bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinicopathologic Characterization of Hypocellular Acute Myeloid Leukemia (AML) Showed Fewer Genetic Abnormalities Involving Cell Proliferation and NPM1 When Compared With Nonhypocellular AML
Authors: Carlsen Eric , Bailey Nathanael G , Aggarwal Nidhi , Illar Gwendolyn M , Wild Matthew , Yatsenko Svetlana A , Rea Bryan , Liu Yen-Chun
Published: July 2020

Objectives

Hypocellular acute myeloid leukemia (AML) is uncommon. Despite the prognostic and therapeutic importance of mutational analysis, the mutational landscape of hypocellular AML is not well understood.

Methods

We identified 25 patients with hypocellular AML, and 141 patients with nonhypocellular AML were identified as a control group. We applied next-generation sequencing for the first time to profile this entity.

Results

The hypocellular AML patients were older than those with nonhypocellular AML (P = .037). At diagnosis, hypocellular AML had lower leukocyte counts (P = .012), higher hemoglobin (P = .003), and lower blast counts in the peripheral blood (P < .001) and bone marrow (P = .003). Hypocellular AML was less likely to have mutations involving cell proliferation (P = .027) and NPM1 (P = .022) compared with nonhypocellular AML. Hypocellular AML showed a high incidence of spliceosomal mutations and myelodysplastic syndrome-defining chromosome abnormalities (65%), but the incidence was not significantly different from that in nonhypocellular AML. There was no significant survival difference between hypocellular and nonhypocellular AML.

Conclusions

To our knowledge, this study is the first to demonstrate hypocellular AML showed fewer genetic alterations involving cell proliferation and NPM1 when compared directly with nonhypocellular AML; this finding likely contributes to the low marrow cellularity in at least a portion of the patients with hypocellular AML.
Forty Postmortem Examinations in COVID-19 Patients
Authors: De Michele Simona , Sun Yu , Yilmaz Mine M , Katsyv Igor , Salvatore Mary , Dzierba Amy L , Marboe Charles C , Brodie Daniel , Patel Nina M , Garcia Christine K , Saqi Anjali
Published: July 2020

Objectives

Although diffuse alveolar damage, a subtype of acute lung injury (ALI), is the most common microscopic pattern in coronavirus disease 2019 (COVID-19), other pathologic patterns have been described. The aim of the study was to review autopsies from COVID-19 decedents to evaluate the spectrum of pathology and correlate the results with clinical, laboratory, and radiologic findings.

Methods

A comprehensive and quantitative review from 40 postmortem examinations was performed. The microscopic patterns were categorized as follows: “major” when present in more than 50% of cases and “novel” if rarely or not previously described and unexpected clinically.

Results

Three major pulmonary patterns were identified: ALI in 29 (73%) of 40, intravascular fibrin or platelet-rich aggregates (IFPAs) in 36 (90%) of 40, and vascular congestion and hemangiomatosis-like change (VCHL) in 20 (50%) of 40. The absence of ALI (non-ALI) was novel and seen in 11 (27%) of 40. Compared with ALI decedents, those with non-ALI had a shorter hospitalization course (P = .02), chest radiographs with no or minimal consolidation (P = .01), and no pathologically confirmed cause of death (9/11). All non-ALI had VCHL and IFPAs, and clinically most had cardiac arrest.

Conclusions

Two distinct pulmonary phenotypic patterns—ALI and non-ALI—were noted. Non-ALI represents a rarely described phenotype. The cause of death in non-ALI is most likely COVID-19 related but requires additional corroboration.
Personality Assessment Inventory Cognitive Bias Scale: Validation in a Military Sample
Authors: Armistead-Jehle Patrick , Ingram Paul B , Morris Cole S
Published: July 2020

Objective

Recently, in a mixed neuropsychological outpatient sample, a measure of cognitive response bias has been developed for the Personality Assessment Inventory (PAI) called the Cognitive Bias Scale (CBS). This study sought to cross-validate this measure in a military sample.

Method

Retrospective review of 197 active duty soldiers referred to an Army outpatient clinic for neuropsychological evaluation. Groups were created based on the number of failed performance validity tests (0, 1, or 2–3 performance validity testing [PVT] failures).

Results

The magnitude of effect for the 10-item CBS scale was medium-to-large when comparing those with one PVT failure to those with two to three (d = .98) and those with no failures (d = 1.21); however, effects between the 1 and 2–3 PVT failure groups were less pronounced. In 1 and 2–3 PVT failure groups, a score of $\ge$16 had high specificity (.92 and .95, respectively) and low to moderate sensitivity (.20 and .55, respectively).

Conclusions

In a military sample, the CBS demonstrated high specificity with relatively low sensitivity. The measure operated similarly to the original study and the current data supports the CBS to rule in, but not rule out, over-reported cognitive symptoms on the PAI.
PTGL: extension to graph-based topologies of cryo-EM data for large protein structures
Authors: Wolf Jan Niclas , Keßler Marcus , Ackermann Jörg , Koch Ina
Published: July 2020

We provide a software to describe the topology of large protein complexes based mainly on cryo-EM data and stored as macromolecular Crystallographic Information Files (mmCIFs) in the PDB. The software extends the Protein Topology Graph Library and implements an efficient file parser to analyze mmCIFs. The extended Protein Topology Graph Library includes a graph-based representation of the topology of protein complexes on the supersecondary and quaternary structure level. The library holds topology graphs of 151 837 PDB files; 921 of them are large structures. The abstraction of protein structure complexes to undirected labeled graphs enables classification and comparison of large protein complexes on quaternary structure level.

Availability and implementation

Online access at http://ptgl.uni-frankfurt.de. Source code in Java under GNU public license 2.0 at https://github.com/MolBIFFM/vplg.

Supplementary information

Supplementary data are available at Bioinformatics online.
Politics and Indigenous Victimization: The Case of Brazil
Authors: de Carvalho Salo , Goyes David R , Vegh Weis Valeria
Published: July 2020

There is a dearth of criminological scholarship on how the political persuasions of governments affect Indigenous people as it relates to human rights and environmental consequences, whether positive or negative, for Indigenous peoples. To address this gap, we develop a comparative instrumental case study of the policies concerning Indigenous peoples implemented during two political periods in Brazil: the administrations of presidents Silva (2003–2010) and Rousseff (2011–2016) and the administrations of Temer (2016–2018) and Bolsonaro (2019–). We explore the consequences for Indigenous peoples of these leftist and the right-wing governments. We argue that governments of both political leanings victimize Indigenous populations, with leftist governments using structural violence and right-wing governments engaging additionally in symbolic and direct violence.
Rapid and accurate detection of carbapenem-resistance gene by isothermal amplification in Acinetobacter baumannii
Authors: Liu Shuang , Huang Guangtao , Gong Yali , Jin Xiaojun , Meng Yudan , Peng Yizhi , Zhao Junning , Li Xiaolu , Li Qin
Published: July 2020

Background

Acinetobacter baumannii (A. baumannii) is one of the pivotal pathogens responsible for nosocomial infections, especially in patients with low immune response, and infection with carbapenem-resistant A. baumannii has been increasing in recent years. Rapid and accurate detection of carbapenem-resistance genes in A. baumannii could be of immense help to clinical staff.

Methods

In this study, a 15-μL reaction system for recombinase polymerase amplification (RPA) was developed and tested. We collected 30 clinical isolates of A. baumannii from the Burn Institute of Southwest Hospital of Third Military Medical University (Army Medical University) for 6 months and tested antibiotic susceptibility using the VITEK 2 system. A. baumannii was detected based on the blaOXA-51 gene by PCR, qPCR and 15 μL-RPA, respectively. Sensitivity and specificity were evaluated. In addition, PCR and 15 μL-RPA data for detecting the carbapenem-resistance gene blaOXA-23 were comparatively assessed.

Results

The detection limit of the blaOXA-51 gene by 15 μL RPA was 2.86 CFU/ml, with sensitivity comparable to PCR and qPCR. No positive amplification signals were detected in non-Acinetobacter isolates, indicating high specificity. However, only 18 minutes were needed for the 15 μL RPA assay. Furthermore, an antibiotic susceptibility test showed that up to 90% of A. baumannii strains were resistant to meropenem and imipenem; 15 μL RPA data for detecting blaOXA-23 showed that only 10% (n = 3) of A. baumannii isolates did not show positive amplification signals, and the other 90% of (n = 27) isolates were positive, corroborating PCR results.

Conclusion

We demonstrated that the new 15 μL RPA assay for detecting blaOXA-23 in A. baumannii is faster and simpler than qPCR and PCR. It is a promising alternative molecular diagnostic tool for rapid and effective detection of A. baumannii and drug-resistance genes in the field and point-of-care testing.
Plasma Plasmodium falciparum Histidine-rich Protein 2 Concentrations in Children With Malaria Infections of Differing Severity in Kilifi, Kenya
Authors: Uyoga Sophie , Wanjiku Perpetual , Rop Jesse C , Makale Johnstone , Macharia Alexander W , Nyutu Gideon M , Shebe Mohammed , Awuondo Kennedy A , Mturi Neema , Woodrow Charles J , Dondorp Arjen M , Maitland Kathryn , Williams Thomas N
Published: July 2020

Background

Most previous studies support a direct link between total parasite load and the clinical severity of Plasmodium falciparum malaria infections.

Methods

We estimated P. falciparum parasite loads in 3 groups of children with malaria infections of differing severity: (1) children with World Health Organization–defined severe malaria (n = 1544), (2) children admitted with malaria but without features of severity (n = 200), and (3) children in the community with asymptomatic parasitemia (n = 33).

Results

Peripheral parasitemias were highest in those with uncomplicated malaria (geometric mean [GM] parasite count, 111 064/μL; 95% confidence interval, CI, 86 798–141 819/μL), almost 3 times higher than in those with severe malaria (39 588/μL; 34 990–44 791/μL) and >100 times higher than in those with asymptomatic malaria (1092/μL; 523–2280/μL). However, the GM P. falciparum histidine-rich protein 2 (PfHRP2) values (95% CI) increased with severity, being 7 (4–12) ng/mL in asymptomatic malaria, 843 (655–1084) ng/mL in uncomplicated malaria, and 1369 (1244–1506) ng/mL in severe malaria. PfHRP2 concentrations were markedly lower in the subgroup of patients with severe malaria and concomitant invasive bacterial infections of blood or cerebrospinal fluid (GM concentration, 312 ng/mL; 95% CI, 175–557 ng/mL; P < .001) than in those without such infections (1439 ng/mL; 1307–1584; P < .001).

Conclusions

The clinical severity of malaria infections related strongly to the total burden of P. falciparum parasites. A quantitative test for plasma concentrations of PfHRP2 could be useful in identifying children at the greatest clinical risk and identifying critically ill children in whom malaria is not the primary cause.
A Random-Line-Graph Approach to Overlapping Line Segments
Authors: Böttcher Lucas
Published: July 2020

We study graphs that are formed by independently positioned needles (i.e. line segments) in the unit square. To mathematically characterize the graph structure, we derive the probability that two line segments intersect and determine related quantities such as the distribution of intersections, given a certain number of line segments $N$. We interpret intersections between line segments as nodes and connections between them as edges in a spatial network that we refer to as random-line graph (RLG). Using methods from the study of random-geometric graphs, we show that the probability of RLGs to be connected undergoes a sharp transition if the number of lines exceeds a threshold $N^*$.
Impaired retinal microvascular function predicts long-term adverse events in patients with cardiovascular disease
Authors: Theuerle James D , Al-Fiadh Ali H , Amirul Islam Fakir M , Patel Sheila K , Burrell Louise M , Wong Tien Yin , Farouque Omar
Published: July 2020

Aims

Endothelial dysfunction is a precursor to the development of symptomatic atherosclerosis. Retinal microvascular reactivity to flicker light stimulation is a marker of endothelial function and can be quantified in vivo. We sought to determine whether retinal microvascular endothelial dysfunction predicts long-term major adverse cardiovascular events (MACE).

Methods and results

In a single-centre prospective observational study, patients with coronary artery disease (CAD) or cardiovascular risk factors underwent dynamic retinal vessel assessment in response to flicker light stimulation and were followed up for MACE. Retinal microvascular endothelial dysfunction was quantified by measuring maximum flicker light-induced retinal arteriolar dilatation (FI-RAD) and flicker light-induced retinal venular dilatation (FI-RVD). In total, 252 patients underwent dynamic retinal vessel assessment and 242 (96%) had long-term follow-up. Of the 242 patients, 88 (36%) developed MACE over a median period of 8.6 years (interquartile range 6.0–9.1). After adjustment for traditional risk factors, patients within the lowest quintile of FI-RAD had the highest risk of MACE [odds ratio (OR) 5.21; 95% confidence interval (CI) 1.78–15.28]. Patients with lower FI-RAD were also more likely to die (OR 2.09; 95% CI 1.00–4.40, per standard deviation decrease in FI-RAD). In Kaplan–Meier analysis, patients with FI-RAD responses below the cohort median of 1.4% exhibited reduced MACE-free survival (55.5 vs. 71.5%; log-rank P = 0.004). FI-RVD was not predictive of MACE.

Conclusion

Retinal arteriolar endothelial dysfunction is an independent predictor of MACE in patients with CAD or cardiovascular risk factors. Dynamic retinal vessel analysis may provide added benefit to traditional risk factors in stratifying patients at risk for cardiovascular events.
WCSdb: a database of wild Coffea species
Authors: Guyot Romain , Hamon Perla , Couturon Emmanuel , Raharimalala Nathalie , Rakotomalala Jean-Jacques , Lakkanna Sreenath , Sabatier Sylvie , Affouard Antoine , Bonnet Pierre
Published: July 2020

Coffee is a beverage enjoyed by millions of people worldwide and an important commodity for millions of people. Beside the two cultivated species (Coffea arabica and Coffea canephora), the 139 wild coffee species/taxa belonging to the Coffea genus are largely unknown to coffee scientists and breeders although these species may be crucial for future coffee crop development to face climate changes. Here we present the Wild Coffee Species database (WCSdb) hosted by Pl@ntNet platform (http://publish.plantnet-project.org/project/wildcofdb_en), providing information for 141 coffee species/taxa, for which 84 contain a photo gallery and 82 contain sequencing data (genotyping-by-sequencing, chloroplast or whole genome sequences). The objective of this database is to better understand and characterize the species (identification, morphology, biochemical compounds, genetic diversity and sequence data) in order to better protect and promote them.

Database URL

http://publish.plantnet-project.org/project/wildcofdb_en
The Medical Management of Paediatric Crohn’s Disease: an ECCO-ESPGHAN Guideline Update
Authors: van Rheenen Patrick F , Aloi Marina , Assa Amit , Bronsky Jiri , Escher Johanna C , Fagerberg Ulrika L , Gasparetto Marco , Gerasimidis Konstantinos , Griffiths Anne , Henderson Paul , Koletzko Sibylle , Kolho Kaija-Leena , Levine Arie , van Limbergen Johan , Martin de Carpi Francisco Javier , Navas-López Víctor Manuel , Oliva Salvatore , de Ridder Lissy , Russell Richard K , Shouval Dror , Spinelli Antonino , Turner Dan , Wilson David , Wine Eytan , Ruemmele Frank M
Published: July 2020

Objective

We aimed to provide an evidence-supported update of the ECCO-ESPGHAN guideline on the medical management of paediatric Crohn’s disease [CD].

Methods

We formed 10 working groups and formulated 17 PICO-structured clinical questions [Patients, Intervention, Comparator, and Outcome]. A systematic literature search from January 1, 1991 to March 19, 2019 was conducted by a medical librarian using MEDLINE, EMBASE, and Cochrane Central databases. A shortlist of 30 provisional statements were further refined during a consensus meeting in Barcelona in October 2019 and subjected to a vote. In total 22 statements reached ≥ 80% agreement and were retained.

Results

We established that it was key to identify patients at high risk of a complicated disease course at the earliest opportunity, to reduce bowel damage. Patients with perianal disease, stricturing or penetrating behaviour, or severe growth retardation should be considered for up-front anti-tumour necrosis factor [TNF] agents in combination with an immunomodulator. Therapeutic drug monitoring to guide treatment changes is recommended over empirically escalating anti-TNF dose or switching therapies. Patients with low-risk luminal CD should be induced with exclusive enteral nutrition [EEN], or with corticosteroids when EEN is not an option, and require immunomodulator-based maintenance therapy. Favourable outcomes rely on close monitoring of treatment response, with timely adjustments in therapy when treatment targets are not met. Serial faecal calprotectin measurements or small bowel imaging [ultrasound or magnetic resonance enterography] are more reliable markers of treatment response than clinical scores alone.

Conclusions

We present state-of-the-art guidance on the medical treatment and long-term management of children and adolescents with CD.
It is easy to see, but it is better to foresee: a case report on the favourable alliance between CardioMEMS and levosimendan
Authors: Visco Valeria , Esposito Cristina , Vitillo Paolo , Vecchione Carmine , Ciccarelli Michele
Published: July 2020

Background

In the past years, different devices have been investigated to help in identifying early decompensation events in patients with heart failure (HF) and reduced ejection fraction (EF), reducing hospital admissions. In this report, we present the first patient experience with levosimendan infusion led by CardioMEMS.

Case summary

A 68-year-old man with HF and reduced EF with more than 20 hospitalizations for exacerbation of HF was enrolled in our HF Clinic from October 2017. Echocardiogram showed a dilated left ventricle with severely reduced EF (29%) and increased pulmonary artery systolic pressure (40 mmHg). From October 2017 to May 2019, the patient went through numerous hospitalizations, despite optimal medical therapy; subsequently, was adopted a strategy of levosimendan infusions guided by CardioMEMS. Levosimendan infusions improved haemodynamic and pressure profiles. The patient was monitored daily by CardioMEMS, and from June to December 2019, he had only two hospitalizations scheduled for levosimendan infusion and none for HF exacerbation.

Discussion

Our case supports the combination of CardioMEMS and levosimendan for the optimal management of patients with advanced HF. These results further strengthen the development of a randomized clinical trial to demonstrate the clinical usefulness of this device in combination with the levosimendan infusion programme in advanced HF patients.
Ticagrelor and the risk of Staphylococcus aureus bacteraemia and other infections
Authors: Butt Jawad H , Fosbøl Emil L , Gerds Thomas A , Iversen Kasper , Bundgaard Henning , Bruun Niels Eske , Larsen Anders R , Petersen Andreas , Andersen Paal S , Skov Robert L , Østergaard Lauge , Havers-Borgersen Eva , Gislason Gunnar H , Torp-Pedersen Christian , Køber Lars , Olesen Jonas B
Published: July 2020

Aims

To investigate the 1-year risks of Staphylococcus aureus bacteraemia (SAB), sepsis, and pneumonia in patients who underwent percutaneous coronary intervention and were treated with ticagrelor vs. clopidogrel.

Methods and results

In this nationwide observational cohort study, 26 606 patients who underwent urgent or emergent percutaneous coronary intervention (January 2011–December 2017) and initiated treatment with ticagrelor [N = 20 073 (75.5%); median age 64 years (25th–75th percentile 55–72 years); 74.8% men] or clopidogrel [N = 6533 (24.5%); median age 68 years (25th–75th percentile 58–77 years); 70.2% men] were identified using Danish nationwide registries. The 1-year standardized absolute risks of outcomes was calculated based on cause-specific Cox regression models, and average treatment effects between treatment groups were obtained as standardized differences in absolute 1-year risks. The absolute 1-year risk of SAB was 0.10% [95% confidence interval (CI), 0.05–0.15%] in the ticagrelor group and 0.29% (95% CI, 0.17–0.42%) in the clopidogrel group. Compared with clopidogrel, treatment with ticagrelor was associated with a significantly lower absolute 1-year risk of SAB [absolute risk difference −0.19% (95% CI, −0.32% to −0.05%), P value 0.006]. Likewise, treatment with ticagrelor was associated with a significantly lower absolute 1-year risk of sepsis [0.99% (95% CI, 0.83–1.14%) vs. 1.49% (95% CI, 1.17–1.80%); absolute risk difference −0.50% (95% CI, −0.86% to −0.14%), P value 0.007] and pneumonia [3.13% (95% CI, 2.86–3.39%) vs. 4.56% (95% CI, 4.03–5.08%); absolute risk difference −1.43% (95% CI, −2.03% to −0.82%), P value < 0.001] compared with clopidogrel.

Conclusion

Treatment with ticagrelor was associated with a significantly lower 1-year risk of SAB, sepsis, and pneumonia compared with clopidogrel.
Sinoatrial nodal artery injury in thoracoscopic epicardial ablation for atrial fibrillation
Authors: Li Haojie , Qu Jianyu , Yu Yitong , Zhang Heng , Rao Chenfei , Liu Sheng , Zheng Lihui , Lu Bin , Zheng Zhe
Published: July 2020

OBJECTIVES

This study aimed to clarify the incidence of sinoatrial nodal artery (SANa) injury in thoracoscopic epicardial surgical ablation for atrial fibrillation (AF) and its impact on postoperative outcomes, which have not been previously elucidated.

METHODS

We enrolled 103 consecutively patients with AF who underwent thoracoscopic epicardial ablation at our institution. In these patients, we evaluated the postoperative incidence of SANa injury by using enhanced cardiac computed tomography. For patients with confirmed SANa injury, 3-day continuous electrocardiographic monitoring and exercise stress tests were performed to assess the sinus rhythm maintenance and sinus node function.

RESULTS

Thirteen patients (12.6%) had a confirmed SANa injury (left anterior type in 6 patients, left posterior type in 2 patients and double-branch type in 5 patients). After a median follow-up of 24 months, the patients with SANa injury were not found to be associated with lower sinus rhythm maintenance (hazard ratio 1.09, 95% confidential interval 0.36–3.31) as compared with those without SANa injury after adjustment for patient characteristics. Sinus node function was evaluated in 7 patients with SANa injury who remained in sinus rhythm after the procedure, and no sinus node dysfunction was confirmed in the 3-day electrocardiographic monitoring and exercise stress tests at a median follow-up of 12 months.

CONCLUSIONS

The prevalence of SANa injury in the patients who underwent thoracoscopic epicardial ablation for AF was relatively low, and the incidence of SANa injury was not associated with postoperative restoration of sinus rhythm and sinoatrial node dysfunction. More studies are required to better understand SANa injury.
Magnetic resonance-guided re-ablation for atrial fibrillation is associated with a lower recurrence rate: a case–control study
Authors: Quinto Levio , Cozzari Jenniffer , Benito Eva , Alarcón Francisco , Bisbal Felipe , Trotta Omar , Caixal Gala , San Antonio Rodolfo , Garre Paz , Prat-Gonzalez Susana , Perea Rosario Jesús , Tolosana José Maria , Berruezo Antonio , Arbelo Elena , Roca-Luque Ivo , Sitges Marta , Brugada Josep , Guasch Eduard , Mont Lluís
Published: July 2020

Aims

Our aim was to analyse whether using delayed enhancement cardiac magnetic resonance imaging (DE-CMR) to localize veno-atrial gaps in atrial fibrillation (AF) redo ablation procedures improves outcomes during follow-up.

Methods and results

We conducted a case–control study with 35 consecutive patients undergoing a DE-CMR-guided Repeat-pulmonary vein isolation (Re-PVI) procedure. Those with more extensive ablations (e.g. roof lines, box) were excluded. Patients were matched for age, sex, AF pattern, and left atrial dimension with 35 patients who had undergone a conventional Re-PVI procedure guided with a three dimensional (3D)-navigation system. Procedural characteristics were recorded, and patients were followed for 24 months in a specialized outpatient clinic. The primary endpoint was freedom from recurrent AF, atrial tachycardia, or flutter. The duration of CMR-guided procedures was shorter compared to the conventional group (161 ± 52 vs. 195 ± 72 min, respectively, P = 0.049), with no significant differences in fluoroscopy or total radiofrequency time. At the 2-year follow-up, more patients in the DE-CMR-guided group remained free from recurrences compared with the conventional group (70% vs. 39%, respectively, P = 0.007). In univariate Cox-regression analyses, AF pattern [persistent AF, hazard ratio (HR) 2.66 (1.27–5.46), P = 0.006] and the use of DE-CMR [HR 0.36 (0.17–0.79), P = 0.009] predicted recurrences during follow-up; both factors remained independent predictors in multivariate analyses.

Conclusion

The substrate characterization provided by DE-CMR facilitates the identification of anatomical veno-atrial gaps and associates with shorter procedures and better clinical outcomes in repeated AF ablation procedures.
A human resources for health analysis of registered family medicine specialists in South Africa: 2002–19
Authors: Tiwari Ritika , Mash Robert , Karangwa Innocent , Chikte Usuf
Published: July 2020

Background

In South Africa, there is a need to clarify the human resources for health policy on family physicians (FPs) and to ensure that the educational and health systems are well aligned in terms of the production and employment of FPs.

Objective

To analyse the human resource situation with regard to family medicine in South Africa and evaluate the requirements for the future.

Methods

A retrospective review of the Health Professions Council of South Africa’s (HPCSA) database on registered family medicine practitioners from 2002 until 2019. Additional data were obtained from the South African Academy of Family Physicians and published research.

Results

A total of 1247 family medicine practitioners were registered with the HPCSA in 2019, including 969 specialist FPs and 278 medical practitioners on a discontinued register. Of the 969, 194 were new graduates and 775 from older programmes. The number of FPs increased from 0.04/10 000 population in 2009 to 0.16/10 000 in 2019, with only 29% in the public sector. On average, seven registrars entered each of nine training programmes per year and three graduated. New graduates and registrars reflect a growing diversity and more female FPs. The number of FPs differed significantly in terms of age, gender, provincial location and population groups.

Conclusions

South Africa has an inadequate supply of FPs with substantial inequalities. Training programmes need to triple their output over the next 10 years. Human resources for health policy should substantially increase opportunities for training and employment of FPs.
Primary care experience and remission of type 2 diabetes: a population-based prospective cohort study
Authors: Dambha-Miller Hajira , Day Alexander , Kinmonth Ann Louise , Griffin Simon J
Published: July 2020

Background

Remission of Type 2 diabetes is achievable through dietary change and weight loss. In the UK, lifestyle advice and referrals to weight loss programmes predominantly occur in primary care where most Type 2 diabetes is managed.

Objective

To quantify the association between primary care experience and remission of Type 2 diabetes over 5-year follow-up.

Methods

A prospective cohort study of adults with Type 2 diabetes registered to 49 general practices in the East of England, UK. Participants were followed-up for 5 years and completed the Consultation and Relational Empathy measure (CARE) on diabetes-specific primary care experiences over the first year after diagnosis of the disease. Remission at 5-year follow-up was measured with HbA1c levels. Univariable and multivariable logistic regression models were constructed to quantify the association between primary care experience and remission of diabetes.

Results

Of 867 participants, 30% (257) achieved remission of Type 2 diabetes at 5 years. Six hundred twenty-eight had complete data at follow-up and were included in the analysis. Participants who reported higher CARE scores in the 12 months following diagnosis were more likely to achieve remission at 5 years in multivariable models; odds ratio = 1.03 (95% confidence interval = 1.01–1.05, P = 0.01).

Conclusion

Primary care practitioners should pay greater attention to delivering optimal patient experiences alongside clinical management of the disease as this may contribute towards remission of Type 2 diabetes. Further work is needed to examine which aspects of the primary care experience might be optimized and how these could be operationalized.
River biofilms adapted to anthropogenic disturbances are more resistant to WWTP inputs
Authors: Freixa Anna , Perujo Núria , Langenheder Silke , Romaní Anna M
Published: July 2020

The sensitivity and spatial recovery of river sediment biofilms along 1 km after the input of two wastewater treatment plants (WWTPs) located in two river reaches with different degrees of anthropogenic influence were investigated. First, at the upper reach, we observed an inhibition of some microbial functions (microbial respiration and extracellular enzyme activities) and strong shifts in bacterial community composition (16S rRNA gene), whereas an increase in microbial biomass and activity and less pronounced effect on microbial diversity and community composition were seen at the lower reach. Second, at the lower reach we observed a quick spatial recovery (around 200 m downstream of the effluent) as most of the functions and community composition were similar to those from reference sites. On the other hand, bacterial community composition and water quality at the upper reach was still altered 1 km from the WWTP effluent. Our results indicate that biofilms in the upstream sites were more sensitive to the effect of WWTPs due to a lower degree of tolerance after a disturbance than communities located in more anthropogenically impacted sites.
Psychological Resilience and Health Among Older Adults: A Comparison of Personal Resources
Authors: Taylor Miles G , Carr Dawn
Published: July 2020

Objectives

Research on life course inequality and successful aging has sought to understand how events and challenges may lead to poor outcomes in later life for some individuals, while others fare well in the face of adversity. Among internalized resources, research suggests psychological resilience is protective in the face of challenges, but little is known about the predictive efficacy of this measure compared to other resources such as mastery. This paper examines connections between psychological resilience and later life health compared to other internalized resources.

Method

Standardized associations between 4 resources (resilience, mastery, optimism, hopelessness) and 5 health outcomes were tested using short-term health transitions and longer term health trajectories in a structural equation modeling (SEM) framework using the Leave Behind Questionnaire (LBQ) and linked Health and Retirement Study (HRS) between 2006/2008 and 2014/2016 (n = 11,050–12,823).

Results

Psychological resilience had consistent and robust associations with health transitions and trajectories. Further, the effects of this resource were generally 4–10 times greater than for mastery, optimism, and hopelessness in combined models. Trajectory analyses replicate these findings and suggest the beneficial associations of resilience over time were persistent for some health outcomes, and cumulative for others.

Discussion

The results suggest that psychological resilience is powerfully associated with health in later life, with substantially greater predictive efficacy than other commonly used resource measures. Future research should establish how this intrapersonal resource works alongside structural and interpersonal resources to promote and protect health and functioning in the face of challenges and adversity.
Caregivers’ Mental Health and Somatic Symptoms During COVID-19
Authors: Park Sung S
Published: July 2020

Objectives

This study examines differences in the mental and physical health of the U.S. population during the early stages of the COVID-19 pandemic among 3 groups: noncaregivers, short-term caregivers (1 year or less), and long-term caregivers (greater than 1 year).

Methods

Data from the Understanding America Study are used to describe group differences in reports of psychological distress and somatic symptoms. Logistic and negative binomial regression models are used to examine whether these differences persist after adjusting for demographic, socioeconomic, and prepandemic health conditions. To understand within-group differences in caregiving demands, the intensity of care provided by short-term and long-term caregivers, as well as selected patients’ health conditions are summarized.

Results

Adults’ mental and physical health varied substantially by caregiver status. Caregivers continued to fare worse than noncaregivers in terms of mental health and fatigue, and long-term caregivers were more likely to report headache, body aches, and abdominal discomfort than both short-term caregivers and noncaregivers, net of controls. The nature of caregiving differed between short-term and long-term caregivers, with the latter more likely to provide greater hours of care, and to be looking after patients with permanent medical conditions.

Discussion

Efforts to understand and mitigate the impact of the pandemic on population health should include caregivers, whose mental and physical health were already vulnerable before COVID-19.
Outcome of reminder text messages intervention on completion of routine immunization in rural areas, Nigeria
Authors: Oladepo Oladimeji , Dipeolu Isaac Oluwafemi , Oladunni Opeyemi
Published: July 2020

Completion of routine immunization for infants has been a challenge in Nigeria, and existing strategies implemented to promote immunization coverage yielded limited success. The use of reminder short services message (SMS) in mobilizing mothers of infants, especially in rural areas with lower immunization coverage has been suggested. This study investigated the effect of reminder SMS sent to mothers in rural communities on full and timely completion of routine childhood immunization. A quasi-experimental design was adopted, 3500 mothers of infants were categorized into the Intervention and Control groups recruited at various Primary Healthcare Centres in 6 states and the FCT, Nigeria. Reminder SMS were sent to mothers in the intervention group for 10 months. We adopted mixed methods of data collection, significance level set at p = 0.05. Majority of respondents were married (Control 94.3%; Intervention 95.5%), have experienced multiple births (Control 79.0%; Intervention 74.9%). Adherence to routine immunization appointment dates and completion of all immunizations was higher in the Intervention group (76.0%) compared with the Control (73.3%). A significant association between adherence to appointment dates and completeness of routine immunization vaccine was found. The Intervention group had a significantly higher completion rate for measles and yellow fever vaccines (55.3%; 75.9%) compared with the Control group (26.8%; 23.9%). Qualitative findings revealed positive comments from mothers in the intervention group that the messages increase awareness of immunization dates, assisted in readjusting their time which influenced timely completion. Interventions using reminder SMS enhanced infant immunization delivery; we recommend scale-up and integration into the health system to increase national immunization coverage.
Publishing and peer reviewing as indicators of the impact of COVID-19 on the productivity of the aquatic science community
Authors: Hobday Alistair J , Browman Howard I , Bograd Steven J
Published: July 2020

Beginning in February 2020, COVID-19-related stay at home orders and workplace shutdowns worldwide have disrupted personal and professional lives, including those of aquatic scientists. Manuscript submission and peer reviewing data from journals may be indicators of productivity impacts among aquatic scientists. We tested four null hypotheses: the COVID-19 disruption has had no effect on (i) the number of submissions to journals, or (ii) the geographic region in which the corresponding author is based, nor on the peer review process in terms of (iii) acceptance rate of requests to review and (iv) time in review. We used data provided by seven leading aquatic science journals covering the period 2009–2020 and representing 32 756 submissions. Submission differences varied between journals and were lower than expected in March 2020, but due to increases in subsequent months, there was no overall change in the number of submissions during the COVID-19 disruption months of February–June 2020. Geographic patterns in the number of submissions varied more by journal than by region, with both higher and lower numbers of submissions relative to expected numbers. Acceptance rates of requests to review were ∼2% lower overall; however, time in review declined by an average of 5 days relative to earlier years, showing that those scientists undertaking reviews did them more quickly during the COVID-19 disruption. Collectively, these results show that the overall productivity of the aquatic science community, as measured by publications and reviewing rates and times, has thus far only been slightly disrupted, although the impacts will vary greatly among individuals depending on life circumstances. The breadth and longevity of this disruption are unprecedented, making it important to continue to assess the relative impacts across a wide demographic range of aquatic scientists and to consider approaches to allow those differentially affected to recover to pre-COVID-19 levels of productivity.
Association of prenatal maternal blood lead levels with birth outcomes in the Japan Environment and Children’s Study (JECS): a nationwide birth cohort study
Authors: Goto Yoshihito , Mandai Marie , Nakayama Takeo , Yamazaki Shin , Nakayama Shoji F , Isobe Tomohiko , Sato Tosiya , Nitta Hiroshi
Published: July 2020

Background

Despite dramatic declines in prenatal maternal blood lead levels (BLLs) in most developed countries, little is known about the effects of extremely low-level (<1.0 µg/dL) lead exposure on fetal growth.

Methods

We measured maternal BLL during the second or third trimester of pregnancy and assessed birth outcomes, including birthweight, preterm birth (<37 gestational weeks) risk, small for gestational age births (SGA; birthweight <10th percentile) and low birthweight (LBW; <2500 g). The association between birthweight and maternal BLL was estimated using linear and quadratic spline models. Multivariable logistic models were used to examine the risk of binary responses.

Results

From 103 099 pregnant women, 20 000 blood samples were randomly selected for analysis. The maternal BLL range was 0.16–7.4 µg/dL, and the median was 0.63 µg/dL. After adjusting for covariates, the linear model showed that each 0.1 μg/dL increase in maternal BLL was associated with a 5.4 g decrease in mean birthweight [95% confidence interval (CI), 3.4 to 7.5 g]. The risk of SGA [adjusted odds ratio (aOR), 1.03; 95% CI, 1.02 to 1.05) and LBW (aOR, 1.03; 95% CI, 1.02 to 1.05) increased, whereas the risk of preterm delivery did not (aOR, 0.99; 95% CI, 0.97 to 1.02).

Conclusions

Even at a maternal BLL below 1.0 µg/dL, prenatal lead exposure was associated with decreased birthweight and increased risk of SGA and LBW, but not preterm delivery. The adverse effect estimates of prenatal lead exposure on birth outcomes were quantitatively small and clinically limited at this low level.
Locating small inclusions in diffuse optical tomography by a direct imaging method
Authors: Jiang Yu , Nakamura Gen , Wang Haibing
Published: July 2020

Optical tomography is a typical non-invasive medical imaging technique, which aims to reconstruct geometric and physical properties of tissues by passing near infrared light through tissues for obtaining the intensity measurements. Other than optical properties of tissues, we are interested in finding locations of small inclusions inside the object from boundary measurements, based on the time-dependent diffusion model. First, we analyze the asymptotic behavior of the boundary measurements weighted by the fundamental solution of a backward diffusion equation as the diameters of inclusions go to zero. Then, we derive an efficient algorithm for locating small inclusions by finite boundary measurements. This algorithm is direct, simple and easy to be implemented numerically, since it only involves matrix operations and has no iteration process. Finally, some numerical results are presented to illustrate the feasibility and robustness of the algorithm. A new observation of the algorithm is that we can take the source points and test points independently and increase the resolution of numerical results by taking more test points.
Earthquakes and Graftings of Hyperbolic Surface laminations
Authors: Alvarez Sébastien , Smith Graham
Published: July 2020

We study compact hyperbolic surface laminations. These are a generalisation of closed hyperbolic surfaces, which appear to be more suited to the study of Teichmüller theory than arbitrary non-compact surfaces. We show that the Teichmüller space of any non-trivial hyperbolic surface lamination is infinite dimensional. In order to prove this result, we study the theory of deformations of hyperbolic surfaces, and we derive a new formula for the derivative of the length of a simple closed geodesic with respect to the action of grafting. This formula complements those derived by McMullen [ 24], in terms of the Weil–Petersson metric, and by Wolpert [ 34], for the case of earthquakes.
Influenza Vaccination and Hospitalization Outcomes Among Older Patients With Cardiovascular or Respiratory Diseases
Authors: Pang Yuanjie , Wang Qi , Lv Min , Yu Mengke , Lu Ming , Huang Yangmu , Wu Jiang , Xie Zheng
Published: July 2020

Background

Influenza vaccination has been suggested to protect against death and recurrent events among patients with cardiovascular disease or chronic obstructive respiratory disease, but there is limited evidence in older adults, who have higher risks of influenza-associated hospitalization and mortality.

Methods

Patients aged ≥60 years hospitalized for cardiovascular or respiratory diseases from the Beijing Urban Employee Basic Medical Insurance database during 3 influenza seasons (2013–2014 through 2015–2016) were pooled to estimate the effects of influenza vaccination on hospitalization outcomes. Vaccination status was ascertained through cross-referencing the Beijing Elderly Influenza Vaccination database. The summer months (June–August) were used as a reference period to adjust for unmeasured confounders during influenza seasons.

Results

After adjustment for both measured and unmeasured confounders, influenza vaccination was associated with lower risks of in-hospital deaths among patients hospitalized for cardiovascular (odds ratio [95% confidence interval], 0.85 [.68–1.06]) or respiratory diseases (0.66 [.54–.82]). Influenza vaccination was associated with a lower risk of readmission among patients with cardiovascular (odds ratio [95% confidence interval], 0.81 [.69–.95]) but not respiratory diseases (1.12 [.92–1.35]). Influenza vaccination was also associated with lower direct medical costs, but not with length of stay.

Conclusions

Influenza vaccination protected against hospitalization outcomes among older adults with cardiovascular or respiratory diseases.
Within- and cross-species predictions of plant specialized metabolism genes using transfer learning
Authors: Moore Bethany M , Wang Peipei , Fan Pengxiang , Lee Aaron , Leong Bryan , Lou Yann-Ru , Schenck Craig A , Sugimoto Koichi , Last Robert , Lehti-Shiu Melissa D , Barry Cornelius S , Shiu Shin-Han
Published: July 2020

Plant specialized metabolites mediate interactions between plants and the environment and have significant agronomical/pharmaceutical value. Most genes involved in specialized metabolism (SM) are unknown because of the large number of metabolites and the challenge in differentiating SM genes from general metabolism (GM) genes. Plant models like Arabidopsis thaliana have extensive, experimentally derived annotations, whereas many non-model species do not. Here we employed a machine learning strategy, transfer learning, where knowledge from A. thaliana is transferred to predict gene functions in cultivated tomato with fewer experimentally annotated genes. The first tomato SM/GM prediction model using only tomato data performs well (F-measure = 0.74, compared with 0.5 for random and 1.0 for perfect predictions), but from manually curating 88 SM/GM genes, we found many mis-predicted entries were likely mis-annotated. When the SM/GM prediction models built with A. thaliana data were used to filter out genes where the A. thaliana-based model predictions disagreed with tomato annotations, the new tomato model trained with filtered data improved significantly (F-measure = 0.92). Our study demonstrates that SM/GM genes can be better predicted by leveraging cross-species information. Additionally, our findings provide an example for transfer learning in genomics where knowledge can be transferred from an information-rich species to an information-poor one.
Beyond “Bouncing”: Resilience as an Expansion–Contraction Dynamic within a Holonic Frame
Authors: Clark Janine Natalya
Published: July 2020

The concept of resilience is often discussed in relation to “bouncing,” whether bouncing back or bouncing forward. This interdisciplinary article looks beyond “bouncing” in either direction. In so doing, it offers a novel conceptualization of resilience as a dialectical process of expansion and contraction across multiple domains and levels. Drawing on fieldwork with victims-/survivors of conflict-related sexual violence in Bosnia and Herzegovina, Colombia, and Uganda, it uses the qualitative data both to empirically critique the notions of “bouncing back” and “bouncing forward” and to explore what expansion and contraction look like in practice. It situates the arguments within a broader holonic perspective, in order to accentuate the systemic dimensions of resilience, and ultimately it discusses what they mean for the field of transitional justice.