A protocol for a systematic review of clinical guidelines and published systematic reviews on the early detection of oral cancer

Background: The predicted increase in incidence of oral cavity cancer (OCC) coupled with high mortality and poor prognosis – particularly when diagnosed at a late/advanced stage – highlights the need for prevention and early detection/screening to reverse these trends. Dental healthcare professionals in primary care settings have a pivotal role in this effort. Aim: The aim of this protocol is to detail the process for assessing the evidence for the best practice and methods of early detection/screening for OCC in primary care dental settings by undertaking a systematic review of global clinical guidelines and published systematic reviews. Method: Searches for clinical guidelines and systematic reviews will be conducted in the following databases: Cochrane library, Medical Literature Analysis and Retrieval System Online (Ovid), Excerpta Medical dataBASE, PubMed, Turning Research into Practice, SCOPUS and Web of Science Core Collection. Our search will extend to include Google Scholar and international professional organizations/associations websites. In addition, we will handsearch the bibliographies and undertake citation searches of the selected papers. Quality appraisal will be undertaken using the Appraisal of Guidelines for Research and Evaluation version II instrument for the clinical guidelines and both A MeaSurement Tool to Assess Systematic Reviews and Risk of Bias in Systematic Reviews tools for the systematic reviews. A narrative synthesis approach will be used to assess the evidence of extracted data, primarily taking account of quality appraisal and recency of publication. Discussion: The synthesis of evidence will determine best practice for OCC early detection/screening by primary care dental healthcare professionals and will evaluate the relationship between clinical guidelines and the evidence base available from systematic reviews in this area

A Global Network of Science and Technology Advice in Foreign Ministries

This paper is a product of the International Dialogue on Science and Technology Advice in Foreign Ministries (Vienna Dialogue) in October 2016, involving more than twenty nations and several international organisations. The event was a key step to further develop the Foreign Minister Science and Technology Advisor Network (FMSTAN), growing from an initial group of five nations. The Vienna Dialogue was convened by the Fletcher School of Law and Diplomacy, Tufts University, and the International Institute for Applied Systems Analysis (IIASA) at the Vienna headquarters of IIASA, bringing together diplomats from foreign ministries to consider the value of evidence for informed decision-making by nations with regard to issues, impacts and resources within, across and beyond national boundaries. The evidence comes from the natural and social sciences with engineering and medicine as well as other areas of technology. By building common interests among nations, science is a tool of diplomacy, promoting cooperation and preventing conflict in our world. Science diplomacy was discussed as an international, interdisciplinary and inclusive process to help balance national interests and common interests in view of urgencies today and across generations in our globally-interconnected civilization

Global Research Priorities to Better Understand the Burden of Iatrogenic Harm in Primary Care: An International Delphi Exercise

There is a need to identify and reach agreement on key foci for patient safety research in primary care contexts and understand how these priorities differ between low-, middle-, and high-income settings. We conducted a modified Delphi exercise, which was distributed to an international panel of experts in patient safety and primary care. Family practice and pharmacy were considered the main contexts on which to focus attention in order to advance patient safety in primary care across all income categories. Other clinical contexts prioritised included community midwifery and nursing in low-income countries and care homes in high-income countries. The sources of patient safety incidents requiring further study across all economic settings that were identified were communication between health care professionals and with patients, teamwork within the health care team, laboratory and diagnostic imaging investigations, issues relating to data management, transitions between different care settings, and chart/patient record com- pleteness. This work lays the foundation for a range of research initiatives that aim to promote a more comprehensive appreciation of the burden of unsafe primary care, develop understanding of the main areas of risk, and identify interventions that can enhance the safety of primary care provision internationall

Twelve-month observational study of children with cancer in 41 countries during the COVID-19 pandemic

Introduction Childhood cancer is a leading cause of death. It is unclear whether the COVID-19 pandemic has impacted childhood cancer mortality. In this study, we aimed to establish all-cause mortality rates for childhood cancers during the COVID-19 pandemic and determine the factors associated with mortality. Methods Prospective cohort study in 109 institutions in 41 countries. Inclusion criteria: children <18 years who were newly diagnosed with or undergoing active treatment for acute lymphoblastic leukaemia, non-Hodgkin's lymphoma, Hodgkin lymphoma, retinoblastoma, Wilms tumour, glioma, osteosarcoma, Ewing sarcoma, rhabdomyosarcoma, medulloblastoma and neuroblastoma. Of 2327 cases, 2118 patients were included in the study. The primary outcome measure was all-cause mortality at 30 days, 90 days and 12 months. Results All-cause mortality was 3.4% (n=71/2084) at 30-day follow-up, 5.7% (n=113/1969) at 90-day follow-up and 13.0% (n=206/1581) at 12-month follow-up. The median time from diagnosis to multidisciplinary team (MDT) plan was longest in low-income countries (7 days, IQR 3-11). Multivariable analysis revealed several factors associated with 12-month mortality, including low-income (OR 6.99 (95% CI 2.49 to 19.68); p<0.001), lower middle income (OR 3.32 (95% CI 1.96 to 5.61); p<0.001) and upper middle income (OR 3.49 (95% CI 2.02 to 6.03); p<0.001) country status and chemotherapy (OR 0.55 (95% CI 0.36 to 0.86); p=0.008) and immunotherapy (OR 0.27 (95% CI 0.08 to 0.91); p=0.035) within 30 days from MDT plan. Multivariable analysis revealed laboratory-confirmed SARS-CoV-2 infection (OR 5.33 (95% CI 1.19 to 23.84); p=0.029) was associated with 30-day mortality. Conclusions Children with cancer are more likely to die within 30 days if infected with SARS-CoV-2. However, timely treatment reduced odds of death. This report provides crucial information to balance the benefits of providing anticancer therapy against the risks of SARS-CoV-2 infection in children with cancer

Development of a date confectionery: Part 1. Relating formulation to instrumental texture

The Sultanate of Oman in the Middle East produces a large amount of dates, which in 2003 amounted to about 285,360 tons. Most of the harvest is used for animal feed and the rest for local consumption. The need to utilize dates in a more efficient way is a must. In this study, a new candy was developed using two date varieties, i.e., Khalas and Umesilla thus spanning from top to bottom of the quality range in terms of consumer preference. Proximate analysis argues that products are nutritious and can contribute especially to the daily allowance in macro-elements. Texture profile analysis suggests that the affordable date candy of Umesilla belongs to the same family of products with the Khalas candy in terms of the attributes of hardness, firmness, brittleness and adhesiveness. Products were aged up to thirteen weeks, with results demonstrating that the textural quality remains stable throughout the storage period

Evaluating the quality and storage stability of fish burgers during frozen storage

In an attempt to initiate seafood biotechnology in the Sultanate of Oman, Middle East, using underutilized fish, fish burgers from two different formulas were developed and the quality and storage stability were evaluated during storage at -20°C for 3 months. Quality and storage stability were evaluated through total aerobic and coliform bacterial count, peroxide value, protein solubility, and color. Total aerobic bacteria were reduced significantly (P < 0.05) by 84% and 97% of the initial load in formulas 1 and 2, respectively, whereas coliforms were completely destroyed in both formulas at the end of storage. Peroxide value increased (P < 0.05) but did not reach detectable levels of rancidity. Salt-soluble protein content decreased remarkably during the storage period. The L value showed good stability during storage, keeping products bright for 3 months. Fish burgers from both formulas were acceptable for 3 months at -20°C. Storage stability was rationalized by the effectiveness of freezing, and antimicrobial and antioxidant properties of food additives. In an attempt to initiate seafood biotechnology in the Sultanate of Oman, Middle East, using underutilized fish, fish burgers from two different formulas were developed and the quality and storage stability were evaluated during storage at -20°C for 3 months. Quality and storage stability were evaluated through total aerobic and coliform bacterial count, peroxide value, protein solubility, and color. Total aerobic bacteria were reduced significantly (P < 0.05) by 84% and 97% of the initial load in formulas 1 and 2, respectively, whereas coliforms were completely destroyed in both formulas at the end of storage. Peroxide value increased (P < 0.05) but did not reach detectable levels of rancidity. Salt-soluble protein content decreased remarkably during the storage period. The L value showed good stability during storage, keeping products bright for 3 months. Fish burgers from both formulas were acceptable for 3 months at -20°C. Storage stability was rationalized by the effectiveness of freezing, and antimicrobial and antioxidant properties of food additives

Evaluation the spoilage and biogenic amines formation potential of marine Gram-positive bacteria

The ability of Gram-positive bacteria to form biogenic amines from different sources has been well documented; however, this ability and the spoilage potential of Gram-positive bacteria from marine sources have not been investigated. Therefore, this study aimed to evaluate the spoilage potential and the potential to form biogenic amines of 228 Gram-positive bacteria isolated from subtropical marine fish through their abilities to utilize organic and inorganic sulphur-containing sources, reduce trimethylamine oxide (TMAO) to trimethylamine (TMAO) and decarboxylate histidine, lysine and ornithine. Strains of Brevibacillus borstelensis (two), Streptococcus uberis (one), Vagococcus fluvialis (two) utilized sodium thiosulphate, cysteine and methionine. However, strains varied in sulphur source utilization. Exiguobacterium acetylicum (one), Exiguobacterium spp. (one), Carnobacterium spp. (one), Brev. borstelensis (two), Streptococcus uberis (two) and Vagococcus fluvialis (two) reduced TMAO. Histidine was not decarboxylated by any Gram-positive bacteria. Lysine and ornithine were decarboxylated mainly by strains of Staphylococcus warneri (eight), Staphylococcus epidermidis (seven) and Micrococcus luteus (two). This study found that Gram-positive bacteria of marine source were weak spoilers, however they had good potential to produce some biogenic amines and their potential was strain-dependent

Biogenic amines in fish: Roles in intoxication, spoilage, and nitrosamine formation - A review

Biogenic amines are non-volatile amines formed by decarboxylation of amino acids. Although many biogenic amines have been found in fish, only histamine, cadaverine, and putrescine have been found to be significant in fish safety and quality determination. Despite a widely reported association between histamine and scombroid food poisoning, histamine alone appears to be insufficient to cause food toxicity. Putrescine and cadaverine have been suggested to potentiate histamine toxicity. With respect to spoilage on the other hand, only cadaverine has been found to be a useful index of the initial stage of fish decomposition. The relationship between biogenic amines, sensory evaluation, and trimethylamine during spoilage are influenced by bacterial composition and free amino acid content. A mesophilic bacterial count of log 6-7 cfu/g has been found to be associated with 5 mg histamine/100 g fish, the Food and Drug Administration (FDA) maximum allowable histamine level. In vitro studies have shown the involvement of cadaverine and putrescine in the formation of nitrosamines, nitrosopiperidine (NPIP), and nitrosopyrrolidine (NPYR), respectively. In addition, impure salt, high temperature, and low pH enhance nitrosamine formation, whereas pure sodium chloride inhibits their formation. Understanding the relationships between biogenic amines and their involvement in the formation of nitrosamines could explain the mechanism of scombroid poisoning and assure the safety of many fish products

Heavy vehicle safety in Oman: Police interviews and heavy vehicle driver survey and focus groups. Third Report of the Heavy Vehicle Safety Research in Oman Project for The Research Council of Oman.

Over the past six months the project has undertaken three key, separate, data collection\ud rounds. Each of these rounds focused on essentially different issues within the broader\ud common construct of heavy vehicle road safety. This document will initially report on a\ud series of two key qualitative data collections rounds. Firstly it will detail findings and report\ud on discussions held in focus groups with 43 heavy vehicle drivers. The second qualitative\ud study involved a series of interviews undertaken with 19 police officers from various levels\ud of command and operations within the Royal Oman Police. The final data collection round\ud reported on in this document is a roadside survey questionnaire undertaken with 400 heavy\ud vehicle drivers