bluuebunny/crossref_metadata_2025 huggingface dataset:
A FUZZY AHP APPROACH FOR RANKING PARAMETERS AND INDICATORS OF SUSTAINABLE FUNCTIONING AND DEVELOPMENT OF OPENING-UP OF AN OPENCAST SYSTEM
Authors:   Nosov Magnitogorsk State Technical University, BURMISTROV Konstantin , OSINTSEV Nikita ,   Nosov Magnitogorsk State Technical University
Published: October 2020

The opening-up of an opencast system is fundamental in the structure of the mining and technical system (MTS) and the efficiency of the functioning and development of the MTS as a whole depends on the quality of the assessment of its functioning. The decision-making on the reconstruction of the mining and technical system and its subsystems in modern conditions cannot be based only on the basis of a comparison of the technical and economic indicators of the options. Decisions on the development of MTS should be made on the basis of measuring and evaluating the parameters and indicators of the elements of the opening-up of an opencast system and taking into account the requirements of the sustainable development concept, i.e. taking into account the technical, economic, environmental and social aspects of the consequences of decisions taken. However, most of the existing approaches do not allow a comprehensive assessment of all elements of the opening-up of an opencast system, which able to take into account the interrelation between the indicators of the MTS elements in terms of the sustainable development concept. In this paper, we analyzed the factors of the sustainable functioning and development of the MTS and the opening-up of an opencast system, the parameters and indicators for their assessment, as well as the decision-making methods used in the practice of operating the MTS subsystems. The system of parameters and indicators for evaluating the opening-up of an opencast system has been substantiated, taking into account five groups of factors for the functioning of MTS: technical, technological, economic, social and environmental. The use of the fuzzy AHP method for ranking the parameters and indicators of the opening-up of an opencast system is proposed. The methodology and calculation example of assessment of the sustainable development of the opening-up of an opencast system using the fuzzy AHP method are presented. The results of the ranking of the parameters and indicators of the openingup of an opencast system showed that the most significant parameters are economic efficiency, the productivity of the transport complex, social efficiency and environmental efficiency, and the indicators are total income, emissions of pollutants and working conditions of personnel. Using the approach proposed in the work to assess the opening-up of an opencast system will improve: the quality of the assessment of the elements of the opening-up of an opencast system for compliance with the requirements of the sustainable development concept; the effectiveness of decision-making on the design, operational and strategic planning of the MTS development,taking into account the coordination of economic goals with goals in the field of ecology and social development.
MODERNIZATION OF THE MINING SYSTEM OF SMALL DEPOSITS OF RICH COPPER PYRITE ORES
Authors:   Institute of Mining of the Ural Branch of the Russian Academy of Sciences, SOKOLOV Igor , ANTIPIN Yury ,   Institute of Mining of the Ural Branch of the Russian Academy of Sciences, ROZHKOV Artem ,   Institute of Mining of the Ural Branch of the Russian Academy of Sciences
Published: October 2020

The purpose work. Substantiation and selection of a safe and effective option of mining technology of the experimental block in the pilot industrial mining of the Skalistoe deposit. Method of research. Analysis and synthesis of project solutions, experience in mining inclined low-thickness ore bodies, economic and mathematical modeling and optimization of the parameters of options mining systems in the conditions of the experimental block. Results of research. As a result of research it was established: - the sublevel caving mining system with the parameters adopted in the project does not guarantee the completeness of the extraction of reserves and the effectiveness of mining operations. Project indicators of extraction by sublevel caving technology with frontal ore drawing are overestimated and difficult to achieve in these geological and technical conditions (combination of low thickness and angle of ore body); project scheme for the delivery and transportation of rock mass seems impractical due to the significant volume of heading workings and increased transportation costs; - eight technically rational options of various mining systems were constructed, most relevant to the geological and technical conditions of the deposit. Five variants of the sublevel chamber system and pillar caving, a project variant of sublevel caving technology with frontal ore drawing and two options flat-back cut-and-fill system were considered; - for mining the Skalistoe deposit, according to the results of economic and mathematical modeling, optimal by the criterion of profit per 1 ton of balance reserves of ore is a option of the technology of chamber extraction with dual chambers, frontal drawing of ore by remote-controlled load-haul-dump machine and subsequent pillars caving, as having the greatest profit; - the calculations justified stable spans of dual chambers (25.3 m) and the width of panel pillars (3 m). With an allowable span of 25.3 m, the roof of the dual chambers will be stable with a safety factor of 1.41, and a panel pillar with a width of 3 m has a sufficient margin of safety (more than 1.6) in the whole range of ore body thickness variation; - the proposed scheme of delivery and transportation of rock mass, which allows to reduce the volume of tunnel works by 26% and the average length of transportation by 10-15% compared with the project. Findings. Developed in the process of modernization the technology sublevel chamber system with double-chamber, compared with the project technology, it is possible to significantly increase the efficiency of mining of the low thickness deposit of rich ores Skalistoe by reducing the specific volume of preparatory-rifled work by 34%, the cost of mined ore by 12%, losses and ore dilution – by 2 and 2.9 times, respectively.
Study of Gel Plug for Temporary Blocking and Well-Killing Technology in Low-Pressure, Leakage-Prone Gas Well
Authors: Ying Xiong , Yuan Xu , Yadong Zhang , Ziyi Fu
Published: October 2020

A gel-plug system for temporary blocking technology is proposed in this paper to address the prevalent leakage of killing fluid in low-pressure wells; the low technical strength of existing gel plugs for temporary blocking in well killing; difficult-to-control crosslinking time; and gel embrittlement and the difficulty of breaking certain gel plugs. A mixture of etherified galactomannan plant gum, isooctanol polyoxyethylene ether surfactant, and oil phase was used as a thickener. An inorganic salt complex containing long-chain polyhydroxy alcohol was used as a crosslinker and the concentration of long-chain polyhydroxy alcohol far exceeds the theoretical amount required to complex the metal ion. A mixture of polyhydroxy alcohol with a small amount of weak acid was used as a crosslinking regulator. Finally, a mixture of sodium thiosulfate and long-chain quaternary ammonium salt surfactant was used as a stabilizer. Laboratory evaluations showed that this gel-plug system can be directly pumped into the wellbore after being mixed homogeneously, and the viscosity of the system on the surface can be controlled by the amount of crosslinking regulator. The viscosity of the gel-plug system after gelling was high (viscoelastic solid colloid); the initial viscosity reached 30 000 mPa·s at 120°C and retained a semisolid gel shape after aging for 72 hours. Right-angle thickening occurred when the gel warmed to target-zone temperature. The acidic liquid breaker acted quickly, and the viscosity of the broken fluid was lower than 5 mPa·s after 1 to 4  hours. This gel plug for temporary blocking and well-killing technology was successfully applied in a low-pressure, leakage-prone gas well. No gas, pressure, or liquid remained in the open well after killing, the wellhead was successfully replaced, and the tubing was successfully removed. The gel plug also exhibited self-healing: The hole formed by the tubing could be filled and sealed automatically by the gel plug in the annulus. The static friction (outer wall) of 73-mm tubing in the gel plug was 39.6 t/km; the dynamic friction (outer wall) after tubing removal was 7.2 t/km. This gel plug thus shows promise as a temporary blocking technology in workover operations of low-pressure, leakage-prone gas wells.
Novel MYO15A Variants are Associated with Hearing Loss in the Two Iranian Pedigrees
Authors: Khatami Somayeh , Askari Masomeh , Bahreini Fatemeh , Chaleshtori Morteza Hashemzadeh , Hematian Saeed , Asgharzade Samira
Published: October 2020

Background: Clinical genetic diagnosis of non-syndromic hearing loss (NSHL) is quite challenging. With regard to its high heterogeneity as well as large size of some genes, it is also really difficult to detect causative mutations using traditional approaches. One of the recent technologies called whole-exome sequencing (WES) has been thus developed in this domain to remove the limitations of conventional methods.Methods: This study was a report on a research study of two unrelated pedigrees with multiple affected cases of hearing loss (HL). Accordingly, clinical evaluations and genetic analysis were performed in both families. Results: The results of WES data analysis to uncover autosomal recessive non-syndromic hearing loss (ARNSHL) disease-causing variants was reported in the present study. Initial analysis identified two novel variants of MYO15A i.e. c.T6442A:p.W2148R and c.10504dupT:p.C3502Lfs*15 correspondingly which were later confirmed by Sanger validations and segregation analyses. According to online prediction tools, both identified variants seemed to have damaging effects.Conclusion: This study further supported the effectiveness of WES for genetic diagnosis of ARNSHL as a first approach.
 Content Development for a Physical Activity and Sedentary Behaviour e-Learning Module for Early Childhood Education Students: A Delphi Study
Authors: Bruijns Brianne , Johnson Andrew M. , Tucker Trish
Published: October 2020

Background: Early childhood educators play a prominent role in promoting healthy activity behaviours in childcare. However, they have expressed that they lack the appropriate pre-service training to confidently lead physical activity (PA), and minimize sedentary behaviour (SB), in childcare. As such, the purpose of this Delphi study was to generate and reach agreement on content areas for inclusion in a PA and SB e-Learning module for Early Childhood Education (ECE) students.Methods: Purposeful sampling of Canadian/international researchers was used to form two expert panels: a PA/SB expert panel (n = 26), and a Canadian ECE panel. The PA/SB experts suggested their top 12 PA/SB topics for the module via online survey. These topics were then pooled to generate a list of 19 content areas. In a second online survey, both panels of experts rated the importance of each content area (0 = unimportant to 5 = very important). Mean ratings (M) were ranked separately for each panel, and then ratings were pooled to create an overall ranking of the 19 content areas. Inter-panel agreement of importance rankings was visually represented as a scatterplot and quantified using Spearman’s rho (rs).Results: The top-rated content area was Outdoor Play (M = 4.77 ± 0.64), followed by Benefits of PA in the Early Years (M = 4.75 ± 0.66), and Factors Influencing PA and SB in Childcare (M = 4.71 ± .74). Monitor PA and Sedentary Time Within Your Classroom had the lowest combined score (M = 3.77 ± 1.44). There was moderate-to strong inter-panel agreement for content area importance rankings (rs = 0.60, 95% CI: 0.20 to 0.83). The majority of the ECE expert panel considered this training important for ECE students (94.3%), aligning with ECE curriculum objectives (91.4%) and accreditation standards (78.8%), and complementary to the present ECE curriculum (88.6%).Conclusions: Providing PA and SB training to ECE students is a proactive way to ensure healthy movement behaviours are prioritized in childcare programming. With the PA/SB expert-developed content areas, and endorsement by the ECE expert panel, implementing this training within ECE programs is a necessary next step.
Women’s healthcare decision-making capacity and HIV testing in sub-Saharan Africa: a multi-country analysis of demographic and health surveys
Authors: Seidu Abdul-Aziz , Oduro Joseph Kojo , Ahinkorah Bright Opoku , Budu Eugene , Appiah Francis , Baatiema Linus , Ameyaw Edward Kwabena , Sambah Francis
Published: October 2020

Background Global commitment to stop Human Immunodeficiency Virus (HIV) and ensure access to HIV treatment calls for women empowerment, as these efforts play major roles in mother-to-child transmission. We explored the association between women’s healthcare decision-making capacity and HIV testing in sub-Saharan Africa (SSA). Methods We used data from the current Demographic and Health Surveys (DHS) conducted between January 1, 2010 and December 31, 2018 in 28 countries in SSA. At the descriptive level, we calculated the prevalence of HIV testing in each of the countries. This was followed by the distribution of HIV testing across the socio-demographic characteristics of women. Finally, we used binary logistic regression to explore the likelihood of HIV testing by women’s health care decision-making capacity and socio-demographic characteristics. The results were presented as Crude Odds Ratios (COR) and Adjusted Odds Ratios (AOR) with their corresponding 95% confidence intervals signifying precision. Statistical significance was set at p-value <0.05. Results We found that prevalence of HIV testing in the 28 SSA countries was 64.4%, with Congo DR having the least (20.2%) and the highest occurred in Rwanda (97.4%). Women who took healthcare decisions alone [COR=3.183, CI=2.880-3.519] or with their partners [COR=2.577, CI=2.335-2.844] were more likely to test for HIV, compared to those whose healthcare decisions were taken by others, and this persisted after controlling for significant covariates: [AOR=1.507, CI=1.321-1.720] and [AOR=1.518, CI=1.334-1.728] respectively. Conclusion SSA countries intending to improve HIV testing need to incorporate women’s healthcare decision-making capacity strategies. These strategies can include education and counselling. This is essential because our study indicates that the capacity of women to make healthcare decisions has an association with their decision to test for their HIV status.
Supporting mental health service users to stop smoking: findings from a process evaluation of the implementation of smokefree policies into two mental health trusts
Authors: Jones Susan E , Mulrine S. , Clements H. , Hamilton S.
Published: October 2020

Background: Life expectancy is 10-20 years lower among people with a severe mental health disorder. Most of these early deaths are due to chronic conditions, including cardiovascular and respiratory diseases. Smoking is a major risk factor for these conditions and introducing smokefree policies has been recommended to mental health service providers in England by the National Institute for Health and Care Excellence (NICE), in their Public Health Guideline 48: Smoking: acute, maternity and mental health services. This paper reports a process evaluation of introducing these policy recommendations, which were updated in 2013. Aim: To reflect on the process outcomes when introducing smokefree policies in National Health Service (NHS) Trusts providing mental health services in an English region. Method: Process data were collected through semi-structured interviews with staff (n=51), members of partnering organisations (n=5), service users (n=7) and carers (n=2) between November 2016 – April 2017. Normalization Process Theory (NPT) was used to design the data collection tools and analyse the data. A framework approach was taken with the analysis, using the four concepts of NPT: coherence, cognitive participation, collective action and reflexive monitoring. Results: The policy made sense to some staff, patients and carers (coherence) who ‘bought-into’ the idea (cognitive participation) but other participants disagreed. Although smokefree policies were operationalised (collective action), sometimes they were opposed. Progress was made, especially in some units, but continued to be resisted in others. Informal appraisal of progress (reflexive monitoring) presented a varied picture. Conclusion Some progress has been made in terms of changing an entrenched, smoking culture into one that is smokefree on Trust sites across the region. Perseverance and resourcing over the long-term is required to establish a non-smoking culture in on-site provision of mental health services.
How is migration background considered in the treatment and care of people? A comparison of national dementia care guidelines in Europe
Authors: Schmachtenberg Tim , Monsees Jessica , Hoffmann Wolfgang , Berg Neeltje van den , Stentzel Ulrike , Thyrian Jochen René
Published: October 2020

Background People with a migration background are vulnerable to dementia. Due to problems such as underdiagnosis or access barriers, the care of this population is a public health challenge in Europe. Many countries are issuing care guidelines, but a systematic overview of their references to migration groups is lacking. This study aims to analyze national dementia care guidelines regarding their focus on people with a migration background, what specific actions to ensure healthcare have been undertaken at the national level, and whether recommendations for action are made for this population.Methods This study is a systematic analysis of national dementia care guidelines of the EU and EFTA (European Free Trade Association) countries. Using the discourse analysis model by Keller (2011), 43 documents from 24 EU and 3 EFTA countries were systematically screened for migration references via keyword and context analysis. The content of the migration-related section was paraphrased, memos and comments were added, and the individual text passages were coded using the strategy of open coding.Results Twenty-seven of the 35 EU and EFTA countries have guidelines or similar documents on care for people with dementia, and twelve refer to migration. Norway, Sweden, and Northern Ireland refer to this topic in detail. The focus of the migration-related guidelines is on the early detection and diagnosis of dementia. The main message is that standardized diagnostic tools such as the MMSE (Mini-Mental State Examination) or the clock test are not suitable for linguistic minorities. Nine countries make recommendations for the care of people with a migration background and dementia, but only Norway, Sweden, and Denmark point to available healthcare services. A key recommendation is that the linguistic and cultural background of people should be considered when selecting diagnostic tests. Several countries refer to the validity of the RUDAS (Rowland Universal Dementia Assessment Scale) for migrants.Conclusions The topic of migration plays a subordinate role in the dementia care guidelines of European countries. Almost all countries lack appropriate diagnostic tools and healthcare services for people with a migration background. Consequently, this group is vulnerable to underdiagnosis and a lower level of care.
The origin and spread of CRF85_BC, driven by heterosexual transmission among older people in Sichuan, China
Authors: Su Ling , Feng Yi , Liang Shu , Zeng Yali , Li Yiping , Yang Hong , Li Ye , Wang Qiushi , Wei Dongbin , Yuan Dan , Lai Wenhong , Zhang Linglin
Published: October 2020

Background：CRF_BC recombinants, including CRF07_BC and CRF08_BC, were considered the predominant subtypes in China. Since the discovery of HIV-1 circulating recombinant form CRF 85_BC in Southwest China in 2016, this BC recombinant forms had been reported in different regions of China. However, the history and magnitude of CRF85_BC transmission were still to be investigated. Method: We conducted the most recent molecular epidemiology of HIV-1 among newly reported HIV-1 infected patients in Sichuan in 2019 by sequencing and phylogenetic analysis of 1291 pol sequences. Then, we used maximum likelihood approach and the Bayesian Markov chain Monte Carlo (MCMC) sampling of pol sequences to reconstruct the phylogeographic and demographic dynamics of the CRF85_BC.Results: HIV-1 CRF85_BC (68/1291, 5.27%) became the fourth most prevalent strain revealing a significant increase in local population. CRF85_BC were only found in heterosexually infected individuals and the majority of CRF85_BC (95.45%) were circulating among the people living with HIV aged 50 years and over (PLHIV50+), suggesting a unique prevalent pattern. The founder lineages of CRF85_BC were likely to have first emerged in Yunnan, a province of Southwest China bordering Sichuan, in the early 2000s. It then spread exponentially to various places (including Guangxi, Sichuan, et al) and became endemic around 2008.6 (2006.7-2010.2) in Sichuan. Conclusion: Taken together, our ﬁndings on HIV-1 subtype CRF85_BC infections provided new insights into the spread of this virus and extended the understanding of the HIV epidemic in China.
Brazilian National Policy of Comprehensive Women’s Health Care and Mortality during Climacteric Period: Has Anything Changed?
Authors: Sorpreso Isabel Cristina Esposito , Figueiredo Francisco Winter dos Santos , Ramos José Lucas Souza , Zuchelo Lea Tami SuzuKi , Adami Fernando , Baracat Edmund Chada , Júnior José Maria Soares
Published: October 2020

Background: The National Policy for Integral Attention to Women’s Health Care (PNAISM) was implemented more than two decades ago, with the monitoring of potential benefits being explored. One of the life cycles of women contemplated in this health policy was the importance of health care during the climacteric. Prevention and health promotion actions carried out by the Brazil National Health System - Unified Health System and enshrined in health Brazilian policies for women. Thus, our purpose was to identify climacteric women’s main causes of death as well as the mortality trends of such causes, especially after PNAISM implementation. Methods: An ecological study was conducted from 2018–2019. Data were retrieved from the Brazilian Health Department by accessing the mortality information system of the National Health Information, divided into periods 1996–2004 and 2005–2016 to correspond with the implementation of the National Policy. The death records of Brazilian women aged 35 to 64 years who had a diagnosis were retrieved. Trends and differences between periods were evaluated using linear regression. The significance level was set at 5%. Results: The main causes of death in women from 1996 to 2016 were circulatory system diseases (29.39%, 736,972 deaths), neoplasms (26.17%, 656,385 deaths), respiratory system diseases (7.29%, 182,812 deaths), endocrine , nutritional and metabolic diseases (6.81%, 170,881 deaths), and external causes of morbidity and mortality (5.49%, 137,674 deaths). Mortality from circulatory system diseases was reduced following implementation of the PNAISM (β=-0.58; 95% CI -0.68 to -0.48; r²=0.93; p<0.001), but no significant changes were observed in mortality from neoplasms (β=0.07; 95% CI -0.01 to 0.15; r²=0.22; p=0.070).Conclusions: The leading causes of death during climacteric are circulatory system diseases, neoplasms, respiratory system diseases, nutritional, metabolic, and endocrine diseases, and external causes of morbidity and mortality, with no changes in neoplasms and respiratory system diseases. Thus, the analysis of women’s health indicators, such as mortality rates, is fundamental in order to enable the monitoring of benefits and results related to PNAISM as well as directing the design and implementation of other new health policies to be developed for women.
Inequality in health service utilization among migrant and local children: a cross-sectional survey of children aged 0–14 years in Shenzhen, China
Authors: Ke Xiatong , Zhang Liang , Li Zhong , Tang Wenxi
Published: October 2020

Background: Shenzhen is characterized with the largest scale of migrant children among all the cities in China. Unequal access to health services among migrant and local children greatly affects health equity and has a profound impact on the quality of human capital. This study aimed to investigate differences in using community-based healthcare between local and migrant children and to identify the influencing factors in Futian District of Shenzhen. Methods: Households in 12 communities in Futian District of Shenzhen were randomly sampled. Children aged 0-14 years were investigated using self-administered questionnaire - the 2018 Survey of Health Service Needs of Chinese Residents. Differences in healthcare including physical examination, feeding guidance, development guidance, disease prevention guidance, injury prevention guidance, oral health guidance, and mental health guidance, were tested between local and migrant children. Binary logistic regressions were used in identifying potential influencing factors which affected the use in the above healthcare items. Results: A total of 936 participants from1512 families were sampled and 508 of them were included. Compared with local children, migrant children had less use of development guidance (OR=0.417, 95% CI: 0.279-0.624) and oral health care guidance (OR=0.557, 95% CI: 0.381-0.813). Children whose father received higher education level enjoyed a better use of disease prevention guidance as compared to whose father stopped at junior high school education or below (senior high vs junior high and below, OR=1.286, 95% CI: 0.791-2.090; bachelor and above vs junior high and below, OR=2.257, 95% CI: 1.417-3.595). Children whose fathers were blue-collar workers had less use of injury prevention guidance (OR=0.750, 95% CI: 0.334-1.684) and mental health guidance (OR=0.784, 95% CI: 0.295-2.080) as compared to whose father were white collar workers. Conclusions: Except feeding guidance, healthcare utilization were lower among migrant children than among local children. Generally, fathers have a stronger influence on children’s use of community-based healthcare than mothers do. The potential influence of fathers in promoting children’s healthcare use behaviors should be carefully considered, and fathers’ attention to children’s health should be increased.
Investigating the effect of social networking site use on mental health in an 18-34 year-old general population. A cross-sectional study using the 2016 Scania Public Health Survey.
Authors: Scott Emily Stella , Canivet Catarina A. , Östergren Per-Olof
Published: October 2020

Background: Social Networking Sites (SNS) are commonly used, especially by young adults. Their impact on mental health is unclear. Moreover, little is known about how social factors, e.g. Perceived Emotional Support (PES), may affect this association. Mental health issues are increasingly burdening the young generation and society as a whole. This study aims to investigate the association between frequency of SNS use and number of SNS contacts with the mental health of a young, Swedish population. Additionally, the potential effect modification of PES will be analysed in regard to these relationships.Method: This cross-sectional study applied logistic regression analyses to data on 1,341 participants (aged 18-34), retrieved from the Scania Public Health Survey (2016). Analyses were stratified by gender and the GHQ-12 scale assessed poor mental health. A 2-way interaction model was used to test for effect modification by PES regarding the association between SNS use and mental health.Results: Increased risk for poor mental health were found in women only. Using SNS almost hourly vs. less often resulted in an odds ratio (OR) of 1.66 (95% confidence interval (CI) = 1.16–2.38). The corresponding figures for having ≥600 contacts vs. ≤599 were (1.89; 1.21–2.97). Having low PES and using SNS almost hourly was associated with an OR of 3.12 (CI = 1.69–5.76; synergy index (SI) = 1.25). Low PES and ≥600 contacts resulted in an OR of 6.07 (CI = 1.73–21.33), whereby interaction was detected (SI = 2.88).Conclusion: Women, but not men, with frequent SNS use and a high number of SNS contacts were more likely to have poor mental health, which was exacerbated in women with low PES. Facilitating PES could be an approach for improving mental health among young adults. Future studies on the use of SNS should focus more on gender analyses.
NAMPT/SIRT2–mediated inhibition of the p53-p21 signaling pathway is indispensable for maintenance and hematopoietic differentiation of human iPS cells
Authors: Xu Yun , Nasri Masoud , Dannenmann Benjamin , Mir Perihan , Zahabi Azadeh , Welte Karl , Morishima Tatsuya , Skokowa Julia
Published: October 2020

Background: Nicotinamide phosphoribosyltransferase (NAMPT) regulates cellular functions through the protein deacetylation activity of nicotinamide adenine dinucleotide (NAD+)-dependent sirtuins (SIRTs). SIRTs regulate functions of histones and none-histone proteins. The role of NAMPT/SIRTs pathway in the regulation of maintenance and differentiation of human induced pluripotent stem (iPS) cells is not fully elucidated.Methods: We evaluated the effects of specific inhibitors of NAMPT-, or SIRT2 on the pluripotency, proliferation, survival and hematopoietic differentiation of human iPS cells. We also studied the molecular mechanism downstream of NAMPT/SIRTs in iPS cells.Results: We demonstrated that NAMPT is indispensable for the maintenance, survival and hematopoietic differentiation of induced pluripotent stem (iPS) cells. We found that inhibition of NAMPT or SIRT2 in iPS cells induces p53 protein by promoting its lysine acetylation. This leads to activation of the p53 target, p21, with subsequent cell cycle arrest and induction of apoptosis in iPS cells. NAMPT and SIRT2 inhibition also affect hematopoietic differentiation of iPS cells in an embryoid body (EB)-based cell culture system.Conclusions: Our data demonstrate the essential role of the NAMPT/SIRT2/p53/p21 signaling axis in the maintenance and hematopoietic differentiation of iPS cells.
Breastfeeding knowledge of mothers in protracted crises: The Gaza Strip example
Authors: Iellamo Alessandro , Monaghan Emily , Moghany Samar AL , Latham Jonathan , Nassereddin Nihal
Published: October 2020

Background: The protection, promotion and support of breastfeeding is the most effective intervention to prevent child morbidity and mortality in all contexts, especially in humanitarian crisis. During the Palestine-Israel conflict that started in the middle of the 20th century, healthcare services are understaffed and lack basic resources, with frequent power cuts and stock-outs of essential drugs and equipment. This case study seeks to answer the questions: (1) How does the protracted crisis in Gaza affect the breastfeeding practices of the most vulnerable population; and (2) What is the role that midwives can play in improving breastfeeding practices?A mixed method (qualitative and quantitative) study was used to collect data. A total of 1044 respondents had a child less than 24 months at the time of the study. A total of 62.75 percent practice early initiation of breastfeeding and 42 percent confirmed that their new-borns were given liquids other than breast milk during the first three days of life. Fifty percent of mothers addressed breast milk insufficiency by drinking additional fluids and 40 percent by using infant formula. More than 50% of women said that they received most breastfeeding information during antenatal care visits. Only 18% of women said that they received breastfeeding information during contact with health professionals throughout labour, delivery, and subsequent post-natal care visits. Many mothers during the FGDs confirm using milk to top up or replace breast milk even if they know how important breastfeeding is for the childrenDiscussion: This study confirms the need to a) adapt the IYCF-E operational guidance in the Gaza strip and b) include breastfeeding counselling in the pre-service and in-service training for midwives. For vulnerable populations in humanitarian contexts, the impact of this cannot be underestimated. Conducting research in humanitarian settings is particularly challenging. The experience included integration and linkage with security officers on the ground, co-ordination with authorities and communities, supportive supervision during data collection, allocation of buffer days in-country and remote assistance to data collection teams Conclusions: This research focuses on a protracted emergency in insecure populated areas. The uncertain security situation, meant that the team adopted a flexible approach. Lessons learned throughout this exercise included the importance of a) allocating additional research time, to account for potential interruption b) daily coordination with security officers to ensure safe access to localities c) identification of extra sites, in case escalation of conflict d) training of additional enumerators in case conflict escalation e) negotiation with authorities to ensure compliance with requirements.
Clinical features of gingivostomatitis due to primary infection of Herpes simplex virus in children
Authors: Huang Chen-Wei , Hsieh Chi-Hsien , Lin Ming-Ru , Huang Yhu-Chering
Published: October 2020

Background:Primary herpetic gingivostomatitis (PHGS) in children, though usually self-limited, might mimic bacterial and enteroviral pharyngitis clinically. We conducted a study to define the clinical features of PHGS in children.Methods:Between January 2012 and December 2016, 282 inpatients aged less than 19 years with cell culture-confirmed herpes simplex virus (HSV) infection in a medical center were identified from the virologic laboratory logbook. Clinical data were retrospectively collected.Results:Among the 282 inpatients, 185 cases were considered as PHGS and were included for analysis. Fever was present in 99.5%. The mean duration of fever was 5.11 days (±2.24) with the longest being 17 days. Common oral manifestations included oral ulcers (84.3%), which equally resided in the anterior and posterior part of the oral cavity (65.4% vs. 63.2%), gum swelling and/or bleeding (67.6%), and exudate coated tonsils (16.8%). Leukocytosis (WBC count >15,000/uL3) was noted in 52 patients (28.1%) and a serum C-reactive protein level >40 mg/L in 55 patients (29.7%). 65 patients (35%) were diagnosed with PHGS on admission and were significantly more likely to have ulcers over the anterior oral cavity (76.1% vs. 26.7%) and gum swelling/bleeding (76.2% vs. 7.5%, p-value all <0.001) on admission and were significantly less likely to receive antibiotic treatment (16.9 vs. 36.7%, p-value < 0.01) than others. 46 patients (25%) undiagnosed as PHGS on discharge were significantly more likely to have exudate coated on the tonsils, to receive antibiotic treatment and significantly less likely to have gum swelling/bleeding and oral ulcers (all p-values < 0.01).Conclusions:Meticulously identifying specific oral manifestations of gum swelling/bleeding and ulcers over the anterior oral cavity in children can help making the diagnosis of PHGS earlier and subsequently reduce unnecessary prescription of antibiotics.
Young women’s autonomy and information needs in the schools-based HPV vaccination programme: A qualitative study
Authors: Fisher Harriet , Evans Karen , Ferrie Jo , Yates Julie , Roderick Marion , Audrey Suzanne
Published: October 2020

Background Until 2019, the English schools-based human papillomavirus (HPV) vaccination programme was offered only to young women aged 12 to 13 years to reduce HPV-related morbidity and mortality. The aim of this study is to explore the extent to which young women were able to exercise autonomy within the HPV vaccination programme from the perspectives of young women, parents and professionals and how this was influenced by the content and form of information provided.Methods Recruitment was facilitated through a healthcare organisation, schools and community organisations in a local authority in the south-west of England. Researcher observations of the delivery of the HPV vaccination session were carried out in three schools. Semi-structured interviews took place with 53 participants (young women, parents of adolescent children, school staff and immunisation nurses) during the 2017/18 and 2018/19 programme years. Interviews were recorded digitally and transcribed verbatim. Thematic analysis was undertaken, assisted by NVivo software.Results Young women’s active participation and independence within the HPV vaccination programme was constrained by the setting of vaccination and the primacy of parental consent procedures. The authoritarian school structure influenced the degree to which young women were able to actively participate in decisions about the HPV vaccination programme. Young women exercised some power, either to avoid or receive the vaccine, by intercepting parental consent forms and procedures. Reliance on leaflets to communicate information led to unmet information needs for young women and their families. Communication may be improved by healthcare professional advocacy, accessible formats of information, and delivery of educational sessions.Conclusions Strategies to improve communication about the HPV vaccine may increase young people’s autonomy in consent procedures, clarify young people’s rights and responsibilities in relation to their health care services, and result in higher uptake of the HPV vaccination programme.Trial registration: ISRCTN registry number 49086105
Lebanese Doctors Facing the SARS-CoV-2 Pandemic: Practical and Ethical Issues
Authors: Gebara Nicole , Dabar Georges , Eid Roland , Haddad Fady Ghassan , Kourie Hampig Raphael , Kattan Joseph
Published: October 2020

Background: In the light of the COVID-19 pandemic, the role of health care providers is essential to maintain the functioning of the health care system. Physicians accept a primary ethical duty to place the wellbeing and health of their patients above their own welfares. However, does the duty to patient well-being have any limit? Two ethical concerns are debated: public health’s ethical principles and medical ethics values. We aimed in this study to assess Lebanese physicians’ attitudes, practice and ethical considerations when treating their patients during the COVID-19 pandemic.Materials and methods: It’s a cross-sectional study conducted in March 2020 among a random sample of Lebanese physicians, using a questionnaire based mainly on a five-point Likert numerical scale to make the answers more reliable and valid. The questionnaire focused on the medical practice during the pandemic and the ethical considerations in public health and in medical practice. It also evaluates the physicians’ point of view toward the management of the pandemic in Lebanon. Results: A total of 318 physicians responded, with a mean age of 40 years. Five doctors of the total were affected by the COVID-19 infection (1.6%). 51.4% of medical specialists considered themselves to be at a higher risk of contracting the infection, while 52.3% of surgeons stated that they were at a lower risk. Doctors were neutral regarding treating patients according to any priority and discontinuing the ventilation of any patient with bad prognosis. The majority of doctors disagreed regarding the respect of the patient’s autonomy in refusing COVID-19 treatment with a mean score of 1.7/5. Finally, doctors expressed a neutral opinion regarding the ability of the country to manage such a pandemic with a mean score of 3.1/5. Conclusion: Although physicians recognize that they are at high risk of contracting COVID-19, they assume their responsibilities and their duty to treat, and they were neutral against any prioritization in treatment approach. However, applying the four ethical principles (autonomy, beneficence, non-maleficence and justice) may become challenging. Hence, more medical and ethical recommendations are required to guide physicians during this pandemic.
Conservative management of CIN2 p16 positive lesions in women with multiple HPV infection
Authors: Bruno Maria Teresa , Scalia Guido , Cassaro Nazario , Costanzo Maria , Boemi Sara
Published: October 2020

BackgroundAccording to the 2006 American Society for Colposcopy and Cervical Pathology guidelines, positive CIN2 p16 in women over the age of 25 should be managed with excisional treatment. However, excisional treatment is associated with physical, psychological and obstetric morbidity and can have a negative impact on sexual function. In our study we sought to identify a clear management strategy, addressing the impact of routine use of p16 immunohistochemistry in this population and identify appropriate criteria for patient selection with the aim of reducing over-treatment.MethodWe studied the medical records of 130 patients who had undergone laser therapy for CIN2. Each patient underwent colposcopy, biopsy and HPV test and were tested for p16 protein,. Patients were divided based on HPV infection into: single infections, multiple infections. All patients underwent ZTA laser therapy with follow-up (2-year follow-up ). Statistical analysis Contingency tables were created to evaluate the correlation between single, multiple and CIN2+ infections. Values with p <0.05 were considered statistically significant.ResultsSingle infections had a histological regression of 61.8% (21/34) and a histological persistence rate of 35.3% (12/34), which was greater than the multiple infection rate. The common characteristic that the women with persistence and progression had was the dimension of the lesion and the genotype 16. Ten cases of histological persistence and the only case of progression had one lesion greater than three quarters of the cervix.ConclusionsWith the progress of our understanding of the natural history of infection from human papillomavirus and the increasing use of colposcopy, thanks to the addition of HPV genotyping and the technique of immunohistochemistry, conservative management of these lesions is now possible
Knowledge and perception of COVID-19 pandemic. Before-and-after online community survey.
Authors: Nazar Wojciech , Leszkowicz Julia , Pieńkowska Agata , Brzeziński Michał , Szlagatys-Sidorkiewicz Agnieszka , Plata-Nazar Katarzyna Gabriela
Published: October 2020

BackgroundCOVID-19 pandemic impacts many communities worldwide. In this study the Poles' knowledge about COVID-19 as well as people’s behaviours, attitudes and fears during the pandemic were assessed. Changes in these between the outset of the pandemic and the imposition of the strictest lockdown measures in Poland were investigated.MethodsPhysicians, nurses, students of medicine-oriented faculties, non-medical professionals, students of non-medicine-oriented faculties and secondary school students were surveyed by an anonymous online questionnaire two times: at the onset of the pandemic and in the second week of the strictest lockdown. Statistical analyses were performed using non-parametric tests – Pearson Chi Square, Kruskal-Wallis tests.ResultsIn total 2618 responses were collected. At the beginning people knew that the respiratory system was attacked (97.9%); correctly identified the major symptoms of COVID-19 (95.0%) and ways to prevent infection: hand washing (99.8%), covering mouth (85.9%) and the need to call sanitary-epidemiological services if one experienced COVID-19-like symptoms (92.1%).The biggest changes between the first and second phase of the study concerned behaviours: more people wearing facial masks (+37.5%) and staying at home (+66.1%). Respondents in the second wave of the survey were also more scared of the pandemic (+19.6%), economic crisis (+64.1%), and worried about their families (+26.5%). However, they were less afraid of the quarantine (lockdown) (-18.2%). Nurses and physicians were the most worried groups.ConclusionsThe study showed that even at the outset of the pandemic Polish population had a good initial knowledge about symptoms, transmission, and preventive behaviours regarding COVID-19. People revealed more short-term concerns, such as the worries about coping with quarantine and isolation. After a month, the knowledge and the concerns among the respondents changed. A shift towards long-term pandemic management issues was observed. Respondents reported to experience more fears concerning the pandemic in general, as well as economic and healthcare crises. Medical professionals reported higher level of fear of the pandemic than other groups included in this study. This study uses before-and-after approach which highlights the changes in people’s knowledge and perception of the COVID-19 pandemic during the pandemic’s progression.
Evolutionary engineering of Lactobacillus bulgaricus reduces enzyme usage and enhances conversion of lignocellulosics to D-lactic acid by simultaneous saccharification and fermentation
Authors: J. Vishnu Prasad , Sahoo Tridweep K. , S. Naveen , Jayaraman Guhan
Published: October 2020

Background Simultaneous saccharification and fermentation (SSF) of pre-treated lignocellulosics to biofuels and other platform chemicals has long been a promising alternative to separate hydrolysis and fermentation processes. However, the disparity between the optimum conditions (temperature, pH) for fermentation and enzyme hydrolysis leads to execution of the SSF process at sub-optimal conditions, which can affect the rate of hydrolysis and cellulose conversion. The fermentation conditions could be synchronized with hydrolysis optima by carrying out the SSF at a higher temperature, but this would require a thermo-tolerant organism. Economically viable production of platform chemicals from lignocellulosic biomass (LCB) has long been stymied because of the significantly higher cost of hydrolytic enzymes. The major objective of this work is to develop an SSF strategy for D- lactic acid production by a thermo-tolerant organism, in which the enzyme loading could significantly be reduced without compromising on the overall conversion. Results A thermo-tolerant strain of Lactobacillus bulgaricus was developed by adaptive laboratory evolution (ALE) which enabled the SSF to be performed at 45 °C with reduced enzyme usage. Despite the reduction of enzyme loading from 15 Filter Paper Unit/ gLCB (FPU/gLCB) to 5 FPU/gLCB, we could still achieve ~8% higher cellulose to D-Lactic acid (D-LA) conversion in batch SSF, in comparison to the conversion by separate enzymatic hydrolysis and fermentation processes at 45 °C and pH 5.5. Extending the batch SSF to SSF with pulse-feeding of 5% pre-treated biomass and 5 FPU/gLCB, at 12-hour intervals (36th h – 96th h), resulted in a titer of 108 g/L D-LA and 60% conversion of cellulose to D-LA. This is one among the highest reported D-LA titers achieved from LCB.Conclusions We have demonstrated that the SSF strategy, in conjunction with evolutionary engineering, could drastically reduce enzyme requirement and be the way forward for economical production of platform chemicals from lignocellulosics. We have shown that fed-batch SSF processes, designed with multiple pulse-feedings of the pre-treated biomass and enzyme, can be an effective way of enhancing the product concentrations.