bluuebunny/crossref_metadata_2025 huggingface dataset:
Evolving stoma appliances to improve patient outcomes and increase stoma acceptance
Authors: Bedford Faye
Published: September 2022

Adjusting to life with a stoma can be difficult physically and emotionally. Preoperative counselling, where possible in cases of elective surgery, is fundamental to preparing those facing stoma formation, and a lack of support can be detrimental and can increase the risk of stoma patients experiencing complications. The stoma care nurse specialist (SCN) uses a range of clinical skills and specialist knowledge to support a patient through their surgical pathway; this is important for helping patients gain the skills and confidence to care for their stoma and reduce the risk of stoma-related complications. Complications are common and can reduce patient wellbeing and quality of life. As well as patient education and SCN support, using the appropriate stoma care appliances is important in achieving positive outcomes and preventing complications. Furthermore, the correct appliance for an individual patient can help to improve their confidence and wellbeing, leading to better stoma acceptance by meeting their needs and allowing them to carry out everyday life without feeling obstructed by having a stoma pouch. This article discusses the Aura Plus stoma pouch range, and highlights the features designed to prevent common complications and improve patient outcomes and confidence. A case study demonstrates how Aura Plus led to positive outcomes for a patient who had been experiencing significant leakage and peristomal skin complications when using a multitude of different pouches. The change to Aura Plus resolved these complications and led to improved wellbeing and quality of life.
Three-dimensional point spread function estimation method for mid-wave infrared microscope imaging
Authors: Jara Anselmo , Torres Sergio N. , Machuca Guillermo , Coelho Pablo , Viafora Laura A.
Published: September 2022

A three-dimensional point spread function experimental estimation method based on the system’s focal plane array spatial local impulse response of a mid-wave infrared microscope is presented. The method uses several out-of-focus two-dimensional point spread function planes to achieve a single three-dimensional point spread function of the whole microscope’s optical spreading, expanding the limits of infrared optical technology by one dimension. This technique includes stages of image acquisition, nonuniformity correction, filtering, and multi-planar reconstruction steps, and its effectiveness is demonstrated on biological sample image restoration by means of a multi-planar refocusing application.
Vortex-Bessel beam generation by 3D direct printing of an integrated multi-optical element on a fiber tip
Authors: Lightman Shlomi , Porat Omer , Hurvitz Gilad , Gvishi Raz
Published: September 2022

Shaping light beams as they propagate out of the tips of optical fibers is a desired ability, as the light could be tailored for various applications in a miniaturized, integrated, and cost-effective manner. However, fabricating sophisticated refractive elements directly onto fibers is challenging. By using 3D-direct laser writing (3D-DLW), high-quality optical devices could be fabricated directly on top of the fiber’s facet by the two-photon absorption process. Here, we demonstrate how a high-order Bessel beam carrying orbital angular momentum (OAM) could be generated by using this lithography process. The beam is shaped using an integrated micro-optical system that consists of a twisted axicon and parabolic lens in an adapted fiber configuration. This work provides the analysis and measurements of the generated beam, along with simulated predictions. The far-field pattern, at a distance of 2 mm from the fiber, was examined, and we have found that the size of the central ring remained nearly unchanged, as expected for this type of beam. The beam's OAM value was measured using either an interference pattern or a mode convertor. Furthermore, the near-field and far-field Bessel beam profiles were investigated simultaneously at various laser power values, reaching intensities of up to 3.8 MW/cm2. This work may pave the way for future integrated beam manipulation on fibers, enabling the use of higher laser outputs.
Rhythmicity is linked to expression cost at the protein level but to expression precision at the mRNA level
Authors: Laloum David , Robinson-Rechavi Marc
Published: September 2022

Many genes have nycthemeral rhythms of expression, i.e. a 24-hours periodic variation, at either mRNA or protein level or both, and most rhythmic genes are tissue-specific. Here, we investigate and discuss the evolutionary origins of rhythms in gene expression. Our results suggest that rhythmicity of protein expression could have been favored by selection to minimize costs. Trends are consistent in bacteria, plants and animals, and are also supported by tissue-specific patterns in mouse. Unlike for protein level, cost cannot explain rhythm at the RNA level. We suggest that instead it allows to periodically reduce expression noise. Noise control had the strongest support in mouse, with limited evidence in other species. We have also found that genes under stronger purifying selection are rhythmically expressed at the mRNA level, and we propose that this is because they are noise sensitive genes. Finally, the adaptive role of rhythmic expression is supported by rhythmic genes being highly expressed yet tissue-specific. This provides a good evolutionary explanation for the observation that nycthemeral rhythms are often tissue-specific.
Associations between occupation, leprosy disability and other sociodemographic factors in an endemic area of Brazil
Authors: Cisneros Juan , Ferreira José Antonio , de Faria Grossi Maria Aparecida , de Filippis Thelma , de Oliveira Ana Laura Grossi , Lyon Sandra , Fairley Jessica K.
Published: September 2022

Background

In Brazil, new leprosy cases with grade-2 disability (G2D) have been increasing. Physical disability has been associated with experienced stigmatization, psychological distress, and social restriction.

Objectives

To identify factors associated with leprosy disability in an endemic area of Brazil focusing on occupational and other sociodemographic factors.

Methods

Between July and December 2015, adult patients with multibacillary leprosy who attended a clinic in Belo Horizonte, Brazil were enrolled. Social, clinical, and demographic factors were collected from an administered questionnaire and medical charts. Occupations were categorized as manual vs non-manual. Descriptive statistics and multivariable logistic regression were performed to study associated factors with disability (Grade 1 disability (G1D) and G2D combined).

Findings

Seventy-three patients were enrolled with 48 (65.8%) presenting with either G1D or G2D at the time of enrollment. Twenty-nine (39.7%) had G2D. About half of the patients (n = 36, 49%) reported a manual labor occupation and reactions were common (n = 53, 73%). On univariate analyses, older age (p = 0.048) and low education (p = 0.007) were associated with disability. On multivariable analyses, only low education (primary or less) was associated with disability (OR = 6.34, 95% CI 1.37, 29.26). Greater distance from clinic, income, smoking, marital status, and occupation were not associated.

Main conclusions

Low education was associated with leprosy disability, consistent with prior studies, and therefore should be a focus for disability reduction programs. While the sample size of this study may have limited detection of associations between disability and social determinants tested, half of the patients reported a manual job, highlighting the need for more extensive studies on associations between occupation, disability, and related injuries.
Methicillin resistance Staphylococcus aureus nasal carriage and its associated factors among HIV patients attending art clinic at Dessie comprehensive specialized hospital, Dessie, North East Ethiopia
Authors: Muhaba Hussein , Fenta Genet Molla , Gebretsadik Daniel
Published: September 2022

Globally the incidence of nosocomial infections and colonization due to methicillin resistantStaphylococcus aureus(MRSA) has become greater concern. The objective of the study was to determine the prevalence and associated factors of nasal carriage of MRSA with its antimicrobial susceptibility patter among HIV patients attending ART clinic. cross-sectional study was conducted from January 01 to May 30, 2020 at Dessie comprehensive specialized hospital, north east Ethiopia. A total of 206 HIV patients were recruited by applying systematic random sampling technique. Nasal specimen was collected from both anterior nares, and inoculated directly on mannitol salt agar, MacConkey, 5% blood agar. Screening of MRSA and methicillin susceptibleStaphylococcus aureus(MSSA) strain was done by using cefoxitin antibiotic disc following modified Kirby-Bauer disc diffusion technique. Bivariable and multivariable logistic regression analyses were performed to assess the associated factors withS.aureusand MRSA. study participants were in the age range between 12 and 72 years and their mean (±SD) age was 41.52 (±11.2). The rate ofS.aureusand MRSA colonization was 127/206 (61.7%) and 58/206 (28.2%), respectively. Having job close contact with human [AOR = 4.41; 95% CI = 1.5–13.02; p = 0.007], picking the nose [AOR = 4.38; 95% CI = 1.34–14.29; p = 0.014] and ART failure [AOR = 7.41; 95% CI = 2.08–26.41; p = 0.002] had statistically significant association with MRSA colonization. MRSA showed resistance for tetracycline (53.4%), erythromycin (84.5%), and trimethoprim-sulfamethoxazole (86.2%). Multi-Drug Resistance (MDR) was detected among 96.5% of MRSA and 20.3% of MSSA isolates. the rate ofS.aureusand MRSA nasal colonization was high and it has associated with different factors. Understanding and managing MRSA among HIV patients is mandatory and stakeholders should find out the way how to decolonize the bacteria from nasal area.
Anxiety and depressive symptoms among home isolated patients with COVID-19: A cross-sectional study from Province One, Nepal
Authors: Khanal Pratik , Paudel Kiran , Mehata Suresh , Thapa Astha , Bhatta Ramesh , Bhattarai Hari Krishna
Published: September 2022

Home isolated patients infected with COVID-19 might be at increased risk of developing mental health problems. The study aimed to identify the prevalence and factors associated with anxiety and depression among COVID-19 home isolated patients in Province One, Nepal. This was a cross-sectional study conducted between February 17, 2021, to April 9, 2021. A total of 372 home isolated patients from Province One were phone interviewed in the study. Anxiety and depression were measured using a 14-items Hospital Anxiety and Depression Scale (HADS). Multivariable logistic regression analysis was done to determine the risk factors of anxiety and depression. Among home isolated COVID-19 infected participants, 74.2% and 79% had symptoms of anxiety (borderline: 48.7% and abnormal: 25.5%) and depression (borderline: 52.7% and abnormal: 26.3%), respectively. Watching television was significantly associated with lower odds of experiencing symptoms of anxiety and depression. Females had significantly higher odds of having depression symptoms compared to males while ever married, those with COVID-19 related complications, and those taking medicine for the treatment of COVID-19 symptoms had a higher likelihood of exhibiting symptoms of anxiety. A focus on improving the mental health well-being of COVID-19 infected patients in home settings with connection to the health services is warranted with timely psychological interventions.
Vaccine-linked chemotherapy with a low dose of benznidazole plus a bivalent recombinant protein vaccine prevents the development of cardiac fibrosis caused by Trypanosoma cruzi in chronically-infected BALB/c mice
Authors: Dzul-Huchim Victor Manuel , Ramirez-Sierra Maria Jesus , Martinez-Vega Pedro Pablo , Rosado-Vallado Miguel Enrique , Arana-Argaez Victor Ermilo , Ortega-Lopez Jaime , Gusovsky Fabian , Dumonteil Eric , Cruz-Chan Julio Vladimir , Hotez Peter , Bottazzi María Elena , Villanueva-Lizama Liliana Estefania
Published: September 2022

Background

Chagas disease (CD) is caused by Trypanosoma cruzi and affects 6–7 million people worldwide. Approximately 30% of chronic patients develop chronic chagasic cardiomyopathy (CCC) after decades. Benznidazole (BNZ), one of the first-line chemotherapy used for CD, induces toxicity and fails to halt the progression of CCC in chronic patients. The recombinant parasite-derived antigens, including Tc24, Tc24-C4, TSA-1, and TSA-1-C4 with Toll-like receptor 4 (TLR-4) agonist-adjuvants reduce cardiac parasite burdens, heart inflammation, and fibrosis, leading us to envision their use as immunotherapy together with BNZ. Given genetic immunization (DNA vaccines) encoding Tc24 and TSA-1 induce protective immunity in mice and dogs, we propose that immunization with the corresponding recombinant proteins offers an alternative and feasible strategy to develop these antigens as a bivalent human vaccine. We hypothesized that a low dose of BNZ in combination with a therapeutic vaccine (TSA-1-C4 and Tc24-C4 antigens formulated with a synthetic TLR-4 agonist-adjuvant, E6020-SE) given during early chronic infection, could prevent cardiac disease progression and provide antigen-specific T cell immunity.

Methodology/ Principal findings

We evaluated the therapeutic vaccine candidate plus BNZ (25 mg/kg/day/7 days) given on days 72 and 79 post-infection (p.i) (early chronic phase). Fibrosis, inflammation, and parasite burden were quantified in heart tissue at day 200 p.i. (late chronic phase). Further, spleen cells were collected to evaluate antigen-specific CD4+ and CD8+ T cell immune response, using flow cytometry. We found that vaccine-linked BNZ treated mice had lower cardiac fibrosis compared to the infected untreated control group. Moreover, cells from mice that received the immunotherapy had higher stimulation index of antigen-specific CD8+Perforin+ T cells as well as antigen-specific central memory T cells compared to the infected untreated control.

Conclusions

Our results suggest that the bivalent immunotherapy together with BNZ treatment given during early chronic infection protects BALB/c mice against cardiac fibrosis progression and activates a strong CD8+ T cell response by in vitro restimulation, evidencing the induction of a long-lasting T. cruzi-immunity.
Adverse drug effects among students following mass de-worming exercise involving administration of Praziquantel and Albendazole in KEEA Municipality, Ghana
Authors: Akrasi Wisdom , Brah Augustine Suurinobah , Essuman Mainprice Akuoko , Osei Viona , Boye Alex
Published: September 2022

Background

To manage the deleterious effects of parasitic infections such as lymphatic filariasis (LF) and schistosomiasis among school children, most countries including Ghana make use of mass drug administration (MDA). Although MDA has proven effective in reducing worm burden, unfortunately adverse drug effects (ADEs) post-MDA are derailing the gains and also remain poorly monitored. The study assessed incidence and factors associated with ADEs among students following a school-based mass de-worming exercise involving administration of Praziquantel (PZQT) and Albendazole (ADZ) against LF and SCH at Komenda-Edina-Eguafo-Abirem (KEEA) Municipal.

Methodology

After fulfilling all ethical obligations, a total of 598 students aged 5–20 years who received PZQT or ADZ monotherapy or a combination of the two (PZQT + ADZ) as part of the mass de-worming exercise were recruited through quota and random sampling. Bodyweight and height of students were measured and body mass index (BMI) calculated. Students were orally interviewed to obtain information such as age, sex, intake of diet before taking drugs. Subsequently, students were monitored over 24 hours post-MDA for cases of ADEs. Descriptive statistics and logistic regression analysis using SPSS version 26 was used to describe data collected and to determine associations between incidence of ADEs and predictor variables.

Principal findings

Out of the 598 students, 243 (40.64%) represented by 124 males (51.03%) and 119 females (48.97%) with mean (SD) age of 13.43 (2.74) years experienced one or more forms of ADE. In decreasing order, the detected ADEs included headache (64.6%), Abdominal pain (48.6%), fever (30.0%), diarrhea (21.4%) and itching (12.8%). Multivariable statistical analysis showed that age 5–9 years (OR: 2.01, p = 0.041) and underweight (OR: 2.02, p = 0.038) were associated with incidence of ADEs. Compared with students who received combination therapy, students who received ADZ only (OR: 0.05, p < 0.001) and PZQT only (OR: 0.26, p < 0.001) had low cases of ADEs. Gender and diet intake before MDA were not associated with ADE incidence.

Conclusion

ADE incidence was common among students in the KEEA municipality. Age, underweight, and double dosing were associated with increase in ADE incidence, while gender and food intake were not associated with increase in ADE incidence. The Disease Control Unit of the Ghana Health Service should incorporate stringent ADE monitoring in post-MDA surveillance in the National MDA program in order to be able to detect, manage and report ADEs to inform planning for future MDA programs. Such initiatives will help not only in improving effectiveness of MDA programs but also identify high risk groups and exact strategies to reduce negative influence of ADE on MDA coverage and anthelminthic drug compliance.
Prolonged delays in leprosy case detection in a leprosy hot spot setting in Eastern Ethiopia
Authors: Urgesa Kedir , de Bruijne Naomi D. , Bobosha Kidist , Seyoum Berhanu , Mihret Adane , Geda Biftu , Schoenmakers Anne , Mieras Liesbeth , van Wijk Robin , Kasang Christa , Kaba Mirgissa , Aseffa Abraham
Published: September 2022

Background

Leprosy or Hansen’s disease is known to cause disability and disfigurement. A delay in case detection of leprosy patients can lead to severe outcomes. In Ethiopia, the disability rates caused by leprosy among new cases are relatively high compared to other endemic countries. This suggests the existence of hidden leprosy cases in the community and a delay in timely detection. To reduce disability rates, it is crucial to identify the factors associated with this delay. This study aimed to determine the extent of delay in case detection among leprosy cases in Eastern Ethiopia.

Methods

This cross-sectional explorative study was conducted in January and February 2019 among 100 leprosy patients diagnosed ≤6 months prior to inclusion. A structured questionnaire was used to collect data, including the initial onset of symptoms, and the reasons for delayed diagnosis. Descriptive statistics, including percentages and medians, were used to describe the case detection delay. Logistic regression analysis was carried out to evaluate the predictors of delay in case detection of >12 months.

Findings

The median age of patients was 35 years, with a range of 7 to 72 years. The majority were male (80%) and rural residents (90%). The median delay in case detection was 12 months (interquartile range 10–36 months) among the included patients. The mean delay in case detection was 22 months, with a maximum delay of 96 months. The overall prevalence of disability among the study population was 42% (12% grade I and 30% grade II). Fear of stigma (p = 0.018) and experiencing painless symptoms (p = 0.018) were highly associated with a delay in case detection of >12 months.

Conclusions

Being afraid of stigma and having painless symptoms, which are often misinterpreted as non-alarming at the onset of the disease, were associated with a delay in case detection. This study showed the need to increase knowledge on early symptoms of leprosy among affected communities. Furthermore, it is important to support initiatives that reduce leprosy related stigma and promote health worker training in leprosy control activities.
The current and future distribution of the yellow fever mosquito (Aedes aegypti) on Madeira Island
Authors: Santos José Maurício , Capinha César , Rocha Jorge , Sousa Carla Alexandra
Published: September 2022

The Aedes aegypti mosquito is the main vector for several diseases of global importance, such as dengue and yellow fever. This species was first identified on Madeira Island in 2005, and between 2012 and 2013 was responsible for an outbreak of dengue that affected several thousand people. However, the potential distribution of the species on the island remains poorly investigated. Here we assess the suitability of current and future climatic conditions to the species on the island and complement this assessment with estimates of the suitability of land use and human settlement conditions. We used four modelling algorithms (boosted regression trees, generalized additive models, generalized linear models and random forest) and data on the distribution of the species worldwide and across the island. For both climatic and non-climatic factors, suitability estimates predicted the current distribution of the species with good accuracy (mean area under the Receiver Operating Characteristic curve = 0.88 ±0.06, mean true skill statistic = 0.72 ±0.1). Minimum temperature of coldest month was the most influential climatic predictor, while human population density, residential housing density and public spaces were the most influential predictors describing land use and human settlement conditions. Suitable areas under current climates are predicted to occur mainly in the warmer and densely inhabited coastal areas of the southern part of the island, where the species is already established. By mid-century (2041–2060), the extent of climatically suitable areas is expected to increase, mainly towards higher altitudes and in the eastern part of the island. Our work shows that ongoing efforts to monitor and prevent the spread of Ae. aegypti on Madeira Island will have to increasingly consider the effects of climate change.
Less is more: Developing an approach for assessing clustering at the lower administrative boundaries that increases the yield of active screening for leprosy in Bihar, India
Authors: Ortuño-Gutiérrez Nimer , Shih Pin-Wei , Wagh Aashish , Mugudalabetta Shivakumar , Pandey Bijoy , de Jong Bouke C. , Richardus Jan Hendrik , Hasker Epco
Published: September 2022

Background

In India, leprosy clusters at hamlet level but detailed information is lacking. We aim to identify high-incidence hamlets to be targeted for active screening and post-exposure prophylaxis.

Methodology

We paid home visits to a cohort of leprosy patients registered between April 1st, 2020, and March 31st, 2022. Patients were interviewed and household members were screened for leprosy. We used an open-source app(ODK) to collect data on patients’ mobility, screening results of household members, and geographic coordinates of their households. Clustering was analysed with Kulldorff’s spatial scan statistic(SaTScan). Outlines of hamlets and population estimates were obtained through an open-source high-resolution population density map(https://data.humdata.org), using kernel density estimation in QGIS, an open-source software.

Results

We enrolled 169 patients and screened 1,044 household contacts in Bisfi and Benipatti blocks of Bihar. Median number of years of residing in the village was 17, interquartile range(IQR)12-30. There were 11 new leprosy cases among 658 household contacts examined(167 per 10,000), of which seven had paucibacillary leprosy, one was a child under 14 years, and none had visible disabilities. We identified 739 hamlets with a total population of 802,788(median 163, IQR 65–774). There were five high incidence clusters including 12% of the population and 46%(78/169) of the leprosy cases. One highly significant cluster with a relative risk (RR) of 4.7(p<0.0001) included 32 hamlets and 27 cases in 33,609 population. A second highly significant cluster included 32 hamlets and 24 cases in 33,809 population with a RR of 4.1(p<0.001). The third highly significant cluster included 16 hamlets and 17 cases in 19,659 population with a RR of 4.8(p<0.001). High-risk clusters still need to be screened door-to-door.

Conclusions

We found a high yield of active household contact screening. Our tools for identifying high-incidence hamlets appear effective. Focusing labour-intensive interventions such as door-to-door screening on such hamlets could increase efficiency.
Cryptosporidiosis outbreaks linked to the public water supply in a military camp, France
Authors: Watier-Grillot Stéphanie , Costa Damien , Petit Cédric , Razakandrainibe Romy , Larréché Sébastien , Tong Christelle , Demont Gwenaëlle , Billetorte David , Mouly Damien , Fontan Didier , Velut Guillaume , Le Corre Alexandra , Beauvir Jean-Christophe , Mérens Audrey , Favennec Loïc , Pommier de Santi Vincent
Published: September 2022

Introduction

Contaminated drinking and recreational waters account for most of the reported Cryptosporidium spp. exposures in high-income countries. In June 2017, two successive cryptosporidiosis outbreaks occurred among service members in a military training camp located in Southwest France. Several other gastroenteritis outbreaks were previously reported in this camp, all among trainees in the days following their arrival, without any causative pathogen identification. Epidemiological, microbiological and environmental investigations were carried out to explain theses outbreaks.

Material and methods

Syndromic diagnosis using multiplex PCR was used for stool testing. Water samples (100 L) were collected at 10 points of the drinking water installations and enumeration of Cryptosporidium oocysts performed. The identification of Cryptosporidium species was performed using real-time 18S SSU rRNA PCR and confirmed by GP60 sequencing.

Results

A total of 100 human cases were reported with a global attack rate of 27.8%. Cryptosporidium spp. was identified in 93% of stool samples with syndromic multiplex PCR. The entire drinking water network was contaminated with Cryptosporidium spp. The highest level of contamination was found in groundwater and in the water leaving the treatment plant, with >1,000 oocysts per 100 L. The same Cryptosporidium hominis isolate subtype IbA10G2 was identified in patients’ stool and water samples. Several polluting activities were identified within the protection perimeters of the water resource. An additional ultrafiltration module was installed at the outlet of the water treatment plant. After several weeks, no Cryptosporidium oocysts were found in the public water supply.

Conclusions

After successive and unexplained gastroenteritis outbreaks, this investigation confirmed a waterborne outbreak due to Cryptosporidium hominis subtype IbA10G2. Our study demonstrates the value of syndromic diagnosis for gastroenteritis outbreak investigation. Our results also highlight the importance of better assessing the microbiological risk associated with raw water and the need for sensitive and easy-to-implement tools for parasite detection.
The PCI domains are “winged” HEAT domains
Authors: Paul Eleanor Elise , Marintchev Assen
Published: September 2022

The HEAT domains are a family of helical hairpin repeat domains, composed of four or more hairpins. HEAT is derived from the names of four family members:huntingtin, eukaryotic translationelongation factor 3 (eEF3), protein phosphatase 2 regulatoryAsubunit (PP2A), and mechanistictarget of rapamycin (mTOR). HEAT domain-containing proteins play roles in a wide range of cellular processes, such as protein synthesis, nuclear transport and metabolism, and cell signaling. The PCI domains are a related group of helical hairpin domains, with a “winged-helix” (WH) subdomain at their C-terminus, which is responsible for multi-subunit complex formation with other PCI domains. The name is derived from the complexes, where these domains are found: the 26SProteasome “lid” regulatory subcomplex, theCOP9 signalosome (CSN), and eukaryotic translationinitiation factor 3 (eIF3). We noted that in structure similarity searches using HEAT domains, sometimes PCI domains appeared in the search results ahead of other HEAT domains, which indicated that the PCI domains could be members of the HEAT domain family, and not a related but separate group, as currently thought. Here, we report extensive structure similarity analysis of HEAT and PCI domains, both within and between the two groups of proteins. We present evidence that the PCI domains as a group have greater structural similarity with individual groups of HEAT domains than some of the HEAT domain groups have among each other. Therefore, our results indicate that the PCI domains have evolved from a HEAT domain that acquired a WH subdomain. The WH subdomain in turn mediated self-association into a multi-subunit complex, which eventually evolved into the common ancestor of the Proteasome lid/CSN/eIF3.
Serum Cystatin-C is linked to increased prevalence of diabetes and higher risk of mortality in diverse middle-aged and older adults
Authors: González Kevin A. , Stickel Ariana M. , Kaur Sonya S. , Ramos Alberto R. , González Hector M. , Tarraf Wassim
Published: September 2022

Objective

Type 2 Diabetes Mellitus (henceforth diabetes) affects roughly 35 million individuals in the US and is a major risk factor for cardiovascular and kidney disease. Serum Cystatin-C is used to monitor renal function and detect kidney damage. Recent research has focused on linking Cystatin-C to cardiovascular risk and disease, but most findings focus on small sample sizes and generalize poorly to diverse populations, thus limiting epidemiological inferences. The aim of this manuscript is to study the association between Cystatin-C, diabetes, and mortality and test for possible sex or racial/ethnic background modifications in these relationships.

Methods

We analyzed 8-years of biennial panel data from Health and Retirement Study participants 50-years and older who self-identified as White (unweighted N (uN) = 5,595), Black (uN = 867), or Latino (uN = 565) for a total of uN = 7,027 individuals. We modeled diabetes and death over 8-years as function of baseline Cystatin-C (log transformed) adjusting for covariates and tested modifications in associations by race/ethnic background and sex.

Results

Mean log Cystatin-C at visit 1 was 0.03±0.32 standard deviation. A 10% increase in Cystatin-C levels was associated with 13% increased relative risk of diabetes at baseline (11% and 9% by years 4 and 8). A 10% increase in Cystatin-C was highly associated with increased relative risk of death (28% and 31% by years 4 and 8). These associations were present even after adjusting for possible confounders and were not modified by sex or racial/ethnic background.

Conclusion

Despite differential risks for diabetes and mortality by racial/ethnic groups, Cystatin-C was equally predictive of these outcomes across groups. Cystatin-C dysregulations could be used as a risk indicator for diabetes and as a warning sign for accelerated risk of mortality.
Changing temporal trends in patient volumes in a pediatric emergency department during a COVID-19 pandemic lockdown: A retrospective cohort study
Authors: Mullan Paul C. , Vazifedan Turaj
Published: September 2022

Objective

Emergency department (ED) teams have had to adjust limited staffing resources to meet the fluctuating levels of patient volume and acuity during the COVID-19 pandemic. Historically, Mondays have had the highest reported ED volumes. We are unaware of any studies reporting on the change of this Monday effect during the COVID-19 pandemic.

Methods

This retrospective, observational study of a single pediatric ED compared a pandemic lockdown period (3/23/2020-11/1/2020) with a seasonally comparative period (3/25/2019-11/3/2019). We compared the mean number of patients who arrived on Monday versus any other specific weekday (Tuesday, Wednesday, Thursday, or Friday) and the aggregate of other weekdays (Tuesday to Friday) for both study periods. Secondary analyses investigated overall mean volumes, admission rates, and differences in triage acuity levels.

Results

There were 31,377 and 18,098 patients in the comparative and pandemic periods. The mean number of ED visits on Mondays in the comparative period was significantly more than any other weekday and the aggregate of weekdays (latter p<0.001). In contrast, there were no significant differences in the mean number of ED visits on Mondays in the pandemic period relative to any other weekday and the aggregate of weekdays (all p>0.05). The pandemic period had significantly lower mean volumes, higher admission rates, and more patients with higher acuity levels.

Conclusion

The previously experienced Monday effect of increased relative ED patient volumes was not seen during the pandemic period. This change has operational implications for scheduling ED staffing resources. Larger database studies are needed to determine the generalizability of these findings.
Critical evaluation of an autologous peripheral blood mononuclear cell-based humanized cancer model
Authors: Janakiraman Harinarayanan , Becker Scott A. , Bradshaw Alexandra , Rubinstein Mark P. , Camp Ernest Ramsay
Published: September 2022

The use of humanized mouse models for oncology is rapidly expanding. Autologous patient-derived systems are particularly attractive as they can model the human cancer’s heterogeneity and immune microenvironment. In this study, we developed an autologous humanized mouse cancer model by engrafting NSG mice with patient-derived xenografts and infused matched peripheral blood mononuclear cells (PBMCs). We first defined the time course of xenogeneic graft-versus-host-disease (xGVHD) and determined that only minimal xGVHD was observed for up to 8 weeks. Next, colorectal and pancreatic cancer patient-derived xenograft bearing NSG mice were infused with 5x106 human PBMCS for development of the humanized cancer models (iPDX). Early after infusion of human PBMCs, iPDX mice demonstrated engraftment of human CD4+ and CD8+ T cells in the blood of both colorectal and pancreatic cancer patient-derived models that persisted for up to 8 weeks. At the end of the experiment, iPDX xenografts maintained the features of the primary human tumor including tumor grade and cell type. The iPDX tumors demonstrated infiltration of human CD3+ cells with high PD-1 expression although we observed significant intra and inter- model variability. In summary, the iPDX models reproduced key features of the corresponding human tumor. The observed variability and high PD-1 expression are important considerations that need to be addressed in order to develop a reproducible model system.
Trends in suicide deaths before and after the COVID-19 outbreak in Korea
Authors: Ryu Seunghyong , Nam Hee Jung , Jhon Min , Lee Ju-Yeon , Kim Jae-Min , Kim Sung-Wan
Published: September 2022

We investigated the effect of the coronavirus disease-2019 (COVID-19) pandemic on suicide trends in Korea via a time-series analysis. We used Facebook Prophet to generate forecasting models based on the monthly numbers of suicide deaths in Korea between 1997 and 2018, validated the models by comparison with the 2019 numbers, and predicted the numbers of suicides in 2020. We compared the expected and observed numbers of suicides during the COVID-19 pandemic. The total numbers of suicides during the COVID-19 pandemic did not deviate from projections based on the pre-pandemic period. However, the number of suicides among women and those under the age of 34 years significantly exceeded the expected level. The COVID-19 pandemic did not increase the overall suicide rate significantly. However, suicides among women and young people increased, suggesting that the pandemic might drive more members of these groups to suicide. Further studies are needed to verify the long-term impact of the COVID-19 pandemic on suicide.
Stopping syphilis transmission in Arctic communities through rapid diagnostic testing: The STAR study protocol
Authors: Caya Chelsea , Maheu-Giroux Mathieu , Xia Yiqing , Serhir Bouchra , Morin Veronique , Libman Michael , Corsini Rachel , Goldfarb David M. , Wong Tom , Singh Ameeta E. , Yansouni Cedric P.
Published: September 2022

Background

Intense transmission of syphilis has emerged in some Canadian Arctic communities despite screening and prevention efforts. The remoteness of most communities and limited diagnostic infrastructure yield long delays (≥14 days) between screening and treatment of cases. These hamper syphilis control efforts and may contribute to sustained transmission. Syphilis rapid diagnostic tests (RDTs) have been developed to make screening more accessible and to inform clinical decision-making within the same clinical encounter. These RDTs have been successfully deployed in several countries, but not yet in Canada.

Methods and design

We describe the methodology of the “Stopping Syphilis Transmission in Arctic Communities Through Rapid Diagnostic Testing” (STAR) study, wherein the clinical and epidemiological impact of deploying a dual syphilis RDT in the context of ongoing transmission in Nunavut and Nunavik will be evaluated. In this prospective multisite field evaluation, sexually active individuals aged ≥14 years at risk for syphilis will be offered screening by an RDT at the point-of-care by non-laboratory trained registered nurses. Whole blood and serum specimens will be concurrently collected, when feasible, for rapid testing with an RDT containing both treponemal and non-treponemal components (Chembio DPP® Syphilis Screen & Confirm) and compared to laboratory-based reference testing according to a reverse sequence algorithm. The diagnostic accuracy of the RDT, using both whole blood and centrifuged serum specimens, will be validated under real-world conditions in remote Northern settings, outside of specialized laboratories. Additionally, screening-to-treatment time, case detection rates, and the number of infectious contacts averted by using the RDT relative to reference testing will be estimated. The impact of both diagnostic approaches on syphilis transmission dynamics will also be modeled.

Discussion

This study will provide much needed evidence for strengthening rapid responses to emerging syphilis outbreaks in remote Arctic regions, by supplementing traditional diagnostic strategies with an RDT to rapidly triage patients likely in need of treatment. These results will also inform the development and tailoring of future diagnostic strategies and public health responses to emerging outbreaks in the North.
COVID-19 related stigma, empathy and intention for testing in Jordan
Authors: Shahrour Ghada , Dardas Latefa , Aldalaykeh Mohammed
Published: September 2022

Stigmatization of COVID-19 disease has been speculated due to misinformation about the disease, fearing of contracting the infection, absence of available cure, and holding responsibility for infecting others. We aimed to establish the prevalence of COVID-19 related stigma and its association with empathic responding, in addition to exploring predictors of stigma and testing intention among Jordanian people. A quantitative, descriptive and predictive design was used and data were collected using a web-based survey from 1074 adults. Findings showed that participants had high stigmatization against COVID-19 infection. Higher empathic responding (both cognitive and affective), being a female participant, and older age resulted in higher stigmatization. Only stigmatization of COVID-19 negatively predicted individuals’ intention for testing. These findings warrant intensive efforts from the Jordanian government on a local and national level to provide ongoing public education related to several aspects of COVID-19 disease, in order to reduce or prevent the associated stigma and increase people’s intention for testing.
Tourism and economic growth: A global study on Granger causality and wavelet coherence
Authors: Wijesekara Chathuni , Tittagalla Chamath , Jayathilaka Ashinsana , Ilukpotha Uvinya , Jayathilaka Ruwan , Jayasinghe Punmadara
Published: September 2022

This paper empirically investigates the relationship between tourism and economic growth by using a panel data cointegration test, Granger causality test and Wavelet coherence analysis at the global level. This analysis examines 105 nations utilising panel data from 2003 to 2020. The findings indicates that in most regions, tourism contributes significantly to economic growth and vice versa. Developing trade across most of the regions appears to be a major influencer in the study, as a bidirectional association exists between trade openness and economic growth. Additionally, all regions other than the American region showed a one-way association between gross capital formation and economic growth. Therefore, it is crucial to highlight that using initiatives to increase demand would advance tourism while also boosting the economy.
Reliability of the accelerometer to control the effects of physical activity in older adults
Authors: Godhe Manne , Pontén Marjan , Nilsson Johnny , Kallings Lena V. , Andersson Eva A.
Published: September 2022

Background

Reliable physical activity measurements in community-dwelling older adults are important to determine effects of targeted health promotion interventions. Many exercise interventions aim to improve time spent sedentary (SED), in light-intensity-physical-activity (LPA) and moderate-to-vigorous-intensity-physical-activity (MVPA), since these parameters have independently proposed associations with health and longevity. However, many previous studies rely on self-reports which have lower validity compared to accelerometer measured physical activity patterns. In addition, separating intervention-effects from reactivity measurements requires sufficient test-retest reliability for accelerometer assessments, which is lacking in older adults.

Objectives

The study objective was to investigate the reliability of sensor-based PA-patterns in community-dwelling older adults. Furthermore, to investigate change over time of physical activity patterns and examine any compensatory-effect from the eight-week supervised exercise-intervention.

Methods

An exercise-group (n = 78, age-range:65-91yrs) performed two 1h-exercise sessions/week during eight-weeks. PA-pattern was assessed (using hip-worn accelerometers), twice before and once during the last-week of the intervention. A control-group (n = 43, age-range:65-88yrs) performed one pre-test and the end-test with no exercise-intervention. A dependent-t-test, mean-difference (95%-CI), limits-of-agreement and intraclass-correlation-coefficient-ICC were used between the two pre-tests. Repeated-measures-ANOVA were used to analyze any intervention-effects.

Results

The exercise-groups´ two pre-tests showed generally no systematic change in any PA- or SED-parameter (ICC ranged 0.75–0.90). Compared to the control group, the exercise intervention significantly (time x group-interaction, p<0.05) increased total-PA-cpm (exercise-group/control-group +17%/+7%) and MVPA-min/week (+41/-2min) and decreased %-of-wear-time for SED-total (-4.7%/-2.7%) and SED-bouts (-5.7%/-1.8%), and SED-bouts min/d (-46/-16min). At baseline level, no significant differences were found between the two groups for any parameter.

Conclusions

The current study presents a good test-retest-reliability of sensor-based-one-week-assessed-PA-pattern in older-adults. Participating in an 8-week supervised exercise intervention improved some physical activity and sedentary parameters compared to the control group. No compensatory-effect was noted in the intervention-group i.e., no decrease in any PA-parameter or increase in SED at End-test (in %-of-wear-time, min/day or total-PA).
Factors influencing health service utilization among mothers for under-five children: A cross-sectional study in Khulna district of Bangladesh
Authors: Akter Shahinur
Published: September 2022

Although Bangladesh has made significant progress in reducing child mortality, proper utilization of health services for under-five children among mothers remains one of the major challenges. Hence, this study was designed to investigate the factors influencing health service utilization among mothers for under-five children in the Khulna district of Bangladesh. Administering a semi-structured interview schedule, data were collected from 364 randomly selected mothers from the study area between June and August 2021. At first, Pearson’s Chi-square test was conducted to measure the association between outcome and predictor variables. Multivariable logistic regression model was used to identify the factors associated with utilization of health services. Overall, about 59 percent of the mother received health services from unqualified doctors during their children’s illness and the rest of them (41.5%) seek care from the qualified doctors. Results of regression analysis revealed that long duration of illness (AOR = 2.338; CI: 1.175–4.649; p = 0.015), the severity of illness (AOR = 6.402; CI: 3.275–12.513; p<0.001), and higher cost of treatment (AOR = 7.371; CI: 3.297–16.480; p<0.001) were the significant predictors of utilization of health services from the qualified doctors for under-five children. Thus, the study suggests that to reduce under-five child mortality by ensuring proper utilization of health services, it is necessary to raise awareness among mothers, improve transport facilities, establish need-based health care centers, and lower treatment costs.
In Vitro neurotoxicity and myotoxicity of Malaysian Naja sumatrana and Naja kaouthia venoms: Neutralization by monovalent and Neuro Polyvalent Antivenoms from Thailand
Authors: Zukifli Nor Asyikin , Ibrahim Zalikha , Othman Iekhsan , Ismail Ahmad Khaldun , Chaisakul Janeyuth , Hodgson Wayne C. , Ahmad Rusmili Muhamad Rusdi
Published: September 2022

Naja sumatranaandNaja kaouthiaare medically important elapids species found in Southeast Asia. Snake bite envenoming caused by these species may lead to morbidity or mortality if not treated with the appropriate antivenom. In this study, thein vitroneurotoxic and myotoxic effectsN.sumatranaandN.kaouthiavenoms from Malaysian specimens were assessed and compared. In addition, the neutralizing capability of Cobra Antivenom (CAV), King Cobra Antivenom (KCAV) and Neuro Polyvalent Antivenom (NPAV) from Thailand were compared. Both venoms produced concentration-dependent neurotoxic and myotoxic effects in the chick biventer cervicis nerve-muscle preparation. Based on the time to cause 90% inhibition of twitches (i.e. t90)N.kaouthiavenom displayed more potent neurotoxic and myotoxic effects thanN.sumatranavenom. All three of the antivenoms significantly attenuated venom-induced twitch reduction of indirectly stimulated tissues when added prior to venom. When added afterN.sumatranavenom, at the t90time point, CAV and NPAV partially restored the twitch height but has no significant effect on the reduction in twitch height caused byN.kaouthiavenom. The addition of KCAV, at the t90time point, did not reverse the attenuation of indirectly stimulated twitches caused by either venom. In addition, none of the antivenoms, when added prior to venom, prevented attenuation of directly stimulated twitches. Differences in the capability of antivenoms, especially NPAV and CAV, to reverse neurotoxicity and myotoxicity indicate that there is a need to isolate and characterize neurotoxins and myotoxins from MalaysianN.kaouthiaandN.sumatranavenoms to improve neutralization capability of the antivenoms.