bluuebunny/crossref_metadata_2025 huggingface dataset:
Soda Consumption Among Mexican Construction Workers in the Context of the Sugar-Sweetened Beverage Tax
Authors: Álvarez-Sánchez Cristina , Guillén Héctor , Contento Isobel R. , Koch Pamela , Théodore Florence L.
Published: October 2021

This study explored the psychosocial determinants of consumption of soda and other taxed sugar-sweetened beverages (SSBs) in Mexican construction workers (CWs) and whether consumption changed as a result of the 2014 SSB tax. We conducted a qualitative case study involving in-depth interviews and focus groups (FGs) with 30 Mexican CWs; supplemented with descriptions of the food and beverages consumed during lunch breaks. We used NVivo 10 to classify information according to the analysis categories, primarily informed by the Reasoned Action Approach (RAA). CWs reported not having changed their consumption of soda and other taxed SSBs as a result of the SSB tax, despite the price increase and “knowing” the potential negative consequences of soda drinking. The most important determinants of soda consumption are a deep-seated social norm of soda drinking and use of soda drinking as part of their professional identity; their likeness for soda; a wide availability of soda in their environments; and a low perceived behavioral control (because they thought themselves as addicted to it). Participants indicated that the best way for them not to consume soda would be if it were not available. These findings lend support for the tight regulation of the availability of SSBs. To have a meaningful impact on these consumers, the SSB tax may need to be much higher. Policy-level interventions should be coupled with interventions at the individual and community levels that aim at denormalizing soda consumption, create new meanings in relation to water consumption, and develop behavioral control to decrease soda consumption.
Ligand Docking Methods to Recognize Allosteric Inhibitors for G-Protein-Coupled Receptors
Authors: Harini K , Jayashree S , Tiwari Vikas , Vishwanath Sneha , Sowdhamini Ramanathan
Published: October 2021

G-protein-coupled receptors (GPCRs) are membrane proteins which play an important role in many cellular processes and are excellent drug targets. Despite the existence of several US Food and Drug Administration (FDA)-approved GPCR-targeting drugs, there is a continuing challenge of side effects owing to the nonspecific nature of drug binding. We have investigated the diversity of the ligand binding site for this class of proteins against their cognate ligands using computational docking, even if their structures are known already in the ligand-complexed form. The cognate ligand of some of these receptors dock at allosteric binding site with better score than the binding at the conservative site. Interestingly, amino acid residues at such allosteric binding site are not conserved across GPCR subfamilies. Such a computational approach can assist in the prediction of specific allosteric binders for GPCRs.
Teaching out loud: Queer futurity within high school settings
Authors: Taylor Donald M
Published: October 2021

The purpose of this study was to examine how four openly gay male music teachers in distinct US regions enacted Jose Muñoz’s vision of queer futurity within their respective campus environments. Data included field notes from a minimum of six class observations and 59 interviews divided between teachers, administrators, instructional colleagues in other subject areas, students, and students’ parents. Administrators at each school were highly supportive and indicated that gay representation provided a valuable contribution to their school’s commitment to diverse representation. Data also showed that when teachers were open about their sexuality, students felt empowered to live life by their own personal standards, rather than bowing to peer pressure.
Professor Duncan Dowson, a source of inspiration
Authors: Lubrecht Ton , Biboulet Nans , Venner Kees
Published: October 2021

The current paper highlights the contribution of the Dowson and Higginson work to numerical line contact elastohydrodynamic lubrication film thickness prediction and the Hamrock and Dowson contribution to the film thickness prediction in elliptical contacts. This paper shows that, even by today’s standards, both the numerical pressure and film thickness results and the curve-fitted film thickness predictions are very accurate. As for the elliptical results, the authors show that the original predictions remain surprisingly accurate for moderately elliptical contact. For very long elliptical contacts, their prediction does not tend to a line contact asymptote. This paper then concludes that the predicted pressure spikes by Dowson, Higginson, and Hamrock are correct in shape and amplitude, at least near pure rolling conditions.
Film thickness interrelationship of base oil and grease lubricated compliant and hard non-conformal contacts
Authors: Fryza Josef , Sperka Petr , Krupka Ivan , Hartl Martin
Published: October 2021

The interfaces of plastic components are often operated as self-lubricating or lubricated with greases close to the piezoviscous-elastic lubrication regime. However, current basic tribological knowledge about grease-lubricated compliant contacts is still very limited. This experimental study provides insight into relations between film thicknesses of grease and its base oil in compliant polymethylmethacrylate–steel and stiff glass–steel point contacts at different speeds and loads. The results are compared with predictions. The ratio between grease and its base oil film thickness was found to be significantly influenced by the interplay of load and the non-Newtonian response of grease, especially for the compliant contact, while the effect of speed and the slide-to-roll ratio was considerably lower. The role of viscoelasticity and grease thickener concentration is discussed.
A higher burden of multiple sclerosis genetic risk confers an earlier onset
Authors: Misicka Elina , Davis Mary F , Kim Woori , Brugger Steven W , Beales Jeremy , Loomis Stephanie , Bronson Paola G , Briggs Farren BS
Published: October 2021

Background:

Age at onset of multiple sclerosis (MS) is an objective, influential predictor of the evolution of MS independent of disease duration.

Objectives:

Determine the influence of MS genetic predisposition on age of onset.

Methods:

We conducted a comprehensive investigation of MS risk variants and age at onset in 3495 non-Latinx white individuals, including for combinations of HLA-DRB1*15:01 alleles and quintiles of an unweighted genetic risk score (GRS) for 198 of 200 autosomal MS risk variants that reside outside the major histocompatibility complex.

Results:

The mean age at onset was 32 years, 29% were male, and 46% were HLA-DRB1*15:01 carriers. For those with the greatest genetic risk burden (the highest GRS quintile with two HLA-DRB1*15:01 alleles) were on average 5 years younger at onset ( p = 0.002) than those with the lowest genetic risk burden (the lowest GRS quintile with no HLA-DRB1*15:01 alleles). There was a strong inverse relationship between the MS genetic risk burden and age at onset of MS ( p < 5 × 10−8).

Conclusion:

We demonstrate a significant gradient between elevated MS genetic risk burden and an earlier onset of MS, suggesting that a higher MS genetic risk burden accelerates onset of the disease.
A new type connection with optimum stiffness configuration for very large floating platforms
Authors: Lu Ye , Zhang Haicheng , Chen Yuchao , Shi Qijia , Zhou Ye
Published: October 2021

A novel connection for super-scale modularized floating platforms is put forward for the purposes of suppressing the oscillation of the platform. The platform consists of multiple blocks where semi-submergible modules are flexibly connected with upper decks by elastic cushions. For the connection between adjacent blocks, neighboring decks are linked by rigid hinges and neighboring floating modules are connected by flexible linkages. Based on the linear wave theory and rigid-module-flexible-connection (RMFC) model, the governing equation of motions for the modularized floating platform is derived by using a network modeling method. In numerical case studies, a five-block platform is investigated. Taking combined responses of the platform and the connector loads as an objective function, the stiffness configuration of the connection and the elastic cushion is optimally determined by using a genetic algorithm. At last, the short-term extreme responses of the floating platform with the optimum setting of the stiffness configuration of the connection are analyzed.
Performance of Renal Allografts Perfused With Verapamil-Treated Perfusion Solution
Authors: Boyer Allison Jo , Ketcham Rachael Erin , Hostetler Clint Allen , Orlowski Jeffrey Paul , Squires Ronald A.
Published: October 2021

Verapamil has been used in perfusion solution to improve kidney performance, but evidence was anecdotal, and no research has been reported on recipient outcomes. Our organization began a program to evaluate Verapamil’s effect on pump performance, transplant rate, and recipient outcomes. One kidney in a pair was treated with Verapamil and one with standard perfusion. Donor inclusion criteria were age 18 or older and both kidneys were placed on the pump. The laterality of the treated kidney was changed every month to reduce bias. From January 1, 2020 to June 30, 2020, 88 kidneys were evaluated. Of those, 21 donors had both kidneys transplanted to different recipients, so for those 42 kidneys, recipient outcomes were evaluated. Small improvements in pump performance were observed in the Verapamil-treated kidneys and more were transplanted. No clinical differences were found in recipients between the Verapamil-treated and standard perfused kidneys. A larger cohort is needed to determine whether differences are significant.
Thioredoxin-mediated alteration of protein content and cytotoxicity of Acinetobacter baumannii outer membrane vesicles
Authors: Shrihari Swathi , May Holly C , Yu Jieh-Juen , Papp Sara B , Chambers James P , Guentzel M Neal , Arulanandam Bernard P
Published: October 2021

Acinetobacter baumannii is a Gram-negative bacterium responsible for many hospital-acquired infections including ventilator-associated pneumonia and sepsis. We have previously identified A. baumannii thioredoxin A protein (TrxA) as a virulence factor with a multitude of functions including reduction of protein disulfides. TrxA plays an important role in resistance to oxidative stress facilitating host immune evasion in part by alteration of type IV pili and cell surface hydrophobicity. Other virulence factors such as outer membrane vesicles (OMV) shed by bacteria have been shown to mediate bacterial intercellular communication and modulate host immune response. To investigate whether OMVs can be modulated by TrxA, we isolated OMVs from wild type (WT) and TrxA-deficient (ΔtrxA) A. baumannii clinical isolate Ci79 and carried out a functional and proteomic comparison. Despite attenuation of ΔtrxA in a mouse challenge model, pulmonary inoculation of ΔtrxA OMVs resulted in increased lung permeability compared to WT OMVs. Furthermore, ΔtrxA OMVs induced more J774 macrophage-like cell death than WT OMVs. This ΔtrxA OMV-mediated cell death was abrogated when cells were incubated with protease-K-treated OMVs suggesting OMV proteins were responsible for cytotoxicity. We therefore compared WT and mutant OMV proteins using proteomic analysis. We observed that up-regulated and unique ΔtrxA OMV proteins consisted of many membrane bound proteins involved in small molecule transport as well as proteolytic activity. Bacterial OmpA, metalloprotease, and fimbrial protein have been shown to enhance mammalian cell apoptosis through various mechanisms. Differential packaging of these proteins in ΔtrxA OMVs may contribute to the increased cytotoxicity observed in this study.
Risk factors of recurrence after endovascular embolization of posterior communicating artery aneurysms
Authors: Wu Degang , Sheng Bin , Fang Xinggen , Li Zhenbao
Published: October 2021

Background and objective

To determine the risk factors for recurrence after endovascular embolization of posterior communicating artery aneurysms (PcomA).

Methods

We retrospectively analyzed a cohort of 163 patients harboring 172 PocmAs who were treated with endovascular embolization from January 2019 to December 2020. The patients were divided into recurrence and stable groups depending on outcome. Univariate and logistic regression analyses were performed to determine the potential risk factors of recurrence during follow-up.

Results

Of the total 163 patients harboring 172 aneurysms, 107 were treated with simple coil occlusion and 65 were treated with stent-assisted coil embolization. There were significant differences in aneurysm sizes and use of non-stent-assisted coil embolizations between the groups (P < 0.05). The incidence of saccular aneurysm and Raymond grade were significantly higher in the recurrent group than in the stable group (P < 0.01). After variable selection, Raymond grade, aneurysm size, saccular aneurysm and non-stent-assisted coil embolization were included in further analysis. Binary logistic regression analysis revealed significant associations with non-stent-assisted coil embolization (P = 0.007), packing density (P < 0.001) and Raymond grades II (P < 0.001) and III (P = 0.002).

Conclusion

Non-stent-assisted coil embolization, as well as packing density and Raymond grades II grade III are associated with recurrence after endovascular treatment of PcomA.
An exploratory study of undergraduate healthcare student perspectives regarding human papillomavirus and vaccine intent in India
Authors: Shetty Seemitha , Shetty Veena , Badiger Sanjeev , Shetty Avinash K
Published: October 2021

Objective:

Safe and effective human papillomavirus vaccines are available against cervical cancer and other human papillomavirus–associated diseases. Vaccine uptake is low in India given lack of universal vaccination programme. This exploratory study describes the medical, dental and nursing undergraduate student perspectives about human papillomavirus and intentions to receive the vaccine.

Methods:

Using a cross-sectional, explorative study design, we conducted two focus group discussions among a convenience sample of male (n = 11) and female (n = 9) student group aged ⩾18 years, respectively, at a medical college in South India. The focus group discussion sessions were recorded, transcribed and analysed using thematic content analysis.

Results:

Over half of the students showed adequate knowledge of cervical cancer and human papillomavirus. Medical students had much in-depth knowledge of cervical cancer, vaccine cost and its side effects compared to dental and nursing students. Human papillomavirus vaccine knowledge was relatively less among males compared to females; most male participants were unaware of the availability of the human papillomavirus vaccine. Intention to receive the vaccine was higher among females than males. All the participants had positive attitude in creating awareness in the community and making the vaccine cost-effective. Cultural concerns and high vaccine cost were cited major barriers for vaccine uptake. Suggestion of physician recommendation in promotion of human papillomavirus vaccine uptake was an emerging theme.

Conclusion:

Educating male students and those enrolled in dental and nursing courses about human papillomavirus vaccine, addressing cultural concerns and advocating provider recommendation for promoting vaccine uptake are potential strategies to improve future human papillomavirus vaccine intent among students and recommendations to patients in their role as future healthcare provider.
Gardner-associated fibroma presenting as an unusual floor of mouth mass in a child
Authors: Anicete Rosslyn , Low Mei-Yi
Published: October 2021

Floor of mouth lesions in the paediatric population are uncommon. The spectrum of pathology that afflicts the floor of mouth spans inflammatory conditions, developmental anomalies, vascular malformations and benign tumours or malignancies. We report a rare case of Gardner-associated fibroma (GAF) presenting as a slow-growing floor of mouth mass in a 10-year-old boy. GAF is associated with Gardner’s syndrome (GS) and familial adenomatous polyposis (FAP), both of which are associated with multiple colonic polyps and increased risk of colorectal malignancy. To our knowledge, this case report represents the first case in the literature of a GAF presenting in the floor of mouth of a paediatric patient, and discusses the clinical implications of this rare diagnosis.
MTORC1 signaling as a biomarker in major depressive disorder and its pharmacological modulation by novel rapid-acting antidepressants
Authors: Cholewinski Tomasz , Pereira Diana , Moerland Matthijs , Jacobs Gabriel E.
Published: October 2021

Major depressive disorder (MDD) is a multifactorial psychiatric disorder with obscure pathophysiology. A biomarker-based approach in combination with standardized interview-based instruments is needed to identify MDD subtypes and novel therapeutic targets. Recent findings support the impairment of the mammalian target of rapamycin complex 1 (mTORC1) in MDD. No well-established biomarkers of mTORC1 disease- and treatment-modulated activity are currently available for use in early phase antidepressant drug (AD) development. This review aims to summarize biomarkers of mTORC1 activity in MDD and to suggest how these could be implemented in future early clinical trials on mTORC1 modulating ADs. Therefore, a PubMed-based narrative literature review of the mTORC1 involvement in MDD was performed. We have summarized recent pre-clinical and clinical findings linking the MDD to the impaired activity of several key biomarkers related to mTORC1. Also, cases of restoration of these impairments by classical ADs and novel fast-acting investigational ADs are summarized. The presented biomarkers may be used to monitor pharmacological effects by novel rapid-acting mTORC1-targeting ADs. Based on findings in the peripheral blood mononuclear cells, we argue that those may serve as an ex vivo model for evaluation of mTORC1 activity and propose the use of the summarized biomarkers for this purpose. This could both facilitate the selection of a pharmacodynamically active dose and guide future early clinical efficacy studies in MDD. In conclusion, this review provides a blueprint for the rational development of rapid-acting mTORC1-targeting ADs.
Transcranial magnetic stimulation for post-traumatic stress disorder
Authors: Petrosino Nicholas J. , Cosmo Camila , Berlow Yosef A. , Zandvakili Amin , van ’t Wout-Frank Mascha , Philip Noah S.
Published: October 2021

Post-traumatic stress disorder (PTSD) is a debilitating psychiatric disorder. While current treatment options are effective for some, many individuals fail to respond to first-line psychotherapies and pharmacotherapy. Transcranial magnetic stimulation (TMS) has emerged over the past several decades as a noninvasive neuromodulatory intervention for psychiatric disorders including depression, with mounting evidence for its safety, tolerability, and efficacy in treating PTSD. While several meta-analyses of TMS for PTSD have been published to date showing large effect sizes on PTSD overall, there is marked variability between studies, making it difficult to draw simple conclusions about how best to treat patients. The following review summarizes over 20 years of the existing literature on TMS as a PTSD treatment, and includes nine randomized controlled trials and many other prospective studies of TMS monotherapy, as well as five randomized controlled trials investigating TMS combined with psychotherapy. While the majority of studies utilize repetitive TMS targeted to the right dorsolateral prefrontal cortex (DLPFC) at low frequency (1 Hz) or high frequency (10 or 20 Hz), others have used alternative frequencies, targeted other regions (most commonly the left DLPFC), or trialed different stimulation protocols utilizing newer TMS modalities such as synchronized TMS and theta-burst TMS (TBS). Although it is encouraging that positive outcomes have been shown, there is a paucity of studies directly comparing available approaches. Biomarkers, such as functional imaging and electroencephalography, were seldomly incorporated yet remain crucial for advancing our knowledge of how to predict and monitor treatment response and for understanding mechanism of action of TMS in this population. Effects on PTSD are often sustained for up to 2–3 months, but more long-term studies are needed in order to understand and predict duration of response. In short, while TMS appears safe and effective for PTSD, important steps are needed to operationalize optimal approaches for patients suffering from this disorder.
Becoming a global nurse: A thematic and interpretive analysis of bachelor's theses at the Swedish Red Cross University College
Authors: Paillard Borg Stéphanie , Kraft Mia
Published: October 2021

The overall purpose of this study was to initiate the process of developing a comprehensive theoretical framework associating the three entities defining the Swedish Red Cross University College (SRCUC): global nursing, global health and Red Cross and Red Crescent's perspective (RCRC). To do so, an analysis of nursing bachelor's theses over two periods (2011–2012 and 2015–2016) was initially needed to capture the academic essence. Two specific aims were defined: 1) To describe how global nursing and global health, in conjunction with the RCRC perspective, were addressed and contextualized in nursing bachelor's theses; and 2) To investigate how students’ knowledge in global awareness and vision has developed over time. Two overarching themes were identified: Conceptualizing caring relations and moving towards the body of global awareness and Understanding the art of nursing and ethics in complex nursing actions. The Standards for Reporting Qualitative Research (SRQR) guidelines were used to ensure the trustworthiness of the findings. By promoting relevant knowledge, the SRCUC prepares future nurses for upcoming health needs at the planetary level.
The Indus and Mekong River Basins: Cooperation and Disputes
Authors: Ranjan Amit
Published: October 2021

The Indus Waters Treaty (IWT) and the Agreement on the Cooperation for the Sustainable Development of the Mekong River Basin are two of the most important transboundary water treaties signed between member states that have a history of disputes and wars. In the case of India and Pakistan, voices to scrap the IWT in both countries are made chiefly because of their day-to-day bitter relationships. The treaty nevertheless remains in effect. The Mekong River Basin countries have had sour relationships in the past, and even after the agreement was signed in 1995 some political differences and disputes between them have remained. In both the Indus and Mekong basins, China is an important upper riparian. This article discusses the IWT and Agreement among the Mekong basin countries and examines the convergences and divergences between the two. It then analyses the role of China, as an upper basin to Indus and Mekong.
A Case of COVID-19 Vaccine Associated New Diagnosis Myasthenia Gravis
Authors: Chavez Augustine , Pougnier Charlotte
Published: October 2021

An 82-year-old man presented with intermittent episodes of slurred speech during his evening meals after receiving the BNT162b2 COVID-19 vaccine. Thorough evaluation was conducted including lab work and EMG confirming a new diagnosis of late-onset myasthenia gravis. Despite treatment, the patient progressed rapidly to severe exacerbation requiring intubation and placement of a PEG tube. Infections provoking new diagnosis and exacerbations of myasthenia gravis have been reported. New diagnosis of myasthenia gravis associated with the COVID-19 vaccine is rarely reported. This case highlights the need for clinicians to be aware of the uncommon presenting symptoms in late-onset myasthenia gravis and the possibility of vaccine provoked diagnoses of immune mediated diseases.
Reporting Issues of Adverse Effect of COVID-19 Vaccine in India: What We Know or Don’t Know?
Authors: Dixit Priyanka , Chanda Srei , Dwivedi Laxmi Kant , Bhatia Mrigesh
Published: October 2021

Vaccines for COVID-19 in India have been allowed to be administered among large pool of adult population. In-depth knowledge regarding the adverse effect of vaccine is scarce till date, mainly due to the lack of reporting, analysing and making the data publicly available. Informed choice by the recipients is totally barred and further, compensation associated with the vaccination is also compromised. These important issues need to be highlighted in the public forum for greater awareness and action.
Baseline IL-6 is a biomarker for unfavourable tuberculosis treatment outcomes: a multisite discovery and validation study
Authors: Gupte Akshay N. , Kumar Pavan , Araújo-Pereira Mariana , Kulkarni Vandana , Paradkar Mandar , Pradhan Neeta , Menon Pradeep , Padmapriyadarsini Chandrasekaran , Hanna Luke-Elizabeth , Yogendra Shivakumar Shri Vijay Bala , Rockwood Neesha , Du Bruyn Elsa , Karyakarte Rajesh , Gaikwad Sanjay , Bollinger Robert , Golub Jonathan , Gupte Nikhil , Viswanathan Vijay , Wilkinson Robert J. , Mave Vidya , Babu Subash , Kornfeld Hardy , Andrade Bruno B. , Gupta Amita
Published: October 2021

Background

Biomarkers of unfavourable tuberculosis (TB) treatment outcomes are needed to accelerate new drug and regimen development. Whether plasma cytokine levels can predict unfavourable TB treatment outcomes is unclear.

Methods

We identified and internally validated the association between 20a prioriselected plasma inflammatory markers and unfavourable treatment outcomes of failure, recurrence and all-cause mortality among adults with drug-sensitive pulmonary TB in India. We externally validated these findings in two independent cohorts of predominantly diabetic and HIV co-infected TB patients in India and South Africa, respectively.

Results

Pre-treatment interferon-γ, interleukin (IL)-13 and IL-6 were associated with treatment failure in the discovery analysis. Internal validation confirmed higher pre-treatment IL-6 concentrations among failure cases compared with controls. External validation among predominantly diabetic TB patients found an association between pre-treatment IL-6 concentrations and subsequent recurrence and death. Similarly, external validation among predominantly HIV co-infected TB patients found an association between pre-treatment IL-6 concentrations and subsequent treatment failure and death. In a pooled analysis of 363 TB cases from the Indian and South African validation cohorts, high pre-treatment IL-6 concentrations were associated with higher risk of failure (adjusted OR (aOR) 2.16, 95% CI 1.08–4.33; p=0.02), recurrence (aOR 5.36, 95% CI 2.48–11.57; p<0.001) and death (aOR 4.62, 95% CI 1.95–10.95; p<0.001). Adding baseline IL-6 to a risk prediction model comprised of low body mass index, high smear grade and cavitation improved model performance by 15% (C-statistic 0.66versus0.76; p=0.02).

Conclusions

Pre-treatment IL-6 is a biomarker for unfavourable TB treatment outcomes. Future studies should identify optimal IL-6 concentrations for point-of-care risk prediction.
The Frail’BESTest: an adaptation of the “balance evaluation system test” for frail older adults; Concurrent validity, responsiveness, validity for fall prediction and detection of slower walkers
Authors: Kubicki A. , Laroche D. , Coquisart L. , Basile G. , Brika M. , Mourey F.
Published: October 2021

Background

The Frail’BESTest was developed in order to include frail older adults when they are using the BESTest. Recently, psychometrics properties (internal coherence, systems usefulness, complementarity and inter-rater reliability) of the Frail’BESTest were tested. To complete these analyses, this study will aim the assessment of its concurrent validity, responsiveness, predictive validity on falls occurrence, and slower walkers detection.

Methods

The correlation between the Frail’BESTest and the Gait Speed Test permitted to assess concurrent validity. The variation between the initial test score and the score obtained after the completion of a rehabilitation program was used to evaluate responsiveness with MANOVA analysis and standard response mean (SRM) calculation. Predictive validity was assessed with receiver-operating characteristic curves and area under the curve (AUC) analysis regarding falls occurrence. Slower walkers detection thresholds were computed by receiver-operating characteristic curves for the Frail’BESTest and the Tinetti test.

Results

The concurrent validity of the test was good (r = 0.74; p < 0.001). The Standard Error of measurement was at 2.81 points and the Minimal Detectable Change at 7.79 points for the total score of the Frail’BESTest. The SRM was at 0.41 for the Tinetti test and 0.56 for the Frail’BESTest. The AUC, computed according to fall occurrence, was at 0.71 for the Gait Speed test, 0.673 for the Tinetti test and 0.693 for the Frail’BESTest. Both the Tinetti (AUC = 0.87) and the Frail’BESTest (AUC = 0.88) were found suitable for tracking slower walkers.

Conclusion

Concurrent validity and responsiveness of the Frail’BESTest were good. As for the Tinetti and the Frail’BESTest, they were unable to predict efficiently falls occurrence in the tested sample. The Frail’BESTest seems enough sensitive to spot the slower walkers efficiently, using a 15/20 threshold method. The Frail’BESTest was found to be a valid and responsive clinical test, therefore it can be recommended as an outcome measure in clinical practice.
A cis-regulatory element promoting increased transcription at low temperature in cultured ectothermic Drosophila cells
Authors: Bai Yu , Caussinus Emmanuel , Leo Stefano , Bosshardt Fritz , Myachina Faina , Rot Gregor , Robinson Mark D. , Lehner Christian F.
Published: October 2021

Background

Temperature change affects the myriad of concurrent cellular processes in a non-uniform, disruptive manner. While endothermic organisms minimize the challenge of ambient temperature variation by keeping the core body temperature constant, cells of many ectothermic species maintain homeostatic function within a considerable temperature range. The cellular mechanisms enabling temperature acclimation in ectotherms are still poorly understood. At the transcriptional level, the heat shock response has been analyzed extensively. The opposite, the response to sub-optimal temperature, has received lesser attention in particular in animal species. The tissue specificity of transcriptional responses to cool temperature has not been addressed and it is not clear whether a prominent general response occurs. Cis-regulatory elements (CREs), which mediate increased transcription at cool temperature, and responsible transcription factors are largely unknown.

Results

The ectotherm Drosophila melanogaster with a presumed temperature optimum around 25 °C was used for transcriptomic analyses of effects of temperatures at the lower end of the readily tolerated range (14–29 °C). Comparative analyses with adult flies and cell culture lines indicated a striking degree of cell-type specificity in the transcriptional response to cool. To identify potential cis-regulatory elements (CREs) for transcriptional upregulation at cool temperature, we analyzed temperature effects on DNA accessibility in chromatin of S2R+ cells. Candidate cis-regulatory elements (CREs) were evaluated with a novel reporter assay for accurate assessment of their temperature-dependency. Robust transcriptional upregulation at low temperature could be demonstrated for a fragment from the pastrel gene, which expresses more transcript and protein at reduced temperatures. This CRE is controlled by the JAK/STAT signaling pathway and antagonizing activities of the transcription factors Pointed and Ets97D.

Conclusion

Beyond a rich data resource for future analyses of transcriptional control within the readily tolerated range of an ectothermic animal, a novel reporter assay permitting quantitative characterization of CRE temperature dependence was developed. Our identification and functional dissection of the pst_E1 enhancer demonstrate the utility of resources and assay. The functional characterization of this CoolUp enhancer provides initial mechanistic insights into transcriptional upregulation induced by a shift to temperatures at the lower end of the readily tolerated range.
COVID-19 underreporting and its impact on vaccination strategies
Authors: Albani Vinicius , Loria Jennifer , Massad Eduardo , Zubelli Jorge
Published: October 2021

Background

Underreporting cases of infectious diseases poses a major challenge in the analysis of their epidemiological characteristics and dynamical aspects. Without accurate numerical estimates it is difficult to precisely quantify the proportions of severe and critical cases, as well as the mortality rate. Such estimates can be provided for instance by testing the presence of the virus. However, during an ongoing epidemic, such tests’ implementation is a daunting task. This work addresses this issue by presenting a methodology to estimate underreported infections based on approximations of the stable rates of hospitalization and death.

Methods

We present a novel methodology for the stable rate estimation of hospitalization and death related to the Corona Virus Disease 2019 (COVID-19) using publicly available reports from various distinct communities. These rates are then used to estimate underreported infections on the corresponding areas by making use of reported daily hospitalizations and deaths. The impact of underreporting infections on vaccination strategies is estimated under different disease-transmission scenarios using a Susceptible-Exposed-Infective-Removed-like (SEIR) epidemiological model.

Results

For the considered locations, during the period of study, the estimations suggest that the number of infected individuals could reach 30% of the population of these places, representing, in some cases, more than six times the observed numbers. These results are in close agreement with estimates from independent seroprevalence studies, thus providing a strong validation of the proposed methodology. Moreover, the presence of large numbers of underreported infections can reduce the perceived impact of vaccination strategies in reducing rates of mortality and hospitalization.

Conclusions

pBy using the proposed methodology and employing a judiciously chosen data analysis implementation, we estimate COVID-19 underreporting from publicly available data. This leads to a powerful way of quantifying underreporting impact on the efficacy of vaccination strategies. As a byproduct, we evaluate the impact of underreporting in the designing of vaccination strategies.
Tertiary hospitals physician’s knowledge and perceptions towards antibiotic use and antibiotic resistance in Cameroon
Authors: Domche Ngongang Sandra C. , Basera Wisdom , Mendelson Marc
Published: October 2021

Background

Infections due to resistant bacteria are associated with severe illness, increased risk for complications, hospital admissions, and higher mortality. Inappropriate use of antibiotics, which contributes to increased antibiotic resistance (ABR), is common in healthcare settings across the globe. In Cameroon, antibiotics have been reported as high as 45–70% of prescriptions. We sought to investigate the knowledge, attitudes, and perceptions regarding appropriate antibiotic use and ABR of medical doctors practicing in tertiary hospitals in Yaoundé, Cameroon.

Methods

We conducted a cross-sectional survey using a 54-item self-administered questionnaire sent via email to medical doctors working in the four major tertiary hospitals of Yaoundé. The questionnaire recorded socio-demographics, perceptions on antibiotic use and ABR, sources and usefulness of education on ABR, and clinical scenarios to appraise knowledge.

Results

A total of 98/206 (48%) doctors responded. Years of experience ranged between 1 and 17 years. Most participants agreed that ABR is a problem nationwide (93%) and antibiotics are overused (96%), but only one third (32%) thought that ABR was a problem in their wards. Most respondents (65%) were confident that they use antibiotics appropriately. We found a mean knowledge score of 56% (± 14), with prescribers not influenced by patient-exerted pressure for antibiotic prescribing scoring better compared to those influenced by patients (67% vs 53%, p = 0.01). Overall, most participants (99%) expressed interest for further education on both appropriate antibiotic use and ABR.

Conclusion

Confidence of prescribers in their ability to appropriately use antibiotics conflicts with the low level of knowledge on antibiotic use in this group of doctors. Moreover, the opinion of the majority, that ABR is not a problem in their own backyard is in keeping with similar studies in other countries and is of significant concern. Introduction of formal antibiotic stewardship programmes in Cameroon may be a useful intervention.
Risk factors for impaired renal function in HIV-infected and HIV-uninfected adults: cross-sectional study in North-Western Tanzania
Authors: Kavishe Bazil Baltazar , Kweka Belinda V. , Nitsch Dorothea , PrayGod George , Jeremiah Kidola , Faurholt-Jepsen Daniel , Filteau Suzanne , Olsen Mette Frahm , Kitilya Brenda W. , Krogh-Madsen Rikke , Friis Henrik , Peck Robert
Published: October 2021

Background

Although the burden of impaired renal function is rising in sub-Saharan Africa (SSA), little is known about correlates of impaired renal function in the region. We determined factors associated with estimated glomerular filtration rate (eGFR) and impaired renal function in HIV-infected and HIV-uninfected adults.

Methods

We undertook cross-sectional analysis of data from 1947 adults at enrolment for a cohort study on diabetes and associated complications in HIV patients in Mwanza, north-western Tanzania. A structured questionnaire was used to collect data on sociodemography, smoking, alcohol, physical activity, antiretroviral therapy (ART) and anthropometry. We measured blood pressure, tested blood samples for creatinine, glucose and HIV, and performed Kato Katz for Schistosoma mansoni. Correlates of eGFR (mL/min/1.73 m2) and impaired renal function (eGFR< 60 mL/min/1.73 m2) were determined using linear regression and logistic regression, respectively.

Results

655 (34%) participants were HIV-uninfected, 956 (49%) were ART-naive HIV-infected and 336 (17%) were HIV-infected adults on ART. The mean age was 41 years (SD12) and majority (59%) were females. Overall, the mean eGFR was 113.6 mL/min/1.73 m2 but 111.2 mL/min/1.73 m2 in HIV-uninfected, 109.7 mL/min/1.73 m2 in ART-naive HIV-infected and 129.5 mL/min/1.73 m2 in HIV-infected ART-experienced adults, and respective prevalence of impaired renal function was 7.0, 5.7, 8.1 and 6.3%. Correlates of lower eGFR were increasing age, higher socioeconomic status, unhealthy alcohol drinking, higher body mass index and diabetes mellitus. Anaemia was associated with 1.9 (95% Confidence Interval (CI):1.2, 2.7, p = 0.001) higher odds of impaired renal function compared to no anaemia and this effect was modified by HIV status (p value 0.02 for interaction).

Conclusion

Impaired renal function is prevalent in this middle-aged study population. Interventions for prevention of impaired renal function are needed in the study population with special focus in HIV-infected adults and those with high socioeconomic status. Interventions targeting modifiable risk factors such as alcohol and weight reduction are warranted.
Measuring the invisible: perinatal health outcomes of unregistered women giving birth in Belgium, a population-based study
Authors: Schoenborn Claudia , De Spiegelaere Myriam , Racape Judith
Published: October 2021

Background

The unregistered population remains under-researched because of its “invisible” status in statistics. Studies on perinatal health outcomes of unregistered women remains particularly limited. Our objectives were 1) to describe the sociodemographic profiles of women who are not legally residing in Belgium and 2) to analyze the associations of registration status with pregnancy outcomes according to socioeconomic status and nationality.

Methods

We analysed data from birth and death certificates taken from the Belgian civil registration system, linked with the National Population Registry (NPR). The data relates to all singleton babies born between 2010 and 2016 (n = 871,283), independent of their mother’s NPR registration status. We used logistic regression to estimate the odds ratios for the associations between perinatal outcomes (perinatal mortality, prematurity and low birth weight) and maternal NPR registration status according to socioeconomic status and maternal nationality.

Results

Over the study period, 1.9% of births were to mothers without NPR-registration. Unregistered women from newer EU member states and non-European countries were particularly disadvantaged from a socioeconomic point of view. Apart from women with a South American nationality, all other groups of unregistered women had higher rates of prematurity, low birth weight, and perinatal mortality, compared to registered mothers (p < 0.0001). Unregistered women from Belgium and EU15 nationalities had particularly higher rates of prematurity, low birth weight, and perinatal mortality, compared to registered mothers, even after adjustment for socioeconomic status (p < 0.0001). The excess of perinatal mortality for non-European unregistered mothers could partly be explained by their precarious socioeconomic situation.

Conclusions

This is the first study to include data on mothers who were not legally residing in Belgium. Unregistered women giving birth in Belgium are likely a heterogeneous socioeconomic group. Overall, unregistered women have increased risks of adverse perinatal outcomes, but it is likely that the causal mechanisms differ starkly between Belgian, European and non-European women. Further research is needed to understand the mechanisms behind these accrued rates. It is important to keep measuring the health outcomes of the populations which are “invisible” in national statistics, in order to identify the groups in most need of integration and access to services.
A technology-based intervention to improve safety, mental health and empowerment outcomes for immigrant women with intimate partner violence experiences: it’s weWomen plus sequential multiple assignment randomized trial (SMART) protocol
Authors: Sabri Bushra , Glass Nancy , Murray Sarah , Perrin Nancy , Case James R. , Campbell Jacquelyn C.
Published: October 2021

Background

Intimate partner violence (IPV) disproportionately affects immigrant women, an understudied and underserved population in need for evidence-based rigorously evaluated culturally competent interventions that can effectively address their health and safety needs.

Methods

This study uses a sequential, multiple assignment, randomized trial (SMART) design to rigorously evaluate an adaptive, trauma-informed, culturally tailored technology-delivered intervention tailored to the needs of immigrant women who have experienced IPV. In the first stage randomization, participants are randomly assigned to an online safety decision and planning or a usual care control arm and safety, mental health and empowerment outcomes are assessed at 3-, 6- and 12-months post-baseline. For the second stage randomization, women who do not report significant improvements in safety (i.e., reduction in IPV) and empowerment from baseline to 3 months follow up (i.e., non-responders) are re- randomized to safety and empowerment strategies delivered via text only or a combination of text and phone calls with trained advocates. Data on outcomes (safety, mental health, and empowerment) for early non-responders is assessed at 6 and 12 months post re-randomization.

Discussion

The study’s SMART design provides an opportunity to implement and evaluate an individualized intervention protocol for immigrant women based on their response to type or intensity of intervention. The findings will be useful for identifying what works for whom and characteristics of participants needing a particular type or intensity level of intervention for improved outcomes. If found to be effective, the study will result in an evidence-based trauma-informed culturally tailored technology-based safety decision and planning intervention for immigrant survivors of IPV that can be implemented by practitioners serving immigrant women in diverse settings.

Trial registration

This trial was registered with ClinicalTrials.gov as NCT04098276 on September 13, 2019.
Key challenges to voluntary medical male circumcision uptake in traditionally circumcising settings of Machinga district in Malawi
Authors: Masese Rodney , Mwalabu Gertrude , Petrucka Pammla , Mapulanga Patrick
Published: October 2021

Background

Voluntary medical male circumcision (VMMC) is becoming more popular as an important HIV prevention strategy. Malawi, with a high HIV and AIDS prevalence rate of 8.8% and a low male circumcision prevalence rate of 28% in 2016, is one of the priority countries recommended for VMMC scale-up. This paper investigates the attitudes and key challenges to VMMC adoption in a traditionally circumcising community in Malawi where male circumcision is culturally significant.

Methods

A mixed design study using quantitative and qualitative data collection methods was carried out to determine the attitudes of 262 randomly selected males towards VMMC in a culturally circumcising community in Malawi. Statistical Package for the Social Sciences (SPSS) version 20 was used to analyse the quantitative data. To identify predictors of VMMC uptake, we used logistic regression analysis. To identify the themes, qualitative data were analysed using content analysis.

Results

The findings indicate that, while more males in this community prefer medical circumcision, traditional circumcision is still practised. Panic (63%) perceived surgical complications (31%), and cost (27%) in accessing VMMC services were some of the barriers to VMMC uptake. Age and culture were found to be statistically significant predictors of voluntary medical male circumcision in the logistic analysis. According to qualitative data analysis, the key challenges to VMMC uptake were the involvement of female health workers in the circumcision team and the incentives provided to traditional circumcisers.

Conclusion

According to the findings of this study, VMMC services should be provided in a culturally competent manner that respects and considers existing cultural beliefs and practices in the community. Coordination between local leaders and health workers should be encouraged so that VMMC services are provided in traditional settings, allowing for safe outcomes, and increasing VMMC uptake.