bluuebunny/crossref_metadata_2025_split huggingface dataset:
Implementation fidelity of Iron and Folic Acid supplementation (IFAs) and associated challenges among pregnant women in Uasin Gishu County Kenya
Authors: Riang'a Roselyter Monchari , Nangulu Anne Kisaka , Broerse Jacqueline E.W. 
Published: July 2020

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

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

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

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

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

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

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

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

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

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

Abstract
This article shows how pine sawdust residues can be used to adsorb nickel ions from synthetic solutions and then to produce porous bricks for civil construction using a mixture of natural clay and biomass containing the adsorbed metals. The adsorption tests were performed by mixing NiCl2 solutions with pine sawdust during a fixed stirring period of 24 h. The set was filtered and the filtrate was analysed. Highest efficiency adsorbate/adsorbent ratio was 1 mol L-1 of NiCl2 solution and 20 g L-1 of pine sawdust. This was the contaminated biomass sample used in the manufacture of the bricks. This paper analyses the properties of the bricks achieved and compares them with bricks without added biomass, porous bricks containing zinc and commercial bricks. The obtained values ​​of apD: bulk density, aspW: apparent specific weight, apP: apparent porosity, H2O Abs: water absorption, apV: apparent volume, LOI: weight loss on ignition, σstr: compression fracture stress, MOR: flexural modulus of rupture and RE: retention efficiency, demonstrate that the ceramic pieces obtained are optimal for construction.