bluuebunny/crossref_metadata_2025 huggingface dataset:
Assessment of the level and distribution of health system responsiveness in Oyo State, Nigeria
Authors: Adelabu Adeyemi , Akinyemi Oluwaseun , Adebayo Ayodeji , Oladokun Blessing
Published: July 2022

Background

Health systems need to be evaluated to ascertain if they are meeting their objectives. There is an increased interest in health system responsiveness (HSR) as a means to appraise health systems. This becomes vital as we put people at the centre of integrated health systems and put a premium on their rights and perspectives. Thus, this study assessed the levels, distribution and factors associated with HSR in Oyo State.

Methods

The study was a cross-sectional study with 717 adults, who had used an out-patient health facility in the preceding 12 months, interviewed using a semi-structured, interviewer-administered questionnaire. HSR was measured on a multi-domain and multi-item (7 domains and 20 items) 5-point Likert scale that was developed by the WHO to measure HSR globally. Summary scores were computed for level, distribution and the most important domains of HSR. Determinants of poor HSR were determined using binomial logistic regression. The level of statistical significance was set at 5%.

Results

The overall level of HSR was 47%. The highest-rated domains were confidentiality (72%), dignity (64%) and choice (60%), while the least rated were prompt attention (43%) and communication (52%). The overall distribution of HSR was 0.228 (range of 0 to 1) with the domains of prompt attention (0.595) and choice (0.506) being the most unequally distributed. The most important domains were communication, prompt attention and dignity. The least important domains were choice and confidentiality. The factors associated with poor HSR (overall) were no formal education, (OR = 2.81; 95% CI: 1.35–5.86), primary education as the highest level of education (OR = 2.19; 95% CI: 1.28–3.75), poor socioeconomic class (OR = 1.86; 95% CI: 1.23–2.80), using a government-owned facility (OR = 1.56; 95% CI: 1.11–2.19) and not using the usual health facility (OR = 1.69; 95% CI: 1.13–2.53).

Conclusions

The overall level of HSR in Oyo State was low with the domains of prompt attention, communication and autonomy being the least rated domains. Therefore, concerted efforts should be targeted at improving HSR as this will improve wellbeing, health system utilization, and the overall health system.
Your height affects your health: genetic determinants and health-related outcomes in Taiwan
Authors: Chiou Jian-Shiun , Cheng Chi-Fung , Liang Wen-Miin , Chou Chen-Hsing , Wang Chung-Hsing , Lin Wei-De , Chiu Mu-Lin , Cheng Wei-Chung , Lin Cheng-Wen , Lin Ting-Hsu , Liao Chiu-Chu , Huang Shao-Mei , Tsai Chang-Hai , Lin Ying-Ju , Tsai Fuu-Jen
Published: July 2022

Background

Height is an important anthropometric measurement and is associated with many health-related outcomes. Genome-wide association studies (GWASs) have identified hundreds of genetic loci associated with height, mainly in individuals of European ancestry.

Methods

We performed genome-wide association analyses and replicated previously reported GWAS-determined single nucleotide polymorphisms (SNPs) in the Taiwanese Han population (Taiwan Biobank; n = 67,452). A genetic instrument composed of 251 SNPs was selected from our GWAS, based on height and replication results as the best-fit polygenic risk score (PRS), in accordance with the clumping and p-value threshold method. We also examined the association between genetically determined height (PRS251) and measured height (phenotype). We performed observational (phenotype) and genetic PRS251 association analyses of height and health-related outcomes.

Results

GWAS identified 6843 SNPs in 89 genomic regions with genome-wide significance, including 18 novel loci. These were the most strongly associated genetic loci (EFEMP1, DIS3L2, ZBTB38, LCORL, HMGA1, CS, and GDF5) previously reported to play a role in height. There was a positive association between PRS251 and measured height (p < 0.001). Of the 14 traits and 49 diseases analyzed, we observed significant associations of measured and genetically determined height with only eight traits (p < 0.05/[14 + 49]). Height was positively associated with body weight, waist circumference, and hip circumference but negatively associated with body mass index, waist-hip ratio, body fat, total cholesterol, and low-density lipoprotein cholesterol (p < 0.05/[14 + 49]).

Conclusions

This study contributes to the understanding of the genetic features of height and health-related outcomes in individuals of Han Chinese ancestry in Taiwan.
Comparison of the effect of sedation and general anesthesia on pattern and flash visual evoked potentials in normal dogs
Authors: Chang Stephanie , Zwueste Danielle , Ambros Barbara , Norton Jonathan , Leis Marina L.
Published: July 2022

Background

Visual evoked potentials (VEPs) can provide objective functional assessment of the post-retinal visual pathway. This study compared the effects of sedation (butorphanol and dexmedetomidine) and general anesthesia (propofol and sevoflurane) on pattern and flash VEPs. Dogs (n = 13) underwent sedation or anesthesia and VEPs were obtained from 3 subcutaneous recording electrodes placed on the head (O1, Oz, O2).

Results

Pattern VEPs could only be recorded under sedation and a maximum of 3 peaks were identified (N75, P100, N135). Flash VEPs could be recorded under both sedation and anesthesia and a maximum of 5 peaks were identified (N1, P1, N2, P2, N3). The latency of the N1 peak and the baseline-N1 amplitude were significantly longer under general anesthesia.

Conclusion

Visual evoked potentials should be preferentially recorded in dogs sedated with dexmedetomidine and butorphanol, regardless of the stimulus.
Identifying the role of transient receptor potential channels (TRPs) in kidney renal clear cell carcinoma and their potential therapeutic significances using genomic and transcriptome analyses
Authors: Ren Jie , Yuan Qihang , Liu Jifeng , Zhong Lei , Li Hanshuo , Wu Guangzhen , Chen Feng , Tang Qizhen
Published: July 2022

Kidney renal clear cell carcinoma (KIRC) is among the major causes of cancer-caused mortality around the world. Transient receptor potential channels (TRPs), due to their role in various human diseases, might become potential drug targets in cancer. The mRNA expression, copy number variation, single-nucleotide variation, prognostic values, drug sensitivity, and pathway regulation of TRPs were studied across cancer types. The ArrayExpress and The Cancer Genome Atlas (TCGA) databases were used to retrieve KIRC samples. Simultaneously, training, internal, and external cohorts were grouped. In KIRC, a prognostic signature with superior survival prediction in contrast with other well-established signatures was created after a stepwise screening of optimized genes linked to TRPs using univariate Cox, weighted gene co-expression network analysis, multivariate Cox, and least absolute shrinkage and selection operator regression analyses. Subsequent to the determination of risk levels, the variations in the expression of immune checkpoint genes, tumor mutation burden, and immune subtypes and response between low-risk and high-risk subgroups were studied using a variety of bioinformatics algorithms, including ESTIMATE, XCELL, EPIC, CIBERSORT-ABS, CIBERSORT, MCPCOUNTER, TIMER, and QUANTISEQ. Gene set enrichment analysis helped in the identification of abnormal pathways across the low- and high-risk subgroups. Besides, high-risk KIRC patients might benefit from ABT888, AZD6244, AZD7762, Bosutinib, Camptothecin, CI1040, JNK inhibitor VIII, KU55933, Lenalidomide, Nilotinib, PLX4720, RO3306, Vinblastine, and ZM.447439; however, low-risk populations might benefit from Bicalutamide, FH535, and OSI906. Finally, calibration curves were used to validate the nomogram with a satisfactory predictive survival probability. In conclusion, this research provides useful insight that can aid and guide clinical practice and scientific research.
Effect of pediatric ventilation weaning technique on work of breathing
Authors: van Dijk Jefta , Koopman Alette A. , de Langen Limme B. , Dijkstra Sandra , Burgerhof Johannes G. M. , Blokpoel Robert G. T. , Kneyber Martin C. J.
Published: July 2022

Background

Ventilator liberation is one of the most challenging aspects in patients with respiratory failure. Most patients are weaned through a transition from full to partial respiratory support, whereas some advocate using a continuous spontaneous ventilation (CSV). However, there is little scientific evidence supporting the practice of pediatric ventilator liberation, including the timing of onset of and the approach to weaning mode. We sought to explore differences in patient effort between a pressure controlled continuous mode of ventilation (PC-CMV) [in this cohort PC assist/control (PC-A/C)] with a reduced ventilator rate and CSV, and to study changes in patient effort with decreasing PS.

Methods

In this prospective physiology cross-over study, we randomized children < 5 years to first PC-A/C with a 25% reduction in ventilator rate, or CSV (continuous positive airway pressure [CPAP] + PS). Patients were then crossed over to the other arm. Patient effort was measured by calculating inspiratory work of breathing (WOB) using the Campbell diagram (WOBCampbell), and by pressure–rate-product (PRP) and pressure–time-product (PTP). Respiratory inductance plethysmography (RIP) was used to calculate the phase angle. Measurements were obtained at baseline, during PC-A/C and CPAP + PS, and during decreasing set PS (maximum -6 cmH2O).

Results

Thirty-six subjects with a median age of 4.4 (IQR 1.5–11.9) months and median ventilation time of 4.9 (IQR 3.4–7.0) days were included. Nearly all patients (94.4%) were admitted with primary respiratory failure. WOBCampbell during baseline [0.67 (IQR 0.38–1.07) Joules/L] did not differ between CSV [0.49 (IQR 0.17–0.83) Joules/L] or PC-A/C [0.47 (IQR 0.17–1.15) Joules/L]. Neither PRP, PTP, ∆Pes nor phase angle was different between the two ventilator modes. Reducing pressure support resulted in a statistically significant increase in patient effort, albeit that these differences were clinically negligible.

Conclusions

Patient effort during pediatric ventilation liberation was not increased when patients were in a CSV mode of ventilation compared to a ventilator mode with a ventilator back-up rate. Reducing the level of PS did not lead to clinically relevant increases in patient effort. These data may aid in a better approach to pediatric ventilation liberation.

Trial registration clinicaltrials.gov NCT05254691. Registered 24 February 2022
Chemokine CXCL12 drives pericyte accumulation and airway remodeling in allergic airway disease
Authors: Bignold Rebecca , Shammout Bushra , Rowley Jessica E. , Repici Mariaelena , Simms John , Johnson Jill R.
Published: July 2022

Background

Airway remodeling is a significant contributor to impaired lung function in chronic allergic airway disease. Currently, no therapy exists that is capable of targeting these structural changes and the consequent loss of function. In the context of chronic allergic inflammation, pericytes have been shown to uncouple from the pulmonary microvasculature, migrate to areas of inflammation, and significantly contribute to airway wall remodeling and lung dysfunction. This study aimed to elucidate the mechanism by which pulmonary pericytes accumulate in the airway wall in a model of chronic allergic airway inflammation.

Methods

Mice were subjected to a protocol of chronic airway inflammation driven by the common environmental aeroallergen house dust mite. Phenotypic changes to lung pericytes were assessed by flow cytometry and immunostaining, and the functional capacity of these cells was evaluated using in vitro migration assays. The molecular mechanisms driving these processes were targeted pharmacologically in vivo and in vitro.

Results

Pericytes demonstrated increased CXCR4 expression in response to chronic allergic inflammation and migrated more readily to its cognate chemokine, CXCL12. This increase in migratory capacity was accompanied by pericyte accumulation in the airway wall, increased smooth muscle thickness, and symptoms of respiratory distress. Pericyte uncoupling from pulmonary vessels and subsequent migration to the airway wall were abrogated following topical treatment with the CXCL12 neutraligand LIT-927.

Conclusion

These results provide new insight into the role of the CXCL12/CXCR4 signaling axis in promoting pulmonary pericyte accumulation and airway remodeling and validate a novel target to address tissue remodeling associated with chronic inflammation.
Improvement in insulin sensitivity and prevention of high fat diet-induced liver pathology using a CXCR2 antagonist
Authors: Phillips Brett E. , Lantier Louise , Engman Carl , Garciafigueroa Yesica , Singhi Aatur , Trucco Massimo , Mantzoros Christos , Wasserman David , Giannoukakis Nick
Published: July 2022

Background

Liver pathology (LP) characteristic of non-alcoholic fatty acid disease (NAFLD)/non-alcoholic steatohepatitis (NASH) is a prevalent co-morbidity of type 2 diabetes (T2D). Accumulating evidence indicates that neutrophils driving insulin resistance (IR), including hepatic IR, precipitate T2D-associated NAFLD/NASH. We hypothesized that targeting neutrophil accumulation into insulin-sensitive tissues in mice using a CXCR2 antagonist under T2D-precipitating high fat diet (HFD) could improve insulin sensitivity and prevent the progression towards liver pathology reminiscent of NAFLD/NASH.

Methods

Mice were age-matched and on standard rodent chow prior to 1:1 randomization into control and HFD formulated with the CXCR2 antagonist AZD5069 or with biologically inactive substitute. They were monitored for metabolic changes including insulin sensitivity using the hyperinsulinemic-euglycemic clamp and hepatic histopathologic evaluation in H&E-stained sections as well as via immunofluorescence microscopy of liver sections for leukocyte markers, collagen 1A1 formation, α-smooth muscle actin (SMA), and galectin-3 expression, for 16 weeks. Statistical tests used to determine significant differences among study groups and outcomes include Student’s t-test, one-way ANOVA, repeated measures two-way ANOVA, and Fisher’s exact test, depending on the analytical question.

Results

Compared to mice on HFD, mice in the AZD5069-formulated HFD exhibited improved insulin sensitivity, a modest reduction in weight gain, and a significant improvement in LP and markers related to NAFLD/NASH. Mice in the AZD5069-formulated HFD also exhibited reduced neutrophil accumulation into the liver at the end of the 16 week study period.

Conclusions

These results show, for the first time, the effectiveness of a selective CXCR2 antagonist to improve insulin sensitivity, concomitantly preventing the progression towards LP characteristic of NAFLD/NASH. This represents a novel approach to target IR and developing LP under T2D-susceptible conditions using a single agent. Furthermore, our data extend the growing evidence in support of neutrophils as a leukocyte population that imprints and maintains a chronic inflammatory state in the progression of dysregulated metabolism in liver-specific co-morbid conditions.
Polar mutagenesis of polycistronic bacterial transcriptional units using Cas12a
Authors: Graffeuil Antoine , Guerrero-Castro Julio , Assefa Aster , Uhlin Bernt Eric , Cisneros David A.
Published: July 2022

Background

Functionally related genes in bacteria are often organized and transcribed as polycistronic transcriptional units. Examples are the fim operon, which codes for biogenesis of type 1 fimbriae in Escherichia coli, and the atp operon, which codes for the FoF1 ATP synthase. We tested the hypothesis that markerless polar mutations could be efficiently engineered using CRISPR/Cas12a in these loci.

Results

Cas12a-mediated engineering of a terminator sequence inside the fimA gene occurred with efficiencies between 10 and 80% and depended on the terminator’s sequence, whilst other types of mutations, such as a 97 bp deletion, occurred with 100% efficiency. Polar mutations using a terminator sequence were also engineered in the atp locus, which induced its transcriptional shutdown and produced identical phenotypes as a deletion of the whole atp locus (ΔatpIBEFHAGDC). Measuring the expression levels in the fim and atp loci showed that many supposedly non-polar mutants induced a significant polar effect on downstream genes. Finally, we also showed that transcriptional shutdown or deletion of the atp locus induces elevated levels of intracellular ATP during the exponential growth phase.

Conclusions

We conclude that Cas12a-mediated mutagenesis is an efficient simple system to generate polar mutants in E. coli. Different mutations were induced with varying degrees of efficiency, and we confirmed that all these mutations abolished the functions encoded in the fim and atp loci. We also conclude that it is difficult to predict which mutagenesis strategy will induce a polar effect in genes downstream of the mutation site. Furthermore the strategies described here can be used to manipulate the metabolism of E. coli as showcased by the increase in intracellular ATP in the markerless ΔatpIBEFHAGDC mutant.
Remineralization and protection from demineralization: effects of a hydroxyapatite-containing, a fluoride-containing and a fluoride- and hydroxyapatite-free toothpaste on human enamel in vitro
Authors: Guntermann Leona , Rohrbach Arno , Schäfer Edgar , Dammaschke Till
Published: July 2022

Background

The aim was to evaluate the remineralization potential as well as the extent of protection against renewed demineralization of enamel by hydroxyapatite-containing toothpaste (Karex) in comparison to fluoride-containing (Elmex) and fluoride- and hydroxyapatite-free toothpaste (Ajona) as control.

Methods

Fifty-seven enamel samples were obtained from 19 human teeth. Five demarcated surfaces were created on each tooth (S0—S4). Four of the surfaces (S1—S4) were exposed to lactic acid (pH 3) for 8 h (demineralization). S0 was left untreated as control. S1 was solely treated with acid. After demineralization, S2 was exposed to Karex for 2 min, of which 15 s were brushing. S3 was treated with Elmex and S4 with Ajona, accordingly. Then, the samples were evaluated using a scanning electron microscope and ImageJ image analysis software to determine the percentage of demineralization. Afterwards, S2-S4 were again exposed to lactic acid for 2 h, and subjected to pixel analysis another time. Data were statistically analysed using ANOVA with post-hoc Scheffé test and the Kurskal-Wallis test.

Results

The surfaces treated with Elmex showed the lowest percentage of demineralization (mean 5.01 ± 0.98%) (p < 0.01). Thus, Elmex remineralized more effectively compared to Ajona (8.89 ± 1.41%) and Karex (9.85 ± 1.63%) (p < 0.01). Furthermore, Elmex showed the lowest percentage of demineralized enamel after new demineralization (median 6.29%), followed by Ajona (11.92%) and Karex (13.46%) (p < 0.001).

Conclusion

In terms of remineralization and protection against renewed demineralization, a hydroxyapatite-containing toothpaste (Karex) appears to be inferior to a fluoride-containing toothpaste (Elmex) and a fluoride- and hydroxyapatite-free toothpaste (Ajona). Hence, the recommendation to use Karex to protect against demineralization should be critically questioned.
SH3GLB1-related autophagy mediates mitochondrial metabolism to acquire resistance against temozolomide in glioblastoma
Authors: Chien Chia-Hung , Yang Wen-Bin , Chuang Jian-Ying , Lee Jung-Shun , Liao Wei-An , Huang Chih-Yuan , Chen Pin-Yuan , Wu An-Chih , Yang Shun-Tai , Lai Chien-Cheng , Chi Pei-I , Chu Jui-Mei , Cheng Siao Muk , Liu Chan-Chuan , Hwang Daw-Yang , Chen Shang-Hung , Chang Kwang-Yu
Published: July 2022

Background

The mechanism by which glioblastoma evades temozolomide (TMZ)-induced cytotoxicity is largely unknown. We hypothesized that mitochondria plays a role in this process.

Methods

RNA transcriptomes were obtained from tumor samples and online databases. Expression of different proteins was manipulated using RNA interference or gene amplification. Autophagic activity and mitochondrial metabolism was assessed in vitro using the respective cellular and molecular assays. In vivo analysis were also carried out in this study.

Results

High SH3GLB1 gene expression was found to be associated with higher disease grading and worse survival profiles. Single-cell transcriptome analysis of clinical samples suggested that SH3GLB1 and the altered gene levels of oxidative phosphorylation (OXPHOS) were related to subsets expressing a tumor-initiating cell signature. The SH3GLB1 protein was regulated by promoter binding with Sp1, a factor associated with TMZ resistance. Downregulation of SH3GLB1 resulted in retention of TMZ susceptibility, upregulated p62, and reduced LC3B-II. Autophagy inhibition by SH3GLB1 deficiency and chloroquine resulted in attenuated OXPHOS expression. Inhibition of SH3GLB1 in resistant cells resulted in alleviation of TMZ-enhanced mitochondrial metabolic function, such as mitochondrial membrane potential, mitochondrial respiration, and ATP production. SH3GLB1 modulation could determine tumor susceptibility to TMZ. Finally, in animal models, resistant tumor cells with SH3GLB1 knockdown became resensitized to the anti-tumor effect of TMZ, including the suppression of TMZ-induced autophagy and OXPHOS.

Conclusions

SH3GLB1 promotes TMZ resistance via autophagy to alter mitochondrial function. Characterizing SH3GLB1 in glioblastoma may help develop new therapeutic strategies against this disease in the future.
Genomics analysis and degradation characteristics of lignin by Streptomyces thermocarboxydus strain DF3-3
Authors: Tan Fangyun , Cheng Jun , Zhang Yu , Jiang Xingfu , Liu Yueqiu
Published: July 2022

Background

Lignocellulose is an important raw material for biomass-to-energy conversion, and it exhibits a complex but inefficient degradation mechanism. Microbial degradation is promising due to its environmental adaptability and biochemical versatility, but the pathways used by microbes for lignin degradation have not been fully studied. Degradation intermediates and complex metabolic pathways require more study.

Results

A novel actinomycete DF3-3, with the potential for lignin degradation, was screened and isolated. After morphological and molecular identification, DF3-3 was determined to be Streptomyces thermocarboxydus. The degradation of alkali lignin reached 31% within 15 days. Manganese peroxidase and laccase demonstrated their greatest activity levels, 1821.66 UL−1 and 1265.58 UL−1, respectively, on the sixth day. The highest lignin peroxidase activity was 480.33 UL−1 on the fourth day. A total of 19 lignin degradation intermediates were identified by gas chromatography–mass spectrometry (GC–MS), including 9 aromatic compounds. Genome sequencing and annotation identified 107 lignin-degrading enzyme-coding genes containing three core enzymatic systems for lignin depolymerization: laccases, peroxidases and manganese peroxidase. In total, 7 lignin metabolic pathways were predicted.

Conclusions

Streptomyces thermocarboxydus strain DF3-3 has good lignin degradation ability. Degradation products and genomics analyses of DF3-3 show that it has a relatively complete lignin degradation pathway, including the β-ketoadipate pathway and peripheral reactions, gentisate pathway, anthranilate pathway, homogentisic pathway, and catabolic pathway for resorcinol. Two other pathways, the phenylacetate–CoA pathway and the 2,3-dihydroxyphenylpropionic acid pathway, are predicted based on genome data alone. This study provides the basis for future characterization of potential biotransformation enzyme systems for biomass energy conversion.
Ipilimumab- and nivolumab-induced myocarditis in a patient with metastatic cholangiocarcinoma: a case report
Authors: Delombaerde Danielle , Vervloet Delphine , Berwouts Dieter , Beckers Roel , Prenen Hans , Peeters Marc , Gremonprez Félix , Croes Lieselot , Vulsteke Christof
Published: July 2022

Background

Myocarditis in patients treated with immune checkpoint inhibitors has previously been reported to be rare, though it has most likely been underreported owing to misdiagnosis in the absence of overt clinical presentation. Early detection and characterization of this potentially life-threatening immune-related adverse event is of major importance. Herein we report a case of early-onset myocarditis in an asymptomatic patient treated with dual checkpoint inhibition for metastatic cholangiocarcinoma.

Case presentation

A 69-year-old male Caucasian patient with metastatic cholangiocarcinoma presented with mild epigastric pain and troponinemia prior to the third dose of dual checkpoint inhibition (ipilimumab 1 mg/kg body weight and nivolumab 3 mg/kg body weight). Initial workup showed no significant abnormalities (physical/neurological examination, electrocardiogram, 72-hour Holter monitoring, and a transthoracic echocardiogram). However, cardiac magnetic resonance imaging revealed a zone of contrast enhancement in the inferior segment of the left ventricular wall indicating a recent episode of myocarditis. Despite steroid initiation (0.5 mg/kg oral prednisolone per day), troponin levels kept increasing, in the absence of coronary disease, for which steroids were increased to 1.5 mg/kg/day. Fluorodeoxyglucose positron emission tomography/computed tomography, 28 days after detecting elevated troponin levels, depicted multiple zones of active myocardial inflammation (basal septal, mid-anterior, and apical inferior). The patient is currently stable, and troponinemia is slowly decreasing while steroids are steadily being tapered.

Conclusion

As the number of cancers treated with immune checkpoint inhibitors is expanding, the incidence of immune checkpoint inhibitor-induced myocarditis is likely to increase. Moreover, the emerging combination of immune checkpoint inhibitors with non-immune checkpoint inhibitor therapies with potential synergistic cardiotoxic side effects (for example, tyrosine kinase inhibitors) will further complicate the diagnosis of immune-related cardiotoxicity. This case highlights the urgent need for predictive biomarkers to stratify patients at risk and to develop a standardized and multidisciplinary management approach for early diagnosis and treatment of this severe immune-related adverse event.
Potentials and limitations of NFIs and remote sensing in the assessment of harvest rates: a reply to Breidenbach et al.
Authors: Ceccherini Guido , Duveiller Gregory , Grassi Giacomo , Lemoine Guido , Avitabile Valerio , Pilli Roberto , Cescatti Alessandro
Published: July 2022

The timely and accurate monitoring of forest resources is becoming of increasing importance in light of the multi-functionality of these ecosystems and their increasing vulnerability to climate change. Remote sensing observations of tree cover and systematic ground observations from National Forest Inventories (NFIs) represent the two major sources of information to assess forest area and use. The specificity of two methods is calling for an in-depth analysis of their strengths and weaknesses and for the design of novel methods emerging from the integration of satellite and surface data. On this specific debate, a recent paper by Breidenbach et al. published in this journal suggests that the detection of a recent increase in EU forest harvest rate—as reported in Nature by Ceccherini et al.—is largely due to technical limitations of satellite-based mapping. The article centers on the difficulty of the approaches to estimate wood harvest based on remote sensing. However, it does not discuss issues with the robustness of validation approaches solely based on NFIs. Here we discuss the use of plot data as a validation set for remote sensing products, discussing potentials and limitations of both NFIs and remote sensing, and how they can be used synergistically. Finally, we highlight the need to collect in situ data that is both relevant and compatible with remote sensing products within the European Union.
Towards inclusive and accessible parks in Pathum Thani Province, Thailand
Authors: Selanon Pattamon , Puggioni Federico , Dejnirattisai Supanut , Rutchamart Autchariya
Published: July 2022

The problem of the lack of inclusive public space in the fringes of Bangkok, Thailand, is related to multiple factors in urban development. The study-area of the Pathum Thani province offers a summary of the critical consequences of the urban development in the past decades. The partial transformation of some environmental tracks onto an urbanized system allows the creation of a nonhomogeneous privatized continuous built surface. The conditions of these urban areas suffer from vehicular traffic, car dependency, absence of differentiated mobility, limited walkability, and lack of public spaces. The research aims to bring these areas to a higher level of inclusion, accessibility and overall quality by rethinking the existent public spaces, creating the grounds for the design of inclusive and accessible park. To reach this objective, the study explores the topics of public space, park, accessibility and inclusivity for disabilities to establish some principles for future design approach for Thaklong–Klongluang, a study-area located in the Pathum Thani Province. Characteristics, features, weaknesses and existing parks of the study area are demonstrated in the subsequent section. The results’ discussion relates all the aforementioned topics, defining the guidelines for the creation of inclusive and accessible parks in the six existent sites of the study area. Because of its premises, besides being based in a specific location, the article aims to be a valid reference for the areas which present similar features and critical points.
The tale of three landslides in the Western Ghats, India: lessons to be learnt
Authors: Ajin R. S. , Nandakumar D. , Rajaneesh A. , Oommen T. , Ali Yunus P. , Sajinkumar K. S.
Published: July 2022

In recent years, landslides have become a typical monsoon calamity in the Western Ghats region of Kerala, India. In addition to property damage, heavy rainfall (36% above normal) and multiple landslides (4728) killed 48 people in 2018. This tendency continued throughout the monsoon seasons of 2019, 2020, and 2021, resulting in the deaths of over 100 people. Anomalous precipitation is ascribed to the frequent development of low-pressure in the surrounding oceans. Using ground real data and satellite imagery, we evaluated the features of three large landslides in the state of Kerala, which occurred during the monsoon season of 2021. Our investigation found that the Kokkayar landslide was triggered by anthropogenic-related agricultural activities, the Plappally landslide by geomorphic and tectonic processes as well as human involvement, and the Kavali landslide by forest fragmentation with dense vegetation on thin soil. The triggering mechanism for all three of these landslides, however, is the intense rainfall of 266 mm in less than 24 h. Thus, an accurate and precise forecast of rainfall can be used to define a threshold for an early warning, which will be vital for saving lives.
Protocol for a systematic review and meta-analysis of the diagnostic accuracy of artificial intelligence for grading of ophthalmology imaging modalities
Authors: Cao Jessica , Chang-Kit Brittany , Katsnelson Glen , Far Parsa Merhraban , Uleryk Elizabeth , Ogunbameru Adeteju , Miranda Rafael N. , Felfeli Tina
Published: July 2022

Background

With the rise of artificial intelligence (AI) in ophthalmology, the need to define its diagnostic accuracy is increasingly important. The review aims to elucidate the diagnostic accuracy of AI algorithms in screening for all ophthalmic conditions in patient care settings that involve digital imaging modalities, using the reference standard of human graders.

Methods

This is a systematic review and meta-analysis. A literature search will be conducted on Ovid MEDLINE, Ovid EMBASE, and Wiley Cochrane CENTRAL from January 1, 2000, to December 20, 2021. Studies will be selected via screening the titles and abstracts, followed by full-text screening. Articles that compare the results of AI-graded ophthalmic images with results from human graders as a reference standard will be included; articles that do not will be excluded. The systematic review software DistillerSR will be used to automate part of the screening process as an adjunct to human reviewers. After the full-text screening, data will be extracted from each study via the categories of study characteristics, patient information, AI methods, intervention, and outcomes. Risk of bias will be scored using Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) by two trained independent reviewers. Disagreements at any step will be addressed by a third adjudicator. The study results will include summary receiver operating characteristic (sROC) curve plots as well as pooled sensitivity and specificity of artificial intelligence for detection of any ophthalmic conditions based on imaging modalities compared to the reference standard. Statistics will be calculated in the R statistical software.

Discussion

This study will provide novel insights into the diagnostic accuracy of AI in new domains of ophthalmology that have not been previously studied. The protocol also outlines the use of an AI-based software to assist in article screening, which may serve as a reference for improving the efficiency and accuracy of future large systematic reviews.

Trial registration

PROSPERO, CRD42021274441
Ethnobotanical perspectives of Bakhar: an indigenous starter culture used to prepare traditionally fermented rice beverage in rural West Bengal, India
Authors: Ghosh Sudipta , Sen Sukanta K. , Mondal Subrata
Published: July 2022

Haria, a fermented rice beverage, is commonly consumed as a traditional drink by the tribal people of rural West Bengal. This beverage is prepared by fermenting steamed rice with the starter culture tablets, known as Bakhar. It is known that some plant parts are added during Bakhar preparation that confer certain ethnomedicinal properties to the beverage as well as to Bakhar itself. An ethnobotanical survey was conducted that allowed documenting the traditional knowledge regarding this ethnic beverage preparation and it reveals that 10 plant species and one lichen species are used by the Santal tribe to prepare the Bakhar. Among them, roots of Kedar, Chaoli, rhizome of Bach, and bark of Lodh plants are essential, while other plant parts are used due to their specific taste, flavor, and therapeutic properties. But nowadays little or no plant additives are used during commercial Haria preparation for cost-effectiveness. Homemade and commercially produced Haria were investigated for their nutritional quality which revealed that homemade beverage contains more bioactive compounds, such as ascorbic acid (15.40 mg/100 ml) and flavonoids (36.67 mg/100 ml), which contribute toward the antioxidant property of the beverage. This current study documents the important medicinal plants used in the starter culture, the detailed process of Bakhar and Haria preparation, and the nutritional quality of Haria highlighting its ethnomedicinal properties.
Effect of preoperative ultrasound mapping of the saphenous vein on leg wound complications after coronary artery bypass surgery: a systematic review
Authors: Media Ara Shwan , Rajendran Rathini , Kimose Hans Henrik , El-Akkawi Ali Imad
Published: July 2022

Background

The long saphenous vein is one of the most used conduits for coronary artery bypass graft surgery. The aim of this study was to assess the existing evidence regarding the effects of preoperative ultrasound mapping of the long saphenous vein with special attention to leg wound complications in patients undergoing elective coronary artery bypass graft surgery.

Main text

A systematic literature search was conducted in PubMed, Cochrane, and Embase databases. Extraction of relevant data was performed including study characteristics, patient characteristics, and all reported outcomes. The Cochrane Risk of Bias tool was used to evaluate the risk of bias of the included studies. The primary outcome measure was leg wound infections.

Of 4514 papers screened in this systematic review, 36 papers underwent full-text assessment with final inclusion of 5 studies; 3 observational studies, and 2 randomized trials. The two randomized controlled trials showed no effects of preoperative ultrasound. Data from the three non-randomized studies was pooled in a meta-analysis, which suggested a significant reduction in the risk of harvest wound complications by ultrasound mapping prior to surgery (RR 0.32; 95%CI = [0.19–0.55]).

Conclusions

The main findings of this systematic review showed, that (1) the evidence in this field is limited and of low quality, i.e., low power or methodology and (2) despite limitations of the included studies, preoperative ultrasound mapping of the saphenous vein seems to be beneficial in terms of reducing the risk of postoperative leg wound complications.
Physiotherapists’ perception on first contact practice in Nigeria: a cross-sectional survey
Authors: Stanley Maduagwu , Muftaudeen Maryam , Muonwe Chidile , Umeonwuka Chuka Ifeanyi , Nwanne Chiamaka Ann , Ishaku Cornelius Mahdi , Okonkwo Uchenna Prosper , Ihegihu Ebere Yvonne , Nwosu Ifeoma , Modu Ali Alhaji
Published: July 2022

Objectives

Physiotherapy has evolved over the years in training and practice. Physiotherapists’ perception of first contact physiotherapy (FCP) and the patient self-referral (PSR) practice model in Nigeria may form a basis for the actualization of FCP practice in Nigeria. This study assessed physiotherapists’ perception of FCP practice and PSR in Nigeria.

Design and setting

This study was a cross-sectional survey of 72 physiotherapists from purposively selected academic and health institutions.

Methods

A previously validated questionnaire on the global view of FCP and PSR was used in this study. Data were analyzed descriptively.

Results

The majority of the physiotherapists were aware of national legislation regulating physiotherapy practice (97.2%) and defined the scope of practice (94%) in Nigeria. Respondents who expressed the view that the expected competency of entry-level physiotherapy is sufficient for first contact practitioners were in preponderance (75%). More than half (52.8%) of the respondents perceived medical and political views, as well as professional skills of the physiotherapists as strong barriers to first contact physiotherapy practice in Nigeria.

Conclusion

Physiotherapists in Nigeria seem to intuitively recognize some form of first contact practice or direct access to patients, but unfortunately lack the legislative backing for such practices. There is a widespread assumption of professional autonomy among physiotherapists in Nigeria.
A study of time spectrum identification of induced polarization field based on Weibull distribution function
Authors: Meng Qingxin , Gao Wenli , Niu Zheng , Chang Jianghao , Sun Shida , Zhang Haibo
Published: July 2022

Identification of time spectrum is one of the core issues of the time-domain induced polarization (IP) method, which can be considered as one of the bases for distinguishing various polarized rocks. Fitting the IP data based on the spectrum forward model and obtaining optimal solution of the model parameters is a key step in spectrum identification. However, the suitable forward model should consider the observation conditions, such as the charging time and the time window. The time spectrum identification may be difficult to implement stably due to the lack of objective reference for the optimal solution. Therefore, our purpose is to improve the forward model and implement the spectrum identification for IP data. First, using the Weibull (WB) distribution function as the basis, a time spectrum forward model considering the charging time and observation time window is provided according to the typical measurement mode. Then, based on the WB spectrum model and Barzilai-Borwein gradient optimization, a method for solution of apparent spectral model parameters for spectrum identification is developed. Finally, this method is used to process the IP data from a mine in which the anomalies related to ore-bearing beds are identified based on the processing results. Results obtained demonstrate that the spectrum forward model based on the WB function is feasible in describing the IP data. The limited charging time and a wide observed time window should be considered to realize accurate simulations and description of the time-domain IP data. The essence of the time spectrum identification is to comprehensively reflect the time-varying state of the whole time channel through the spectral model parameters, whereas the decay field ratio of the adjacent time channel can be used as an objective reference. The parameters of the spectrum model characterizing the time-varying state are independent of polarization and resistivity and thus can be directly used for identification of IP anomalies.
Molecular Mechanisms of the Medicines for COVID-19
Authors: Komiyama Makoto
Published: July 2022

For these three years, COVID-19 has globally spread and caused enormous damage all over the world. Although vaccines served to reduce its infection, their effects are still limited mainly due to rapid and vigorous mutations of SARS-CoV-2 virus. In order to bring this pandemic under control, we must develop novel medicines which are easily administered when needed and very effective without undesired side-effects. In this account, the developments of specific medicines for COVID-19 are surveyed with the emphasis on the molecular mechanisms of their therapeutic actions. Most of them are inhibitors of enzymes, which are indispensable for the virus, but unnecessary for human beings. These inhibitors selectively hamper the critical steps for viral proliferation (viral entry to human cells, replication of RNA genome, production of viral proteins, and others). There have been several successful examples, which are already approved as medicines for the treatment of COVID-19. Unfortunately, however, few of them sufficiently satisfy all the requirements to overcome this unprecedented pandemic completely, and thus further innovation is necessary.
The impact of COVID-19 pandemic and its associations with government responses in Europe
Authors: Chantzaras Athanasios , Yfantopoulos John
Published: July 2022

Although stringent containment strategies are generally effective in slowing COVID-19 transmission, they also entail severe socioeconomic implications. This study uses aggregated data from Eurostat and the Oxford COVID-19 Government Response Tracker (OxCGRT) to quantify changes in GDP and their association with the stringency index. We examine the evolution of Covid-19 cases and deaths per 100.000 thousand inhabitants in Europe and discuss the impact on the economy. On average, EU member states witnessed an 11.4% reduction in their GDP, due to the COVID-19 crisis. The impact on the southern member states was even greater. We use OxCGRT methodology to rank the European countries on their performance against COVID-19 on the base of four aggregate indices referring to: i) the overall government response, ii) containment and health measures, iii) the stringency index and iv) economic support measures. It is shown that the southern European states and Ireland, top the rankings in terms of the stringency of the implement strategies to contain the pandemic.
Case Report: Incidental finding of didelphys uterus in a multigravida woman at Caesarean delivery
Authors: Awolude Olutosin , Olutoye Ademola , Obajimi Gbolahan
Published: July 2022

Didelphys uterus is one of the rarest Müllerian duct anomalies (MDA) of the female genital tract. Many remain undiagnosed due to possibilities of successful pregnancies and vaginal deliveries in those without or with mild forms of associated cervical and/or vaginal anomalies.  Due to this, data on didelphys uterus in pregnancy are rare, with most cases seen during routine ultrasound in pregnancies’ Caesarean section for other obstetric indications. This case was a 36-year-old G4P1+2 female who had successful vaginal delivery in her preceding pregnancy; in index pregnancy, she presented with fetal footling breech in labour and had an emergency caesarean section during which uterine didelphys was diagnosed. Many pregnant women with didelphys uterus will deliver vaginally and, as such, remain undiagnosed.  Its presence is one of the possible reasons for persistent abnormal presentations like fetal breech presentation, especially in women with prior successful vaginal deliveries. Early recognition and availability of facilities for management of such incidentally found cases of uterine didelphys will prevent many of the complications associated with pregnancy with them.
Fiber-coupled light-emitting diodes (LEDs) as safe and convenient light sources for the characterization of optoelectronic devices
Authors: Quereda Jorge , Zhao Quinghua , Diez Enrique , Frisenda Riccardo , Castellanos-Gomez Andrés
Published: July 2022

Optoelectronic device characterization requires to probe the electrical transport changes upon illumination with light of different incident powers, wavelengths, and modulation frequencies. This task is typically performed using laser-based or lamp + monochromator-based light sources, that result complex to use and costly to implement. Here, we describe the use of multimode fiber-coupled light-emitting diodes (LEDs) as a simple, low-cost alternative to more conventional light sources, and demonstrate their capabilities by extracting the main figures of merit of optoelectronic devices based on monolayer MoS2, i.e. optical absorption edge, photoresponsivity, response time and detectivity. The described light sources represent an excellent alternative for performing optoelectronic characterization experiments on a limited budget.
Case Report: β-thalassemia major on the East African coast
Authors: Macharia Alexander W. , Mochamah George , Makale Johnstone , Howard Thad , Mturi Neema , Olupot-Olupot Peter , Färnert Anna , Ware Russell E. , Williams Thomas N.
Published: July 2022

Background: β-thalassemia is rare in sub-Saharan Africa and to our knowledge there has been no case of homozygous β-thalassemia major reported from this region. In a recent cohort study, we identified four β-thalassemia mutations among 83 heterozygous carriers in Kilifi, Kenya. One of the mutations identified was a rare β-globin gene initiation codon mutation (ATG➝ACG) (rs33941849). Here we present a patient with β-thalassemia major resulting from this mutation, only the second homozygous patient to have been reported. 

Methods: The female patient presented to Kilifi County Hospital aged two years with a one week left sided abdominal swelling. Clinical, hematological and genetic information were collected at admission and follow-up. 

Results: Admission bloods revealed marked anemia, with a hemoglobin (Hb) value of 6.6 g/dL and a low mean corpuscular volume of 64 fL. High performance liquid chromatography (HPLC) revealed the absence of HbA0 and elevated levels of HbF, suggesting a diagnosis of β-thalassemia major. Sequencing revealed that the child was homozygous for the rs33941849 initiation codon mutation. 

Conclusions: We hope that this study will create awareness regarding the presence of β-thalassemia as a potential public health problem in the East Africa region and will prompt the development of local guidelines regarding the diagnosis and management of this condition.