bluuebunny/crossref_metadata_2025 huggingface dataset:
A cluster randomized controlled trial for the Evaluation of routinely Measured PATient reported outcomes in HemodialYsis care (EMPATHY): a study protocol
Authors: Johnson Jeffrey A. , Al Sayah Fatima , Buzinski Robert , Corradetti Bonnie , Davison Sara N. , Elliott Meghan J. , Klarenbach Scott , Manns Braden , Schick-Makaroff Kara , Short Hilary , Thomas Chandra , Walsh Michael
Published: August 2020

Background

Kidney failure requiring dialysis is associated with poor health outcomes and health-related quality of life (HRQL). Patient-reported outcome measures (PROMs) capture symptom burden, level of functioning and other outcomes from a patient perspective, and can support clinicians to monitor disease progression, address symptoms, and facilitate patient-centered care. While evidence suggests the use of PROMs in clinical practice can lead to improved patient experience in some settings, the impact on patients’ health outcomes and experiences is not fully understood, and their cost-effectiveness in clinical settings is unknown. This study aims to fill these gaps by evaluating the effectiveness and cost-effectiveness of routinely measuring PROMs on patient-reported experience, clinical outcomes, HRQL, and healthcare utilization.

Methods

The EMPATHY trial is a pragmatic multi-centre cluster randomized controlled trial that will implement and evaluate the use of disease-specific and generic PROMs in three kidney care programs in Canada. In-centre hemodialysis units will be randomized into four groups, whereby patients: 1) complete a disease-specific PROM; 2) complete a generic PROM; 3) complete both types of PROMs; 4) receive usual care and do not complete any PROMs. While clinical care pathways are available to all hemodialysis units in the study, for the three active intervention groups, the results of the PROMs will be linked to treatment aids for clinicians and patients. The primary outcome of this study is patient-provider communication, assessed by the Communication Assessment Tool (CAT). Secondary outcomes include patient management and symptoms, use of healthcare services, and the costs of implementing this intervention will also be estimated. The present protocol fulfilled the Standard Protocol Items: Recommendations for Intervention Trials (SPIRIT) checklist.

Discussion

While using PROMs in clinical practice is supported by theory and rationale, and may engage patients and enhance their role in decisions regarding their care and outcomes, the best approach of their use is still uncertain. It is important to rigorously evaluate such interventions and investments to ensure they provide value for patients and health systems.

Trial registration

Protocol version (1.0) and trial registration data are available on www.clinicaltrials.gov, identifier: NCT03535922, registered May 24, 2018.
Quality and extent of implementation of a nurse-led care management intervention: care coordination for health promotion and activities in Parkinson’s disease (CHAPS)
Authors: Connor Karen I. , Siebens Hilary C. , Mittman Brian S. , Ganz David A. , Barry Frances , Ernst E. J. , Edwards Lisa K. , McGowan Michael G. , McNeese-Smith Donna K. , Cheng Eric M. , Vickrey Barbara G.
Published: August 2020

Background

A recent nurse-led, telephone-administered 18-month intervention, Care Coordination for Health Promotion and Activities in Parkinson’s Disease (CHAPS), was tested in a randomized controlled trial and improved care quality. Therefore, intervention details on nurse care manager activity (types and frequencies) and participant actions are needed to support potential dissemination. Activities include nurse care manager use of a holistic organizing framework, identification of Parkinson's disease (PD)-related problems/topics, communication with PD specialists and care coordination, participant coaching, and participant self-care actions including use of a notebook self-care tool.

Methods

This article reports descriptive data on the CHAPS intervention. The study setting was five sites in the Veterans Affairs Healthcare System. Sociodemographic data were gathered from surveys of study participants (community-dwelling veterans with PD). Nurse care manager intervention activities were abstracted from electronic medical records and logbooks. Statistical analysis software was used to provide summary statistics; closed card sorting was used to group some data.

Results

Intervention participants (n = 140) were primarily men, mean age 69.4 years (standard deviation 10.3) and community-dwelling. All received the CHAPS Initial Assessment, which had algorithms designed to identify 31 unique CHAPS standard problems/topics. These were frequently documented (n = 4938), and 98.6% were grouped by assigned domain from the Organizing Framework (Siebens Domain Management Model™). Nurse care managers performed 27 unique activity types to address identified problems, collaborating with participants and PD specialists. The two most frequent unique activities were counseling/emotional support (n = 387) and medication management (n = 349). Both were among 2749 total performed activities in the category Implementing Interventions (coaching). Participants reported unique self-care action types (n = 23) including use of a new notebook self-care tool.

Conclusions

CHAPS nurse care managers implemented multiple activities including participant coaching and care coordination per the CHAPS protocol. Participants reported various self-care actions including use of a personalized notebook. These findings indicate good quality and extent of implementation, contribute to ensuring reproducibility, and support CHAPS dissemination as a real-world approach to improve care quality.

Trial registration

ClinicalTrials.gov as NCT01532986, registered on January 13, 2012.
Genome-wide pQTL analysis of protein expression regulatory networks in the human liver
Authors: He Bing , Shi Jian , Wang Xinwen , Jiang Hui , Zhu Hao-Jie
Published: August 2020

Background

Previous expression quantitative trait loci (eQTL) studies have identified thousands of genetic variants to be associated with gene expression at the mRNA level in the human liver. However, protein expression often correlates poorly with mRNA levels. Thus, protein quantitative trait loci (pQTL) study is required to identify genetic variants that regulate protein expression in human livers.

Results

We conducted a genome-wide pQTL study in 287 normal human liver samples and identified 900 local pQTL variants and 4026 distant pQTL variants. We further discovered 53 genome hotspots of pQTL variants. Transcriptional region mapping analysis showed that 1133 pQTL variants are in transcriptional regulatory regions. Genomic region enrichment analysis of the identified pQTL variants revealed 804 potential regulatory interactions among 595 predicted regulators (e.g., non-coding RNAs) and 394 proteins. Moreover, pQTL variants and trait-variant integration analysis implied several novel mechanisms underlying the relationships between protein expression and liver diseases, such as alcohol dependence. Notably, over 2000 of the identified pQTL variants have not been reported in previous eQTL studies, suggesting extensive involvement of genetic polymorphisms in post-transcriptional regulation of protein expression in human livers.

Conclusions

We have partially established protein expression regulation networks in human livers and generated a wealth of pQTL data that could serve as a valuable resource for the scientific community.
Correction to: Invasion-related circular RNA circFNDC3B inhibits bladder cancer progression through the miR-1178-3p/G3BP2/SRC/FAK axis
Authors: Liu Hongwei , Bi Junming , Dong Wei , Yang Meihua , Shi Juanyi , Jiang Ning , Lin Tianxin , Huang Jian
Published: August 2020

An amendment to this paper has been published and can be accessed via the original article.
Migration experiences, life conditions, and drug use practices of Russian-speaking drug users who live in Paris: a mixed-method analysis from the ANRS-Coquelicot study
Authors: Tibi-Lévy Yaël , Serebryakova Daria , Jauffret-Roustide Marie ,   ANRS-Coquelicot Study Group, Barin F. , Brunet S. , Chevaliez S. , Jauffret-Roustide M. , Léon L. , Le Strat Y. , Pawlotsky J.-M. , Pillonel J. , Semaille C. , Sommen C. , Soulier A. , Thierry D. , Weill-Barillet L.
Published: August 2020

Background

After the collapse of the Soviet Union at the beginning of the 1990s, people who inject drugs spiked in Eastern Europe. Facing local repression and an array of factors encouraging emigration, some users have migrated to France. This population now make up to a third of the patient list of some harm reduction services in Paris. This article aims to present original data on the sociodemographic profiles of these users, on their migration trajectory, their life conditions, and on the evolution of their drug use practices since arriving in Paris.

Methods

Data were collected as part of the ANRS-Coquelicot Survey, an HIV and HCV seroprevalence study among French-speaking people who use drugs. A sub-sample of Russian-speaking drug users who had relocated from Eastern Europe to live in Paris completed a quantitative questionnaire (N = 150) and a qualitative semi-structured interview (N = 20). The survey aimed to describe participants’ backgrounds, and a thematic analysis of interviews was conducted to explore participants’ migration histories, their life conditions in Paris, and their drug use practices before and after arriving in France.

Results

This study highlights the great vulnerability of the participating population, often following a loss of social status after migrating to France. Another important finding is that participants had better access to harm reduction tools and reduced their risk of exposure to HIV and HCV infections linked to needle sharing. Although 60% said they had already shared a syringe in their lifetime (49.9% of them in their home country), the proportions shrank to 13.9% after they arrived in France and to 9.3% in the month before the study, a proportion that is lower than among French-speaking people who use drugs.

Conclusions

Our main findings on the profiles and behaviors of the study population lead us to make two recommendations: to offer stronger global care to these users in Paris and to reform drug policy in their home countries by integrating it into a public health approach.
Characterization of occupational, demographic and health determinants in Canadian reservists veterans and the relationship with poor self-rated health
Authors: Reyes Julian , Sweet Jill , MacLean MaryBeth , Poirier Alain , VanTil Linda
Published: August 2020

Background

Self-rated health is an useful indicator of the general health in specific populations and used to propose interventions after service in the military context. However, there is scarce literature about self- rated health (SRH) in the Canadian Veterans of the Reserve Force and its relationship with demographic, health and occupational characteristics of this specific group. The aims of this research were to determine the SRH in Canadian Reserve Force Veterans and to explore the relationship between demographic, military service and health factors by reserve class.

Methods

Data from the individuals was collected from the Life After Service (LASS) 2013 survey, including Veterans with Reserve Class C (n = 922) and Class A/B (n = 476). Bivariate and multivariate analysis using logistic regression models, were used to assess the association between the demographic characteristics, physical health, mental health, and military service characteristics and the self-rate health by both reserve classes.

Results

The overall prevalence of poor SRH in Reserve Class C Veterans was 13.1% (CI:11.08–15.4) and for Reserve Class A/B was 6.9% (CI:5.0–9.1). Different degrees of associations were observed during the bivariate analysis and two different models were produced for each reserve class. Veterans of Reserve Class C showed that being single was (OR = 2.76, CI: 1.47–5.16), being 50–59 years old (OR = 4.6, CI: 1.28–17.11), reporting arthritis (OR = 2.49, CI: 1.33–4.67), back problems (OR = 3.02, CI:1.76–5.16), being obese (OR = 1.96, CI: 1.13–3.38), depression (OR = 2.34, CI: 1.28–4.20), anxiety (OR = 4.11, CI: 2.00–8.42), PTSD (OR = 2.1 CI: 0.98–4.47), and being medically released (OR = 4.48, CI: 2.43–8.24) were all associated with higher odds of poor SRH. The Reserve Class A/B model showed that completing high school (OR = 4.30, CI: 1.37–13.81), reporting arthritis (OR = 6.60, CI: 2.15–20.23), diabetes (OR = 11.19, CI: 2.72–46.0), being obese (OR = 3.37, CI: 1.37–8.27), daily smoking (OR = 2.98, CI: 1.05–8.38), having anxiety (OR = 9.8, CI: 3.70–25.75) were associated with higher odds of poor SRH.

Conclusions

These results suggested that the relationship of poor SRH with demographic, health and military occupation domains varied depending on the class on the Reserve Force Service. Different strengths of association showed different risk compositions for both populations. This can be used to better understand the health and well-being of Veterans of the Reserve Force.
Neurocognitive impacts of arbovirus infections
Authors: Clé Marion , Eldin Patrick , Briant Laurence , Lannuzel Annie , Simonin Yannick , Van de Perre Philippe , Cabié André , Salinas Sara
Published: August 2020

Arthropod-borne viruses or arbovirus, are most commonly associated with acute infections, resulting on various symptoms ranging from mild fever to more severe disorders such as hemorrhagic fever. Moreover, some arboviral infections can be associated with important neuroinflammation that can trigger neurological disorders including encephalitis, paralysis, ophthalmological impairments, or developmental defects, which in some cases, can lead to long-term defects of the central nervous system (CNS). This is well illustrated in Zika virus-associated congenital brain malformations but also in West Nile virus-induced synaptic dysfunctions that can last well beyond infection and lead to cognitive deficits. Here, we summarize clinical and mechanistic data reporting on cognitive disturbances triggered by arboviral infections, which may highlight growing public health issues spanning the five continents.
Correction to: The impact on functioning of second-generation antipsychotic medication side effects for patients with schizophrenia: a worldwide, cross-sectional, web-based survey
Authors: Tandon Rajiv , Lenderking William R. , Weiss Catherine , Shalhoub Huda , Barbosa Carla Dias , Chen Jun , Greene Mallik , Meehan Stine R. , Duvold Laëtitia Bouérat , Arango Celso , Agid Ofer , Castle David
Published: August 2020

An amendment to this paper has been published and can be accessed via the original article.
Chlorophyll fluorescence imaging captures photochemical efficiency of grain sorghum (Sorghum bicolor) in a field setting
Authors: Herritt Matthew T. , Pauli Duke , Mockler Todd C. , Thompson Alison L.
Published: August 2020

Background

Photosynthesis is one of the most important biological reactions and forms the basis of crop productivity and yield on which a growing global population relies. However, to develop improved plant cultivars that are capable of increased productivity, methods that can accurately and quickly quantify photosynthetic efficiency in large numbers of genotypes under field conditions are needed. Chlorophyll fluorescence imaging is a rapid, non-destructive measurement that can provide insight into the efficiency of the light-dependent reactions of photosynthesis.

Results

To test and validate a field-deployed fluorescence imaging system on the TERRA-REF field scanalyzer, leaves of potted sorghum plants were treated with a photosystem II inhibitor, DCMU, to reduce photochemical efficiency (FV/FM). The ability of the fluorescence imaging system to detect changes in fluorescence was determined by comparing the image-derived values with a handheld fluorometer. This study demonstrated that the imaging system was able to accurately measure photochemical efficiency (FV/FM) and was highly correlated (r = 0.92) with the handheld fluorometer values. Additionally, the fluorescence imaging system was able to track the decrease in photochemical efficiency due to treatment of DCMU over a 7 day period.

Conclusions

The system’s ability to capture the temporal dynamics of the plants’ response to this induced stress, which has comparable dynamics to abiotic and biotic stressors found in field environments, indicates the system is operating correctly. With the validation of the fluorescence imaging system, physiological and genetic studies can be undertaken that leverage the fluorescence imaging capabilities and throughput of the field scanalyzer.
Efficacy of Glyceryl trinitrate (GTN) to facilitate the rewarming process during cardiopulmonary bypass
Authors: Mullane Darren , Lenihan Martin , Hanley Ciara , Wall Tom , Bukowska Irmina , Griffin Michael , Flood Georgina
Published: August 2020

Background

Does Glyceryl trinitrate (GTN) administered during rewarming on cardiopulmonary bypass (CPB) impact: time to completion of rewarming prior to separation from CPB circuit, early post-op patient peripheral – core temperature gradient, time to maintenance of normothermia (core temperature > 36.5 °C) for minimum of 2 h in the initial post-op period, and plasma lactate concentrations initially post-CPB.

Methods

Single centre prospective randomized trial conducted in the Mater Misericordiae University teaching hospital in Dublin Ireland. Trial registration: ISRCTN registry,ISRCTN10480871, registered 16th of August 2017. 82 patients enrolled. Patients randomised to low dose GTN infusion (0.01 mcg/kg/min) or higher dose GTN infusion (0.5 mcg/kg/min) during rewarming on CPB.

Measurements and Main results

There was no significant difference between the treatment arms for the total time to being rewarmed, U = 759.0,p = 0.84. There were also no differences between the treatment arms for the time to achieve core temperature greater than 36.5 after two hours, U = 714.0,p = 0.52, the time to achieve plateau core skin temperature, U = 688.0,p = 0.37, and the post-intervention protamine lactate, U = 721.0,p = 0.56.

Conclusions

Higher dose GTN infusion during rewarming on CPB does not improve peripheral-core temperature gradient post operatively and has no effect on post-operative lactate concentrations.
Research progress on the ethanol precipitation process of traditional Chinese medicine
Authors: Tai Yanni , Shen Jichen , Luo Yu , Qu Haibin , Gong Xingchu
Published: August 2020

Ethanol precipitation is a purification process widely used in the purification of Chinese medicine concentrates. This article reviews the research progress on the process mechanism of ethanol precipitation, ethanol precipitation process application for bioactive component purification, ethanol precipitation and traditional Chinese medicine quality, ethanol precipitation equipment, critical parameters, parameter research methods, process modeling and calculation methods, and process monitoring technology. This review proposes that ethanol precipitation technology should be further developed in terms of five aspects, namely, an in-depth study of the mechanism, further study of the effects on traditional Chinese medicine quality, improvement of the quality control of concentrates, development of new process detection methods, and development of a complete intelligent set of equipment.
Detailed analysis of phenotypes and genotypes in megalencephaly-capillary malformation-polymicrogyria syndrome caused by somatic mosaicism of PIK3CA mutations
Authors: Park Hyun Jin , Shin Chang Ho , Yoo Won Joon , Cho Tae-Joon , Kim Man Jin , Seong Moon-Woo , Park Sung Sup , Lee Jeong Ho , Sim Nam Suk , Ko Jung Min
Published: August 2020

Background

Megalencephaly-capillary malformation-polymicrogyria syndrome (MCAP) belongs to a group of conditions called the PIK3CA-related overgrowth spectrum (PROS). The varying phenotypes and low frequencies of each somatic mosaic variant make confirmative diagnosis difficult. We present 12 patients who were diagnosed clinically and genetically with MCAP. Genomic DNA was extracted mainly from the skin of affected lesions, also from peripheral blood leukocytes and buccal epithelial cells, and target panel sequencing using high-depth next-generation sequencing technology was performed.

Results

Macrocephaly was present in 11/12 patients (92%). All patients had normal body asymmetry. Cutaneous vascular malformation was found in 10/12 patients (83%). Megalencephaly or hemimegalencephaly was noted in all 11 patients who underwent brain magnetic resonance imaging. Arnold–Chiari type I malformation was also seen in 10 patients. Every patient was identified as having pathogenic or likely pathogenic variants of the PIK3CA gene. The variant allele frequency (VAF) ranged from 6.3 to 35.3%, however, there was no direct correlation between VAF and the severity of associated anomalies. c.2740G > A (p.Gly914Arg) was most commonly found, in four patients (33%). No malignancies developed during follow-up periods.

Conclusions

This is the first and largest cohort of molecularly diagnosed patients with MCAP in Korea. Targeted therapy with a PI3K-specific inhibitor, alpelisib, has shown successful outcomes in patients with PROS in a pilot clinical study, so early diagnosis for genetic counseling and timely introduction of emerging treatments might be achieved in the future through optimal genetic testing.
Novel FANCA mutation in the first fully-diagnosed patient with Fanconi anemia in Polish population – case report
Authors: Repczynska Anna , Pastorczak Agata , Babol-Pokora Katarzyna , Skalska-Sadowska Jolanta , Drozniewska Malgorzata , Mlynarski Wojciech , Haus Olga
Published: August 2020

Background

Fanconi anemia is a rare genetic disorder caused by mutations in genes which protein products are involved in replication, cell cycle control and DNA repair. It is characterized by congenital malformations, bone marrow failure, and high risk of cancer. The diagnosis is based on morphological and hematological abnormalities such as pancytopenia, macrocytic anaemia and progressive bone marrow failure. Genetic examination, often very complex, includes chromosomal breakage testing and mutational analysis.

Case presentation

We present a child with clinical diagnosis of Fanconi anemia. Although morphological abnormalities of skin and bones were present from birth, diagnosis was only suspected at the age of 8. Chromosome breakage test in patient’s lymphocytes showed increased level of aberrations (gaps, chromatid breaks, chromosome breaks, radial figures and rearrangements) compared to control. Next generation sequencing revealed presence of two pathogenic variants in FANCA gene, one of which was not previously reported.

Conclusions

The article provides additional supportive evidence that compound biallelic mutations of FANCA are associated with Fanconi anemia. It also illustrates the utility of combination of cytogenetic and molecular tests, together with detailed clinical evaluation in providing accurate diagnosis of Fanconi anemia. This report, to the best of our knowledge, describes the first fully diagnosed FA patient in Polish population.
Effect of dexmedetomidine on inflammation in patients with sepsis requiring mechanical ventilation: a sub-analysis of a multicenter randomized clinical trial
Authors: Ohta Yoshinori , Miyamoto Kyohei , Kawazoe Yu , Yamamura Hitoshi , Morimoto Takeshi
Published: August 2020

Background

Administration of dexmedetomidine has been reported to improve inflammatory response in animals. We explored the effects of administering dexmedetomidine on the levels of C-reactive protein (CRP) and procalcitonin, and thus on inflammation, in patients with sepsis enrolled in a randomized clinical trial.

Methods

The DESIRE trial was a multicenter randomized clinical trial in which adult patients with sepsis were sedated with (DEX group) or without (non-DEX group) dexmedetomidine while on mechanical ventilators. As a prespecified sub-analysis, we compared CRP and procalcitonin levels during the first 14 days of treatment between the two groups. The 14-day mortality rate, albumin level, and the number of patients with disseminated intravascular coagulation (DIC) were also assessed. We used generalized linear models to estimate the differences in these outcomes between groups. We also used the Kaplan-Meier method to estimate the 14-day mortality rate and the log-rank test to assess between-group differences.

Results

Our study comprised 201 patients: 100 in the DEX group and 101 in the non-DEX group. CRP and procalcitonin levels were lower in the DEX vs. non-DEX group during the 14-day treatment period [CRP—range, 5.6–20.3 vs. 8.3–21.1 mg/dL (P = 0.03); procalcitonin—range, 1.2–37.4 vs. 1.7–52.9 ng/mL (P = 0.04)]. Albumin levels were higher in the DEX group (range, 2.3–2.6 g/dL) than in the non-DEX group (range, 2.1–2.7 g/dL; P = 0.01). The percentage of patients with DIC did not significantly differ between the groups (range, 21–59% and 17–56% for the DEX and non-DEX groups, respectively; P = 0.49). The 14-day mortality rates in the DEX and non-DEX groups were 13 and 21%, respectively (P = 0.16).

Conclusion

Sedation using dexmedetomidine reduced inflammation in patients with sepsis requiring mechanical ventilation.

Trial registration

ClinicalTrials.gov, NCT01760967. Registered on 4 January 2013.
Correction to: Investigating the non-specific effects of BCG vaccination on the innate immune system in Ugandan neonates: study protocol for a randomised controlled trial
Authors: Prentice Sarah , Webb Emily L. , Dockrell Hazel M. , Kaleebu Pontiano , Elliott Alison M. , Cose Stephen
Published: August 2020

An amendment to this paper has been published and can be accessed via the original article.
What impact does oocyte vitrification have on epigenetics and gene expression?
Authors: Barberet Julie , Barry Fatima , Choux Cécile , Guilleman Magali , Karoui Sara , Simonot Raymond , Bruno Céline , Fauque Patricia
Published: August 2020

Children conceived by assisted reproductive technologies (ART) have a moderate risk for a number of adverse events and conditions. The question whether this additional risk is associated with specific procedures used in ART or whether it is related to the intrinsic biological factors associated with infertility remains unresolved. One of the main hypotheses is that laboratory procedures could have an effect on the epigenome of gametes and embryos. This suspicion is linked to the fact that ART procedures occur precisely during the period when there are major changes in the organization of the epigenome. Oocyte freezing protocols are generally considered safe; however, some evidence suggests that vitrification may be associated with modifications of the epigenetic marks. In this manuscript, after describing the main changes that occur during epigenetic reprogramming, we will provide current information regarding the impact of oocyte vitrification on epigenetic regulation and the consequences on gene expression, both in animals and humans. Overall, the literature suggests that epigenetic and transcriptomic profiles are sensitive to the stress induced by oocyte vitrification, and it also underlines the need to improve our knowledge in this field.
Registration and local production of essential medicines in Uganda
Authors: Brhlikova Petra , Maigetter Karen , Murison Jude , Agaba Amon G. , Tusiimire Jonans , Pollock Allyson M.
Published: August 2020

Background

Universal access to high quality essential medicines is critical to sustainable development (SDG 3.8). However low- and middle-income countries struggle to ensure access to all medicines on their national essential medicines lists (EML). Market registration is the first step in determining both access and availability yet the extent to which essential medicines are registered for use at country level is not known. Companies apply for a marketing authorisation, however low price or lack of a market is a disincentive. Local production has been promoted to ensure availability of essential medicines but research in this area is also limited.

Methods

The study took place between 2011 and 2015. We systematically examined the registration status of medicines and vaccines listed in the Ugandan 2012 EML and conducted 20 interviews with regulators, ministry of health representatives, donors, and pharmaceutical producers and analysed quality assurance issues affecting registration, procurement, and local production of medicines in Uganda. In 2017 we conducted a further three interviews to clarify issues around non-registration of essential medicines highlighted by our analysis.

Results

Of the 566 essential medicines and vaccines nearly half (49%; 275/566) had no registered product in 2012. Of the 3130 registered products, just over a quarter (28%; 880/3130) were listed on the EML. Six local producers had registered 138 products of which 40 corresponded to 32 unique essential medicines. Interviews highlighted alternative routes to availability other than registration. Local producers faced considerable barriers to achieving international quality standards required for international procurement of medicines for the domestic market.

Conclusions

Monitoring and audit of the registration of essential and non-essential medicines should be a priority nationally and, regionally through harmonisation of registration requirements in the East African Community. National and regional manufacturing plans should consider local production of unregistered essential medicines.
Graphene impregnated electrospun nanofiber sensing materials: a comprehensive overview on bridging laboratory set-up to industry
Authors: Al-Dhahebi Adel Mohammed , Gopinath Subash Chandra Bose , Saheed Mohamed Shuaib Mohamed
Published: August 2020

Owing to the unique structural characteristics as well as outstanding physio–chemical and electrical properties, graphene enables significant enhancement with the performance of electrospun nanofibers, leading to the generation of promising applications in electrospun-mediated sensor technologies. Electrospinning is a simple, cost-effective, and versatile technique relying on electrostatic repulsion between the surface charges to continuously synthesize various scalable assemblies from a wide array of raw materials with diameters down to few nanometers. Recently, electrospun nanocomposites have emerged as promising substrates with a great potential for constructing nanoscale biosensors due to their exceptional functional characteristics such as complex pore structures, high surface area, high catalytic and electron transfer, controllable surface conformation and modification, superior electric conductivity and unique mat structure. This review comprehends graphene-based nanomaterials (GNMs) (graphene, graphene oxide (GO), reduced GO and graphene quantum dots) impregnated electrospun polymer composites for the electro-device developments, which bridges the laboratory set-up to the industry. Different techniques in the base polymers (pre-processing methods) and surface modification methods (post-processing methods) to impregnate GNMs within electrospun polymer nanofibers are critically discussed. The performance and the usage as the electrochemical biosensors for the detection of wide range analytes are further elaborated. This overview catches a great interest and inspires various new opportunities across a wide range of disciplines and designs of miniaturized point-of-care devices.
Spatiotemporal variations in the stress field in the northeasternmost part of the NE Japan arc: constraints from microearthquakes
Authors: Maeda Sumire , Matsuzawa Toru , Okada Tomomi , Katao Hiroshi , Yoshida Takeyoshi , Kosuga Masahiro , Otsubo Makoto
Published: August 2020

We determined focal mechanism solutions of microearthquakes and examined the stress field in the low-seismicity region from southern Hokkaido to eastern Aomori, NE Japan. The stress fields determined in this study comprise (1) a reverse faulting stress regime in southern Hokkaido with the axis of maximum compressional stress (σ1) being sub-horizontal and trending WNW–ESE, and (2) a stress regime in eastern Aomori to Tsugaru Strait that shows temporal variations and differential stress of less than tens of MPa. The spatiotemporal variation in stress from eastern Aomori to Tsugaru Strait might reflect the effects of the upper-plate bending and the 2011 Mw 9.0 Tohoku-Oki earthquake. It also indicates that the compressional stress caused by the descending Pacific plate is relatively weak, which is similar to other areas in eastern parts of the NE Japan arc.
A new infrared volcano monitoring using GCOM-C (SHIKISAI) satellite: applications to the Asia-Pacific region
Authors: Kaneko Takayuki , Yasuda Atsushi , Takasaki Kenji , Nakano Shun , Fujii Toshitsugu , Honda Yoshiaki , Kajiwara Kouji , Murakami Hiroshi
Published: August 2020

The GCOM-C (SHIKISAI) satellite was developed to understand the mechanisms of global climate change. The second-generation global imager (SGLI) onboard GCOM-C is an optical sensor observing wavelengths from 380 nm to 12.0 μm in 19 bands. One of the notable features is that the resolution of the 1.63, 10.8, and 12.0 µm bands is 250 m, with an observation frequency of 2–3 days. To investigate the effective use and potential of the 250 m resolution of these SGLI bands in the study of eruptive activities, we analyzed four practical cases. As an example of large-scale effusive activity, we studied the 2018 Kilauea eruption. By analyzing the series of 10.8 μm band images using cumulative thermal anomaly maps, we could observe that the lava effused on the lower East Rift Zone, initially flowed down the southern slope to the sea, and then moved eastward. As an example of lava dome growth and generation of associated pyroclastic flows, the activity at Sheveluch between December 2018 and December 2019 was analyzed. The 1.63 and 10.8 µm bands were shown to be suitable for observing growth of the lava dome and occurrence of pyroclastic flows, respectively. We found that the pyroclastic flows occurred during periods of rapid lava dome expansion. For the study of an active crater lake, the activity of Ijen during 2019 was analyzed. The lake temperature was found to rise rapidly in mid-May and reach 38 °C in mid-June. We also analyzed the intermittent activities of small-scale vulcanian eruptions at Sakurajima in 2019. The 1.63 µm band was useful for detecting activities that are associated with vulcanian eruptions. Analytical results for these case studies demonstrated that the GCOM-C SGLI images are beneficial for observing various aspects of volcanic activity, and their real-time use may contribute to reducing eruption-related disasters.
Global and Arctic effective radiative forcing of anthropogenic gases and aerosols in MRI-ESM2.0
Authors: Oshima Naga , Yukimoto Seiji , Deushi Makoto , Koshiro Tsuyoshi , Kawai Hideaki , Tanaka Taichu Y. , Yoshida Kohei
Published: August 2020

The effective radiative forcing (ERF) of anthropogenic gases and aerosols under present-day conditions relative to preindustrial conditions is estimated using the Meteorological Research Institute Earth System Model version 2.0 (MRI-ESM2.0) as part of the Radiative Forcing Model Intercomparison Project (RFMIP) and Aerosol and Chemistry Model Intercomparison Project (AerChemMIP), endorsed by the sixth phase of the Coupled Model Intercomparison Project (CMIP6). The global mean total anthropogenic net ERF estimate at the top of the atmosphere is 1.96 W m−2 and is composed primarily of positive forcings due to carbon dioxide (1.85 W m−2), methane (0.71 W m−2), and halocarbons (0.30 W m−2) and negative forcing due to the total aerosols (− 1.22 W m−2). The total aerosol ERF consists of 23% from aerosol-radiation interactions (− 0.32 W m−2), 71% from aerosol-cloud interactions (− 0.98 W m−2), and slightly from surface albedo changes caused by aerosols (0.08 W m−2). The ERFs due to aerosol-radiation interactions consist of opposing contributions from light-absorbing black carbon (BC) (0.25 W m−2) and from light-scattering sulfate (− 0.48 W m−2) and organic aerosols (− 0.07 W m−2) and are pronounced over emission source regions. The ERFs due to aerosol-cloud interactions (ERFaci) are prominent over the source and downwind regions, caused by increases in the number concentrations of cloud condensation nuclei and cloud droplets in low-level clouds. Concurrently, increases in the number concentration of ice crystals in high-level clouds (temperatures < –38 °C), primarily induced by anthropogenic BC aerosols, particularly over tropical convective regions, cause both substantial negative shortwave and positive longwave ERFaci values in MRI-ESM2.0. These distinct forcings largely cancel each other; however, significant longwave radiative heating of the atmosphere caused by high-level ice clouds suggests the importance of further studies on the interactions of aerosols with ice clouds. Total anthropogenic net ERFs are almost entirely positive over the Arctic due to contributions from the surface albedo reductions caused by BC. In the Arctic, BC provides the second largest contribution to the positive ERFs after carbon dioxide, suggesting a possible important role of BC in Arctic surface warming.
Sustainability economic study of the islands of the Azores archipelago using photovoltaic panels, wind energy and storage system
Authors: Melo Inês , Neto Torres João Paulo , Ferreira Fernandes Carlos Alberto , Marques Lameirinhas Ricardo A.
Published: August 2020

Currently, the nine islands of the Autonomous Region of the Azores have fossil fuel-fired power stations as the main source of electric power. Each island has an independent electrical system classified as an isolated micro-system, given its size and location. The aim of this paper is to analyse the best set of technologies to have nine sustainable hybrid systems. For this purpose, some factors will be considered, such as actual data production of the island, economic scenarios, growth perspectives of consumption and reliability of supply. The results of these studies will allow us to conclude on the applicability of these systems and to quantify the consequent socio-economic, environmental and fossil energy-saving benefits. A system is projected to the archipelago, in order to reduce the energy production due to non-renewable energies, budgeted on 783.28 million euros, which intend to instal wind farms and photovoltaic parks (using polycrystalline and cadmium telluride technologies).
BRIGHTLIGHT researchers as ‘dramaturgs’: creating There is a Light from complex research data
Authors: Taylor Rachel M. , Lobel Brian , Thompson Keisha , Onashile Adura , Croasdale Mark , Hall Nathaniel , Gibson Faith , Martins Ana , Wright David , Morgan Sue , Whelan Jeremy S. , Fern Lorna A.
Published: August 2020

Background

BRIGHTLIGHT is a national evaluation of cancer services for young people aged 13–24 years in England. It is a mixed methods study with six interlinked studies aiming to answer the question: do specialist cancer services for teenagers and young adults add value? http://www.brightlightstudy.com/. Young people have been integral to study development and management, working as co-researchers, consultants and collaborators throughout. We aimed to share results in a way that was meaningful to young people, the public, and multidisciplinary professionals. This paper reports the development of ‘There is a Light: BRIGHTLIGHT’, a theatrical interpretation of study results by young people, and offers insight into the impact on the cast, researchers and audiences.

Methods

The BRIGHTLIGHT team collaborated with Contact Young Company, a youth theatre group in Manchester. Twenty members of Contact Young Company and four young people with cancer worked together over an eight-week period during which BRIGHTLIGHT results were shared along with explanations of cancer, healthcare policy and models of care in interactive workshops. Through their interpretation, the cast developed the script for the performance. The impact of the process and performance on the cast was evaluated through video diaries. The research team completed reflective diaries and audiences completed a survey.

Results

‘There is a Light’ contained five acts and lasted just over an hour. It played 11 performances in six cities in the United Kingdom, to approximately 1377 people. After nine performances, a 30-min talk-back between members of the cast, creative team, an expert healthcare professional, and the audience was conducted, which was attended by at least half the audience. Analysis of cast diaries identified six themes: initial anxieties; personal development; connections; cancer in young people; personal impact; interacting with professionals. The cast developed strong trusting relationships with the team. Professionals stated they felt part of the process rather than sitting on the periphery sharing results. Both professional and lay audiences described the performance as meaningful and understandable. Feedback was particularly positive from those who had experienced cancer themselves.

Conclusions

Using theatre to present research enabled BRIGHTLIGHT results to be accessible to a larger, more diverse audience.
Hemodynamic changes in superficial arteriovenous malformation surgery measured by intraoperative ICG fluorescence videoangiography with FLOW 800 software
Authors: Ye Xun , Wang Liang , Li Ming-tao , Chen Xiao-lin , Wang Hao , Ma Li , Wang Rong , Zhang Yan , Cao Yong , Zhao Yuan-li , Zhang Dong , Wang Shuo
Published: August 2020

Background

Arteriovenous malformation(AVM) have long-term “blood stealing” characteristics, which result in complicated hemodynamic features. To analyze the application of intraoperative indocyanine green angiography with FLOW 800 software in AVM surgeries.

Methods

Data on 17 patients undergoing surgery with ICG fluorescence were collected in Beijing Tiantan Hospital. To analyze the hemodynamic features of AVM and the influence on the peripheral cortex of AVM resection, we assessed the following hemodynamic parameters: maximum intensity, slope of rise, time to half-maximal fluorescence, and transit time from arteries to veins.

Results

In the 17 superficial AVMs studied, the time-delay color mode of the FLOW 800 software was superior to the traditional playback mode for identifying feeding arteries, draining veins, and their relation to normal cortical vessels. The maximum fluorescence intensity and slope of the ICG fluorescence curve of feeder arteries and draining veins were higher than those of normal peripheral vessels (P < 0.05). The transit times in AVMs were significantly shorter than those in normal peripheral vessels (P < 0.05). After AVM resection, cerebral flow increased in the cortex, and local cycle time becomes longer, although the differences were not significant (P > 0.05).

Conclusions

Hemodynamic parameter analysis provided quality guidance for the resection of AVMs and could also be used in estimating changes in blood flow in the local cortex to identify abnormal hyperperfusion and residual nidus.
Genome evolution of SARS-CoV-2 and its virological characteristics
Authors: Nakagawa So , Miyazawa Takayuki
Published: August 2020

Coronavirus disease of 2019 (COVID-19), which originated in China in 2019, shows mild cold and pneumonia symptoms that can occasionally worsen and result in deaths. SARS-CoV-2 was reported to be the causative agent of the disease and was identified as being similar to SARS-CoV, a causative agent of SARS in 2003. In this review, we described the phylogeny of SARS-CoV-2, covering various related studies, in particular, focusing on viruses obtained from horseshoe bats and pangolins that belong to Sarbecovirus, a subgenus of Betacoronavirus. We also describe the virological characteristics of SARS-CoV-2 and compare them with other coronaviruses. More than 30,000 genome sequences of SARS-CoV-2 are available in the GISAID database as of May 28, 2020. Using the genome sequence data of closely related viruses, the genomic characteristics and evolution of SARS-CoV-2 were extensively studied. However, given the global prevalence of COVID-19 and the large number of associated deaths, further computational and experimental virological analyses are required to fully characterize SARS-CoV-2.
The thermochemical non-equilibrium scale effects of the high enthalpy nozzle
Authors: Shen Junmou , Lu Hongbo , Li Ruiqu , Chen Xing , Ma Handong
Published: August 2020

The high enthalpy nozzle converts the high enthalpy stagnation gas into the hypervelocity free flow. The flow region of the high enthalpy nozzle consists of three parts: an equilibrium region upstream of the throat, a non-equilibrium region near the throat, and a frozen region downstream of the throat. Here we propose to consider the thermochemical non-equilibrium scale effects in the high enthalpy nozzle. By numerically solving axisymmetric compressible Navier-Stokes equations coupling with Park’s two-temperature model, the fully non-equilibrium solution is employed throughout the entire nozzle. Calculations are performed at different stagnation conditions with the different absolute scales and expansion ratio. The results of this study are twofold. Firstly, as the absolute scale and expansion ratio increase, the freezing position is delayed, and the flow approaches equilibrium. Secondly, the vibrational temperature and Mach number decrease with the increase in the nozzle scale and expansion ratio, while the speed of sound, static pressure, and translational temperature increase as the nozzle scale and expansion ratio increase.
Correlation of serum betatrophin levels with disease severity and the emergence of insulin resistance in cirrhotic patients
Authors: Salama Mohamed Magdy , Kabiel Walaa Ahmed , Hana Silvia Shoukry , Mohamed Ghada Abdelrahman
Published: August 2020

Background

Insulin resistance (IR) is frequently associated with chronic liver disease. There has been an increased interest in betatrophin protein and its involvement in the compensatory response to IR. We aimed to investigate the correlation of serum betatrophin levels with disease severity and the emergence of IR in cirrhotic patients. This study included 27 cirrhotic patients and 30 healthy participants who served as a control group. IR was assessed by the Homeostasis Model Assessment (HOMA-IR). Serum insulin and betatrophin levels were measured using Enzyme-Linked Immunosorbent Assay (ELISA).

Results

IR was existing in 74% of cirrhotic patients (p < 0.001). Subjects with IR had higher serum betatrophin levels than those without IR (p = 0.04). Serum betatrophin levels were significantly higher in cirrhotic patients than controls (p < 0.001). In addition, Child-Pugh class C patients had higher serum betatrophin levels than those with Child-Pugh class B cirrhosis (p = 0.01). Moreover, the highest serum betatrophin levels were detected in patients with tense ascites followed by those with moderate and mild ascites (p = 0.01). In the cirrhosis group, serum betatrophin levels correlated positively with fasting blood glucose levels (p < 0.001), fasting insulin levels (p = 0.006), HOMA-IR (p = 0.006), Child-Pugh score (p = 0.023), MELD score (p < 0.001), and INR (p = 0.005), and correlated negatively with platelets count (p = 0.01).

Conclusion

Cirrhotic patients have higher serum betatrophin levels; moreover, these levels are positively correlated with disease severity as well as the emergence of insulin resistance.