bluuebunny/crossref_metadata_2025 huggingface dataset:
Molecular Tracing of SARS-CoV-2 in Italy in the First Three Months of the Epidemic
Authors: Lai Alessia , Bergna Annalisa , Caucci Sara , Clementi Nicola , Vicenti Ilaria , Dragoni Filippo , Cattelan Anna Maria , Menzo Stefano , Pan Angelo , Callegaro Annapaola , Tagliabracci Adriano , Caruso Arnaldo , Caccuri Francesca , Ronchiadin Silvia , Balotta Claudia , Zazzi Maurizio , Vaccher Emanuela , Clementi Massimo , Galli Massimo , Zehender Gianguglielmo
Published: July 2020

The aim of this study is the characterization and genomic tracing by phylogenetic analyses of 59 new SARS-CoV-2 Italian isolates obtained from patients attending clinical centres in North and Central Italy until the end of April 2020. All but one of the newly characterized genomes belonged to the lineage B.1, the most frequently identified in European countries, including Italy. Only a single sequence was found to belong to lineage B. A mean of 6 nucleotide substitutions per viral genome was observed, without significant differences between synonymous and non-synonymous mutations, indicating genetic drift as a major source for virus evolution. tMRCA estimation confirmed the probable origin of the epidemic between the end of January and the beginning of February with a rapid increase in the number of infections between the end of February and mid-March. Since early February, an effective reproduction number (Re) greater than 1 was estimated, which then increased reaching the peak of 2.3 in early March, confirming the circulation of the virus before the first COVID-19 cases were documented. Continuous use of state-of-the-art methods for molecular surveillance is warranted to trace virus circulation and evolution and inform effective prevention and containment of future SARS-CoV-2 outbreaks.
Intestinal Schistosomiasis and Giardiasis Co-Infection in Sub-Saharan Africa: Can a One Health Approach Improve Control of Each Waterborne Parasite Simultaneously?
Authors: Archer John , O'Halloran Lisa , Al-Shehri Hajri , Summers Shannan , Bhattacharyya Tapan , Kabaterine Narcis , Atuhaire Aaron , Adriko Moses , Arianaitwe Moses , Stewart Martyn , LaCourse James , Webster Bonnie , Bustinduy Amaya , Stothard Russell
Published: July 2020

Both intestinal schistosomiasis and giardiasis are co-endemic throughout many areas of sub-Saharan Africa, significantly impacting the health of millions of children within endemic areas. While giardiasis is not considered a neglected tropical disease, intestinal schistosomiasis is formally grouped within the NTD umbrella and, as such, receives significant advocacy and financial support for large-scale control, annually. Given the many epidemiological similarities between intestinal schistosomiasis and giardiasis, in this review, we critically discuss why disease surveillance and control activities for giardiasis are largely absent within low- and middle-income countries. With advances in new methods of parasite diagnostics and provision of existing anti-parasitic medications, better management of intestinal schistosomiasis and giardiasis co-infection could, not only be better understood but also, more effectively controlled. In this light, we appraise the suitability of a One Health approach for intestinal schistosomiasis, for if adopted more broadly, could also pave a way forward for more inclusive public health actions against giardiasis.
A Hitchhiker’s Guide to Working with Large, Open-Source Neuroimaging Datasets
Authors: Horien Corey , Noble Stephanie , Greene Abigail , Lee Kangjoo , Barron Daniel , Gao Siyuan , O'Connor Dave , Salehi Mehraveh , Dadashkarimi Javid , Shen Xilin , Lake Evelyn , Constable R. Todd , Scheinost Dustin
Published: July 2020

Large datasets that enable researchers to perform investigations with unprecedented rigor are growing increasingly common in neuroimaging. Due to the simultaneous increasing popularity of open science, these state-of-the-art datasets are more accessible than ever to researchers around the world. While analysis of these samples has pushed the field forward, they pose a new set of challenges that might cause difficulties for novice users. Here, we offer practical tips for working with large datasets from the end-user’s perspective. We cover all aspects of the data life cycle: from what to consider when downloading and storing the data, to tips on how to become acquainted with a dataset one did not collect, to what to share when communicating results. This manuscript serves as a practical guide one can use when working with large neuroimaging datasets, thus dissolving barriers to scientific discovery.
Covid-19 Fatality Rate Between 0.1 and 0.3%, Gangelt and Santa Clara Combined
Authors: Mergel Dieter
Published: July 2020

Covid-19 fatality rates of 0.37% (Gangelt, Germany) and 0.17% (Santa Clara, USA) have been reported, estimated from serological studies. We show that the two confidence intervals strongly overlap when the uncertainty in the number of deaths is taken into account, so that the two investigations may be regarded as representative of the same population (tentatively: “Western society with no overload of the Health Care System during the pandemic”). Combining the results, the Covid-19 fatality rate is estimated to be found with 95% confidence in the range [0.1%; 0.3%].
Financial Technology Peer-To-Peer Lending Berbasis Syariah Di Indonesia
Authors: Baihaqi Jadzil
Published: July 2020

This research aims to explain the concept of online peer-to-peer lending based on sharia rules. This research uses a literature study. The findings are, first, online peer-to-peer lending allowed in Islamic law that free from prohibited transactions, using sharia contracts, transparent, and in good manner. Second, there are 6 online peer-to-peer lending models that can be done according to Fatwa DSN-MUI: 1) financing for factoring, 2) financing for procurement ordered good, 3) financing for online seller, 4) financing for online seller through payment gateway, 5) financing for employee, 5) financing for community-based.
Jaminan dalam Pembiayaan Mudharabah (Studi Kasus Perbankan Syariah di Indonesia)
Authors: Zakiyah Faridatuz , Hisam Luqman Nur
Published: July 2020

Mudharabah transactions are currently included in the main elements of a fairly risky position, because even though this system takes place due to cooperation between sahibul mall and mudharib, the implementation is quite difficult. Moreover, the practice carried out in banking is not exactly the same as the system applied with the classical concept, coupled with the existence of several new provisions such as the implementation of collateral in the mudharabah financing contract.

The purpose of this study is to find out analyzing the application of guarantees in mudharabah financing practiced by banks in Indonesia using the Islamic legal framework. The research method used in this study is descriptive-qualitative analysis. From this study it can be concluded that the application of guarantees in mudharabah financing in Islamic banks is absolutely required. Because the thing that becomes a special consideration is to avoid things that cause harm to one party. In this case an aspect of assymetric information which in this situation will create moral hazard.
Strategi Pemasaran dalam Pencapaian Target Produk Simpanan Pada BRI Syari’ah
Authors: Kusrini Eni
Published: July 2020

The achievement of the savings product target obtained is based on the optimism of BRI Syari'ah employees that the majority of Demak people are Muslims who certainly want a trustworthy service in accordance with their beliefs. In addition, BRI Syari'ah's market share in Demak is increasingly providing opportunities to help customers' needs. This study aims to find out: (1) strategies to achieve the target of marketing savings products at Bank Rakyat Indonesia (BRI) Syari'ah in Demak; (2) and analyze the implementation of efforts to implement strategic analysis on savings products at Bank Rakyat Indonesia (BRI) Syari'ah in Demak. This research is expected to provide various benefits. Theoretically, it is useful in the development of Islamic economics related to shari'ah banking, especially the strategy analysis and achievement of its savings targets. Practically beneficial for practitioners, especially for deposit product managers, as a consideration for managing savings products in shari'ah banking in order to achieve the expected targets.
Standarisasi Perjanjian Baku Pada Perbankan Syariah
Authors: Latif Moh Abdul
Published: July 2020

The legal relationship applies general terms and conditions set forth in the standard agreement. In connection with the legal relationship between Islamic banks and their customers, they will be questioned, especially those who do not understand the law, what law will be applied in the event of a dispute between Islamic banks and customers regarding the use of an Islamic banking service? Will the existing Islamic law apply to the disputes that arise? Or what will be applied are the terms and conditions set forth in the agreement? This question needs to be raised and the answer is needed to avoid misunderstandings for those who are lawless who intend to connect with Islamic banks, because at this time Indonesia does not yet have Standardization in the form of a Law on standard agreements. therefore it is very necessary to standardize the agreements that apply to the relationship between Islamic banks and their customers by Indonesian banks.
Strategi Pemasaran Pembiayaan Arrum Haji Dalam Meningkatakan Jumlah Nasabah di Unit Pegadaian Syariah (UPS) Cirebon Bisnis Center
Authors: Fajrin Oktavia , Muamar Afif
Published: July 2020

Hajj Financing for Micro Business (Arrum) Hajj in Pegadaian Syariah is relatively new, because this product was only launched in 2016. For this new product an introduction is needed to be able to attract the interest of the community. Therefore, this study aims to determine marketing strategies, the mechanism of Arrum Hajj financing registration, and to determine customer responses to Arrum Hajj products at the Pegadaian Syariah Cirebon Business Center. This study used a qualitative method with a descriptive analytical approach, and this research resulted in a marketing strategy conducted by the CBC Sharia Pawnshop Unit using a 4p strategy, namely Product, Price, Place, and Promotion. The results of this study found that the price and place strategy had been determined by the head office and the Pegaadian Sharia branch office. While the product strategy has been going very well, by providing services and comfort, as well as promotion strategies carried out by sharia pawnshops are quite diverse such as holding seminars, socialization, cross selling techniques and so on. Hajj arrum registration mechanism is in accordance with existing procedures. And the response given by Arrum Hajj financing customers is very good, because with the availability of Arrum Hajj products can ease the burden on customers and can quickly get a portion of Hajj.
Epistimologi Tafsir Hukum Ayat Riba
Authors: Fauziatal N Inna
Published: July 2020

Riba atau bunga memiliki arti tambahan. Arti tambahan dalam transaksi perekonomian perlu diperjelas dan dipertegas sesuai dengan ketentuan teks dalil al-Qur’an maupun dalam Hadits. Usaha memperjelas dan mempertegas dimaksudkan untuk menemukan bagaimana pesan Tuhan dapat pahami dengan baik oleh pelaku ekonomi terkait dengan kode-kode Tuhan. Maka dari itu diperlukan suatu ilmu atau metide yang secara khusus membahas dan mendalami bagaimana Tuhan menyapa hambanya dengan lembut untuk menunjukkan jalan yang benar agar tidak tenggelam dalam kebinasahan atas tafsir-tafsir yang tidak dibenarkan.
Sistem Pertanggungan Pada Penjaminan Bancassurance oleh Asuransi X Syariah Menurut Konsep Kafālah
Authors: Zahara Nuraiza
Published: July 2020

Cooperation agreement between the Bank and Insurance in the form of a bancassurance system the Bank transfers part of the risk that will arise to the Insurance. Such as the risk of debtor customer financing bottlenecks due to death, the risk borne by the Bank is transferred to the insurance company with life insurance coverage. Insurance agreement for debtor customers, Insurance applies a system based on the kafālah concept. This study explores how the insurance system between the customer and the Bank with the involvement of Insurance as a guarantor in the Bancassurance agreement and how the Islamic legal review of the insurance system carried out by the Insurance against the Bank with the Bancassurance agreement. This research uses descriptive analysis method, which describes or gives a description of the object under study through data or samples that have been collected. The conclusion of the research is that the coverage applied by the Insurance against the Bank is not in accordance with the true kafālah concept, the Insurance has paid the principal fund fully but does not pay the service fee in accordance with the minimum amount determined by the Bank. Based on the concept of insurance, the insurance should be obliged to fulfill everything that is the responsibility of the customer to the Bank, including compensation for services as stipulated. From the explanation above, the concept of kafālah applied by Insurance in its coverage of the Bank is still a mismatch between the concept and its application.
Operating Room Traffic in Total Joint Arthroplasty
Authors: Osborn Nathaniel S. , Hoehmann Christopher L. , McCormack Richard , Owens Jonathan
Published: July 2020

Background:

Periprosthetic joint infection remains a devastating complication of total joint arthroplasty (TJA). The literature suggests that unnecessary operating room (OR) traffic increases the risk of surgical site infection by increasing bacterial load in the OR. We attempted to determine whether the posting of “restricted access” signs on the outside and inside of OR doors during primary TJA procedures would result in a reduction of OR door openings.

Methods:

This prospectively designed, 2-phase study investigated the number of door openings per case for primary TJA. An independent observer collected data for each TJA case; the OR staff were blinded to the data collection to avoid bias. The first phase of this study recorded OR traffic without the use of “restricted access” signs. In the second, interventional phase of the study, OR traffic was monitored with the concomitant application of “restricted access” signs on the doors. The number of openings per case, from the time of incision to the time of dressing application, was collected.

Results:

The average number of openings per case during the first phase was 75, with 0.59 door openings per minute. The average number of openings per case during the second phase was 40, with 0.28 door openings per minute. Therefore, a 47% reduction in openings per case and a 53% reduction in the number of openings per minute during primary TJA cases were observed.

Conclusions:

We demonstrated that the simple addition of “restricted access” signs on the outside and inside of OR doors produced a significant reduction (p < 0.001) in OR traffic during primary TJA.

Clinical Relevance:

Posting signs can decrease door openings, potentially decreasing infection.
Pengaruh modal psikologis terhadap kinerja melalui burnout di PT PLN (Persero) UID Jawa Timur
Authors: Putri Chinta Ayuning , Kistyanto Anang
Published: July 2020

The purpose of this study is to analyze the effect of psychological capital on employee performance through burnout on employees of PT PLN (Persero) East Java Distribution Unit. The sampling technique used a saturated sample with 40 respondents in the employees of PT PLN (Persero) East Java Distribution Unit. The results of this study explain that psychological capital has no effect on burnout. Psychological capital has a positive and significant effect on employee performance. Burnout does not affect employee performance. And found the results that it is not proven that burnout has an intervening role between psychological capital on employee performance.
Analisis efek ukuran perusahaan, profitabilitas, likuditas, dan kinerja lingkungan terhadap pengungkapan Islamic Social Reporting
Authors: Aziz Muhammad Rusydi , Roekhudin Roekhudin , Andayani Wuryan
Published: July 2020

This study aims to test and empirically prove the influence of company size, profitability, liquidity and environmental performance on the disclosure of Islamic Social Reporting. This type of research is quantitative research, uses secondary data taken from the Indonesia Stock Exchange (IDX) or the Ministry of Environment. Based on the purposive sampling method, there are 33 samples of companies for 3 years in companies registered with ISSI. This study uses a special regression analysis for panel data using Eviews 10. The results of this study indicate that company size and profitability have a positive effect on the disclosure of Islamic Social Reporting. While liquidity and environmental performance failed to have an effect on the disclosure of Islamic Social Reporting. The results of this study are expected to be a consideration of what factors influence the disclosure of Islamic Social Reporting on companies listed on the Indonesian Islamic stock index (ISSI) in 2015 - 2017 which are also listed on PROPER
Programming as a mathematical activity
Authors: Rowlett Peter
Published: July 2020

Programming in undergraduate mathematics is an opportunity to develop various mathematical skills. This paper outlines some topics covered in a second year, optional module â€˜Programming with Mathematical Applicationsâ€™ that develop mathematical thinking and involve mathematical activities, showing that practical programming can be taught to mathematicians as a mathematical skill.
Automated assessment in a programming course for mathematicians
Authors: Bostelmann Henning
Published: July 2020

The paper reports on a programming course for undergraduate Mathematics students in their 2nd year, with some parts compulsory for single-subject students. Assessment takes the form of several programming projects. Formative feedback as well as summative assessment is aided by automated unit tests, which allow for rapid and consistent marking, while focussing markerâ€™s time on students who require the most help.
Programming in the recently-updated pre-university maths curriculum â€“ Further Pure Mathematics with Technology (FPT)
Authors: Lee Stephen , Button Tom
Published: July 2020

The Further Pure with Technology unit has been updated and is still available as an optional component for Further Mathematics students and in this short update we will address its role and how it can support pre-university students in developing their mathematical programming skills.
Using Python in the Teaching of Numerical Analysis
Authors: Gwynllyw D. Rhys , Henderson Karen L. , Van lent Jan , Guillot Elsa G.
Published: July 2020

In this Case Study we describe the rationale, methodology and results of teaching Python as part of a third year optional Numerical Analysis module taken by undergraduate BSc Mathematics students at the University of the West of England, Bristol. In particular we focus on how we have used programming mini-tasks to engage and prepare students for using Python to complete a more significant piece of coursework, taken later in the course. These mini-tasks are marked electronically using the Dewis e-assessment system which provides the students with immediate and tailored feedback on their Python code.
Programming in the Mathematics Curriculum at Manchester Metropolitan University
Authors: Lynch Stephen
Published: July 2020

An increasing number of schools are teaching programming to their pupils and there is also an increase in programming in Higher Education with recent reports recommending this approach. At Manchester Metropolitan University (MMU) we wanted to attract and retain mathematics students and prepare them for careers upon graduation. By integrating Mathematics/Statistics/Operational Research packages across the curriculum and by solving real world problems we have managed to make the course highly desirable and loved by our students. In this case study, we show how it is possible to integrate programming and mathematical/computational modelling across the curriculum.
Editorial
Authors: Rowlett Peter , Jones Matthew M.
Published: July 2020

This special issue of MSOR Connections is based on contributions to a workshop, â€˜Programming in the undergraduate mathematics curriculumâ€™, which took place at Middlesex University on 27th June 2019, and other submissions received on the same theme.
Development, reliability and validity of the Safe Use of Mobility Aids Checklist (SUMAC) for 4-wheeled walker use in people living with dementia
Authors: Hunter Susan , Divine Alison , Omana Humberto , Madou Edward , Holmes Jeffrey
Published: July 2020

Background: Balance and gait problems are common and progressive in dementia. Mobility aid use in people with dementia increases the likelihood of falls three-fold. An assessment tool to quantify mobility aid safety in people with dementia does not currently exist. The objectives of this study were: 1) to develop a tool for the evaluation of physical function and safety with use of a 4-wheeled walker in people with dementia, and 2) to evaluate its construct and criterion validity, inter-rater and test-retest reliability and minimal detectable change.Methods: Healthcare professionals (HCP) experienced in care and rehabilitation of people with dementia participated in focus groups for item generation of the new tool, entitled The Safe Use of Mobility Aid Checklist (SUMAC). The SUMAC evaluates physical function (PF) and safe use of the equipment (EQ) on nine tasks of daily life. Ten individuals with dementia using a 4-wheeled walker were recorded performing the tasks within the SUMAC. Reliability was evaluated by having five HCP score participant videos on two occasions. Inter-rater and test-retest reliability was assessed using intra-class correlation coefficients (ICC). Construct validity was evaluated using scores determined by a consensus panel compared to the individual HCP scores using Spearman’s rank-order correlations. Criterion validity was assessed between SUMAC-PF and the Performance-Oriented Mobility Assessment (POMA) gait subscale using Spearman’s rank-order correlations. Results: Three focus groups (n=17) were completed and these generated a tool comprised of nine tasks and the components within each task that the clinicians would observe for physical function and safe use. Inter-rater reliability was statistically significant for the SUMAC-PF (ICC=0.92, 95%CI (0.81, 0.98), p<0.001) and SUMAC-EQ (ICC=0.82, 95%CI (0.54, 0.95), p<0.001). Test-retest reliability was also statistically significant for the SUMAC-PF (ICC=0.89, 95%CI (0.81, 0.94), p<0.001) and SUMAC-EQ (ICC=0.88, 95%CI (0.79, 0.93), p<0.001). The POMA gait subscale correlated strongly with the SUMAC-PF (r=0.84), but not EQ (r=0.39).Conclusions: Each of the scores of the SUMAC, physical function and safe use of the equipment, demonstrated content validity, strong inter-rater and test-retest reliability and strong criterion and concurrent validity for the assessment of mobility aid safety in people with dementia.
The Effect of Oral Sildenafil Therapy on Health-Related Quality of Life in Adults with Pulmonary Arterial Hypertension related to Uncorrected Secundum Atrial Septal Defect: A Quasi Experimental Study
Authors: hidayati fera , Gharini Putrika , Hartopo Anggoro Budi , Anggrahini Dyah Wulan , Dinarti Lucia Kris
Published: July 2020

Background: Assessment of health-related quality of life (HRQoL) are often measured as an important patient-reported outcome (PRO) in clinical studies. Pulmonary arterial hypertension (PAH) is a common complication of atrial septal defect (ASD). This study aimed to compare the HRQoL of PAH related uncorrected secundum ASD at pre and post therapy with oral sildenafil therapy. Methods: We conducted quasi experimental study at Sardjito General Hospital Yogyakarta since April 2016 to August 2017. Adults with PAH related uncorrected secundum ASD, listed on Congenital Heart Disease and Pulmonary Hypertension (COHARD-PH) registry, and met the inclusion and exclusion criteria were recruited as subject. Interview was done at pre and 12 weeks post oral sildenafil therapy 3 x 20 mg using the EQ-5D-3L questionnaire. Statistical analysis was done using Wilcoxon test and paired T-test to determine the differences of EQ5D utility and EQVAS score at pre and post therapy. Results: A total of 18 adult patients with PAH related to uncorrected secundum ASD were enrolled in this study (83.33% female; mean age 38.72 ± 10.81 years old). The most frequent reported problems pre therapy were pain/discomfort (83%) and anxiety/depression (78%). Wilcoxon test showed the median of EQ5D utility score were increased after sildenafil therapy (before= 0.604, after=0.664; Z= -2,703; p:0.007), respectively. Meanwhile, the paired T-test results showed an increase of EQ-VAS mean difference 6.67±8.75 (p:0.005; 95% CI 2.32-11.02) after sildenafil therapy. Conclusion: The administration of oral sildenafil therapy 3 x 20 mg during 12 weeks in adult patients with PAH related uncorrected secundum ASD gives better HRQoL.
Prevalence and Distribution of Resistance and Enterotoxins/Enterotoxin-likes Genes in Different Clinical Isolates of Coagulase-negative Staphylococcus
Authors: Nasaj Mona , Saeidi Zahra , Tahmasebi Hamed , Dehbashi Sanaz , Arabestani Mohammad
Published: July 2020

Background: Coagulase-negative staphylococcus (CoNS) are considered to be the major reservoirs for genes facilitating the evolution of S. aureus as a successful pathogen. The present study aimed to determine the occurrence of genes conferring resistance to fluoroquinolone, determining of the prevalence of insertion sequence elements IS256, IS257 and different superantigenes (SAgs) among CoNS isolates obtained from various clinical sources.Materials and Methods: The current study conducted on a total of the 91 CoNS species recovered from clinical specimens in Hamadan hospitals in western Iran in 2017-19. The antimicrobial susceptibility testing was performed using disk diffusion method and the presence of the IS256 and IS257, genes conferring resistance to fluoroquinolone and enterotoxins/enterotoxin-like encoding genes were investigated by Polymerase Chain Reaction (PCR) method. Results: Among genes encoding classic enterotoxins, sec was the most frequent which was carried by 48.4% of the 91 isolates, followed by seb in 27.5% of the isolates. None of the CoNS isolates was found to be positive to enterotoxin-like encoding genes. In 11(12%) of all isolates that were phenotypically resistant to levofloxacin, 9 isolates (81.8%) were positive for gyrB, 8 isolates (72.7%) were positive for gyrA, 8 isolates (72.7%) harbored grlB and 7 isolates (63.6%) were found to carry grlA. The IS256 and IS257 were identified in 31.8 % and 74.7% of the isolates, respectively. The results of statistical analysis showed a significant association between the occurrence of staphylococcal enterotoxins (SEs) encoding genes and antimicrobial resistance.Conclusion: Antimicrobial resistant determinants and SEs are co-present in clinical CoNS isolates that confer selective advantage for colonization and survival in hospital settings. The coexistence of insertion elements and antibiotic resistance indicate their role in pathogenesis and infectious diseases.
Implementation fidelity of Iron and Folic Acid supplementation (IFAs) and associated challenges among pregnant women in Uasin Gishu County Kenya
Authors: Riang'a Roselyter Monchari , Nangulu Anne Kisaka , Broerse Jacqueline E.W.
Published: July 2020

Background Implementation fidelity which is defined as the degree to which programmes are implemented as intended is one of the factors that affect programme outcome, thus requiring careful examination. This study aims to acquire insight into the degree to which nutritional counselling and Iron and Folic Acid supplementation (IFAs) policy guidelines during pregnancy have been implemented as intended and the challenges to implementation fidelity. Methods Data were collected in rural Uasin Gishu County in the western part of Kenya through document analysis, questionnaires among programme recipients (n=188) and semi-structured interviews with programme implementers (n=6). Data collection and analysis were guided by an implementation fidelity framework. We specifically evaluated adherence to intervention design (content, frequency, duration and coverage), exposure or dosage quality of delivery and participant responsiveness. Results Coverage of nutritional counselling and IFAs policy is widespread. However, partial provision was reported in all the intervention components. Only 10% accessed intervention within the first trimester as recommended by policy guidelines, only 18% and 15% of the respondents received 90 or more iron and folic acid pills respectively during their entire pregnancy period, only 28% reported receiving nutritional counselling, and 66% completed taking the IFAs pills that were issued to them. Late initial bookings to antenatal care, drug stock shortage, staff shortage and long queues, confusing dosage instructions, side effects of the pills and issuing of many pills at one go, were established to be the main challenges to effective implementation fidelity. Anticipated health consequences and emphasis by the health officer to take the pills were established to be motivations for adherence to nutritional counselling and IFAs guidelines. Conclusions Implementation fidelity of nutritional counselling and IFAs policy in Kenya is generally weak. There is need for approaches to enhance early access to interventions, enhance stock availability, provide mitigation measures for the side effects, as well as intensify nutritional counselling to promote the consumption of micronutrient-rich food sources available in the local environment to substitute for the shortage of nutritional supplements and low compliance to IFAs.
Influence of biofilm growth age, media, antibiotic concentration and exposure time on Staphylococcus aureus and Pseudomonas aeruginosa biofilm removal in vitro
Authors: Chen Xiaofeng , Thomsen Trine Rolighed , Winkler Heinz , Xu Yijuan
Published: July 2020

Background: Biofilm is known to be tolerant towards antibiotics and difficult to eradicate. Numerous studies have reported Minimum Biofilm Eradication Concentration (MBEC) values of antibiotics for many known biofilm pathogens. However, the experimental parameters applied in these studies differ considerably, and often the rationale behind the experimental design are not well described. This makes it difficult to compare the findings. To demonstrate the importance of experimental parameters, we investigated the influence of biofilm growth age, antibiotic concentration and treatment duration, and growth media on biofilm eradication. Additionally, OSTEOmycinTM, a clinically used antibiotic containing allograft bone product, was tested for antibiofilm efficacy. Results: The commonly used Calgary biofilm device was used to grow 24 h and 72 h biofilms of Staphylococcus aureus and Pseudomonas aeruginosa, which were treated with time-dependent vancomycin (up to 3000 mg/L) and concentration-dependent tobramycin (up to 80 mg/L), respectively. Two common bacteriological growth media Tryptic Soy Broth (TSB) and Cation-adjusted Mueller Hinton Broth (CaMHB) were tested. We found for both species that biofilms were more difficult to kill in TSB than in CaMHB. Furthermore, young biofilms (24 h) were easier to eradicate than old biofilms (72 h). In agreement with vancomycin being time-dependent, extension of the vancomycin exposure increased killing of S. aureus biofilms. Tobramycin treatment of 24 h P. aeruginosa biofilms was found concentration-dependent and time-independent, however, increasing killing was indicated for 72 h P. aeruginosa biofilms. Treatment with tobramycin containing OSTEOmycin TTM removed 72 h and 168 h P. aeruginosa biofilms after one day treatment, while few 72h S. aureus biofilms survived after two days treatment with vancomycin containing OSTEOmycin VTM. Conclusions: This study demonstrated biofilm removal efficacy was influenced by media, biofilm age and antibiotic concentration and treatment duration. It is therefore necessary to taking these parameters into consideration when designing experiments. The results of OSTEOmycin products indicated that simple in vitro biofilm test could be used for initial screening of antibiofilm products. For clinical application, a more clinically relevant biofilm model for the specific biofilm infection in question should be developed to guide the amount of antibiotics used for local antibiofilm treatment.
Ovarian Cancer: Diagnostic accuracy and tumor types distribution in East Africa compared to North America
Authors: Rambau Peter Fabian , Köbel Martin , Tilley Derek , Mremi Alex , Lukande Robert , Muller William
Published: July 2020

Background: Ovarian cancer is a spectrum of several histologically distinct tumor types that differ in etiology, response to therapy, and prognosis. In resource-limited settings, the diagnosis of ovarian cancer can be challenging. This study describes the distribution of ovarian cancer tumor types in East Africa as well as assessing the diagnostic accuracy by using contemporary methods. Methods: Data from 210 women identified from the records with a diagnosis of ovarian cancer in a period of 15 years were included. Two tissue microarrays were constructed and stained with 20 antibodies relevant to ovarian cancer subtyping. An integrated diagnosis was reached by the review of full Haematoxylin and Eosin stained sections, with consideration of immunohistochemical results. The integrated diagnoses were compared with the original diagnoses, and the degree of agreement was evaluated by percentage and Kappa statistics. Results: Though limited by selection bias, the results suggest lower rates of ovarian cancer in East Africa compared to a North American population from Alberta, Canada. There was a higher proportion of sex cord stromal tumors and germ cell tumors in the East African population. Diagnostic accuracy for main ovarian tumor type categories was substantial (Kappa 0.70), but only fair for specific ovarian carcinoma histotypes (Kappa 0.34). Poor Haematoxylin and Eosin stain was the main factor hindering the correct diagnosis, which was not related to tissue processing. Conclusions: In a resource-limited setting, where immunohistochemistry is not routinely carried out, diagnostic accuracy for the main categories of ovarian carcinoma is substantial and could be further improved by standardization of the basic Haematoxylin and Eosin stain.
Relationship between formulaic breast volume and risk of breast cancer based on linear measurements
Authors: li xiaoxia , Zhou Chunlan , Wu Yanni , Chen Xiaohong
Published: July 2020

Background: Whether breast volume is a risk factor for breast cancer is controversial. This study aimed to evaluate whether a significant association between breast volume and risk of breast cancer, based on linear measurements,was present by applying propensity score matching (PSM).Methods: The study was designed as a hospital-based case-control study. Between March 2018 and May 2019, 208 cases and 340 controls were retrospectively reviewed. Information on menarche, smoking, feeding mode, oral contraceptives, reproductive history and family history was obtained through a structured questionnaire. Breast volume was calculated using a formula based on linear measurements of breast parameters. Cox regression and PSM were used to estimate odds ratios and 95% confidence intervals for breast cancer using risk factors adjusted for potential confounders. Results: There was a significant difference in breast volume between the two groups before propensity score matching(P = 0.014) . Binary logistic regression showed that the risk of breast cancer was slightly higher in the case group with larger breast volumes than in the control group（P = 0.009, OR = 1.002， 95%CI：1.000~1.003). However, there was no significant statistical difference between the two groups using an independent sample Mann-Whitney U test (P = 0.438) or conditional logistic regression (P = 0.446). Conclusions: After PSM for potential confounding factors, the breast volume of cases did not differ from that of controls. The risk of breast cancer may not be related to breast volume in Chinese women.
Characterization of TMAO productivity from carnitine challenge facilitates personalized nutrition and microbiome signatures discovery
Authors: Wu Wei-Kai , Panyod Suraphan , Liu Po-Yu , Chen Chieh-Chang , Kao Hsien-Li , Chuang Hsiao-Li , Chen Ying-Hsien , Zou Hsin-Bai , Kuo Han-Chun , Kuo Ching-Hua , Liao Ben-Yang , Chiu Tina H.T. , Chung Ching-Hu , Lin Angela Yu-Chen , Lee Yi-Chia , Tang Sen-Lin , Wang Jin-Town , Wu Yu-Wei , Hsu Cheng-Chih , Sheen Lee-Yan , Orekhov Alexander N. , Wu Ming-Shiang
Published: July 2020

The capability of gut microbiota in degrading foods and drugs administered orally can result in diversified efficacies and toxicity interpersonally and cause significant impact on human health. Production of atherogenic trimethylamine N-oxide (TMAO) from carnitine is a gut microbiota-directed pathway and varies widely among individuals. Here we demonstrated a personalized TMAO formation and carnitine bioavailability from carnitine supplements by differentiating individual TMAO productivities with a recently developed oral carnitine challenge test (OCCT). By exploring gut microbiome in subjects characterized by TMAO producer phenotypes, we identified 39 operational taxonomy units that were highly correlated to TMAO productivity, including Emergencia timonensis, which has been recently discovered to convert γ-butyrobetaine to TMA in vitro. A microbiome-based random forest classifier was therefore constructed to predict the TMAO producer phenotype (AUROC = 0.81) which was then validated with an external cohort (AUROC = 0.80). A novel bacterium called Ihubacter massiliensis was also discovered to be a key microbe for TMA/TMAO production by using an OCCT-based humanized gnotobiotic mice model. Simply combining the presence of E. timonensis and I. massiliensis could account for 43% of high TMAO producers with 97% specificity. Collectively, this human gut microbiota phenotype-directed approach offers potential for developing precision medicine and provides insights into translational research.
The Co-Culture of ASCs and EPCs Promotes Vascularized Bone Regeneration in Critical-Sized Bone Defects of Cranial Bone in Rats
Authors: he yuanjia , Lin Shuang , Ao Qiang , He Xiaoning
Published: July 2020

Background: The repair of critical-sized bone defect represents a challenging problem in bone tissue engineering. To address the most important problem in bone defect repair, namely insufficient blood supply, this study aimed to find a method that can promote the formation of vascularized bone tissue.Method The phenotypes of ASCs and EPCs were identified respectively, and ASCs/EPCs were co-cultured in vitro to detect the expression of osteogenic and angiogenic genes. Furthermore, the co-culture system combined with scaffold material was used to repair the critical-sized bone defects of the cranial bone in rats.Results The co-culture of ASCs/EPCs could increase osteogenesis and angiogenesis-related gene expression in vitro. The results of in vivo animal experiments demonstrated that the ASCs/EPCs group could promote bone regeneration and vascularization in the meantime and, then significantly accelerate the repair of critical-sized bone defects.Conclusion It is feasible to replace traditional single seed cells with ASCs/EPCs co-culture system for vascularized bone regeneration. This system could ultimately enable clinicians to better repair the defect of craniofacial bone and avoid donor site morbidity.
Impact of Q.Clear reconstruction algorithm on the interpretation of PET/CT images in patients with lymphoma
Authors: Wyrzykowski Michał , Siminiak Natalia , Kaźmierczak Maciej , Ruchała Marek , Czepczyński Rafał
Published: July 2020

Background. Q.Clear is a new Bayesian penalized-likelihood PET reconstruction algorithm. It has been documented that Q.Clear increases SUVmax values of different malignant lesions. Purpose. As SUVmax values are crucial for interpretation of PET/CT images in patients with lymphoma, particularly when early and final response to treatment is evaluated. The aim of the study was to systematically analyze the impact of the use of Q.Clear on interpretation of PET/CT in patients with lymphoma.Methods. 280 18F-FDG PET/CT scans in patients with lymphoma were performed for staging (sPET), for early treatment response (iPET), after the end of treatment (ePET) and when a relapse of the lymphoma was suspected (rPET). Scans were separately reconstructed with two algorithms: Q.Clear and OSEM and further compared.Results. The stage of lymphoma was concordantly diagnosed in 69/70 patients with both algorithms in sPET. Discordant assessment of Deauville score (p<0.001) was found in 11 cases (15.7%) of 70 iPET scans and in 11 cases of 70 ePET scans. An upgrade from negative to positive scan by Q.Clear resulted in 3 cases (4.3%) of iPET scans and 7 (10.0%) of ePET. Results of all 70 r-PET scans were concordant. SUVmax values of the target lymphoma lesions measured with Q.Clear were higher than with OSEM in 88.8% scans. Conclusion. Although the Q.Clear algorithm may alter interpretation of PET/CT only in a small proportion of patients, we recommend to use standard OSEM reconstruction for the assessment of treatment response.
Trichomes form genotype-specific microbial hotspots in the phyllosphere of tomato
Authors: Kusstatscher Peter , Wicaksono Wisnu Adi , Bergna Alessandro , Cernava Tomislav , Bergau Nick , Tissier Alain , Hause Bettina , Berg Gabriele
Published: July 2020

Background : The plant phyllosphere is a well-studied habitat characterized by low nutrient availability and high community dynamics. In contrast, plant trichomes, known for their production of a large number of metabolites, are a yet unexplored habitat for microbes. We analyzed the phyllosphere as well as trichomes of two tomato genotypes (Solanum lycopersicum LA4024, S. habrochaites LA1777) by targeting bacterial 16S rRNA gene fragments.Results: Leaves, leaves without trichomes, and trichomes alone harbored similar abundances of bacteria (108- 109 16S rRNA gene copy numbers per gram of sample). In contrast, bacterial diversity was found significantly increased in trichome samples (Shannon index: 4.4 vs. 2.5). Moreover, the community composition was significantly different when assessed with beta diversity analysis and corresponding statistical tests. At the bacterial class level, Alphaproteobacteria (23.6%) were significantly increased, whereas Bacilli (8.6%) were decreased in trichomes. The bacterial family Sphingomonadacea (8.4%) was identified as the most prominent, trichome-specific taxa; Burkholderiaceae and Actinobacteriaceae showed similar pattern. Moreover, Sphingomonas was identified as a central element in the core microbiome of trichome samples, while distinct low-abundant bacterial families including Hymenobacteraceae and Alicyclobacillaceae were exclusively found in trichome samples. Niche preferences were statistically significant for both genotypes and genotype-specific enrichments were further observed.Conclusion : Our results provide first evidence of a highly specific trichome microbiome in tomato and show the importance of micro-niches for the structure of bacterial communities on leaves. These findings provide further clues for breeding, plant pathology and protection as well as so far unexplored natural pathogen defense strategies.
Knowledge, Attitudes and Practices (KAP) towards pandemic COVID-19 among Syrians
Authors: Ahdab Sanaa Al
Published: July 2020

Background Effective COVID-19 pandemic management requires adequate understanding of factors that influence behavioral changes. This study aims to assess knowledge, attitudes and practices towards COVID-19 among Syrians in a post-conflict context. Method This study is based on a web-based survey, conducted on Syrians of 16 years and above. It contains questions on knowledge, attitudes and practices (KAP) with respect to COVID-19. Participants’ demographic characteristics are recorded and analyzed. The study is conducted during the global outbreak of COVID-19.Results Among the 706 participants, more than 85% of respondents are aware of the main symptoms of COVID-19 infection and 56.2% know that the virus can be transmitted from ill to healthy persons even without fever symptoms. The overall achieved knowledge score towards the disease is about 60% while attitudes and practices score higher at 63.5% and 73.75%, respectively. The results from multiple linear regression indicate that lower knowledge scores are significantly associated with lower education level (P<0.05), whereas poor preventive practices are common among male, young and unemployed participants with significance levels of P<0.01, P=.000, P<0.01, respectively. Conclusion The findings of this study suggest that Syrians demonstrate modest knowledge, attitudes and practices towards COVID-19 at the time of its global outbreak. Efforts should be directed towards raising Syrians awareness of the disease to improve their practices in the current COVID-19 pandemic, as well as for future epidemics.
Two months of Radiation Oncology in the heart of Italian “red zone” during COVID-19 pandemic: paving a safe path over thin ice.
Authors: Buglione Michela , Spiazzi Luigi , Guerini Andrea Emanuele , Barbera Fernando , Pasinetti Nadia , Pegurri Ludovica , Triggiani Luca , Davide Tomasini , Greco Diana , Costantino Gianluca , Bragaglio Alessandra , Bonometti Nadia , Liccioli Mara , Mascaro Lorella , Staff Radiation Oncology Department , Alongi Filippo , Magrini Stefano Maria
Published: July 2020

Background: Coronavirus Disease 2019 (COVID-19) pandemic had an overwhelming impact on healthcare worldwide. Outstandingly, the aftermath on neoplastic patients is still largely unknown, and only isolated cases of COVID-19 during radiotherapy have been published. We will report the two-months experience of our Department, set in Lombardy “red-zone”.Methods: data of 402 cancer patients undergoing active treatment from February 24 to April 24, 2020 were retrospectively reviewed; several indicators of the Department functioning were also analyzed.Results: dedicated measures allowed an overall limited reduction of the workload. Decrease of radiotherapy treatment number reached 17%, while the number of administration of systemic treatment and follow up evaluations kept constant. Conversely, new treatment planning faced substantial decline. Considering the patients, infection rate was 3.23% (13/402) and mortality 1.24% (5/402). Median age of COVID-19 patients was 69.7 years, the large majority were male and smokers (84.6%); lung cancer was the most common tumor type (61.5%), 84.6% of subjects were stage III-IV and 92.3% had comorbidities. Remarkably, 92.3% of the cases were detected before March 24. Globally, only 2.5% of ongoing treatments were suspended due to suspect or confirmed COVID-19 and 46.2% of positive patients carried on radiotherapy without interruption. Considering only the last month, infection rate among patients undergoing treatment precipitated to 0.43% (1/232) and no new contagions were reported within our staff. Conclusions: although mortality rate in COVID-19 cancer patients is elevated, our results support the feasibility and safety of continuing anticancer treatment during SARS-Cov-2 pandemic by endorsing consistent preventive measures.