bluuebunny/crossref_metadata_2025 huggingface dataset:
Antithrombotic treatment strategies in patients with established coronary atherosclerotic disease
Authors: Valgimigli Marco , Aboyans Victor , Angiolillo Dominick , Atar Dan , Capodanno Davide , Halvorsen Sigrun , James Stefan , Jüni Peter , Kunadian Vijay , Landi Antonio , Leonardi Sergio , Mehran Roxana , Montalescot Gilles , Navarese Eliano Pio , Niebauer Josef , Oliva Angelo , Piccolo Raffaele , Price Susanna , Storey Robert F , Völler Heinz , Vranckx Pascal , Windecker Stephan , Fox Keith A A
Published: April 2023

Multiple guidelines and consensus papers have addressed the role of antithrombotic strategies in patients with established coronary artery disease (CAD). Since evidence and terminology continue to evolve, the authors undertook a consensus initiative to guide clinicians to select the optimal antithrombotic regimen for each patient. The aim of this document is to provide an update for clinicians on best antithrombotic strategies in patients with established CAD, classifying each treatment option in relation to the number of antithrombotic drugs irrespective of whether the traditional mechanism of action is expected to mainly inhibit platelets or coagulation cascade. With the aim to reach comprehensiveness of available evidence, we systematically reviewed and performed meta-analyses by means of both direct and indirect comparisons to inform the present consensus document.
Comparison of aortic valve repair techniques with single- and double-ring annuloplasties
Authors: Benhassen Leila Louise , Hedensted Jacob Hesselby , Sharghbin Mona , Bechsgaard Tommy , Nielsen Sten Lyager , Hasenkam John Michael , Johansen Peter
Published: May 2023

OBJECTIVES

For patients with isolated aortic regurgitation, a double sub- and supravalvular annuloplasty has been shown to reduce recurrent aortic regurgitation after aortic valve repair compared with a single subvalvular annuloplasty. The objective of this study was to compare the geometrical and dynamic properties of single- and double-ring annuloplasties in an in vitro model.

METHODS

Eighteen aortic roots from 80 kg pigs were randomized into a control, single-ring and double-ring group. Experiments were conducted in a pulsatile in vitro model. Hydrodynamics, radial force measurements at annular and sinotubular level and 2D echographic imaging were obtained.

RESULTS

Both the single- and double-ring annuloplasties downsized the aortic annulus and sinotubular junction (STJ) significantly and increased the coaptation height. The double-ring annuloplasty showed an additional significant increase in coaptation height compared with the single ring [8.5 (0.9)–9.8 (0.8) mm, P < 0.01]. The single-ring annuloplasty reduced radial forces at both levels, whereas the double-ring annuloplasty showed the greatest force reduction of the STJ.

CONCLUSIONS

By treating the whole functional aortic annulus, encompassing both the aortic annulus and the STJ, a greater force reduction is observed. A subvalvular annuloplasty alone is efficient in reducing aortic annulus diameter and increasing coaptation height, however, by treating the STJ as well, an additional effect is observed on coaptation height, creating a more efficient stabilization. Reduction of annular force–distensibility ratio with the double-ring annuloplasty compared with the native controls indicates a sustained stabilizing effect.
Meropenem in combination with baicalein exhibits synergism against extensively drug resistant and pan-drug-resistant Acinetobacter baumannii clinical isolates in vitro
Authors: Güran Mümtaz , Çakıral Kadir , Teralı Kerem , Kandemir Tülay , Şanlıtürk Gizem , Öcal Melda Meral , Nagiyev Toğrul , Köksal Fatih
Published: April 2023

Several studies have demonstrated that the effectiveness of carbapenems against drug-resistant Acinetobacter baumannii infections has been decreasing. Combination therapy with two or more drugs is currently under investigation to overcome the emerging resistance against carbapenems. In this study, we tested the possible synergistic interactions of a potent antibacterial flavonoid, baicalein, with meropenem to illustrate this duo’s antibacterial and antibiofilm effects on 15 extensively drug resistant or pan-drug-resistant (XDR/PDR) A. baumannii clinical isolates in vitro. Isolates included in the study were identified with MALDI-TOF MS, and antibiotic resistance patterns were studied according to EUCAST protocols. Carbapenem resistance was confirmed with the modified Hodge test, and resistance genes were also analyzed with genotypical methods. Then, checkerboard and time-kill assays were performed to analyze antibacterial synergism. Additionally, a biofilm inhibition assay was performed for screening the antibiofilm activity. To provide structural and mechanistic insights into baicalein action, protein–ligand docking, and interaction profiling calculations were conducted. Our study shed light on the remarkable potential of the baicalein–meropenem combination, since either synergistic or additive antibacterial activity was observed against every XDR/PDR A. baumannii strain in question. Furthermore, the baicalein–meropenem combination displayed significantly better antibiofilm activity in contrast to standalone use. In silico studies predicted that these positive effects arose from inhibition by baicalein of A. baumannii beta-lactamases and/or penicillin-binding proteins. Overall, our findings highlight the prospective potential benefits of baicalein in combination with meropenem for the treatment of carbapenem-resistant A. baumannii infections.
A Long-Standing Hybrid Population Between Pacific and Atlantic Herring in a Subarctic Fjord of Norway
Authors: Pettersson Mats E , Fuentes-Pardo Angela P , Rochus Christina M , Enbody Erik D , Bi Huijuan , Väinölä Risto , Andersson Leif
Published: April 2023

Atlantic herring (Clupea harengus) and Pacific herring (C. pallasii) are sister species that split from a common ancestor about 2 million years ago. Balsfjord, a subarctic fjord in Northern Norway, harbors an outpost population of Pacific herring within the range of the Atlantic herring. We used whole genome sequencing to show that gene flow from Atlantic herring into the Balsfjord population has generated a stable hybrid population that has persisted for thousands of generations. The Atlantic herring ancestry in Balsfjord was estimated in the range 25–26%. The old age and large proportion of introgressed regions suggest there are no obvious genetic incompatibilities between species. Introgressed regions were widespread in the genome and large, with some in excess of 1 Mb, and they were overrepresented in low-recombination regions. We show that the distribution of introgressed material is non-random; introgressed sequence blocks in different individuals are shared more often than expected by chance. Furthermore, introgressed regions tend to show elevated divergence (FST) between Atlantic and Pacific herring. Together, our results suggest that introgression of genetic material has facilitated adaptation in the Balsfjord population. The Balsfjord population provides a rare example of a stable interspecies hybrid population that has persisted over thousands of years.
Validation of the Arabic Version of the Health Literacy (HLS-Q12) Questionnaire in chronically ill patients
Authors: Awwad Oriana , AlMuhaissen Suha A , Al-Kharouf Mohammad , Al-Nashwan Ayat , Abdeljalil Mariam , Al-Qerem Walid
Published: May 2023

Health literacy (HL) is an essential component of public health. Few tools are used to measure HL in Arabic-speaking countries, essentially the Short Test of Functional Health Literacy in Adults and the Single Item Literacy Screener. The new 12-item version of the European Health Literacy Survey Questionnaire (HLS-Q12), has not been validated in the Arabic language. This study aimed to translate the English version of HLS-Q12 into Arabic, test its structure and explain any variance in HLS-Q12 scores, allowing its use in Arabic-speaking healthcare contexts. A forward–backward translation was adopted. Reliability was assessed using Cronbach’s α. Confirmatory factor analysis (CFA) and Rasch Model evaluated the model fit of the Arabic version of HLS-12. The effects of different patient-related variables on HLS-Q12 scores were tested using linear regression. A total of 389 patients visiting the site hospital outpatient clinics participated in the study. HLS-Q12 mean ± SD score was 35.8 ± 5.0, 50.9% of the participants showed an intermediate HL score. Good reliability (α = 0.832) was observed. CFA confirmed the scale unidimensionality. Rasch analysis indicated HLS-Q12 items to be within the fit acceptable thresholds except for Item 12. The only item that displayed unordered response categories was Item 4. Most of the items were considered relatively easy by respondents. Linear regression revealed age, education, healthcare-related education and income to have effects significantly different from zero on HLS-Q12 score. Interventions targeting the most health-disparate groups of individuals with characteristics contributing to lower HL, are needed.
Stigmatization and Social Death of Survivors of Wartime Sexual Violence
Authors: Rose Sofie
Published: May 2023

Wartime sexual violence leaves many survivors deeply stigmatized and deprived of emotional, social, and financial support. Evidence suggests that stigmatization is often the most life-altering and destructive aspect of sexual violence. It calls for a deeper examination of how stigmatization is experienced by the survivors and from where the stigma emanates. Based on the concept of social death and its three constitutive components: loss of social identity, loss of social relationships, and loss of social vitality, this article explores the experience of stigmatization by men and women survivors in the Central African Republic. The analysis shows that stigmatization can be so severe that it resembles social death for some survivors and that the stigma is deeply informed by gendered understandings of identity, social status, and appropriate behavior. Stigmatization works as a social punishment for not “doing” one's gender correctly and therefore threatens gendered power hierarchies, demonstrating how gender structures play a key role in the production of stigmatization. The insight from this study contributes to the emerging field of feminist peace research by pointing at how sexual violence stigma is a continuation of gendered violence which travels between wartime and peacetime and perpetuates the experience of violence for the survivors.
What constitutes evidence for over-the-counter medicines? A cross-sectional study of community pharmacists’ knowledge, attitude, and practices
Authors: De Chun Lik , Anwar Mudassir
Published: May 2023

Objectives

To assess the knowledge, attitude and practices of evidence-based medicine (EBM) with regard to over-the-counter (OTC) medicines among New Zealand community pharmacists.

Methods

A pre-piloted, self-administered online questionnaire was disseminated through email to 2788 registered community pharmacists. The questionnaire covered the aspects of knowledge, attitude and barriers towards EBM, and factors influencing pharmacists’ product recommendations. Responses were collected over 4 weeks in January 2021. Data were analysed using SPSS (version 26).

Key findings

A total of 326 responses were collected (11.7% response rate). Participants had an average knowledge score of 15.6 (out of 33). More than 50% had a favourable attitude towards EBM. Insufficient time (20.2%) and a lack of resources (16.4%) were reported as the major barriers to practicing EBM. The majority (72.8%) of participants believed that guideline recommendations were important for OTC recommendations; however, 44.9% would always use their own judgement. Recent graduates (P = 0.048) and pharmacists with a higher level of education (P = 0.00) scored significantly higher for knowledge. A higher knowledge score predicted ‘more favourable’ attitude towards EBM.

Conclusions

Deficiencies exist in community pharmacists’ EBM-related knowledge, attitude and practices. An educational intervention targeting older pharmacists is required since the relevant knowledge was found to be deteriorating with age.
A retained foreign body in a jejunal diverticulum
Authors: Phillipos Joseph , Jaya Joseph , Mills Chris
Published: April 2023

Retained foreign bodies in small bowel diverticula are a rare occurrence. Batteries and battery containing products can cause bowel perforation, and when retained in diverticula, retrieval methods may need to be considered. We present a novel case of a hearing aid powered by lithium battery getting stuck in a jejunal diverticulum, and outline an approach to retrieval.
Intraventricular ganglioglioma: a rare case report
Authors: Thoma Constantinos , McKenna Gráinne
Published: April 2023

We report a case of an intraventricular ganglioglioma in a 23-year-old male. The patient presented with a 3-day history of headache and vomiting. Preoperative brain imaging revealed a calcified lesion within the trigone of the right lateral ventricle, with irregular enhancement, causing entrapment of the temporal horn of the lateral ventricle. At surgery, the lesion was haemorrhagic, easily friable and exhibited evidence of a previous recent haemorrhage. Histological and immunohistochemical studies showed a ganglioglioma with World Health Organisation Grade 1 characteristics. Gangliogliomas of the central nervous system are uncommon, and rarely occur in the lateral ventricle.
Identifying an optimal ejaculation latency for the diagnosis of men reporting orgasmic/ejaculation difficulty
Authors: Horvath Zsolt , Hevesi Krisztina , Kövi Zsuzsanna , Rowland David L
Published: May 2023

Background

Criteria for the definition and diagnosis of delayed ejaculation (DE) are yet under consideration.

Aim

This study sought to determine an optimal ejaculation latency (EL) threshold for the diagnosis of men with DE by exploring the relationship between various ELs and independent characterizations of delayed ejaculation.

Methods

In a multinational survey, 1660 men, with and without concomitant erectile dysfunction (ED) and meeting inclusion criteria, provided information on their estimated EL, measures of DE symptomology, and other covariates known to be associated with DE.

Outcomes

We determined an optimal diagnostic EL threshold for men with DE.

Results

The strongest relationship between EL and orgasmic difficulty occurred when the latter was defined by a combination of items related to difficulty reaching orgasm and percent of successful episodes in reaching orgasm during partnered sex. An EL of ≥16 minutes provided the greatest balance between measures of sensitivity and specificity; a latency ≥11 minutes was the best threshold for tagging the highest number/percentage of men with the severest level of orgasmic difficulty, but this threshold also demonstrated lower specificity. These patterns persisted even when explanatory covariates known to affect orgasmic function/dysfunction were included in a multivariate model. Differences between samples of men with and without concomitant ED were negligible.

Clinical Implications

In addition to assessing a man’s difficulty reaching orgasm/ejaculation during partnered sex and the percent of episodes reaching orgasm, an algorithm for the diagnosis of DE should consider an EL threshold in order to control diagnostic errors.

Strengths and Limitations

This study is the first to specify an empirically supported procedure for diagnosing DE. Cautions include the use of social media for participant recruitment, relying on estimated rather than clocked EL, not testing for differences between DE men with lifelong vs acquired etiologies, and the lower specificity associated with using the 11-minute criterion that could increase the probability of including false positives.

Conclusion

In diagnosing men with DE, after establishing a man’s difficulty reaching orgasm/ejaculation during partnered sex, using an EL of 10 to 11 minutes will help control type 2 (false negative) diagnostic errors when used in conjunction with other diagnostic criteria. Whether or not the man has concomitant ED does not appear to affect the utility of this procedure.
Mutagenesis of the melon Prv gene by CRISPR/Cas9 breaks papaya ringspot virus resistance and generates an autoimmune allele with constitutive defense responses
Authors: Nizan Shahar , Amitzur Arie , Dahan-Meir Tal , Benichou Jennifer I C , Bar-Ziv Amalia , Perl-Treves Rafael
Published: May 2023

The majority of plant disease resistance (R) genes encode nucleotide binding-leucine-rich repeat (NLR) proteins. In melon, two closely linked NLR genes, Fom-1 and Prv, were mapped and identified as candidate genes that control resistance to Fusarium oxysporum f.sp. melonis races 0 and 2, and to papaya ringspot virus (PRSV), respectively. In this study, we validated the function of Prv and showed that it is essential for providing resistance against PRSV infection. We generated CRISPR/Cas9 [clustered regularly interspaced palindromic repeats (CRISPR)/CRISPR-associated protein 9] mutants using Agrobacterium-mediated transformation of a PRSV-resistant melon genotype, and the T1 progeny proved susceptible to PRSV, showing strong disease symptoms and viral spread upon infection. Three alleles having 144, 154, and ~3 kb deletions, respectively, were obtained, all of which caused loss of resistance. Interestingly, one of the Prv mutant alleles, prvΔ154, encoding a truncated product, caused an extreme dwarf phenotype, accompanied by leaf lesions, high salicylic acid levels, and defense gene expression. The autoimmune phenotype observed at 25 °C proved to be temperature dependent, being suppressed at 32 °C. This is a first report on the successful application of CRISPR/Cas9 to confirm R gene function in melon. Such validation opens up new opportunities for molecular breeding of disease resistance in this important vegetable crop.
The Gaia-ESO Survey: empirical estimates of stellar ages from lithium equivalent widths (eagles)
Authors: Jeffries R D , Jackson R J , Wright Nicholas J , Weaver G , Gilmore G , Randich S , Bragaglia A , Korn A J , Smiljanic R , Biazzo K , Casey A R , Frasca A , Gonneau A , Guiglion G , Morbidelli L , Prisinzano L , Sacco G G , Tautvaišienė G , Worley C C , Zaggia S
Published: April 2023

We present an empirical model of age-dependent photospheric lithium depletion, calibrated using a large homogeneously analysed sample of 6200 stars in 52 open clusters, with ages from 2 to 6000 Myr and −0.3 < [Fe/H] < 0.2, observed in the Gaia-ESO spectroscopic survey. The model is used to obtain age estimates and posterior age probability distributions from measurements of the Li i 6708 Å equivalent width for individual (pre) main-sequence stars with 3000 < Teff/K < 6500, a domain where age determination from the HR diagram is either insensitive or highly model-dependent. In the best cases, precisions of 0.1 dex in log age are achievable; even higher precision can be obtained for coeval groups and associations where the individual age probabilities of their members can be combined. The method is validated on a sample of exoplanet-hosting young stars, finding agreement with claimed young ages for some, but not others. We obtain better than 10 per cent precision in age, and excellent agreement with published ages, for seven well-studied young moving groups. The derived ages for young clusters (<1 Gyr) in our sample are also in good agreement with their training ages, and consistent with several published model-insensitive lithium depletion boundary ages. For older clusters, there remain systematic age errors that could be as large as a factor of 2. There is no evidence to link these errors to any strong systematic metallicity dependence of (pre) main-sequence lithium depletion, at least in the range −0.29 < [Fe/H] < 0.18. Our methods and model are provided as software – ‘Empirical AGes from Lithium Equivalent widthS’ (eagles).
New quasar proximity zone size measurements at z ∼ 6 using the enlarged XQR-30 sample
Authors: Satyavolu Sindhu , Eilers Anna-Christina , Kulkarni Girish , Ryan-Weber Emma , Davies Rebecca L , Becker George D , Bosman Sarah E I , Greig Bradley , Mazzucchelli Chiara , Bañados Eduardo , Bischetti Manuela , D’Odorico Valentina , Fan Xiaohui , Farina Emanuele Paolo , Haehnelt Martin G , Keating Laura C , Lai Samuel , Walter Fabian
Published: May 2023

Proximity zones of high-redshift quasars are unique probes of their central supermassive black holes as well as the intergalactic medium (IGM) in the last stages of reionization. We present 22 new measurements of proximity zones of quasars with redshifts between 5.8 and 6.6, using the enlarged XQR-30 sample of high-resolution, high-SNR quasar spectra. The quasars in our sample have ultraviolet magnitudes of M1450 ∼ −27 and black hole masses of 109–1010 M⊙. Our inferred proximity zone sizes are 2–7 physical Mpc, with a typical uncertainty of less than 0.5 physical Mpc, which, for the first time, also includes uncertainty in the quasar continuum. We find that the correlation between proximity zone sizes and the quasar redshift, luminosity, or black hole mass, indicates a large diversity of quasar lifetimes. Two of our proximity zone sizes are exceptionally small. The spectrum of one of these quasars, with z  = 6.02, displays, unusually for this redshift, damping wing absorption without any detectable metal lines, which could potentially originate from the IGM. The other quasar has a high-ionization absorber ∼0.5 pMpc from the edge of the proximity zone. This work increases the number of proximity zone measurements available in the last stages of cosmic reionization to 87. This data will lead to better constraints on quasar lifetimes and obscuration fractions at high redshift, that in turn will help probe the seed mass and formation redshift of supermassive black holes.
QPE or QPO? – Quasiperiodic activity in low-mass galaxy nuclei
Authors: King Andrew
Published: April 2023

Quasiperiodic eruptions (QPEs) from low-mass galaxy centres may result from accretion from a white dwarf in a very eccentric orbit about the central massive black hole. Evolution under gravitational radiation losses reduces the separation and eccentricity. I note that below a critical eccentricity ecrit ≃ 0.97, the accretion disc’s viscous time-scale at pericentre passage is probably longer than the orbital period P, and periodic eruptive behaviour is no longer possible. These QPE descendant systems (QPEDs) are then likely to produce quasiperiodic oscillations rather than eruptions, varying more smoothly over the orbital cycle, with duty cycles ∼1. I identify 2XMM J123103.2+110648 (P ≃ 3.9 h) and (more tentatively) RE J1034+396 (P ≃ 1 h) as candidate systems of this type, and find agreement with their deduced eccentricities e < ecrit. The absence of eruptions and the lower accretion luminosities resulting from the smaller gravitational radiation losses may make QPED systems harder to discover. Ultimately they must evolve to have viscous times much longer than the orbital period, and either remain steady, or possibly have infrequent but large outbursts. The latter systems would be massive analogues of the soft X-ray transients produced by low stellar-mass X-ray binaries.
Genomic Evidence for the Nonpathogenic State in HIV-1–Infected Northern Pig-Tailed Macaques
Authors: Pang Wei , Shao Yong , Zhuang Xiao-Lin , Lu Ying , He Wen-Qiang , Zheng Hong-Yi , Xin Rong , Zhang Ming-Xu , Zhang Xiao-Liang , Song Jia-Hao , Tian Ren-Rong , Shen Fan , Li Yi-Hui , Zhao Zu-Jiang , Wu Dong-Dong , Zheng Yong-Tang
Published: May 2023

HIV-1 is a highly host-specific retrovirus that infects humans but not most nonhuman primates. Thus, the lack of a suitable primate model that can be directly infected with HIV-1 hinders HIV-1/AIDS research. In the previous study, we have found that the northern pig-tailed macaques (NPMs) are susceptible to HIV-1 infection but show a nonpathogenic state. In this study, to understand this macaque–HIV-1 interaction, we assembled a de novo genome and longitudinal transcriptome for this species during the course of HIV-1 infection. Using comparative genomic analysis, a positively selected gene, Toll-like receptor 8, was identified with a weak ability to induce an inflammatory response in this macaque. In addition, an interferon-stimulated gene, interferon alpha inducible protein 27, was upregulated in acute HIV-1 infection and acquired an enhanced ability to inhibit HIV-1 replication compared with its human ortholog. These findings coincide with the observation of persistently downregulated immune activation and low viral replication and can partially explain the AIDS-free state in this macaque following HIV-1 infection. This study identified a number of unexplored host genes that may hamper HIV-1 replication and pathogenicity in NPMs and provided new insights into the host defense mechanisms in cross-species infection of HIV-1. This work will facilitate the adoption of NPM as a feasible animal model for HIV-1/AIDS research.
Non-crystalline light chain proximal tubulopathy, a morphologically protean entity
Authors: Kousios Andreas , Blakey Sarah , Moran Linda , Atta Maria , Charif Rawya , Duncan Neill , Smith Andrew , Tam Frederick W K , Levy Jeremy B , Chaidos Aristeidis , Roufosse Candice
Published: April 2023

Background

Light chain proximal tubulopathy (LCPT) is a rare form of paraprotein-related disease, occurring in two main histopathological forms: crystalline and non-crystalline. The clinicopathological features, treatment strategies and outcomes, especially of the non-crystalline form, are not well described.

Methods

We conducted a single-centre retrospective case series of 12 LCPT patients, 5 crystalline and 7 non-crystalline, between 2005 and 2021.

Results

The median age was 69.5 years (range 47–80). Ten patients presented with CKD and significant proteinuria (median estimated glomerular filtration rate of 43.5 ml/min/1.73 m2; urine protein:creatinine ratio 328 mg/mmol). Only six patients had known haematological disease at the time of renal biopsy. Multiple myeloma (MM) was diagnosed in seven patients cases and monoclonal gammopathy of renal significance (MGRS) in five patients. A clone was detected in all cases combining serum/urine electrophoresis and free light chain (LC) assays. Crystalline and non-crystalline variants had similar clinical presentations. For the non-crystalline variant, a diagnosis was reached based on a combination of CKD without another cause, haematological workup, LC restriction on immunofluorescence and abnormalities on electron microscopy (EM). Nine of 12 patients received clone-directed treatment. Patients who achieved haematological response (including all non-crystalline LCPT) had improved renal outcomes over a median follow-up of 79 months.

Conclusions

The non-crystalline variant may go unrecognised because of its subtle histopathological features and requires EM to distinguish it from ‘excessive LC resorption without tubular injury’. Clone-directed treatment with good haematological response improves renal outcomes in both variants but limited data exist in MGRS. Multicentre prospective studies are needed to better define the clinicopathological characteristics associated with poor outcomes and optimize treatment strategies in patients with MGRS.
Food insecurity screening procedures used in reproductive healthcare settings
Authors: Zinga Julia , van der Pligt Paige , Lindberg Rebecca , Vasilevski Vidanka , Lee Amelia , McKay Fiona
Published: April 2023

Context

Food insecurity is an important determinant of health and should be identified by clinicians during routine reproductive healthcare. The procedures used in reproductive healthcare settings to identify people experiencing food insecurity have not been fully researched.

Objective

The objective of this study was to synthesize evidence from published studies that describe the procedures implemented by clinicians in healthcare settings to identify food insecurity in pregnant women, or women of reproductive age (15 years–49 years).

Data Sources

Four databases were searched in April 2022 to identify studies that met the eligibility criteria.

Data Extraction

Studies that used tools that were both validated or newly developed were considered, as were studies that incorporated food insecurity screening as part of a multidomain screening tool. Two authors completed the screening, data extraction, and quality assessment independently.

Data Analysis

There were 1075 studies identified; after screening, 7 studies were included in the narrative synthesis, including studies relating to women who were pregnant or in the postpartum period; none of the included studies related to women in the preconception stage. Four screening tools were identified: 2- and 6-item tools specifically focused on food insecurity, a 58-item multidomain tool incorporating 4 food insecurity items, and a modified version of the 2-item tool. Methods of implementing screening varied across studies. Three described subsequent processes that supported food-insecure patients once identified.

Conclusion

Few published studies have investigated optimal screening tools and their implementation within reproductive healthcare settings to address food insecurity for this priority population group. Further research is required to determine: the optimal tool, preferable screening methods from the perspectives of both patients and clinicians, and potential strategies for implementation in countries outside of the United States. An additional evidence gap remains about referral pathways and appropriate supports for this population once food insecurity is identified.

Systematic Review Registration

PROSPERO registration no. CRD42022319687.
Beyond Undetectable: Modeling the Clinical Benefit of Improved Antiretroviral Adherence in Persons With Human Immunodeficiency Virus With Virologic Suppression
Authors: Castillo-Mancilla Jose R , Morrow Mary , Hunt Peter W , Schnittman Samuel R , Phillips Andrew N , Baker Jason V , Haberer Jessica E , Janeiro Maria Joao , Aragao Filipa , Cohen Cal , Musinguzi Nicholas , Brown Todd T , Cavassini Matthias , Glass Tracy R , Serrano-Villar Sergio , Mawhinney Samantha , Siedner Mark
Published: May 2023

Background

Incomplete antiretroviral therapy (ART) adherence has been linked to deleterious immunologic, inflammatory, and clinical consequences, even among virally suppressed (<50 copies/mL) persons with human immunodeficiency virus (PWH). The impact of improving adherence in the risk of severe non-AIDS events (SNAEs) and death in this population is unknown.

Methods

We estimated the reduction in the risk of SNAEs or death resulting from an increase in ART adherence by (1) applying existing data on the association between adherence with high residual inflammation/coagulopathy in virally suppressed PWH, and (2) using a Cox proportional hazards model derived from changes in plasma interleukin 6 (IL-6) and D-dimer from 3 randomized clinical trials. Comparatively, assuming 100% ART adherence in a PWH who achieves viral suppression, we estimated the number of persons in whom a decrease in adherence to <100% would need to be observed for an additional SNAE or death event to occur during 3- and 5-year follow-up.

Results

Increasing ART adherence to 100% in PWH who are suppressed on ART despite imperfect adherence translated into a 6%–37% reduction in the risk of SNAEs or death. Comparatively, based on an anticipated 12% increase in IL-6, 254 and 165 PWH would need to decrease their adherence from 100% to <100% for an additional event to occur over 3- and 5-year follow-up, respectively.

Conclusions

Modest gains in ART adherence could have clinical benefits beyond virologic suppression. Increasing ART adherence (eg, via an intervention or switch to long-acting ART) in PWH who remain virally suppressed despite incomplete adherence should be evaluated.
Systematic Review of the Prevalence of Long COVID
Authors: Woodrow Mirembe , Carey Charles , Ziauddeen Nida , Thomas Rebecca , Akrami Athena , Lutje Vittoria , Greenwood Darren C , Alwan Nisreen A
Published: May 2023

Background

Long COVID occurs in those infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) whose symptoms persist or develop beyond the acute phase. We conducted a systematic review to determine the prevalence of persistent symptoms, functional disability, or pathological changes in adults or children at least 12 weeks postinfection.

Methods

We searched key registers and databases from January 1, 2020 to November 2, 2021, limited to publications in English and studies with at least 100 participants. Studies in which all participants were critically ill were excluded. Long COVID was extracted as prevalence of at least 1 symptom or pathology, or prevalence of the most common symptom or pathology, at 12 weeks or later. Heterogeneity was quantified in absolute terms and as a proportion of total variation and explored across predefined subgroups (PROSPERO ID CRD42020218351).

Results

One hundred twenty studies in 130 publications were included. Length of follow-up varied between 12 weeks and 12 months. Few studies had low risk of bias. All complete and subgroup analyses except 1 had I2 ≥90%, with prevalence of persistent symptoms range of 0%–93% (pooled estimate [PE], 42.1%; 95% prediction interval [PI], 6.8% to 87.9%). Studies using routine healthcare records tended to report lower prevalence (PE, 13.6%; PI, 1.2% to 68%) of persistent symptoms/pathology than self-report (PE, 43.9%; PI, 8.2% to 87.2%). However, studies systematically investigating pathology in all participants at follow up tended to report the highest estimates of all 3 (PE, 51.7%; PI, 12.3% to 89.1%). Studies of hospitalized cases had generally higher estimates than community-based studies.

Conclusions

The way in which Long COVID is defined and measured affects prevalence estimation. Given the widespread nature of SARS-CoV-2 infection globally, the burden of chronic illness is likely to be substantial even using the most conservative estimates.
Effectiveness of BA.1- and BA.4/BA.5-containing bivalent COVID-19 mRNA vaccines against symptomatic SARS-CoV-2 infection during the BA.5-dominant period in Japan
Authors: Arashiro Takeshi , Arima Yuzo , Kuramochi Jin , Muraoka Hirokazu , Sato Akihiro , Chubachi Kumi , Yanai Atsushi , Arioka Hiroko , Uehara Yuki , Ihara Genei , Kato Yasuyuki , Yanagisawa Naoki , Ueda Akihiro , Kato Hideaki , Oka Hideaki , Nishida Yusuke , Nidaira Yuki , Asami Takahiro , Jinta Torahiko , Nakamura Akira , Oba Kunihiro , Taniyama Daisuke , Yamamoto Kei , Tanaka Katsushi , Ueshima Kankuro , Fuwa Tetsuji , Stucky Ashley , Suzuki Tadaki , Smith Chris , Hibberd Martin , Ariyoshi Koya , Suzuki Motoi
Published: May 2023

In this multi-center prospective test-negative case-control study in Japan, the effectiveness of both BA.1-containing and BA.4/BA.5-containing bivalent COVID-19 mRNA vaccines against symptomatic infection during the BA.5-dominant period was high compared to no vaccination (65% and 76%) and moderate compared to monovalent vaccines administered over half a year before (46% combined).
Prevalence of Cardiometabolic Disease Risk Factors in People with HIV Initiating Anti-retroviral Therapy at a High-Volume HIV Clinic in Kampala, Uganda
Authors: Amutuhaire Willington , Mulindwa Frank , Castelnuovo Barbara , Brusselaers Nele , Schwarz Jean-Marc , Edrisa Mutebi , Dujanga Simon , Salata Robert A , Yendewa George A
Published: May 2023

Background

Cardiometabolic diseases are a leading cause of HIV-related morbidity and mortality, yet routine screening is not undertaken in high burden countries. We aimed to assess the prevalence and risk factors of the metabolic syndrome (MetS) and its components in adult Ugandan people living with HIV (PWH) initiating dolutegravir-based antiretroviral therapy (ART).

Methods

We conducted a cross-sectional study using baseline sociodemographic and clinical data of PWH aged ≥ 18 years enrolled in the GLUMED (Glucose metabolism changes in Ugandan HIV patients on Dolutegravir) Study from January to October 2021. MetS was defined as having ≥ 3 of the following: abdominal obesity, hypertension (HTN), hyperglycemia, elevated triglycerides and low high-density lipoprotein cholesterol. Multiple logistic regression was used to assess associations between potential risk factors and MetS and its components.

Results

309 PWH were analyzed (100% ART-naive, 59.2% female, median age 31 years and median CD4 count 318 cells/mm3). The prevalence of MetS was 13.9%. The most common cardiometabolic condition was dyslipidemia (93.6%), followed by abdominal obesity (34.0%), hyperglycemia (18.4%), and HTN (8.1%). In adjusted analysis, MetS was associated with age > 40 years (adjusted odds ratio 3.33, 95% confidence interval 1.45-7.67) and CD4 count > 200 cells/mm3 (3.79, 1.23-11.63). HTN was associated with age > 40 years (2.96, 1.32-6.64), and dyslipidemia was associated with urban residence (4.99, 1.35-18.53).

Conclusion

Cardiometabolic risk factors were common in this young Ugandan cohort of PWH initiating dolutegravir-based ART, underscoring the need for programmatic implementation of surveillance and management of comorbidities in Uganda and similar settings.
Flutamide With or Without PROSTVAC in Non-metastatic Castration Resistant (M0) Prostate Cancer
Authors: Madan Ravi A , Bilusic Marijo , Stein Mark N , Donahue Renee N , Arlen Philip M , Karzai Fatima , Plimack Elizabeth , Wong Yu-Ning , Geynisman Daniel M , Zibelman Matthew , Mayer Tina , Strauss Julius , Chen Gang , Rauckhorst Myrna , McMahon Sheri , Couvillon Anna , Steinberg Seth , Figg William D , Dahut William L , Schlom Jeffrey , Gulley James L
Published: May 2023

Background

Before 2018, there was no standard of care for non-metastatic (M0) castration resistant prostate cancer nmCRPC. Androgen receptor antagonists (ARAs) were commonly used sequentially nmCRPC.

Methods

This was a multicenter, randomized clinical trial comparing the ARA flutamide+/−PROSTVAC, a pox viral vaccine targeting PSA that includes T-cell co-stimulatory molecules. Eligible men had negative CT and Tc99 bone scans, and rising PSA on ADT. Previous treatment with ARA was a stratification factor. Patients were also evaluated for antigen-specific immune responses using intracellular cytokine staining.

Results

Thirty-three patients randomized to flutamide and 31 to flutamide+vaccine. The median age was 71.8 and 69.8 years, respectively. The median time to treatment failure after a median potential follow-up of 46.7 months was, 4.5 months (range 2-70) for flutamide alone vs. 6.9 months (2.5-40; P = .38) with flutamide+vaccine. Seven patients in each arm had a >50% PSA response. Antigen-specific responses were similar in both arms (58% of patients in flutamide alone and 56% in flutamide+vaccine). The treatments were well tolerated. The most common side effect > grade 2 was injection site reaction seen in 29/31 vaccine patients which were self-limiting.

Conclusion

The combination of flutamide+PROSTVAC did not improve outcomes in men with nmCRPC compared with flutamide alone. (ClinicalTrials.gov Identifier: NCT00450463)
Stramenopile-Type Lipid Droplet Protein Functions as a Lipid Droplet Scaffold Protein in the Marine Diatom Phaeodactylum tricornutum
Authors: Yoneda Kohei , Oishi Reika , Yoshida Masaki , Matsuda Yusuke , Suzuki Iwane
Published: May 2023

Oleaginous microalgae are gaining great attention as feedstock for biofuels because of their substantial accumulation capacity for neutral lipids in the cytosolic compartment called the lipid droplet (LD). Understanding the regulatory mechanism of neutral lipid accumulation and degradation, which is mediated by LD-associated proteins, is an important issue in improving lipid productivity. However, LD-associated proteins vary among species and are waiting to be characterized in many microalgae. Stramenopile-type LD protein (StLDP) was previously identified as a primary LD protein in the marine diatom Phaeodactylum tricornutum. We produced a knockout mutant of StLDP by clustered regularly interspaced short palindromic repeat (CRISPR)/Cas9 genome editing. Also, we tried to complement this mutant by expressing recognition site–modified StLDP (RSM-StLDP), which is designed to avoid an attack by Cas9 nuclease expressing in the mutant. The RSM-StLDP:enhanced green fluorescent protein was localized to both LDs and the outer chloroplast-endoplasmic reticulum. The decrease in the LD number per cell, increase in LD size and no alteration of neutral lipid content in the mutant under nitrogen deficiency clearly indicate that StLDP acts as an LD scaffold protein. The number of LDs per cell increased in the complemented strain compared to wild-type (WT) cells. The LD morphology in the mutant is probably over-rescued in the complemented strain by the strong function of the nitrate reductase promoter, which is also supported by high neutral lipid content in the complemented strain. The growth of stldp mutant showed a long lag phase relative to WT cells, suggesting that the low surface-to-volume ratio of fused LD decreased the efficiency of LD hydrolysis during the initial growth phase.
Ethylene enhances MdMAPK3-mediated phosphorylation of MdNAC72 to promote apple fruit softening
Authors: Wei Yun , Liu Zhi , Lv Tianxing , Xu Yaxiu , Wei Yajing , Liu Weiting , Liu Li , Wang Aide , Li Tong
Published: May 2023

The phytohormone ethylene plays an important role in promoting the softening of climacteric fruits, such as apples (Malus domestica); however, important aspects of the underlying regulatory mechanisms are not well understood. In this study, we identified apple MITOGEN-ACTIVATED PROTEIN KINASE 3 (MdMAPK3) as an important positive regulator of ethylene-induced apple fruit softening during storage. Specifically, we show that MdMAPK3 interacts with and phosphorylates the transcription factor NAM-ATAF1/2-CUC2 72 (MdNAC72), which functions as a transcriptional repressor of the cell wall degradation-related gene POLYGALACTURONASE1 (MdPG1). The increase in MdMAPK3 kinase activity was induced by ethylene, which promoted the phosphorylation of MdNAC72 by MdMAPK3. Additionally, MdPUB24 functions as an E3 ubiquitin ligase to ubiquitinate MdNAC72, resulting in its degradation via the 26S proteasome pathway, which was enhanced by ethylene-induced phosphorylation of MdNAC72 by MdMAPK3. The degradation of MdNAC72 increased the expression of MdPG1, which in turn promoted apple fruit softening. Notably, using variants of MdNAC72 that were mutated at specific phosphorylation sites, we observed that the phosphorylation state of MdNAC72 affected apple fruit softening during storage. This study thus reveals that the ethylene–MdMAPK3–MdNAC72–MdPUB24 module is involved in ethylene-induced apple fruit softening, providing insights into climacteric fruit softening.
Long Covid: conceptualizing the challenges for public health
Authors: Prashar Jai
Published: May 2023

Background

Long Covid has caused significant disruption to public services, economies and population health worldwide, but no single public health approach has proven effective in its management. This essay was the winning entry for the Faculty of Public Health’s Sir John Brotherston Prize 2022.

Methods

In this essay, I synthesize existing literature on public health policy in long Covid, and discuss the challenges and opportunities posed by long Covid for the public health profession. The utility of specialist clinics and community care, in the UK and internationally, is examined, as well as key outstanding issues relating to evidence generation, health inequality and defining long Covid. I then use this information to inform a simple conceptual model.

Results

The generated conceptual model integrates community- and population-level interventions; key areas of identified policy need at both levels include ensuring equitable access to long Covid care, developing screening programmes for high-risk populations, co-production of research and clinical services with patients, and using interventions to generate evidence.

Conclusions

Significant challenges remain in the management of long Covid from a public health policy perspective. Multidisciplinary community-level and population-level interventions should be employed with a view to achieving an equitable and scalable model of care.
Earning the Role: Father Role Institutionalization and the Achievement of Contemporary Fatherhood
Authors: Brown-Weinstock Rachel , Gold Sarah , Edin Kathryn , Nelson Timothy
Published: May 2023

Fatherhood has become an achieved status among complex, disadvantaged families. Stepfathers may have an advantage over nonresident biological fathers in earning the father role; in-depth interview studies reveal that nonresident fathers are often stripped of the father label while stepfathers commonly achieve it instead. This stepfather advantage is surprising given extant institutionalization theory, which suggests that the stronger institutionalization of the biological father role should benefit nonresident fathers over stepfathers. Drawing on 55 in-depth interviews with adolescents and their primary caregivers, we recenter youth agency in family theory by exploring how some men and not others earn the father role from the perspective of their adolescent children. We find that the strongly institutionalized role obligations of biological fathers impeded rather than aided nonresident father-child engagement. When nonresident fathers did not meet institutionalized expectations, adolescents experienced psychological trauma and usually resisted their attempts to become more involved. In contrast, the incomplete institutionalization of the stepparent role benefited stepfather-stepchild relations by allowing stepfathers to flexibly adapt to complex family dynamics. Further, stepfathers more easily met, and even exceeded, their stepchildren’s limited expectations of them. Thus, stepfathers may face a lower cultural bar for and gain greater satisfaction from fulfilling the father role than nonresident biological fathers.
Molecular Diversity of Rice Yellow Mottle Virus in Uganda and Relationships with Other Strains from Africa
Authors: Ramathani Idd , Sserumaga Julius P. , Nanyiti Sarah , Mukasa Settumba B. , Alicai Titus
Published: May 2023

Rice yellow mottle virus disease, caused by Rice yellow mottle virus (RYMV), is the most important disease of lowland rice in Uganda. However, little is known about its genetic diversity in Uganda and relationships with other strains elsewhere across Africa. A new degenerate primer pair that targets amplification of the entire RYMV coat protein gene (circa 738 bp) was designed to aid virus variability analysis using RT-PCR and Sanger sequencing. A total of 112 rice leaf samples from plants with RYMV mottling symptoms were collected during the year 2022 in 35 lowland rice fields within Uganda. The RYMV RT-PCR results were 100% positive, and all 112 PCR products were sequenced. BLASTn analysis revealed that all isolates were closely related (93 to 98%) to those previously studied originating from Kenya, Tanzania, and Madagascar. Despite high purifying selection pressure, diversity analysis on 81 out of 112 RYMV CP sequences revealed a very low diversity index of 3 and 1.0% at the nucleotide and amino acid levels, respectively. Except for glutamine, amino acid profile analysis revealed that all 81 Ugandan isolates shared the primary 19 amino acids based on the RYMV coat protein region examined. Except for one isolate (UG68) from eastern Uganda that clustered alone, phylogeny analysis revealed two major clades. The Ugandan RYMV isolates were phylogenetically related to those from the Democratic Republic of Congo, Madagascar, and Malawi but not to RYMV isolates in West Africa. Thus, the RYMV isolates in this study are related to serotype 4, a strain common in eastern and southern Africa. RYMV serotype 4 originated in Tanzania, where evolutionary forces of mutation have resulted in the emergence and spread of new variants. Furthermore, mutations are evident within the coat protein gene of the Ugandan isolates, which may be attributed to changing RYMV pathosystems as a result of rice production intensification in Uganda. Overall, the diversity of RYMV was limited and most noticeably in eastern Uganda.