bluuebunny/crossref_metadata_2025 huggingface dataset:
Supporting adolescents living with HIV within boarding schools in Kenya
Authors: Kose Judith , Lenz Cosima , Akuno Job , Kiiru Fred , Jelagat Odionyi Justine , Otieno-Masaba Rose , Okoth Elizabeth A. , Woelk Godfrey , Leselewa Solomon , Leendert Fraaij Pieter , Rakhmanina Natella
Published: December 2021

Adolescents and youth living with HIV (AYLHIV) are a uniquely vulnerable population facing challenges around adherence, disclosure of HIV status and stigma. Providing school-based support for AYLHIV offers an opportunity to optimize their health and wellbeing. The purpose of this study was to evaluate the feasibility of school-based supportive interventions for AYLHIV in Kenya. From 2016–2019, with funding from ViiV Healthcare, the Elizabeth Glaser Pediatric AIDS Foundation implemented the innovative Red Carpet Program (RCP) for AYLHIV in participating public healthcare facilities and boarding schools in Homa Bay and Turkana Counties in Kenya. In this analysis, we report the implementation of the school-based interventions for AYLHIV in schools, which included: a) capacity building for overall in-school HIV, stigma and sexual and reproductive health education; b) HIV care and treatment support; c) bi-directional linkages with healthcare facilities; and d) psychosocial support (PSS). Overall, 561 school staff and 476 school adolescent health advocates received training to facilitate supportive environments for AYLHIV and school-wide education on HIV, stigma, and sexual and reproductive health. All 87 boarding schools inter-linked to 66 regional healthcare facilities to support care and treatment of AYLHIV. Across all RCP schools, 546 AYLHIV had their HIV status disclosed to school staff and received supportive care within schools, including treatment literacy and adherence counselling, confidential storage and access to HIV medications. School-based interventions to optimize care and treatment support for AYLHIV are feasible and contribute to advancing sexual and reproductive health within schools.
SARS-CoV-2 spike protein displays sequence similarities with paramyxovirus surface proteins; a bioinformatics study
Authors: Ahmadi Ehsan , Zabihi Mohammad Reza , Hosseinzadeh Ramin , Mohamed Khosroshahi Leila , Noorbakhsh Farshid
Published: December 2021

Recent emergence of SARS-CoV-2 and associated COVID-19 pandemic have posed a great challenge for the scientific community. In this study, we performed bioinformatic analyses on SARS-CoV-2 protein sequences, trying to unravel potential molecular similarities between this newly emerged pathogen with non-coronavirus ssRNA viruses. Comparing the proteins of SARS-CoV-2 with non-coronavirus positive and negative strand ssRNA viruses revealed multiple sequence similarities between SARS-CoV-2 and non-coronaviruses, including similarities between RNA-dependent RNA-polymerases and helicases (two highly-conserved proteins). We also observed similarities between SARS-CoV-2 surface (i.e. spike) protein with paramyxovirus fusion proteins. This similarity was restricted to a segment of spike protein S2 subunit which is involved in cell fusion. We next analyzed spike proteins from SARS-CoV-2 “variants of concern” (VOCs) and “variants of interests” (VOIs) and found that some of these variants show considerably higher spike-fusion similarity with paramyxoviruses. The ‘spike-fusion’ similarity was also observed for some pathogenic coronaviruses other than SARS-CoV-2. Epitope analysis using experimentally verified data deposited in Immune Epitope Database (IEDB) revealed that several B cell epitopes as well as T cell and MHC binding epitopes map within the spike-fusion similarity region. These data indicate that there might be a degree of convergent evolution between SARS-CoV-2 and paramyxovirus surface proteins which could be of pathogenic and immunological importance.
Physical-mental health comorbidity: A population-based cross-sectional study
Authors: Jürisson Mikk , Pisarev Heti , Uusküla Anneli , Lang Katrin , Oona Marje , Elm Lisanna , Kalda Ruth
Published: December 2021

Background

Multimorbidity is associated with physical-mental health comorbidity (PMHC). However, the scope of overlap between physical and mental conditions, associated factors, as well as types of mental illness involved are not well described in Eastern Europe. This study aims to assess the PMHC burden in the Estonian population.

Methods

In this population-based cross-sectional study we obtained health claims data for 55 chronic conditions from the Estonian Health Insurance Fund (EHIF) database, which captures data for all publicly insured individuals (n = 1 240 927 or 94.1% of the total population as of 31 December 2017). We assessed the period-prevalence (3 years) of chronic physical and mental health disorders, as well as associations between them, by age and sex.

Results

Half of the individuals (49.1% (95% CI 49.0–49.3)) had one or more chronic conditions. Mental health disorders (MHD) were present in 8.1% (8.1–8.2) of individuals, being higher among older age groups, women, and individuals with a higher number of physical conditions. PMHC was present in 6.2% (6.1–6.2) of the study population, and 13.1% (13.0–13.2) of the subjects with any chronic physical disorder also presented with at least one MHD. Dominating MHDs among PMHC patients were anxiety and depression. The prevalence of MHD was positively correlated with the number of physical disorders. We observed variation in the type of MHD as the number of physical comorbidities increased. The prevalence of anxiety, depression, and mental and behavioral disorders due to the misuse of alcohol and other psychoactive substances increased as physical comorbidities increased, but the prevalence of schizophrenia and dementia decreased with each additional physical disease. After adjusting for age and sex, this negative association changed the sign to a positive association in the case of dementia and mental and behavioral disorders due to psychoactive substance misuse.

Conclusions

The burden of physical-mental comorbidity in the Estonian population is relatively high. Further research is required to identify clusters of overlapping physical and mental disorders as well as the interactions between these conditions. Public health interventions may include structural changes to health care delivery, such as an increased emphasis on integrated care models that reduce barriers to mental health care.
Uninterrupted HIV treatment for women: Policies and practices for care transitions during pregnancy and breastfeeding in Côte d’Ivoire, Lesotho and Malawi
Authors: Phillips Tamsin K. , Olsen Halli , Teasdale Chloe A. , Geller Amanda , Ts’oeu Mamorapeli , Buono Nicole , Kayira Dumbani , Ngeno Bernadette , Modi Surbhi , Abrams Elaine J.
Published: December 2021

Transitions between services for continued antiretroviral treatment (ART) during and after pregnancy are a commonly overlooked aspect of the HIV care cascade, but ineffective transitions can lead to poor health outcomes for women and their children. In this qualitative study, we conducted interviews with 15 key stakeholders from Ministries of Health along with PEPFAR-supported and other in-country non-governmental organizations actively engaged in national programming for adult HIV care and prevention of mother-to-child-transmission of HIV (PMTCT) services in Côte d’Ivoire, Lesotho and Malawi. We aimed to understand perspectives regarding transitions into and out of PMTCT services for continued ART. Thematic analysis revealed that, although transitions of care are necessary and a potential point of loss from ART care in all three countries, there is a lack of clear guidance on transition approach and no formal way of monitoring transition between services. Several opportunities were identified to monitor and strengthen transitions of care for continued ART along the PMTCT cascade.
Characterizing health care provider knowledge: Evidence from HIV services in Kenya, Rwanda, South Africa, and Zambia
Authors: Pineda-Antunez Carlos , Contreras-Loya David , Rodriguez-Atristain Alejandra , Opuni Marjorie , Bautista-Arredondo Sergio
Published: December 2021

Background

Identifying approaches to improve levels of health care provider knowledge in resource-poor settings is critical. We assessed level of provider knowledge for HIV testing and counseling (HTC), prevention of mother-to-child transmission (PMTCT), and voluntary medical male circumcision (VMMC). We also explored the association between HTC, PMTCT, and VMMC provider knowledge and provider and facility characteristics.

Methods

We used data collected in 2012 and 2013. Vignettes were administered to physicians, nurses, and counselors in facilities in Kenya (66), Rwanda (67), South Africa (57), and Zambia (58). The analytic sample consisted of providers of HTC (755), PMTCT (709), and VMMC (332). HTC, PMTCT, and VMMC provider knowledge scores were constructed using item response theory (IRT). We used GLM regressions to examine associations between provider knowledge and provider and facility characteristics focusing on average patient load, provider years in position, provider working in another facility, senior staff in facility, program age, proportion of intervention exclusive staff, person-days of training in facility, and management score. We estimated three models: Model 1 estimated standard errors without clustering, Model 2 estimated robust standard errors, and Model 3 estimated standard errors clustering by facility.

Results

The mean knowledge score was 36 for all three interventions. In Model 1, we found that provider knowledge scores were higher among providers in facilities with senior staff and among providers in facilities with higher proportions of intervention exclusive staff. We also found negative relationships between the outcome and provider years in position, average program age, provider working in another facility, person-days of training, and management score. In Model 3, only the coefficients for provider years in position, average program age, and management score remained statistically significant at conventional levels.

Conclusions

HTC, PMTCT, and VMMC provider knowledge was low in Kenya, Rwanda, South Africa, and Zambia. Our study suggests that unobservable organizational factors may facilitate communication, learning, and knowledge. On the one hand, our study shows that the presence of senior staff and staff dedication may enable knowledge acquisition. On the other hand, our study provides a note of caution on the potential knowledge depreciation correlated with the time staff spend in a position and program age.
Prediction of suicidal ideation risk in a prospective cohort study of medical interns
Authors: Malone Tyler L. , Zhao Zhou , Liu Tzu-Ying , Song Peter X. K. , Sen Srijan , Scott Laura J.
Published: December 2021

The purpose of this study was to identify individual and residency program factors associated with increased suicide risk, as measured by suicidal ideation. We utilized a prospective, longitudinal cohort study design to assess the prevalence and predictors of suicidal ideation in 6,691 (2012–2014 cohorts, training data set) and 4,904 (2015 cohort, test data set) first-year training physicians (interns) at hospital systems across the United States. We assessed suicidal ideation two months before internship and then quarterly through intern year. The prevalence of reported suicidal ideation in the study population increased from 3.0% at baseline to a mean of 6.9% during internship. 16.4% of interns reported suicidal ideation at least once during their internship. In the training dataset, a series of baseline demographic (male gender) and psychological factors (high neuroticism, depressive symptoms and suicidal ideation) were associated with increased risk of suicidal ideation during internship. Further, prior quarter psychiatric symptoms (depressive symptoms and suicidal ideation) and concurrent work-related factors (increase in self-reported work hours and medical errors) were associated with increased risk of suicidal ideation. A model derived from the training dataset had a predicted area under the Receiver Operating Characteristic curve (AUC) of 0.83 in the test dataset. The suicidal ideation risk predictors analyzed in this study can help programs and interns identify those at risk for suicidal ideation before the onset of training. Further, increases in self-reported work hours and environments associated with increased medical errors are potentially modifiable factors for residency programs to target to reduce suicide risk.
Cortical and autonomic responses during staged Taoist meditation: Two distinct meditation strategies
Authors: Volodina Maria , Smetanin Nikolai , Lebedev Mikhail , Ossadtchi Alexei
Published: December 2021

Meditation is a consciousness state associated with specific physiological and neural correlates. Numerous investigations of these correlates reported controversial results which prevented a consistent depiction of the underlying neurophysiological processes. Here we investigated the dynamics of multiple neurophysiological indicators during a staged meditation session. We measured the physiological changes at rest and during the guided Taoist meditation in experienced meditators and naive subjects. We recorded EEG, respiration, galvanic skin response, and photoplethysmography. All subjects followed the same instructions split into 16 stages. In the experienced meditators group we identified two subgroups with different physiological markers dynamics. One subgroup showed several signs of general relaxation evident from the changes in heart rate variability, respiratory rate, and EEG rhythmic activity. The other subgroup exhibited mind concentration patterns primarily noticeable in the EEG recordings while no autonomic responses occurred. The duration and type of previous meditation experience or any baseline indicators we measured did not explain the segregation of the meditators into these two groups. These results suggest that two distinct meditation strategies could be used by experienced meditators, which partly explains the inconsistent results reported in the earlier studies evaluating meditation effects. Our findings are also relevant to the development of the high-end biofeedback systems.
The impacts on food purchases and tax revenues of a tax based on Chile’s nutrient profiling model
Authors: Colchero M. Arantxa , Paraje Guillermo , Popkin Barry M.
Published: December 2021

Background

In June 2016, Chile implemented the Law of Food Labelling and Advertising, which included a mandatory front-of-pack warning labels on food and beverages high in added sugar, saturated fat, sodium or energy density, restrictions on child-directed marketing and on the promotion and sales of these products in schools. The regulation does not include taxes although Chile had implemented a tiered tax on SSBs two years before this law was implemented. Therefore, the objective of the study was to simulate the impact of taxing food and beverages based on the cutoff’s points for warning labels on purchases and revenues.

Methods

We derived price elasticities using the linear approximation of the almost ideal demand system for six groups of labeled food and beverages (with a warning label based on the regulation) and unlabeled (with no warning label): 1) unlabeled beverages, 2) labeled beverages, 3) unlabeled cereal based products, 4) labeled cereal based products, 5) labeled meat and fish and 6) labeled sweet snacks and desserts. The study used data on household food beverage purchases from the Kantar WorldPanel Chile and Euromonitor sales to adjust the Kantar elasticity results to the national average. We estimated revenues under three tax scenarios for all labeled food and beverages: 10%, 20%, 30% of the final price excluding taxes.

Results

Except for labeled fish and meat, all food and beverage groups were price elastic. After accounting for a reduction in consumption after the taxes, economic and population growth, revenues for all groups could reach between 457 million USD to 1.3 billion USD. These results based on the much larger tax base of these labeled “high in added sugar, salt or saturated fat or energy density” foods and beverages is much larger.

Conclusion

This fiscal package could be implemented in countries with warning labels to enhance health and welfare. The Chilean warning label front-of-the-package system provides an important guide for countries considering policies to reduce diet-related non communicable diseases, including obesity. The fiscal policy impact alone, as shown here for Chile, will be highly impactful in reducing ultra-processed food intake and generating revenues.
Improving uptake of prevention of mother-to-child HIV transmission services in Benue State, Nigeria through a faith-based congregational strategy
Authors: Montandon Michele , Efuntoye Timothy , Itanyi Ijeoma U. , Onoka Chima A. , Onwuchekwa Chukwudi , Gwamna Jerry , Schwitters Amee , Onyenuobi Chibuzor , Ogidi Amaka G. , Swaminathan Mahesh , Oko John Okpanachi , Ijaodola Gbenga , Odoh Deborah , Ezeanolue Echezona E.
Published: December 2021

Background

Nigeria has low antiretroviral therapy (ART) coverage among HIV-positive pregnant women. In a previous cluster-randomized trial in Nigeria, Baby Shower events resulted in higher HIV testing coverage and linkage of pregnant women to ART; here, we assess outcomes of Baby Shower events in a non-research setting.

Methods

Baby Shower events, including a prayer ceremony, group education, music, gifting of a “mama pack” with safe delivery supplies, and HIV testing with ART linkage support for HIV-positive pregnant women, were conducted in eighty sites in Benue State, Nigeria. Client questionnaires (including demographics, ANC attendance, and HIV testing history), HIV test results, and reported linkage to ART were analyzed. Descriptive data on HIV testing and ART linkage data for facility-based care at ANC clinics in Benue State were also analyzed for comparison.

Results

Between July 2016 and October 2017, 10,056 pregnant women and 6,187 male partners participated in Baby Shower events; 61.5% of women attended with a male partner. Nearly half of female participants (n = 4515, 44.9%) were not enrolled in ANC for the current pregnancy, and 22.3% (n = 2,241) of female and 24.8% (n = 1,532) of male participants reported they had never been tested for HIV. Over 99% (n = 16,240) of participants had their HIV status ascertained, with 7.2% of females (n = 724) and 4.0% of males (n = 249) testing HIV-positive, and 2.9% of females (n = 274) and 2.3% of males (n = 138) receiving new HIV-positive diagnoses. The majority of HIV-positive pregnant women (93.0%, 673/724) were linked to ART. By comparison, at health facilities in Benue State during a similar time period, 99.7% of pregnant women had HIV status ascertained, 8.4% had a HIV-positive status, 2.1% were newly diagnosed HIV-positive, and 100% were linked to ART.

Conclusion

Community-based programs such as the faith-based Baby Shower intervention complement facility-based approaches and can reach individuals who would not otherwise access facility-based care. Future Baby Showers implementation should incorporate enhanced support for ART linkage and retention to maximize the impact of this intervention on vertical HIV transmission.
Longitudinal changes in Super League match locomotor and event characteristics: A league-wide investigation over three seasons in rugby league
Authors: Rennie Gordon , Hart Brian , Dalton-Barron Nicholas , Weaving Dan , Williams Sean , Jones Ben
Published: December 2021

The 2019 and 2020 Super League (SL) seasons included several competition rule changes. This study aimed to quantify the difference between the 2018, 2019 and 2020 SL seasons for duration, locomotor and event characteristics of matches. Microtechnology and match event data were analysed from 11 SL teams, comprising 124 players, from 416 competitive matches across a three-year data collection period. Due to an enforced suspension of league competition as a consequence of COVID-19 restrictions, and subsequent rule changes upon return to play, season 2020 was divided into season 2020a (i.e. Pre-COVID suspension) and season 2020b (i.e. Post-COVID suspension). Duration, locomotor variables, and match events were analysed per whole-match and ball-in-play (BIP) periods with differences between seasons determined using mixed-effects models. There were significant (ρ ≤ 0.05) reductions in whole-match and BIP durations for adjustables and backs in 2019 when compared to 2018; albeit the magnitude of reduction was less during BIP analyses. Despite reduced duration, adjustables reported an increased average speed suggesting reduced recovery time between bouts. Both forwards and adjustables also experienced an increase in missed tackles between 2018 and 2019 seasons. When comparing 2019 to 2020a, adjustables and backs increased their average speed and distance whilst all positional groups increased average acceleration both for whole-match and BIP analyses. When comparing 2020a to 2020b, all positional groups experienced reduced average speed and average acceleration for both whole-match and BIP analyses. Forwards experienced an increased number of tackles and carries, adjustables experienced an increased number of carries, and backs experienced an increased number of missed tackles when comparing these variables between season 2020a and 2020b. Rule changes have a greater effect on whole-match duration and locomotor characteristics than those reported during BIP periods which suggests the implemented rule changes have removed stagnant time from matches. Amendments to tackle related rules within matches (e.g., introduction of the ‘six-again’ rule) increases the number of collision related events such as carries and tackles.
Patient health records and whole viral genomes from an early SARS-CoV-2 outbreak in a Quebec hospital reveal features associated with favorable outcomes
Authors: Paré Bastien , Rozendaal Marieke , Morin Sacha , Kaufmann Léa , Simpson Shawn M. , Poujol Raphaël , Mostefai Fatima , Grenier Jean-Christophe , Xing Henry , Sanchez Miguelle , Yechouron Ariane , Racette Ronald , Hussin Julie G. , Wolf Guy , Pavlov Ivan , Smith Martin A.
Published: December 2021

The first confirmed case of COVID-19 in Quebec, Canada, occurred at Verdun Hospital on February 25, 2020. A month later, a localized outbreak was observed at this hospital. We performed tiled amplicon whole genome nanopore sequencing on nasopharyngeal swabs from all SARS-CoV-2 positive samples from 31 March to 17 April 2020 in 2 local hospitals to assess viral diversity (unknown at the time in Quebec) and potential associations with clinical outcomes. We report 264 viral genomes from 242 individuals–both staff and patients–with associated clinical features and outcomes, as well as longitudinal samples and technical replicates. Viral lineage assessment identified multiple subclades in both hospitals, with a predominant subclade in the Verdun outbreak, indicative of hospital-acquired transmission. Dimensionality reduction identified two subclades with mutations of clinical interest, namely in the Spike protein, that evaded supervised lineage assignment methods–including Pangolin and NextClade supervised lineage assignment tools. We also report that certain symptoms (headache, myalgia and sore throat) are significantly associated with favorable patient outcomes. Our findings demonstrate the strength of unsupervised, data-driven analyses whilst suggesting that caution should be used when employing supervised genomic workflows, particularly during the early stages of a pandemic.
Antifungal activity of volatile compounds generated by endophytic fungi Sarocladium brachiariae HND5 against Fusarium oxysporum f. sp. cubense
Authors: Yang Yang , Chen Yipeng , Cai Jimiao , Liu Xianbao , Huang Guixiu
Published: December 2021

The soil-born filamentous fungal pathogen Fusarium oxysporum f. sp. cubense (FOC), which causes vascular wilt disease in banana plants, is one of the most economically important Fusarium species. Biocontrol using endophytic microorganisms is among the most effective methods for controlling banana Fusarium wilt. In this study, volatile organic compounds (VOCs) showed strong antifungal activity against FOC. Seventeen compounds were identified from the VOCs produced by endophytic fungi Sarocladium brachiariae HND5, and three (2-methoxy-4-vinylphenol, 3,4-dimethoxystyrol and caryophyllene) showed antifungal activity against FOC with 50% effective concentrations of 36, 60 and 2900 μL/L headspace, respectively. Transmission electron microscopy (TEM) and double fluorescence staining revealed that 2-methoxy-4-vinylphenol and 3,4-dimethoxystyrol damaged the plasma membranes, resulting in cell death. 3,4-dimethoxystyrol also could induce expression of chitin synthases genes and altered the cell walls of FOC hyphae. Dichloro-dihydro-fluorescein diacetate staining indicated the caryophyllene induced accumulation of reactive oxygen species (ROS) in FOC hyphae. FOC secondary metabolism also responded to active VOC challenge by producing less fusaric acid and expressions of genes related to fusaric acid production were interrupted at sublethal concentrations. These findings indicate the potential of S. brachiariae HND5 as a biocontrol agent against FOC and the antifungal VOCs as fumigants.
Caregiver perceived barriers to the use of micronutrient powder for children aged 6–59 months in Bangladesh
Authors: Rahman Mahfuzur , Tariqujjaman Md. , Mahfuz Mustafa , Ahmed Tahmeed , Sarma Haribondhu
Published: December 2021

Background

The effectiveness of micronutrient powder (MNP) on the health outcome of children is yet to be proved. Although studies identified the barriers to the use of MNP the underlying factors related to the barriers to the use of MNP are still unexplored. We examined the underlying factors associated with the barriers reported by the caregivers of the children aged 6–59 months in Bangladesh.

Methods

We analyzed pooled data of 3, 634 caregiver-child dyads extracted from eight cross-sectional surveys. The surveys were conducted as part of an evaluation of the Maternal, Infant and Young Children Nutrition programme (phase 2) in Bangladesh. We performed univariate analysis to find the barriers reported by the caregivers of the children. We identified the underlying factors related to the reported barriers by performing multiple logistic regression analysis.

Results

The mostly reported barrier was perceived lack of need for MNP among the caregivers of the children (39.9%), followed by lack of awareness of the product (21.7%) and cost of the product (18.1%). Caregivers of older children (adjusted odds ratio (aOR): 1.69; 95% CI: 1.43, 2.00) and caregivers who maintained good infant and young child feeding practices (aOR: 1.32; 95% CI: 1.12, 1.57) perceived more lack of need for MNP. Caregivers of the female children (aOR: 0.79; 95% CI: 0.63, 0.98) were less likely to report that their children disliked MNP compared to the caregivers of the male children.

Conclusion

Programmes intended to effectively promote MNP among the caregivers of children aged 6–59 months should carefully consider the factors that could underlie the barriers to the use of MNP.
Differentiating busking from begging: A psychological approach
Authors: Ho Robbie , Au Wing Tung
Published: December 2021

Despite the research support that street performance is generally a beneficial element to public space, the legitimacy of street performance remains controversial. One critical issue is that busking is often confused with begging. With a psychological perspective, the present research examines the distinction of busking from begging. Two studies approached the problem from the viewpoints of street performers and passersby, respectively. Study 1 (N = 188) surveyed street performers on their reasons for street performance and reasons for why donations to street performance should be acceptable. The respondents could articulate various features of street performance along which busking could be similar to and yet distinguishable from begging. Study 2 (N = 189) experimentally compared busking and begging in how they could affect people’s perception of public space. Relative to public space with begging, public space with busking was perceived as significantly more comforting, more active, less prone to crimes, and overall more likeable. These descriptive (Study 1) and experimental (Study 2) findings help to clarify the difference between busking and begging: Street performance is not merely an act of soliciting donations in public space, but it also possesses artistic and entertaining qualities that can in turn make public space more favorable. The current findings can inform the policy making and regulations of street performance. Moreover, since the present research was conducted in Hong Kong, it contributes a cultural perspective to the literature on street performance.
Prospective comparison of CT and 18F-FDG PET/MRI in N and M staging of primary breast cancer patients: Initial results
Authors: Bruckmann Nils Martin , Kirchner Julian , Morawitz Janna , Umutlu Lale , Herrmann Ken , Bittner Ann-Kathrin , Hoffmann Oliver , Mohrmann Svjetlana , Ingenwerth Marc , Schaarschmidt Benedikt M. , Li Yan , Stang Andreas , Antoch Gerald , Sawicki Lino M. , Buchbender Christian
Published: December 2021

Objectives

To compare the diagnostic accuracy of contrast-enhanced thoraco-abdominal computed tomography and whole-body 18F-FDG PET/MRI in N and M staging in newly diagnosed, histopathological proven breast cancer.

Material and methods

A total of 80 consecutive women with newly diagnosed and histopathologically confirmed breast cancer were enrolled in this prospective study. Following inclusion criteria had to be fulfilled: (1) newly diagnosed, treatment-naive T2-tumor or higher T-stage or (2) newly diagnosed, treatment-naive triple-negative tumor of every size or (3) newly diagnosed, treatment-naive tumor with molecular high risk (T1c, Ki67 >14%, HER2neu over-expression, G3). All patients underwent a thoraco-abdominal ceCT and a whole-body 18F-FDG PET/MRI. All datasets were evaluated by two experienced radiologists in hybrid imaging regarding suspect lesion count, localization, categorization and diagnostic confidence. Images were interpreted in random order with a reading gap of at least 4 weeks to avoid recognition bias. Histopathological results as well as follow-up imaging served as reference standard. Differences in staging accuracy were assessed using Mc Nemars chi2 test.

Results

CT rated the N stage correctly in 64 of 80 (80%, 95% CI:70.0–87.3) patients with a sensitivity of 61.5% (CI:45.9–75.1), a specificity of 97.6% (CI:87.4–99.6), a PPV of 96% (CI:80.5–99.3), and a NPV of 72.7% (CI:59.8–82.7). Compared to this, 18F-FDG PET/MRI determined the N stage correctly in 71 of 80 (88.75%, CI:80.0–94.0) patients with a sensitivity of 82.1% (CI:67.3–91.0), a specificity of 95.1% (CI:83.9–98.7), a PPV of 94.1% (CI:80.9–98.4) and a NPV of 84.8% (CI:71.8–92.4). Differences in sensitivities were statistically significant (difference 20.6%, CI:-0.02–40.9; p = 0.008). Distant metastases were present in 7/80 patients (8.75%). 18 F-FDG PET/MRI detected all of the histopathological proven metastases without any false-positive findings, while 3 patients with bone metastases were missed in CT (sensitivity 57.1%, specificity 95.9%). Additionally, CT presented false-positive findings in 3 patients.

Conclusion

18F-FDG PET/MRI has a high diagnostic potential and outperforms CT in assessing the N and M stage in patients with primary breast cancer.
Prevalence and factors associated with anxiety and depression amongst hospitalised COVID-19 patients in Laquintinie Hospital Douala, Cameroon
Authors: Ngasa Stewart Ndutard , Tchouda Leticia Armelle Sani , Abanda Christabel , Ngasa Neh Chang , Sanji Eric Wah , Dingana Therence Nwana , Babila Carlson-Sama
Published: December 2021

Studies assessing the mental health of patients with COVID-19 infection remain limited. Disasters and major emergencies, not just COVID-19, undoubtedly lead to greater incidence of mental health problems. Previous studies indicate that the novel Coronavirus disease can cause panic and stress in patients. Our literature search didn’t reveal any previous published data from Cameroon and the Central African sub-region. In order to bridge this gap, we assessed the prevalence and factors associated with depression and anxiety in COVID-19 patients. We carried out a cross-sectional study in a secondary hospital in the Littoral Region of Cameroon. We recruited hospitalised COVID-19 patients during a 4-month period. We collected data on sociodemographic characteristics. The HADS score was used to assess levels of anxiety and depression. All analysis were done using Stata 14. A P value of <0.05 was used as the cut-off for statistical significance. A total number of 285 patients took part in this study with a mean age of 48.47 years. The prevalence of anxiety in COVID-19 patients was 60.35% while the prevalence of depression was 81.40%. At multivariate logistic regression male gender (OR: 1.89, P = 0.04), hypoxaemia (OR: 2.20, P = 0.01), presence of COVID-19 complications (OR: 1.61, P = 0.02) and current episode of depression (OR: 4.14, P<0.01) were independently associated with anxiety. Similarly, age > 35 years (OR:2.03, P = 0.02), presence of comorbidity (OR: 1.68, P = 0.01), BMI > = 30kg/m2 (OR: 1.78, P = 0.02), presence of COVID-19 complications (OR: 1.28, P = 0.01) and anxiety (OR: 4.60, P<0.001) were independently associated with depression. Hospitalised patients with COVID-19 experienced high levels of anxiety and depression. Treatment of hospitalised patients with COVID-19 should therefore include psychotherapy and psychiatric support.
Clinical Outcomes of low-voltage area-guided left atrial linear ablation for non-paroxysmal atrial fibrillation patients
Authors: Liu Hao-Tien , Yang Chia-Hung , Lee Hui-Ling , Chang Po-Cheng , Wo Hung-Ta , Wen Ming-Shien , Wang Chun-Chieh , Yeh San-Jou , Chou Chung-Chuan
Published: December 2021

Background

The therapeutic effect of low-voltage area (LVA)-guided left atrial (LA) linear ablation for non-paroxysmal atrial fibrillation (non-PAF) is uncertain. We aimed to investigate the efficacy of LA linear ablation based on the preexisting LVA and its effects on LA reverse remodeling in non-PAF patients.

Methods

We retrospectively evaluated 145 consecutive patients who underwent radiofrequency catheter ablation for drug-refractory non-PAF. CARTO-guided bipolar voltage mapping was performed in atrial fibrillation (AF). LVA was defined as sites with voltage ≤ 0.5 mV. If circumferential pulmonary vein isolation couldn’t convert AF into sinus rhythm, additional LA linear ablation was performed preferentially at sites within LVA.

Results

After a mean follow-up duration of 48 ± 33 months, 29 of 145 patients had drugs-refractory AF/LA tachycardia recurrence. Low LA emptying fraction, large LA size and high extent of LVA were associated with AF recurrence. There were 136 patients undergoing LA linear ablation. The rate of linear block at the mitral isthmus was significantly higher via LVA-guided than non-LVA-guided linear ablation. Patients undergoing LVA-guided linear ablation had larger LA size and higher extent of LVA, but the long-term AF/LA tachycardia-free survival rate was higher than the non-LVA-guided group. The LA reverse remodeling effects by resuming sinus rhythm were noted even in patients with a diseased left atrium undergoing extensive LA linear ablation.

Conclusions

LVA-guided linear ablation through targeting the arrhythmogenic LVA and reducing LA mass provides a better clinical outcome than non-LVA guided linear ablation, and outweighs the harmful effects of iatrogenic scaring in non-PAF patients.
Comparison of TCF4 repeat expansion length in corneal endothelium and leukocytes of patients with Fuchs endothelial corneal dystrophy
Authors: Wieben Eric D. , Aleff Ross A. , Rinkoski Tommy A. , Baratz Keith H. , Basu Shubham , Patel Sanjay V. , Maguire Leo J. , Fautsch Michael P.
Published: December 2021

Expansion of CTG trinucleotide repeats (TNR) in the transcription factor 4 (TCF4) gene is highly associated with Fuchs Endothelial Corneal Dystrophy (FECD). Due to limitations in the availability of DNA from diseased corneal endothelium, sizing of CTG repeats in FECD patients has typically been determined using DNA samples isolated from peripheral blood leukocytes. However, it is non-feasible to extract enough DNA from surgically isolated FECD corneal endothelial tissue to determine repeat length based on current technology. To circumvent this issue, total RNA was isolated from FECD corneal endothelium and sequenced using long-read sequencing. Southern blotting of DNA samples isolated from primary cultures of corneal endothelium from these same affected individuals was also assessed. Both long read sequencing and Southern blot analysis showed significantly longer CTG TNR expansion (>1000 repeats) in the corneal endothelium from FECD patients than those characterized in leukocytes from the same individuals (<90 repeats). Our findings suggest that the TCF4 CTG repeat expansions in the FECD corneal endothelium are much longer than those found in leukocytes.
Danube as a symbol of Europe. Perception of the river from varied geographical perspectives
Authors: Padło Tomasz , Struś Paweł , Gil Agnieszka
Published: December 2021

The Danube is promoted as a pan-European river, what can be justified for instance by the vast range of its drainage basin, covering 19 countries on both sides of the historical border diving Eastern and Western Europe. Differentiation of imaginations of Danube course from the perspective of 7 European cities, based on research covering 1577 respondents, conducted between 2005–2007 and 2016–2018 has been presented in the paper. Maps presenting the generalized imagination of river course have been generated for each city. It has been proved that in spite of substantial political, economical and symbolical importance of this river for big part of Europe, the course of Danube remains unknown for inhabitants of its Western part, in parallel to more correct recognition of the river by students from Eastern Europe. It has been shown that the perception does not change despite the progressing integration processes.
Comparison of post-activation performance enhancement (PAPE) after isometric and isotonic exercise on vertical jump performance
Authors: Vargas-Molina Salvador , Salgado-Ramírez Ulises , Chulvi-Medrano Iván , Carbone Leandro , Maroto-Izquierdo Sergio , Benítez-Porres Javier
Published: December 2021

Purpose

This study aimed to compare the post-activation performance enhancement (PAPE) induced by isometric and isotonic exercise on vertical jump performance.

Methods

18 healthy trained men (25.8±2.7 years; 78.4±8.2 kg; 175.7±6.1 cm; 25.4±1.8 BMI; 126.72±10.8 kg squat 1-RM) volunteered for this study. They randomly performed two different PAPE protocols: Isotonic squats (ISOTS), which consisted of 2 sets of 3 repetitions at 75% of one-maximum repetition (1-RM); and isometric squats (ISOMS), which consisted of 2 sets of 4 seconds of submaximal (75% of 1-RM) isometric contraction at 90°-knee flexion. Countermovement jump (CMJ) height was tested at baseline and 4 minutes after each conditioning set.

Results

CMJ height significantly increased after set 1 in both PAPE protocols (ISOMS: p <0.001; ES = 0.34; ISOTS: p <0.001; ES = 0.24), with respect to the baseline jump. However, after set 2 no significant changes in CMJ height were observed for any protocol (ISOMS: p = 0.162; ES = 0.11; ISOTS: p = 0.976; ES = 0.06). No significant differences (p>0.05) were found between both isometric and isotonic exercise conditions.

Conclusions

Despite both protocols showed similar PAPE effects on CMJ height after set 1, none of the protocols demonstrated greater efficacy in increasing subsequent performance in healthy trained men.
Application of principal component analysis on temporal evolution of COVID-19
Authors: Nobi Ashadun , Tuhin Kamrul Hasan , Lee Jae Woo
Published: December 2021

The COVID-19 is one of the worst pandemics in modern history. We applied principal component analysis (PCA) to the daily time series of the COVID-19 death cases and confirmed cases for the top 25 countries from April of 2020 to February of 2021. We calculated the eigenvalues and eigenvectors of the cross-correlation matrix of the changes in daily accumulated data over monthly time windows. The largest eigenvalue describes the overall evolution dynamics of the COVID-19 and indicates that evolution was faster in April of 2020 than in any other period. By using the first two PC coefficients, we can identify the group dynamics of the COVID-19 evolution. We observed groups under critical states in the loading plot and found that American and European countries are represented by strong clusters in the loading plot. The first PC plays an important role and the correlations (C1) between the normalized logarithmic changes in deaths or confirmed cases and the first PCs may be used as indicators of different phases of the COVID-19. By varying C1 over time, we identified different phases of the COVID-19 in the analyzed countries over the target time period.
The effects of environmental enrichment on hatchery-performance, smolt migration and capture rates in landlocked Atlantic salmon
Authors: Janhunen Matti , Piironen Jorma , Vainikka Anssi , Hyvärinen Pekka
Published: December 2021

Enrichment of rearing environment with natural elements has been suggested to improve the welfare and post-release survival of cultured fish. We studied the combined effects of shelter structures, periodical water flow and water level changes on pre- and post-release performance of critically endangered landlocked Atlantic salmon (Salmo salarm. sebago). Relative to standard (plain) rearing tanks, provision of enrichment improved fish condition factor and survival during the first year of rearing when most mortality was attributable to parasitic and bacterial infections. The consequent higher density in enriched tanks probably induced greater growth variation and more dorsal fin damages than found in fish of standard tanks. Possibly this was partly due to the applied changes in water level. Experimentally determined smolt migration tendency at age 3 did not differ, on average, between the rearing groups, but enriched-reared fish showed clearly less variation in total movement activity than standard-reared fish. Experimental angling in earthen ponds did not suggest divergent vulnerability between the differentially reared fish at age 3, but decreased condition during the preceding growth season increased vulnerability to fishing. Based on long-term post-stocking tag returns in large-lake fisheries, fish length at release but not rearing method affected the capture rates of fish released at age 2. When released at age 3 the fish grown in enriched environment had a higher risk to be captured with stationary gears and earlier by hook and line gears compared to standard-reared conspecifics. Earlier time of maximal smolt migration activity was associated with an increased risk of being captured. We suggest that environmental enrichment may modulate growth- and behavior-related qualities that indirectly increased the vulnerability to fishing in natural conditions but not in experimental setting. The favorable effects of enrichment on early survival encourages adopting enriched rearing practices in supportive breeding of landlocked salmon.
Prevalence and clinical profile of glaucoma patients in rural Nigeria—A hospital based study
Authors: Ezinne Ngozika E. , Ojukwu Chukwuebuka S. , Ekemiri Kingsley K. , Akano Obinna F. , Ekure Edgar , Osuagwu Uchechukwu Levi
Published: December 2021

Purpose

To determine the prevalence and clinical presentation of participants with glaucoma attending a public eye care facility in Nigeria.

Method

Hospital based retrospective study of glaucoma participants aged 50 years and above seen over a 5-year period. Descriptive statistics summarized the demographic, clinical characteristics and treatment of the participants and determined the association of variables with gender and age. Prevalence of the glaucoma by type, and their 95% confidence intervals (CI) were also calculated.

Result

Of the 5482 case files that were reviewed, 995 (18.15%, 95% Cl 17.15–19.19%) had glaucoma particularly primary open angle glaucoma (11.55%, 95%CI 10.73–12.42%) and were mostly females (564, 56.7%) aged 69 ± 12 years (range, 50–103 years). In contrast to other glaucoma types, the prevalence of primary angle closure glaucoma (3.68, 95%CI 3.22–4.22) increased by 15% over 5 years. The mean intraocular pressure ranged from 15–50 mmHg but higher in females than males (27.8 ± 6.1mmHg versus 26.6 ± 6.0 mmHg, P <0.05) who had comparable VA (0.58 ± 0.4 Log MAR) and cup-disc ratios (P >0.05). On presentation, the glaucoma hemi field test (GHFT) was outside the normal limits in 45.5% and 54.5% of males and females, respectively. The type of visual field defect was associated with glaucoma type (P = 0.047). Arcuate scotoma was most common (35.5%) across glaucoma types, paracentral scotoma more common in Secondary glaucoma while Seidel scotoma was highest in NTG (19.3%). Beta-blocker was the mainstay of management (42.2%) but more likely to be prescribed to males while more females received carbonic anhydrase inhibitors.

Conclusions

The high prevalence of glaucoma in older people remains a public health problem in Nigeria. The fact that about half of the participants presented with visual field defect suggests there is a need for public health messages to emphasize on early glaucoma screening, detection and management.
Male coloration affects female gestation period and timing of fertilization in the guppy (Poecilia reticulata)
Authors: Sato Aya , Aihara Ryu-ichi , Karino Kenji
Published: December 2021

The trade-up hypothesis is a female behavioral strategy related to mating with multiple males. In this hypothesis, females can produce high-quality offspring while avoiding the risk of losing reproductive opportunities by non-selective mating with males at first mating and then re-mating with more attractive males. As an internal mechanism to realize this behavioral strategy, we predicted that females would immediately fertilize their eggs when they mated with attractive males, whereas females would delay fertilization when they mated with unattractive males to trade-up sires of offspring. The guppy (Poecilia reticulata) is an ovoviviparous fish with internal fertilization, and females show a clear mate preference based on the area of orange coloration on the bodies of males. In addition, it is known that females show a re-mating strategy consistent with the trade-up hypothesis. We tested whether the attractiveness of mated males affected the gestation period and the timing of fertilization. Females were paired with either colorful males or drab males, and the gestation periods (the number of days from mating to parturition) were compared. In addition, we dissected the abdomens of the females at intervals of several days after mating and observed whether the eggs were fertilized. The gestation period in females that were paired with attractive colorful males was significantly shorter than that in females that were paired with drab males. We found that females that mated with colorful males also had their eggs fertilized earlier than those that mated with drab males. Our findings show that differences in the timing of fertilization according to attractiveness of the mate increase the opportunity for cryptic female choice and trading up.