An evaluation of the Birchwood Junk Food Café, Skelmersdale.

Food waste is an issue of global concern requiring worldwide action. In the UK, £19 billion worth of food is wasted every year. A variety of initiatives have been developed to redistribute surplus food to those in need. The Birchwood Junk Food Café in Skelmersdale combines the reduction of food waste with community and societal benefits. The University of Manchester and the Birchwood Centre conducted an evaluation of the café including a customer satisfaction survey, a long-form health and wellbeing survey and qualitative interviews. Each day the café produces a three-course menu for the public on a 'pay-as-you-feel' basis. During an 18-month period, the café intercepted 32 729 kg of food that would otherwise have gone to waste, served over 1500 people, with 3500 covers, 60 different dishes and 1200 volunteer hours. Customer satisfaction was extremely high with 88% being repeated visitors and 86% rating the café as excellent. Volunteers include youth from the local Birchwood Centre, who gain valuable experiences. Customers benefit from social interactions and additional community cohesion. The café offers an unique opportunity to impact on the wider community and provides support and structure for the volunteers.

abc4pwm: affinity based clustering for position weight matrices in applications of DNA sequence analysis.

BACKGROUND: Transcription factor (TF) binding motifs are identified by high throughput sequencing technologies as means to capture Protein-DNA interactions. These motifs are often represented by consensus sequences in form of position weight matrices (PWMs). With ever-increasing pool of TF binding motifs from multiple sources, redundancy issues are difficult to avoid, especially when every source maintains its own database for collection. One solution can be to cluster biologically relevant or similar PWMs, whether coming from experimental detection or in silico predictions. However, there is a lack of efficient tools to cluster PWMs. Assessing quality of PWM clusters is yet another challenge. Therefore, new methods and tools are required to efficiently cluster PWMs and assess quality of clusters. RESULTS: A new Python package Affinity Based Clustering for Position Weight Matrices (abc4pwm) was developed. It efficiently clustered PWMs from multiple sources with or without using DNA-Binding Domain (DBD) information, generated a representative motif for each cluster, evaluated the clustering quality automatically, and filtered out incorrectly clustered PWMs. Additionally, it was able to update human DBD family database automatically, classified known human TF PWMs to the respective DBD family, and performed TF motif searching and motif discovery by a new ensemble learning approach. CONCLUSION: This work demonstrates applications of abc4pwm in the DNA sequence analysis for various high throughput sequencing data using ~ 1770 human TF PWMs. It recovered known TF motifs at gene promoters based on gene expression profiles (RNA-seq) and identified true TF binding targets for motifs predicted from ChIP-seq experiments. Abc4pwm is a useful tool for TF motif searching, clustering, quality assessment and integration in multiple types of sequence data analysis including RNA-seq, ChIP-seq and ATAC-seq.

A Comprehensive Review of Internet of Things: Technology Stack, Middlewares, and Fog/Edge Computing Interface.

The Internet of Things (IoT) is an extensive network of heterogeneous devices that provides an array of innovative applications and services. IoT networks enable the integration of data and services to seamlessly interconnect the cyber and physical systems. However, the heterogeneity of devices, underlying technologies and lack of standardization pose critical challenges in this domain. On account of these challenges, this research article aims to provide a comprehensive overview of the enabling technologies and standards that build up the IoT technology stack. First, a layered architecture approach is presented where the state-of-the-art research and open challenges are discussed at every layer. Next, this research article focuses on the role of middleware platforms in IoT application development and integration. Furthermore, this article addresses the open challenges and provides comprehensive steps towards IoT stack optimization. Finally, the interfacing of Fog/Edge Networks to IoT technology stack is thoroughly investigated by discussing the current research and open challenges in this domain. The main scope of this study is to provide a comprehensive review into IoT technology (the horizontal fabric), the associated middleware and networks required to build future proof applications (the vertical markets).

Peripheral blood blast rate of clearance is an independent predictor of clinical response and outcomes in acute myeloid leukaemia.

The day 14 bone marrow aspirate and biopsy (D14BM) is regularly used to predict achievement of complete remission (CR) with induction chemotherapy in acute myeloid leukemia (AML), however its utility has been questioned. Clearance of peripheral blood blasts (PBB) may serve as an early measure of chemosensitivity. PBB rate of clearance (PBB-RC) was calculated for treatment-naive AML patients (n = 164) undergoing induction with an anthracycline and cytarabine (7+3) and with detectable PBB at diagnosis. PBB-RC was defined as the percentage of the absolute PBB count on the day of diagnosis that was cleared with each day of therapy, on average, until D14 or day of PBB clearance. Each 5% increase in PBB-RC approximately doubled the likelihood of D14BM clearance (OR = 1·81; 95% CI: 1·24-2·64, P < 0·005). PBB-RC was also associated with improved CR rates (OR per 5% = 1·97; 95% CI: 1·27-3·01, P < 0·005) and overall survival (OS) [hazard ratio (HR) per 5% = 0·67; 95% CI: 0·52-0·87]. African American patients had poorer OS adjusted for PBB-RC (HR = 2·18; 95% CI: 1·13-4·23), while race was not associated with D14BM or CR rate. PBB-RC during induction chemotherapy is predictive of D14BM clearance, CR, and OS, and can therefore serve as a prognostic marker for clinical outcomes in AML.

Immunization coverage in Ethiopia among 12-23 month old children: systematic review and meta-analysis.

BACKGROUND: Immunization is a cost-effective public health strategy. Immunization averts nearly three million deaths annually but immunization coverage is low in some countries and some regions within countries. The aim of this systematic review and meta-analysis is to assess pooled immunization coverage in Ethiopia. METHOD: A systematic search was done from PubMed, Google Scholar, EMBASE, HINARI, and SCOPUS, WHO's Institutional Repository for Information Sharing (IRIS), African Journals Online databases, grey literature and reviewing reference lists of already identified articles. A checklist from the Joanna Briggs Institute was used for appraisal. The I2 was used to assess heterogeneity among studies. Funnel plot were used to assess publication bias. A random effect model was used to estimate the pooled prevalence of immunization among 12-23 month old children using STATA 13 software. RESULT: Twenty eight articles were included in the meta-analysis with a total sample size of 20,048 children (12-23 months old). The pooled prevalence of immunization among 12-23 month old children in Ethiopia was found to be 47% (95%, CI: 46.0, 47.0). A subgroup analysis by region indicated the lowest proportion of immunized children in the Afar region, 21% (95%, CI: 18.0, 24.0) and the highest in the Amhara region, 89% (95%, CI: 85.0, 92.0). CONCLUSION: Nearly 50% of 12-23 month old children in Ethiopia were fully vaccinated according to this systematic review and meta-analysis this indicates that the coverage, is still low with a clear disparity among regions. Our finding suggests the need for mobile and outreach immunization services for hard to reach areas, especially pastoral and semi-pastoral regions. In addition, more research may be needed to get more representative data for all regions. PROSPERO REGISTRATION NUMBER: CRD42020166787.

Predictors of immunization coverage among 12-23 month old children in Ethiopia: systematic review and meta-analysis.

BACKGROUND: Immunization is one of modern medicine's greatest achievements in the last three decades. Annually it can prevent nearly 2 to 3 million deaths. Understanding the determinants of effective immunization coverage is a critical undertaking. Accordingly, we set out to check the best available evidence of outstanding predictors of immunization coverage among children aged 12-23 months in Ethiopia. METHOD: Electronic databases including PubMed, Google Scholar, HINARI, and SCOPUS, Web of Science, African Journals Online, Ethiopian Medical Journals were searched. The search process, study selection, critical appraisal, and data extraction were done independently by two reviewers using Joanna Briggs Institute Meta-analysis for Review Instrument (JBI-MAStARI). The difference between reviewers was resolved with a third person. The risk of bias was assessed by the Newcastle Ottawa Tool for observational studies. Data were extracted using the Microsoft Excel checklist and exported to STATA 13. Heterogeneity was assessed using I2, Funnel plot and Egger's test was used to check for publication bias. RESULTS: We identified 26 studies with 15,042 children with mothers/caretakers to assess factors associated with immunization coverage and significant factors were: maternal formal education, (OR = 2.45; 95% CI: 1.62-3.72), paternal formal education, (OR = 1.01; 95% CI: 0.27-3.77), residence, (OR = 2.11; 95% CI: 1.00-4.45), birth at health facility (OR = 1.86; 95% CI: 0.99-3.49), family size less than four, (OR = 1.81; 95% CI: 1.16-2.84), knowledge on age of immunization to be completed (OR = 6.18;95% CI: 3.07-12.43), knowledge on immunization schedule (OR = 2.49; 95% CI: 1.35-4.59), time to travel to health faculties, (OR = 1.74; 95% CI: 0.62-4.89), antennal care, (OR = 3.11; 95% CI: 1.64-5.88), and tetanus toxoid vaccination, (OR = 4.82; 95% CI: 2.99-7.75). CONCLUSION: Our findings showed that literacy, residence, awareness, family size, maternal health services use, and proximity of the health facilities were factors associated with full immunization. This implies that there is a need for primary health service expansion and health education to "hard to reach areas" to improve immunization coverage for children aged 12-23 months.

A case report of a young girl with recurrent hematuria: a missed diagnosis - renal nutcracker syndrome.

BACKGROUND: Nutcracker syndrome is an easily missed cause of hematuria in children. It is characterized by left renal vein entrapment between the abdominal aorta and the superior mesenteric artery causing renal venous hypertension. Intermittent hematuria and orthostatic proteinuria with or without abdominal or flank pain are the common clinical manifestations. Presence of variable non-specific symptoms and non-significant physical findings results in a delayed diagnosis. CASE PRESENTATION: We present a ten -year -old girl with four episodes of painless gross hematuria and recurrent microscopic hematuria since the age of two years. Doppler ultrasound showed left renal vein compression while 3 D computerized tomography angiography confirmed the diagnosis of an anterior nutcracker. The patient was conservatively treated with nutritional support (pediasure complete formula and high calorie food), iron supplements and followed up, monitored for anemia, hypertension and renal insufficiency. CONCLUSION: Nutcracker syndrome is a rare cause of recurrent gross hematuria in children. A high index of suspicion and proper imaging is needed to reach a proper diagnosis and avoid the psychological and financial stress on the family.

The link between perceived characteristics of neighbourhood green spaces and adults' physical activity in UK cities: analysis of the EURO-URHIS 2 Study.

Background: Urban dwellers represent half the world's population and are increasing worldwide. Their health and behaviours are affected by the built environment and green areas may play a major role in promoting physical activity, thus decreasing the burden of chronic diseases, overweight and inactivity. However, the availability of green areas may not guarantee healthy levels of physical activity among the urban dwellers. It is therefore necessary to study how the perceived characteristics of green areas affect physical activity. Methods: Data from the EURO-URHIS 2 survey of residents of 13 cities across the UK were analyzed and a multivariable model was created in order to assess the association between their perceptions of the green areas in their neighbourhood and their engagement in physical activity. Results were adjusted for age, gender and other potential confounders. Results: Those who felt unable to engage in active recreational activities in their local green spaces were significantly less likely to carry out moderate physical exercise for at least 60 min per week (adjusted OR: 0.50; 95% 0.37-0.68). Availability of green areas within walking distance did not affect engagement in physical activity. Other characteristics such as accessibility and safety may play an important role. Conclusion: This study showed that the presence of green space may not itself encourage the necessary preventative health behaviours to tackle physical inactivity in urban populations. Development of more appropriate green spaces may be required. Further research is needed to shed light on the types green spaces that are most effective.

Correlation of Smoking and Myocardial Infarction Among Sudanese Male Patients Above 40 Years of Age.

To find an association between smoking and the development of myocardial infarction in male patients above forty years of age presenting at the echocardiology department of Sudan heart center Khartoum. A prospective cohort study was carried out at the echocardiography department of Sudan Heart Center in Khartoum-Sudan between July 2012 and June 2014. The study population comprised a total of 168 adult male patients who underwent cardiac ultrasound scanning. Out of a total of 144 cases, 65% (94) of patients were smokers, 74% of the 94 cases smoked for more than 10 years, and 26% of the 94 cases smoked for less than 10 years. With this study it was concluded that smoking is a risk factor for the development of myocardial infarction. This study showed that patients with myocardial infarction are more likely to have a past history of smoking.

Acute diverticulitis of the appendix.

Acute diverticulitis of the appendix (ADA), though uncommon, often presents similarly to acute appendicitis but carries a higher risk of complications such as perforation and malignancy. We report the case of a male patient in his 50s with acute right iliac fossa abdominal pain, diagnosed via CT scan with ADA. Urgent laparoscopic appendicectomy was performed, and the patient was discharged without further issues. This case highlights the importance of promptly identifying and managing such conditions to minimise complications and improve outcomes. Despite the overlap in symptoms between appendiceal diverticulitis and acute appendicitis, accurate diagnosis is crucial for appropriate treatment. Healthcare providers should maintain a high index of suspicion, particularly in older patients presenting with an acute appendicitis, like clinical picture to ensure timely intervention and optimal patient care.

Predicting regulatory mutations and their target genes by new computational integrative analysis: A study of follicular lymphoma.

Mutations in DNA regulatory regions are increasingly being recognized as important drivers of cancer and other complex diseases. These mutations can regulate gene expression by affecting DNA-protein binding and epigenetic profiles, such as DNA methylation in genome regulatory elements. However, identifying mutation hotspots associated with expression regulation and disease progression in non-coding DNA remains a challenge. Unlike most existing approaches that assign a mutation score to individual single nucleotide polymorphisms (SNP), a mutation block (MB)-based approach was introduced in this study to assess the collective impact of a cluster of SNPs on transcription factor-DNA binding affinity, differential gene expression (DEG), and nearby DNA methylation. Moreover, the long-distance target genes of functional MBs were identified using a new permutation-based algorithm that assessed the significance of correlations between DNA methylation at regulatory regions and target gene expression. Two new Python packages were developed. The Differential Methylation Region (DMR-analysis) analysis tool was used to detect DMR and map them to regulatory elements. The second tool, an integrated DMR, DEG, and SNP analysis tool (DDS-analysis), was used to combine the omics data to identify functional MBs and long-distance target genes. Both tools were validated in follicular lymphoma (FL) cohorts, where not only known functional MBs and their target genes (BCL2 and BCL6) were recovered, but also novel genes were found, including CDCA4 and JAG2, which may be associated with FL development. These genes are linked to target gene expression and are significantly correlated with the methylation of nearby DNA sequences in FL. The proposed computational integrative analysis of multiomics data holds promise for identifying regulatory mutations in cancer and other complex diseases.

Understanding GPs' referral decisions for younger patients with symptoms of cancer: a qualitative interview study.

BACKGROUND: Cancer incidence increases with age, so some clinical guidelines include patient age as one of the criteria used to decide whether a patient should be referred through the urgent suspected cancer (USC) pathway. Little is known about how strictly GPs adhere to these age criteria and what factors might influence their referral decisions for younger patients. AIM: To understand GPs' clinical decision making for younger patients with concerning symptoms who do not meet the age criteria for USC referral. DESIGN AND SETTING: Qualitative study using in-depth, semi-structured interviews with GPs working in surgeries across England. METHOD: Participants (n = 23) were asked to recall consultations with younger patients with cancer symptoms, describe factors influencing their clinical decisions, and discuss their overall attitude to age thresholds in cancer referral guidelines. A thematic analysis guided by the Framework approach was used to identify recurring themes. RESULTS: GPs' decision making regarding younger patients was influenced by several factors, including personal experiences, patients' views and behaviour, level of clinical concern, and ability to bypass system constraints. GPs weighted potential benefits and harms of a referral outside guidelines both on the patient and the health system. If clinical concern was high, GPs used their knowledge of local systems to ensure patients were investigated promptly even when not meeting the age criteria. CONCLUSION: While most GPs interpret age criteria flexibly and follow their own judgement and experience when making clinical decisions regarding younger patients, system constraints may be a barrier to timely investigation.