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We report a 7-year-old boy presenting with an acute upper gastrointestinal (GI) haemorrhage subsequently diagnosed to have a very rare duodenal gastrointestinal stromal tumour (GIST). Endoscopy, pertechnetate and red cell scans were negative. Abdominal US detected a 17-mm mass lesion of the third part of the duodenum. This was confirmed on CT and shown to be hypervascular on selective angiography. At laparotomy, a 20-mm submucosal duodenal lesion was found associated with mucosal ulceration. Immunohistochemical analysis revealed it to be positive for CD117 (c-KIT protein) consistent with a GIST. We emphasize the importance of a thorough abdominal US examination in children with GI haemorrhage and the consideration of GIST in the diagnosis after the common causes have been excluded. [ABSTRACT FROM AUTHOR]

The presence of latent infections was studied in five cowpeas varieties. Seeds of the varieties were planted and the seedlings inoculated with antigens from Cucumber mosaic virus (CMV) genus Cucumovirus, Bean common mosaic virus (BCMV) genus Potyvirus (Blackeye cowpea mosaic virus strain), Southern bean mosaic virus (SBMV) genus Sobemovirus and Cowpea mottle virus (CPMoV) genus Carmovirus seven days after planting. Seedlings expressing symptoms were rouged at two weeks after inoculation, while asymptomatic ones were subjected to serological indexing to detect the presence/absence of latent infection. Protein A-sandwich enzyme-linked immunosorbent assay (PAS ELISA) was employed for the serological detection of CMV, SBMV and CPMoV, while antigen-coated plate (ACP) ELISA was used to detect BCMV in the asymptomatic plants. Cowpea seedlings without virus symptoms but with positive serological reactions were considered as being latently infected. All of the inoculated TVu 1272 and SuVita-2 plants showed symptoms consistent with CMV and CPMoV infections, respectively. The rate of CMV latent infection was high in TVu 1179 (14.5%), low in SuVita-2 (1.3%) but not recorded in TVu 1272. [ABSTRACT FROM AUTHOR]

1. The codling moth Cydia pomonella, one of the most important pest insects of apple fruit orchards worldwide, is regarded as a ‘sedentary’ insect, but the natural populations consist of both mobile and sedentary genotypes that display different dispersal capacity in the field. The current study investigated whether there is a fitness consequence of being mobile in this species by comparing two strains with contrasting levels of mobility obtained through bi-directional selection. 2. Female moths of the sedentary strain were significantly larger, laid more eggs during their lifespan, and both male and female moths of this strain lived longer, when compared with the mobile strain. 3. The age-specific fecundity of female moths from the sedentary strain was significantly greater, in particular between 3 and 5 days after emergence when the peaks of both oviposition and flight capacity occur, relative to the mobile moths, thereby leading to a greater reproductive function. 4. These differences resulted in different demographic parameters between the two strains. The sedentary strain had a significantly greater net reproductive rate ( R o) and a higher intrinsic rate of natural increase ( r m), although the generation time ( T) was similar, hence requiring a shorter time to double the population size, in comparison to the mobile strain. 5. This study provides empirical evidence for the cost of being mobile in C. pomonella. Trade-offs between mobility and fitness might have contributed to the existence of genetic variance for dispersal behaviour in the natural populations and the maintenance of relative sedentariness in the species. [ABSTRACT FROM AUTHOR]

Background: Although MRI prognostic features for juvenile osteochondritis dissecans (JOCD) have been determined, the natural history of JOCD on serial MRI has not been fully documented.Objectives: To document the natural history of JOCD on serial MRI and to correlate this with arthroscopy and clinical outcome over a 5-year follow-up.Materials and Methods: Twenty-one knees in 19 patients (15 boys, 4 girls; age range 5-15 years) with JOCD underwent MRI and clinical follow-up over 5 years. Lesions were classified as stable or unstable on MRI and compared with clinical and arthroscopic data.Results: On 5-year follow-up, 17 of 19 patients were asymptomatic and 2 of 19 had minimal pain. Fourteen arthroscopies were performed on 11/21 knees. One of twenty-one had fragment fixation. On initial MRI, eight knees had marked fragmentation, high signal at the fragment/bone interface and incomplete defects in the hyaline cartilage (MRI stage III-stable), but no tear. Of these, five had arthroscopy, all confirming intact cartilage. One of twenty-one knees was unstable (MRI stage IVb) with a detached osteochondral fragment, requiring surgery.Conclusions: Despite extensive subchondral bone changes on MRI, all cases with intact cartilage (95%) improved with conservative treatment. Early MRI allows prompt diagnosis and institution of conservative treatment. This results in healing and avoidance of surgery in most patients. [ABSTRACT FROM AUTHOR]

Background/aims: The value of using qualitative methods within clinical trials is widely recognised. How qualitative research is integrated within trials units to achieve this is less clear. This paper describes the process through which qualitative research has been integrated within Cardiff University's Centre for Trials Research (CTR) in Wales, UK. We highlight facilitators of, and challenges to, integration. Methods: We held group discussions on the work of the Qualitative Research Group (QRG) within CTR. The content of these discussions, materials for a presentation in CTR, and documents relating to the development of the QRG were interpreted at a workshop attended by group members. Normalisation Process Theory (NPT) was used to structure analysis. A writing group prepared a document for input from members of CTR, forming the basis of this paper. Results: Actions to integrate qualitative research comprised: its inclusion in Centre strategies; formation of a QRG with dedicated funding/roles; embedding of qualitative research within operating systems; capacity building/training; monitoring opportunities to include qualitative methods in studies; maximising the quality of qualitative research and developing methodological innovation. Facilitators of these actions included: the influence of the broader methodological landscape within trial/study design and its promotion of the value of qualitative research; and close physical proximity of CTR qualitative staff/students allowing sharing of methodological approaches. Introduction of innovative qualitative methods generated interest among other staff groups. Challenges included: pressure to under-resource qualitative components of research, preference for a statistical stance historically in some research areas and funding structures, and difficulties faced by qualitative researchers carving out individual academic profiles when working across trials/studies. Conclusions: Given that CTUs are pivotal to the design and conduct of RCTs and related study types across multiple disciplines, integrating qualitative research into trials units is crucial if its contribution is to be fully realised. We have made explicit one trials unit's experience of embedding qualitative research and present this to open dialogue on ways to operationalise and optimise qualitative research in trials. NPT provides a valuable framework with which to theorise these processes, including the importance of sense-making and legitimisation when introducing new practices within organisations. [ABSTRACT FROM AUTHOR]

Explores the origins of action planning and action plans. Views of staff involved in action planning initiatives; Roots of action planning in guidance, psychology, organizational management, experiential learning and action research; Elements of action planning; Origins and their relationship to practice.

Background: COVID-19 related lockdowns may have affected engagement in health behaviours among the UK adult population. This prospective observational study assessed socio-demographic patterning in attempts to change and maintain a range of health behaviours and changes between two time points during the pandemic.Methods: Adults aged 18 years and over (n = 4,978) were recruited using Dynata (an online market research platform) and the HealthWise Wales platform, supplemented through social media advertising. Online surveys were conducted in August/September 2020 when lockdown restrictions eased in the UK following the first major UK lockdown (survey phase 1) and in February/March 2021 during a further national lockdown (survey phase 2). Measures derived from the Cancer Awareness Measure included self-reported attempts to reduce alcohol consumption, increase fruit/vegetable consumption, increase physical activity, lose weight and reduce/stop smoking. Multivariable logistic regressions were used to assess individual health behaviour change attempts over time, adjusted for age, sex, ethnicity, employment and education.Results: Around half of participants in survey phase 1 reported trying to increase physical activity (n = 2607, 52.4%), increase fruit/vegetables (n = 2445, 49.1%) and lose weight (n = 2413, 48.5%), with 19.0% (n = 948) trying to reduce alcohol consumption among people who drink. Among the 738 participants who smoked, 51.5% (n = 380) were trying to reduce and 27.4% (n = 202) to stop smoking completely. Most behaviour change attempts were more common among women, younger adults and minority ethnic group participants. Efforts to reduce smoking (aOR: 0.98, 95% CI: 0.82-1.17) and stop smoking (aOR: 0.98, 95% CI: 0.80-1.20) did not differ significantly in phase 2 compared to phase 1. Similarly, changes over time in attempts to improve other health behaviours were not statistically significant: physical activity (aOR: 1.07; 95% CI: 0.99-1.16); weight loss (aOR: 0.95; 95% CI: 0.90-1.00); fruit/vegetable intake (aOR: 0.98, 95% CI: 0.91-1.06) and alcohol use (aOR: 1.32, 95% CI: 0.92-1.91).Conclusion: A substantial proportion of participants reported attempts to change health behaviours in the initial survey phase. However, the lack of change observed over time indicated that overall motivation to engage in healthy behaviours was sustained among the UK adult population, from a period shortly after the first lockdown toward the end of the second prolonged lockdown. [ABSTRACT FROM AUTHOR]

Background: Paediatric mortality rates in the United Kingdom are amongst the highest in Europe. Clinically missed deterioration is a contributory factor. Evidence to support any single intervention to address this problem is limited, but a cumulative body of research highlights the need for a systems approach.Methods: An evidence-based, theoretically informed, paediatric early warning system improvement programme (PUMA Programme) was developed and implemented in two general hospitals (no onsite Paediatric Intensive Care Unit) and two tertiary hospitals (with onsite Paediatric Intensive Care Unit) in the United Kingdom. Designed to harness local expertise to implement contextually appropriate improvement initiatives, the PUMA Programme includes a propositional model of a paediatric early warning system, system assessment tools, guidance to support improvement initiatives and structured facilitation and support. Each hospital was evaluated using interrupted time series and qualitative case studies. The primary quantitative outcome was a composite metric (adverse events), representing the number of children monthly that experienced one of the following: mortality, cardiac arrest, respiratory arrest, unplanned admission to Paediatric Intensive Care Unit, or unplanned admission to Higher Dependency Unit. System changes were assessed qualitatively through observations of clinical practice and interviews with staff and parents. A qualitative evaluation of implementation processes was undertaken.Results: All sites assessed their paediatric early warning systems and identified areas for improvement. All made contextually appropriate system changes, despite implementation challenges. There was a decline in the adverse event rate trend in three sites; in one site where system wide changes were organisationally supported, the decline was significant (ß = -0.09 (95% CI: - 0.15, - 0.05); p = < 0.001). Changes in trends coincided with implementation of site-specific changes.Conclusions: System level change to improve paediatric early warning systems can bring about positive impacts on clinical outcomes, but in paediatric practice, where the patient population is smaller and clinical outcomes event rates are low, alternative outcome measures are required to support research and quality improvement beyond large specialist centres, and methodological work on rare events is indicated. With investment in the development of alternative outcome measures and methodologies, programmes like PUMA could improve mortality and morbidity in paediatrics and other patient populations. [ABSTRACT FROM AUTHOR]

Background: Water immersion during labour can provide benefits including reduced need for regional analgesia and a shorter labour. However, in the United Kingdom a minority of women use a pool for labour or birth, with pool use particularly uncommon in obstetric-led settings. Maternity unit culture has been identified as an important influence on pool use, but this and other possible factors have not been explored in-depth. Therefore, the aim of this study was to identify factors influencing pool use through qualitative case studies of three obstetric units and three midwifery units in the UK.Methods: Case study units with a range of waterbirth rates and representing geographically diverse locations were selected. Data collection methods comprised semi-structured interviews, collation of service documentation and public-facing information, and observations of the unit environment. There were 111 interview participants, purposively sampled to include midwives, postnatal women, obstetricians, neonatologists, midwifery support workers and doulas. A framework approach was used to analyse all case study data.Results: Obstetric unit culture was a key factor restricting pool use. We found substantial differences between obstetric and midwifery units in terms of equipment and resources, staff attitudes and confidence, senior staff support and women's awareness of water immersion. Generic factors influencing use of pools across all units included limited access to waterbirth training, sociodemographic differences in desire for pool use and issues using waterproof fetal monitoring equipment.Conclusions: Case study findings provide new insights into the influence of maternity unit culture on waterbirth rates. Access to pool use could be improved through midwives based in obstetric units having more experience of waterbirth, providing obstetricians and neonatologists with information on the practicalities of pool use and improving accessibility of antenatal information. In terms of resources, recommendations include increasing pool provision, ensuring birth room allocation maximises the use of unit resources, and providing pool room environments that are acceptable to midwives. [ABSTRACT FROM AUTHOR]

Despite impressive success in molecular physiological understanding of photosynthesis, and preliminary evidence on its potential for quantum shifts in agricultural productivity, the question remains of whether increased photosynthesis, without parallel fine-tuning of the associated processes, is enough. There is a distinct lack of formal socio-economic impact studies that address the critical questions of product profiling, cost–benefit analysis, environmental trade-offs, and technological and market forces in product acceptability. When a relatively well understood process gains enough traction for translational value, its broader scientific and technical gap assessment, in conjunction with its socio-economic impact assessment for success, should be a prerequisite. The successes in the upstream basic understanding of photosynthesis should be integrated with a gap analysis for downstream translational applications to impact the farmers' and customers' lifestyles and livelihoods. The purpose of this review is to assess how the laboratory, the field, and the societal demands from photosynthesis could generate a transformative product. Two crucial recommendations from the analysis of the state of knowledge and potential ways forward are (i) the formulation of integrative mega-projects, which span the multistakeholder spectrum, to ensure rapid success in harnessing the transformative power of photosynthesis; and (ii) stipulating spatiotemporal, labour, and economic criteria to stage-gate deliverables. [ABSTRACT FROM AUTHOR]

Mungbean [ Vigna radiata (L.) R. Wilczek var. radiata ] is an important pulse crop grown in south, east and southeast Asia. Mungbean seed samples harvested from field trials conducted in two environments in Hyderabad, India were utilized to determine genetic variation in the concentrations of minerals Fe, Ca, Mg, Zn, Cu, Mn, Se, Na, K and P and to determine the concentrations of phytic acid (PA) and phenolic compounds. Significant variations in Fe (35–87 mg/kg), Ca (1190–1580 mg/kg), Mg (970–1700 mg/kg), Zn (21–62 mg/kg), Cu (7.5–11.9 mg/kg), Mn (9.8–19.6 mg/kg), Se (0.21–0.91 mg/kg), K (8670–14,100 mg/kg) and P (2760–5170 mg/kg) were recorded in mungbean lines commonly grown in South Asia. The effect of the environment on the concentration of minerals in mungbean lines was observed. The Fe concentration of lines CN 9-5 and Harsha doubled when grown in soil with increased availability of Fe. The low PA concentration (2.6–3.8 g/kg) and the presence of phenolic compounds such as ferulic acid (1540–3400 μg/g) in mungbean may lead to increased bioavailability of micronutrients. Nutrient-rich mungbean should be included in diets to combat micronutrient malnutrition. [ABSTRACT FROM AUTHOR]

Legume breeding at AVRDC - The World Vegetable Center currently focuses on two crops: mungbean (Vigna radiata [L.] Wilzcek var. radiata) and vegetable soybean (Glycine max [L.] Merrill). High yielding, short duration mungbean varieties bred by AVRDC in conjunction with 29 national partners across Asia revolutionized the industry over the last two decades and increased global production by more than a third. New sources of resistance to mungbean yellow mosaic disease have been identified in related species such as black gram (Vigna mungo [L.] Hepper) and are being introgressed into elite mungbean lines. Improving protein quality by transferring high methionine and bruchid resistance traits from black gram is in progress. Selection of local land races and transfer of desirable traits from grain soybean are being used to develop vegetable soybean with higher pod yield, improved seed size and colour, higher sugar content, basmati flavour, less sensitive to photoperiod and temperature. [ABSTRACT FROM AUTHOR]

By the year 2050, agriculture will have to provide the food and nutrition requirements of some 9 billion people. Moreover, to maintain that level of productivity indefinitely it must do so using environmentally sustainable production systems. This task will be profoundly complicated by the effects of climate change, increasing competition for water resources and loss of productive lands. Agricultural production methods will also need to recognize and accommodate ongoing rural to urban migration and address a host of economic, ecological and social concerns about the 'high inputs/high outputs' model of present-day industrial agriculture. At the same time, there is a need to confront the unacceptable levels of continuing food and nutrition insecurity, greatest in the emerging economy countries of Africa and Asia where poverty, rapid population growth and climate change present additional challenges and where agriculture is practiced primarily by small-scale farmers. Within this context, we here review science-based evidence arguing that diversification with greater use of highly valuable but presently under-valorised crops and species should be an essential element of any model for sustainable smallholder agriculture. The major points of these development opportunity crops are presented in four sections: agricultural farming systems, health and nutrition, environmental sustainability and prosperity of the populations. For each section, these crops and their associated indigenous knowledge are reported to bring benefits and services when integrated with food systems. In this paper, we conclude that not only a change in policy is needed to influence behaviours and practices but also strong leadership able to synergize the various initiatives and implement an action plan. [ABSTRACT FROM AUTHOR]

Cowpea plays a key nutritional role in the diet of the Nigerian people. Viral diseases are a major limitation to cowpea production worldwide, and thus, constant viral surveillance is crucial for monitoring and management purposes. In this study, cowpea leaf samples from fields in three northern Nigeria states, Kano, Kaduna and Niger, were tested to determine the status of six common viruses previously reported in these cowpea-producing states following the release of virus-resistant varieties.Cowpea aphid-borne mosaic virus(CABMV),Blackeye cowpea mosaic virus(BICMV),Cowpea mottle virus,Southern bean mosaic virusandCucumber mosaic virus(CMV) were detected.Cowpea yellow mosaic virus, which was previously reported in all three states, was not detected in any of the samples tested, while CMV that was previously regarded as unimportant to cowpea production in Nigeria had the highest incidence in all three states, and the overall highest incidence of 58.8%, while CABMV had the lowest incidence (7.5%). CMV was also present in seven of the ten mixed infection combinations detected. Dual infection of CMV and BICMV, which often results in cowpea stunt, the most devastating cowpea disease in the USA, was the most frequently detected mixed infection (28.1%) and was detected in all three states. This observed elevation in CMV infection in cowpea must be closely monitored and swiftly managed to avert possible devastating crop yield losses. [ABSTRACT FROM AUTHOR]

Worldwide, cancer screening faced significant disruption in 2020 due to the COVID-19 pandemic. If this has led to changes in public attitudes towards screening and reduced intention to participate, there is a risk of long-term adverse impact on cancer outcomes. In this study, we examined previous participation and future intentions to take part in cervical and colorectal cancer (CRC) screening following the first national lockdown in the UK. Overall, 7543 adults were recruited to a cross-sectional online survey in August-September 2020. Logistic regression analyses were used to identify correlates of strong screening intentions among 2319 participants eligible for cervical screening and 2502 eligible for home-based CRC screening. Qualitative interviews were conducted with a sub-sample of 30 participants. Verbatim transcripts were analysed thematically. Of those eligible, 74% of survey participants intended to attend cervical screening and 84% intended to complete home-based CRC screening when next invited. Thirty percent and 19% of the cervical and CRC samples respectively said they were less likely to attend a cancer screening appointment now than before the pandemic. Previous non-participation was the strongest predictor of low intentions for cervical (aOR 26.31, 95% CI: 17.61-39.30) and CRC (aOR 67.68, 95% CI: 33.91-135.06) screening. Interview participants expressed concerns about visiting healthcare settings but were keen to participate when screening programmes resumed. Intentions to participate in future screening were high and strongly associated with previous engagement in both programmes. As screening services recover, it will be important to monitor participation and to ensure people feel safe to attend. [ABSTRACT FROM AUTHOR]

Mungbean ( Vigna radiata (L.) R. Wilczek var. radiata) is one of the most important pulse crops grown in South, East and Southeast Asia. It provides significant amounts of protein (240 g kg−1) and carbohydrate (630 g kg−1) and a range of micronutrients in diets. Mungbean protein and carbohydrate are easily digestible and create less flatulence than proteins derived from other legumes. In addition, mungbean is lower in phytic acid (72% of total phosphorus content) than pigeonpea ( Cajanus cajan L. Millsp.), soybean ( Glycine max L.) and cereals; phytic acid is commonly found in cereal and legume crops and has a negative impact on iron and zinc bioavailability in plant-based diets. Owing to its palatable taste and nutritional quality, mungbean has been used as an iron-rich whole food source for baby food. The wide genetic variability of mineral concentrations (e.g. 0.03-0.06 g Fe kg−1, 0.02-0.04 g Zn kg−1) in mungbean indicates possibilities to improve its micronutrient content through biofortification. Therefore biofortification of existing mungbean varieties has great potential for enhancing the nutritional quality of diets in South and Southeast Asia, where protein and micronutrient malnutrition are among the highest in the world. This review paper discusses the importance of mungbean in agricultural production and traditional diets and the potential of enhancing the nutritional quality of mungbean through breeding and other means, including agronomic practices. © 2013 Society of Chemical Industry [ABSTRACT FROM AUTHOR]

Diversifying diets and agricultural enterprises with fruit and vegetables is a potent weapon in the current global battle against malnutrition and poverty. Agricultural science can contribute substantially to enhance the development prospects and health of not only disadvantaged and vulnerable individuals at one end of the spectrum but also the growth and equity of national economies at the other. Moreover, with relatively simple applied research, new crop species and technologies can rapidly enter the development pathway to benefit even the poorest people or nations. More upstream research can help to guard fruit and vegetable production against the vagaries of potential climatic uncertainty, which is projected to become more prominent over future decades. However, historical and continuing widespread underinvestment in fruit and vegetable research and development from the national to the global level may severely compromise the world's ability to use such high- value species for crop diversification and as a major engine of development growth to ensure global food and nutritional security. [ABSTRACT FROM AUTHOR]

Studies the fatty-acid-and retinol-binding (FAR) protein family of nematode Caenorhabditis elegans (Ce). Interference of the proteins with intercellular lipid signaling to manipulate the defense reactions of the host; Production of a characteristic shift in peak fluorescence emission of DAUDA; Analysis of Ce-FAR proteins by circular dichroism and differential scanning calorimetry.