Chen Lingjing , Alexanderson Kristina A. E.
Published: January 2021

Objectives

Working-aged colorectal cancer (CRC) patients have a much better survival, indicating the importance of their future work situation. We investigated trajectories of sickness absence and disability pension (SADP) days before and after CRC diagnosis, and risk factors associated with different trajectories.

Methods

A longitudinal, population-based matched cohort study of 4735 CRC survivors in Sweden aged 19–62 when first diagnosed with CRC in 2008–2011, and 18,230 matched references was conducted, using microdata linked from several nationwide registers. The annual SADP net days for 2 years before through 5 years after diagnosis date were computed. A group-based trajectory model was used to depict SADP trajectories. Associations between trajectory membership, and sociodemographic and clinical variables were tested by chi2test and multinomial logistic regression.

Results

Four trajectories of SADP days/year for CRC survivors were identified: “only increase around diagnosis” (52% of all), “slight increase after diagnosis” (27%), “high then decrease moderately after diagnosis” (13%), and “constantly very high” (8%). Educational level, Charlson’s Comorbidity Index, and prediagnostic mental disorders were the strongest factors determining the SADP trajectory groups. In references, three trajectories (“constantly low” (80% of all), “constantly moderate and decrease gradually” (12%), and “very high then decrease overtime” (8%)) were identified.

Conclusion

Approximately 80% of CRC survivors return to a low level of SADP at 5 years postdiagnosis. Prediagnostic status of mental disorders, somatic comorbidity, and low educational level are good indicators of future high SADP levels for them. CRC survivors will benefit from early rehabilitation programs with identified risk factors.
Current status of cervical cytology during pregnancy in Japan
Authors: Suzuki Shunji , Hayata Eijiro , Hoshi Shin-ichi , Sekizawa Akihiko , Sagara Yoko , Tanaka Masanobu , Kinoshita Katsuyuki , Kitamura Tadaichi
Published: January 2021

In Japan, uterine cancer screening during pregnancy is subsidized by public funds. We examined the current status of the results of cervical cytology conducted during pregnancy in Japan. We requested 2,293 obstetrical facilities to provide information on cervical cytology in pregnant women who delivered between October 2018 and March 2019. A total of 1,292 obstetrical facilities responded, with valid information on a total of 238,743 women. The implementation rate of cervical cytology during pregnancy was 86.8% in Japan. The prevalence of abnormal cervical cytology during pregnancy was 3.3% in total and 4.9% using a spatula/brush with liquid-based cytology (LBC). The prevalence of positive high-risk human papillomavirus (HPV) in teenagers with atypical squamous cells of undetermined significance (ASC-US) was significantly higher than women of other ages (p < 0.01). Because HPV vaccine coverage has dropped to less than 1% in Japan, a further study with various conditions will be needed to improve the accuracy of cervical cancer screening during pregnancy.
The influence of travel time to health facilities on stillbirths: A geospatial case-control analysis of facility-based data in Gombe, Nigeria
Authors: Wariri Oghenebrume , Onuwabuchi Egwu , Alhassan Jacob Albin Korem , Dase Eseoghene , Jalo Iliya , Laima Christopher Hassan , Farouk Halima Usman , El-Nafaty Aliyu U. , Okomo Uduak , Dotse-Gborgbortsi Winfred
Published: January 2021

Access to quality emergency obstetric and newborn care (EmONC); having a skilled attendant at birth (SBA); adequate antenatal care; and efficient referral systems are considered the most effective interventions in preventing stillbirths. We determined the influence of travel time from mother’s area of residence to a tertiary health facility where women sought care on the likelihood of delivering a stillbirth. We carried out a prospective matched case-control study between 1st January 2019 and 31st December 2019 at the Federal Teaching Hospital Gombe (FTHG), Nigeria. All women who experienced a stillbirth after hospital admission during the study period were included as cases while controls were consecutive age-matched (ratio 1:1) women who experienced a live birth. We modelled travel time to health facilities. To determine how travel time to the nearest health facility and the FTHG were predictive of the likelihood of stillbirths, we fitted a conditional logistic regression model. A total of 318 women, including 159 who had stillborn babies (cases) and 159 age-matched women who had live births (controls) were included. We did not observe any significant difference in the mean travel time to the nearest government health facility for women who had experienced a stillbirth compared to those who had a live birth [9.3 mins (SD 7.3, 11.2) vs 6.9 mins (SD 5.1, 8.7) respectively, p = 0.077]. However, women who experienced a stillbirth had twice the mean travel time of women who had a live birth (26.3 vs 14.5 mins) when measured from their area of residence to the FTHG where deliveries occurred. Women who lived farther than 60 minutes were 12 times more likely of having a stillborn [OR = 12 (1.8, 24.3), p = 0.011] compared to those who lived within 15 minutes travel time to the FTHG. We have shown for the first time, the influence of travel time to a major tertiary referral health facility on the occurrence of stillbirths in an urban city in, northeast Nigeria.
Prevalence of and factors associated with anaemia in women of reproductive age in Bangladesh, Maldives and Nepal: Evidence from nationally-representative survey data
Authors: Rahman Md. Ashfikur , Rahman Md. Sazedur , Aziz Rahman Muhammad , Szymlek-Gay Ewa A. , Uddin Riaz , Islam Sheikh Mohammed Shariful
Published: January 2021

Background

Anaemia is a significant public health problem in most South-Asian countries, causing increased maternal and child mortality and morbidity. This study aimed to estimate the prevalence of and factors associated with anaemia in women of reproductive age in Bangladesh, Maldives, and Nepal.

Methods

We used the nationally-representative Demographic and Health Surveys Program data collected from women of reproductive age (15–49 years) in 2011 in Bangladesh (n = 5678), 2016 in Maldives (n = 6837), and 2016 in Nepal (n = 6419). Anaemia was categorized as mild (haemoglobin [Hb] of 10.0–10.9 g/dL for pregnant women and 11.0–11.9 g/dL for non-pregnant women), moderate (Hb of 7.0–9.9 g/dL for pregnant women and 8.0–10.9 g/dL for non-pregnant women), and severe (Hb <7.0 g/dL for pregnant women and <8.0 g/dL for non-pregnant women). Multinomial logistic regression analyses were used to identify factors associated with anaemia.

Results

The prevalence of anaemia was 41.8% in Bangladesh, 58.5% in Maldives, and 40.6% in Nepal. In Bangladesh, postpartum amenorrhoeic, non-educated, and pregnant women were more likely to have moderate/severe anaemia compared to women who were menopausal, had secondary education, and were not pregnant, respectively. In Maldives, residence in urban areas, underweight, having undergone female sterilization, current pregnancy, and menstruation in the last six weeks were associated with increased odds of moderate/severe anaemia. In Nepal, factors associated with increased odds of moderate/severe anaemia were having undergone female sterilization and current pregnancy.

Conclusion

Anaemia remains a significant public health issue among 15-49-year-old women in Bangladesh, Maldives, and Nepal, which requires urgent attention. Effective policies and programmes for the control and prevention of anaemia should take into account the unique factors associated with anaemia identified in each country. In all three countries, strategies for the prevention and control of anaemia should particularly focus on women who are pregnant, underweight, or have undergone sterilization.
Higher pulse frequency of near-infrared laser irradiation increases penetration depth for novel biomedical applications
Authors: Barbora Ayan , Bohar Oryan , Sivan Ariel Alexander , Magory Eyal , Nause Ariel , Minnes Refael
Published: January 2021

Background

The clinical efficiency of laser treatments is limited by the low penetration of visible light used in certain procedures like photodynamic therapy (PDT). Second Harmonic Generation (SHG) PDT is an innovative technique to overcome this limitation that enables the use of Near Infrared (NIR) light instead of visible light. NIR frequency bands present an optical window for deeper penetration into biological tissue. In this research, we compare the penetration depths of 405 and 808 nm continuous wave (CW) lasers and 808 nm pulsed wave (PW) laser in two different modes (high and low frequency).

Methods

Increasing thicknesses of beef and chicken tissue samples were irradiated under CW and PW lasers to determine penetration depths.

Results

The 808 nm CW laser penetrates 2.3 and 2.4 times deeper than the 405 nm CW laser in beef and chicken samples, respectively. 808 nm PW (pulse frequency—500 Hz) penetrates deeper than CW laser at the same wavelength. Further, increasing the pulse frequency achieves higher penetration depths. High frequency 808 nm PW (pulse frequency—71.4 MHz) penetrates 7.4- and 6.0-times deeper than 405 nm CW laser in chicken and beef, respectively.

Conclusions

The results demonstrate the higher penetration depths of high frequency PW laser compared to low frequency PW laser, CW laser of the same wavelength and CW laser with half the wavelength. The results indicate that integrating SHG in the PDT process along with pulsed NIR light may allow the treatment of 6–7 times bigger tumours than conventional PDT using blue light.
Etiology of lactic acidosis in malaria
Authors: Possemiers Hendrik , Vandermosten Leen , Van den Steen Philippe E.
Published: January 2021

Lactic acidosis and hyperlactatemia are common metabolic disturbances in patients with severe malaria. Lactic acidosis causes physiological adverse effects, which can aggravate the outcome of malaria. Despite its clear association with mortality in malaria patients, the etiology of lactic acidosis is not completely understood. In this review, the possible contributors to lactic acidosis and hyperlactatemia in patients with malaria are discussed. Both increased lactate production and impaired lactate clearance may play a role in the pathogenesis of lactic acidosis. The increased lactate production is caused by several factors, including the metabolism of intraerythrocytic Plasmodium parasites, aerobic glycolysis by activated immune cells, and an increase in anaerobic glycolysis in hypoxic cells and tissues as a consequence of parasite sequestration and anemia. Impaired hepatic and renal lactate clearance, caused by underlying liver and kidney disease, might further aggravate hyperlactatemia. Multiple factors thus participate in the etiology of lactic acidosis in malaria, and further investigations are required to fully understand their relative contributions and the consequences of this major metabolic disturbance.
The genetic proteome: Using genetics to inform the proteome of mycobacterial pathogens
Authors: Nicholson Kathleen R. , Mousseau C. Bruce , Champion Matthew M. , Champion Patricia A.
Published: January 2021

Mycobacterial pathogens pose a sustained threat to human health. There is a critical need for new diagnostics, therapeutics, and vaccines targeting both tuberculous and nontuberculous mycobacterial species. Understanding the basic mechanisms used by diverse mycobacterial species to cause disease will facilitate efforts to design new approaches toward detection, treatment, and prevention of mycobacterial disease. Molecular, genetic, and biochemical approaches have been widely employed to define fundamental aspects of mycobacterial physiology and virulence. The recent expansion of genetic tools in mycobacteria has further increased the accessibility of forward genetic approaches. Proteomics has also emerged as a powerful approach to further our understanding of diverse mycobacterial species. Detection of large numbers of proteins and their modifications from complex mixtures of mycobacterial proteins is now routine, with efforts of quantification of these datasets becoming more robust. In this review, we discuss the “genetic proteome,” how the power of genetics, molecular biology, and biochemistry informs and amplifies the quality of subsequent analytical approaches and maximizes the potential of hypothesis-driven mycobacterial research. Published proteomics datasets can be used for hypothesis generation and effective post hoc supplementation to experimental data. Overall, we highlight how the integration of proteomics, genetic, molecular, and biochemical approaches can be employed successfully to define fundamental aspects of mycobacterial pathobiology.
The Purification Of Rennin-Like Protease From Lactobacillus Paracasei Isolated From Ettawa Goat Milk
Authors: Putranto Wendry Setiyadi , Mustopa Apon Zaenal , Kusumawati Arizah , Prastyowati Anika
Published: January 2021

There is a protease produced by bateria that has characteristics similar to rennin from a calf.  Rennin has the ability to clot casein in milk. Rennin-like protease (RLP) is produced by bacteria extracellularly. Lactic Acid Bacteria (LAB) have the potential to be developed for RLP production because they are safe and non-pathogenic bacteria. Rennin is needed in the process of milk coagulation to subsequently obtain a curd in the process of making cheese. In this study, the LAB isolated from Ettawa goat milk (isolate 2.12) which produced RLP was 99% identical to Lactobacillus paracasei based on 16S rRNA gene sequence analysis. The purification of the RLP L. paracasei 2.12 with 60% ammonium sulfate deposition, dialysis, and filtration gel chromatography Sephadex G-50 showed a single 38 kDa protein band with SMCA/SPA was 4.48 higher than that of the calf rennet with a ratio value of 1, therefore in this study, RLP L. paracasei 2.12  was developed as an alternative to renin in cheese making.