bluuebunny/crossref_metadata_2025 huggingface dataset:
Addressing practicalities in multivariate nonlinear regression for mitigating environmental and operational variations
Authors: Roberts Callum , Cava David Garcia , Avendaño-Valencia Luis D
Published: June 2022

A significant problem associated with the implementation of Vibration-Based Structural Health Monitoring (VSHM) systems originates from the detrimental effects caused by Environmental and Operational Variations (EOVs). The EOVs cause observations from the same structural condition to behave in different manners. As such, this leads to issues when defining a robust baseline state as well as making the discrimination between undamaged and damaged observations more challenging. In order to address these challenges, multivariate nonlinear regression is implemented to account for the EOVs. Damage Sensitive Features (DSFs) are extracted from acceleration data and then are regressed based on environmental and operational parameters. New features are effectively normalised by finding the difference between the measured and predicted values. This process removes the influence of the EOVs in an explicit manner, allowing for more reliable damage detection. While the benefit of the application of different regression methodologies has already been demonstrated in the past, this work addresses a number of practicalities in the implementation of VSHM on real systems. The analysis investigates the selection of the DSF and is investigated alongside another analysis into how the damage detection behaves under varying amounts of input information. Furthermore, a method is proposed to understand and account for a large number of outliers in the training data.
Impact of COVID-19 therapy on hyperglycemia
Authors: Parise Rachel , Deruiter Jack , Ren Jun , Govindarajulu Manoj , Ramesh Sindhu , Nadar Rishi M , Moore Timothy , Dhanasekaran Muralikrishnan
Published: June 2022

The goal of this study was to analyze the effect of COVID-19 drugs and biologicals on hyperglycemia. A literature search with key terms, such as “COVID-19 drugs and hyperglycemia” and “COVID-19 vaccines and hyperglycemia,” was conducted using PubMed through September 2021. The CDC data were referenced for current COVID-19 profile and statistics. The NIH COVID-19 guidelines were referenced for updated treatment recommendations. Micromedex and UpToDate were used for drug and disease information. Current results suggested that corticosteroids (dexamethasone), remdesivir and antivirals (lopinavir and ritonavir) all have the potential to significantly raise blood glucose levels putting patients at elevated risk for severe complications. In contrary, hydroxychloroquine is associated with hypoglycemia, and tocilizumab decreases inflammation which is associated with improving glucose levels. Other anti-cytokine bioactive molecules are correlated with lower blood glucose in patients with and without diabetes mellitus. Ivermectin, used for mild COVID-19 disease, possesses the potential for lowering blood glucose. Covishield, Pfizer-BioNTech, and Moderna have all been associated with hyperglycemia after the first dose. Individualized /personalized patient care is required for diabetic mellitus patients with COVID-19 infection. Improper drug therapy aggravates hyperglycemic conditions and other comorbid conditions, leading to increased morbidity and mortality.
Lowering the voting age to 16: Young people making a case for political education in fostering voting competencies
Authors: Ribeiro Norberto , Malafaia Carla , Ferreira Teresa
Published: June 2022

The intention of this article is to contribute to the debate about whether the voting age should be lowered to the age of 16, by examining quantitative and qualitative data collected in a local participation project with young people in Portugal: questionnaires ( N = 961), interviews ( N = 3), and focus group discussions ( N = 15). Considering the coexistence of both willingness and reluctance to get engaged in formal politics – as youngsters often feel ill-equipped politically – it is argued that adequate political education needs to be provided by schools to enable young people to be confident and knowledgeable voters. We propose that governments recognise the importance of this area in the school curriculum, in order to enable the young people’s acquisition of knowledge and skills that can sustain their growth as competent voters. This is crucial in legitimising democratic representative systems.
The hospitalization burden of inflammatory bowel disease in China: a nationwide study from 2013 to 2018
Authors: He Yi-Ming , Mao Ren , Yuan Gang , Liang Rui-Ming , Long Jian-Yan , Ye Xiao-Qi , Iacucci Marietta , Ghosh Subrata , Ben-Horin Shomron , Kaplan Gilaad G. , He Yao , Sung Joseph J.Y. , Peng Sui , Wang Hai-Bo , Chen Min-Hu
Published: June 2022

Background:

The past decade has witnessed a dramatic increase in the number of patients with inflammatory bowel disease (IBD) in China. The nationwide burden of hospitalization remains unclear, however. We aimed to address this gap by conducting analysis using a nationwide database.

Methods:

Population-based hospitalization rates from 2013 to 2018 were calculated by extrapolating the number of patients in the database to the national level. Surgical rates, annual hospital charges, and length of stay were also used for quantification of hospitalization burden. The Poisson regression analysis and the Cochran–Armitage trend test were conducted to analyze temporal trends as expressed as annual percentage of change (APC) with 95% confidential intervals (CIs).

Results:

From 2013 to 2018, the hospitalization rates for Crohn’s disease (CD) and ulcerative colitis (UC) in China increased from 2.20 (95% CI = 2.17–2.22) to 3.62 (3.59–3.65) per 100,000 inhabitants ( p < 0.0001) with an APC of 10.68% (6.00–15.36%) and from 6.24 (6.20–6.28) to 8.29 (8.23–8.33) per 100,000 inhabitants ( p < 0.0001) with an APC of 5.73% (2.32–9.15%), respectively. Surgical rates decreased from 7.96% (7.29–8.63%) to 5.56% (5.11–6.00%) for CD patients ( p < 0.0001) with APC of −6.30% (−11.33 to −1.27%) and from 3.54% (3.26–3.82%) to 2.52% (2.32–2.72%) for UC patients ( p < 0.0001) with APC of −6.35% (−16.21 to 3.51). In 2018, there were estimated 166,000 IBD patients hospitalized costing a total of $426.37 million ($149.91 + $276.46 million) across the entire China.

Conclusion:

The population-based hospitalization rate of IBD increased, whereas the surgical rate decreased from 2013 to 2018 in China.
Explainable Machine Learning for Real-Time Hypoglycemia and Hyperglycemia Prediction and Personalized Control Recommendations
Authors: Duckworth Christopher , Guy Matthew J. , Kumaran Anitha , O’Kane Aisling Ann , Ayobi Amid , Chapman Adriane , Marshall Paul , Boniface Michael
Published: June 2022

Background:

The occurrences of acute complications arising from hypoglycemia and hyperglycemia peak as young adults with type 1 diabetes (T1D) take control of their own care. Continuous glucose monitoring (CGM) devices provide real-time glucose readings enabling users to manage their control proactively. Machine learning algorithms can use CGM data to make ahead-of-time risk predictions and provide insight into an individual’s longer term control.

Methods:

We introduce explainable machine learning to make predictions of hypoglycemia (<70 mg/dL) and hyperglycemia (>270 mg/dL) up to 60 minutes ahead of time. We train our models using CGM data from 153 people living with T1D in the CITY (CGM Intervention in Teens and Young Adults With Type 1 Diabetes)survey totaling more than 28 000 days of usage, which we summarize into (short-term, medium-term, and long-term) glucose control features along with demographic information. We use machine learning explanations (SHAP [SHapley Additive exPlanations]) to identify which features have been most important in predicting risk per user.

Results:

Machine learning models (XGBoost) show excellent performance at predicting hypoglycemia (area under the receiver operating curve [AUROC]: 0.998, average precision: 0.953) and hyperglycemia (AUROC: 0.989, average precision: 0.931) in comparison with a baseline heuristic and logistic regression model.

Conclusions:

Maximizing model performance for glucose risk prediction and management is crucial to reduce the burden of alarm fatigue on CGM users. Machine learning enables more precise and timely predictions in comparison with baseline models. SHAP helps identify what about a CGM user’s glucose control has led to predictions of risk which can be used to reduce their long-term risk of complications.
Oxyresveratrol Reduces the Migration of Human Osteosarcoma Cell U2OS via Attenuating STAT3 Activation
Authors: Lv Tao , Ye Xiuzhang , Jian Zhen , Zhong Zeyuan , Zhang Chongjing , Yi Chengqing , Yu Baoqing
Published: June 2022

Objective: Osteosarcoma is a malignant tumor with high metastatic properties that are associated with increased mortality and poor prognosis. Therefore, it is crucial to develop an effective treatment for metastatic osteosarcoma. Oxyresveratrol (ORES), derived from mulberry twigs and fruits, has antitumor effects. However, it remains unknown whether ORES inhibits osteosarcoma metastasis. In this study, we determined the inhibitory effect of ORES on osteosarcoma metastasis. Key Findings: ORES attenuated the migration of U2OS cells, dose-dependently increased E-cadherin expression, and reduced N-cadherin expression in U2OS cells, indicating that ORES can inhibit epithelial–mesenchymal transition (EMT) in osteosarcoma cells. Furthermore, ORES inhibited the expression of Twist, which is associated with the downregulation of STAT3 phosphorylation. IL-6-induced STAT3 phosphorylation rescues the inhibitory effect of ORES on U2OS metastasis. Summary: Our results indicate that ORES is a potential therapeutic agent for metastatic osteosarcoma. ORES inhibits osteosarcoma cell migration by reducing EMT formation.
Optimization of Evaluation Indicators for Driver’s Traffic Literacy: An Improved Principal Component Analysis Method
Authors: Chen Zhuo , Tian Kang
Published: June 2022

The traditional traffic concept seems to be unable to adapt to the traffic problems brought by cities’ rapid development. People must cultivate new modern traffic literacy to deal with traffic problems. Based on traffic literacy, this paper constructs a traffic literacy evaluation indicator system including 13 evaluation indicators such as traffic rules and mechanical knowledge by summarizing relevant literature. We propose an Improved Principal Component Analysis (I-PCA) method, introduce the concept of information contribution sensitivity, and optimize and empower the traffic literacy indicator system. The primary research is to construct a traffic literacy evaluation indicator system including 13 evaluation indicators such as traffic rules and mechanical knowledge. The top 10 indicators that satisfy the cumulative information contribution rate value greater than 90% are retained, and the three indicators with low contribution rate are excluded. The optimization method can retain the indicator with a relatively large information contribution rate so that the indicator’s weight can genuinely reflect the information content of the corresponding indicator. The optimization method can retain the indicator with a relatively large information contribution rate so that the indicator’s weight can genuinely reflect the information content of the corresponding indicator.
Adherence to and Forgiveness of 3TC/DTG in a Real-World Cohort
Authors: Maggiolo Franco , Valenti Daniela , Teocchi Rodolfo , Comi Laura , Filippo Elisa Di , Rizzi Marco
Published: June 2022

Background: adherence and forgiveness are key factors for virologic success. We evaluated them for 3TC/DTG. Methods: pharmacy refills were used to calculate the proportion of days covered (PDC). Forgiveness was calculated as the achieved rate of HIV-RNA threshold by a given level of imperfect adherence. Results: 240 PLWH were included. The median follow-up was 819 days (IQR 450-1459) for a total of 681 person/years of follow-up. Adherence was very high with a median of 99% (IQR 95%-100%). Consequently, the virologic response was sustained with 83.8% of PLWH never exceeding a HIV RNA of 50 copies/ml and 95.8% of subjects with a steadily HIV-RNA < 200 copies/ml. A PDC lower than 80% was associated with a negative outcome irrespective of the HIV-RNA threshold considered. Conclusions: The extensive virologic efficacy of 3TC/DTG demonstrated both in clinical trials and real-world experiences seems to rely more on its friendliness than on its forgiveness.
“I Want to Help Others Like Me”: A Pilot Qualitative Study on Patients’ Participation in a Screening for Distress Program
Authors: Rivest Jacynthe , Desbeaumes Jodoin Véronique , Martineau Joé T , Folch Nathalie , Charpentier Danielle
Published: June 2022

Screening for distress was implemented in our academic hospital with the engagement of patients as partners. Little is known about how they appreciate such participation. This pilot qualitative study aimed to explore their experience. Six participants completed a semi-structured interview, which was transcribed verbatim. Thematic analysis was performed on the transcripts. Four themes emerged: “opinions about their participation”, “working with others”, “role of patient partners”, and “barriers encountered”. Mean global satisfaction reported on a Likert scale reached 8.92 over 10. Our preliminary findings suggest that patients-as-partners appreciated their participation, and also identified barriers that should be explored in future quality improvement (QI) projects.
CIC-39Na reverses the thrombocytopenia that characterizes tubular aggregate myopathy
Authors: Cordero-Sanchez Celia , Pessolano Emanuela , Riva Beatrice , Vismara Mauro , Trivigno Silvia Maria Grazia , Clemente Nausicaa , Aprile Silvio , Ruffinatti Federico Alessandro , Portararo Paola , Filigheddu Nicoletta , Zaggia Ivan , Bhela Irene P. , Serafini Marta , Pirali Tracey , Colombo Mario P. , Torti Mauro , Sangaletti Sabina , Bertoni Alessandra , Genazzani Armando A.
Published: June 2022

Store-operated Ca2+-entry is a cellular mechanism that governs the replenishment of intracellular stores of Ca2+ upon depletion caused by the opening of intracellular Ca2+-channels. Gain-of-function mutations of the 2 key proteins of store-operated Ca2+-entry, STIM1 and ORAI1, are associated with several ultra-rare diseases clustered as tubular aggregate myopathies. Our group has previously demonstrated that a mouse model bearing the STIM1 p.I115F mutation recapitulates the main features of the STIM1 gain-of-function disorders: muscle weakness and thrombocytopenia. Similar findings have been found in other mice bearing different mutations on STIM1. At present, no valid treatment is available for these patients. In the present contribution, we report that CIC-39Na, a store-operated Ca2+-entry inhibitor, restores platelet number and counteracts the abnormal bleeding that characterizes these mice. Subtle differences in thrombopoiesis were observed in STIM1 p.I115F mice, but the main difference between wild-type and STIM1 p.I115F mice was in platelet clearance and in the levels of platelet cytosolic basal Ca2+. Both were restored on treatment of animals with CIC-39Na. This finding paves the way to a pharmacological treatment strategy for thrombocytopenia in tubular aggregate myopathy patients.
Hematopoietic stem cell boost for persistent neutropenia after CAR T-cell therapy: a GLA/DRST study
Authors: Gagelmann Nico , Wulf Gerald Georg , Duell Johannes , Glass Bertram , van Heteren Pearl , von Tresckow Bastian , Fischer Monika , Penack Olaf , Ayuk Francis , Einsele Herrmann , Holtick Udo , Thomson Julia , Dreger Peter , Kröger Nicolaus
Published: June 2022

Hematotoxicity after chimeric antigen receptor (CAR) T-cell therapy is associated with infection and death but management remains unclear. We report results of 31 patients receiving hematopoietic stem cell boost (HSCB; 30 autologous, 1 allogeneic) for either sustained severe neutropenia of grade 4 (<0.5 × 109/L), sustained moderate neutropenia (≤1.5 × 109/L) and high risk of infection, or neutrophil count ≤2.0 × 109/L and active infection. Median time from CAR T-cell therapy to HSCB was 43 days and median absolute neutrophil count at time of HSCB was 0.2. Median duration of neutropenia before HSCB was 38 days (range, 7-151). Overall neutrophil response rate (recovery or improvement) was observed in 26 patients (84%) within a median of 9 days (95% confidence interval, 7-14). Time to response was significantly associated with the duration of prior neutropenia (P = .007). All nonresponders died within the first year after HSCB. One-year overall survival for all patients was 59% and significantly different for neutropenia (≤38 days; 85%) vs neutropenia >38 days before HSCB (44%; P = .029). In conclusion, early or prophylactic HSCB showed quick response and improved outcomes for sustained moderate to severe neutropenia after CAR-T.
Combining QTL mapping and gene co-expression network analysis for prediction of candidate genes and molecular network related to yield in wheat
Authors: Wei Jun , Fang Yu , Jiang Hao , Wu Xing-ting , Zuo Jing-hong , Xia Xian-chun , Li Jin-quan , Stich Benjamin , Cao Hong , Liu Yong-xiu
Published: June 2022

Background

Wheat (Triticum aestivum L.) is an important cereal crop. Increasing grain yield for wheat is always a priority. Due to the complex genome of hexaploid wheat with 21 chromosomes, it is difficult to identify underlying genes by traditional genetic approach. The combination of genetics and omics analysis has displayed the powerful capability to identify candidate genes for major quantitative trait loci (QTLs), but such studies have rarely been carried out in wheat. In this study, candidate genes related to yield were predicted by a combined use of linkage mapping and weighted gene co-expression network analysis (WGCNA) in a recombinant inbred line population.

Results

QTL mapping was performed for plant height (PH), spike length (SL) and seed traits. A total of 68 QTLs were identified for them, among which, 12 QTLs were stably identified across different environments. Using RNA sequencing, we scanned the 99,168 genes expression patterns of the whole spike for the recombinant inbred line population. By the combined use of QTL mapping and WGCNA, 29, 47, 20, 26, 54, 46 and 22 candidate genes were predicted for PH, SL, kernel length (KL), kernel width, thousand kernel weight, seed dormancy, and seed vigor, respectively. Candidate genes for different traits had distinct preferences. The known PH regulation genes Rht-B and Rht-D, and the known seed dormancy regulation genes TaMFT can be selected as candidate gene. Moreover, further experiment revealed that there was a SL regulatory QTL located in an interval of about 7 Mbp on chromosome 7A, named TaSL1, which also involved in the regulation of KL.

Conclusions

A combination of QTL mapping and WGCNA was applied to predicted wheat candidate genes for PH, SL and seed traits. This strategy will facilitate the identification of candidate genes for related QTLs in wheat. In addition, the QTL TaSL1 that had multi-effect regulation of KL and SL was identified, which can be used for wheat improvement. These results provided valuable molecular marker and gene information for fine mapping and cloning of the yield-related trait loci in the future.
Non-adherence to guideline recommendations for insulins: a qualitative study amongst primary care practitioners
Authors: Dankers M. , van den Berk-Bulsink M. J. E. , van Dalfsen-Slingerland M. , Nelissen-Vrancken H.J.M.G. , Mantel-Teeuwisse A. K. , van Dijk L.
Published: June 2022

Background

Guideline adherence is generally high in Dutch general practices. However, the prescription of insulins to type 2 diabetes mellitus patients is often not in line with the guideline, which recommends NPH insulin as first choice and discourages newer insulins. This qualitative study aimed to identify the reasons why primary care healthcare professionals prescribe insulins that are not recommended in guidelines.

Methods

Digital focus groups with primary care practitioners were organised. A topic list was developed, based on reasons for preferred insulins obtained from literature and a priori expert discussions. The discussions were video and audio-recorded, transcribed verbatim and coded with a combination of inductive and deductive codes. Codes were categorized into an existing knowledge, attitudes and behaviour model for guideline non-adherence.

Results

Four focus groups with eleven general practitioners, twelve practice nurses, six pharmacists, four diabetes nurses and two nurse practitioners were organised. The prescription of non-recommended insulins was largely driven by argumentation in the domain of attitudes. Lack of agreement with the guideline was the most prominent category. Most of those perspectives did not reflect disagreement with the guideline recommendations in general, but were about advantages of non-recommended insulins, which led, according to the healthcare professionals, to better applicability of those insulins to specific patients. The belief that guideline-recommended insulins were less effective, positive experience with other insulins and marketing from pharmaceutical companies were also identified as attitude-related barriers to prescribe guideline-recommended insulins. One additional category in the domain of attitudes was identified, namely the lack of uniformity in policy between healthcare professionals in the same practice. Only a small number of external barriers were identified, focusing on patient characteristics that prevented the use of recommended insulins, the availability of contradictory guidelines and other, mostly secondary care, healthcare providers initiating non-recommended insulins. No knowledge-related barriers were identified.

Conclusions

The prescription of non-recommended insulins in primary care is mostly driven by lack of agreement with the guideline recommendations and different interpretation of evidence. These insights can be used for the development of interventions to stimulate primary care practitioners to prescribe guideline-recommended insulins.
Postoperative hyperprogression disease of pancreatic ductal adenocarcinoma after curative resection: a retrospective cohort study
Authors: Zou Siyi , Wang Xinjing , Chen Haoda , Lin Jiewei , Wen Chenlei , Zhan Qian , Chen Hao , Lu Xiongxiong , Deng Xiaxing , Shen Baiyong
Published: June 2022

Background

Prognosis for patients recurred rapidly after resection of pancreatic ductal adenocarcinoma (PDAC) was extremely poor. We proposed the concept of postoperative hyper-progression disease (PO-HPD) to define recurrence within 2 months after surgery, explored the role of surgery for postoperative HPD patients and determined the predictive preoperative risk factors and genomic features of PO-HPD.

Methods

976 patients undergoing curative resection of PDAC were enrolled. Survival data of 1733 stage IV patients from the US Surveillance, Epidemiology and End Results database was also collected. Patients relapsed were grouped into 3 groups regarding of the recurrence time (within 2 months were PO-HPD, within 2 to 12 months were early recurrence (ER) and within > 12 months were late recurrence (LR)). Risk factors for PO-HPD were explored with logistic regression models. Genomic features of 113 patients were investigated using next-generation sequencing-based gene panel testing.

Results

718 of 976 cases relapsed, 101were PO-HPD, 418 were ER and 199 were LR. Total survival of PO-HPD was 12.5 months, shorter than that of ER (16.7 months) and LR (35.1 months), and verged on that of stage IV patients (10.6 months). Preoperative risk factors for PO-HPD included red blood cell count < 3.94*10^12/L, CA19–9 ≥ 288.6 U/mL, CA125 ≥ 22.3 U/mL and tumor size≥3.45 cm. Mutations of CEBPA, ATR and JAK1 were only identified in PO-HPD and they owned lower level of CN gain compared to others.

Conclusions

Prognosis of PO-HPD was extremely poor and the role of surgery for PO-HPD should be prudently assessed.
Cultural adaptation of the mental health first aid guidelines for assisting a person at risk of suicide in Brazil: a Delphi expert consensus study
Authors: Requena Simone Scotti , Cerqueira Amanda Vidotto , Assumpção Thais Alves , Peres Carlos Henrique Mesquita , Loch Alexandre Andrade , Reavley Nicola J.
Published: June 2022

Background

Suicide is a major public health concern in Brazil, with nearly 115,000 Brazilians dying by suicide in 2010–2019. As support for individuals at risk of suicide may come from the community, particularly family and friends, it is fundamental that evidence-based programs or resources to improve such support are in place when needed. This study aimed to culturally adapt the mental health first aid guidelines for assisting a person at risk of suicide used in English-speaking countries for Brazil.

Methods

A Delphi expert consensus study was conducted among a diverse range of Brazilian health professionals and individuals with lived experience of suicide (n = 60). A total of 161 items from the mental health first aid questionnaire used in English-speaking countries were translated and used in the Brazilian questionnaire. Participants were asked to rate the appropriateness of those items to the Brazilian culture and to recommend any new items when appropriate.

Results

Data were collected over two survey rounds. Consensus was achieved on 145 items. While 123 out of 161 items were adopted from the English guidelines, 22 new endorsed items were created from the expert panel comments.

Conclusions

Even though there were similarities among the Brazilian and English-language guidelines, the adapted guidelines incorporated actions that were specific to the Brazilian culture, such as new items emphasising the role of family and friends. Further research is warranted on dissemination and uptake of the guidelines in Brazil as well as research into incorporation of the guidelines into Mental Health First Aid (MHFA) training for Brazil.
Modelling the prevalence of hepatitis B towards eliminating it as a major public health threat in China
Authors: Liu Wenjun , Zhuang Tianyi , Xia Ruyi , Zou Zhuoru , Zhang Lei , Shen Mingwang , Zhuang Guihua
Published: June 2022

Background

The World Health Organization (WHO) requires reduction in the prevalence of hepatitis B virus (HBV) surface antigen (HBsAg) in children to 0.1% by 2030, a key indicator for eliminating viral hepatitis as a major public health threat. Whether and how China can achieve this target remains unknown, although great achievements have been made. We aimed to predict the decline of HBsAg prevalence in China and identify key developments needed to achieve the target.

Methods

An age- and time-dependent dynamic compartmental model was constructed based on the natural history of HBV infection and the national history and current status of hepatitis B control. The model was run from 2006 to 2040 to predict the decline of HBsAg prevalence under three scenarios including maintaining current interventions (status quo), status quo + peripartum antiviral prophylaxis (PAP, recommended by WHO in 2020), and scaling up current interventions + PAP.

Results

Under the status quo, HBsAg prevalence would decrease steadily in all age groups, but the WHO’s target of 0.1% prevalence in children aged < 5 years would not be achieved until 2037. The results are robust according to sensitivity analyses. Under the status quo + PAP, the HBsAg prevalence of children aged < 5 years would significantly decrease with the introduction of PAP, and the higher the successful interruption coverage is achieved by PAP, the more significant the decline. However, even if the successful interruption coverage reaches 90% by 2030, the 0.1% prevalence target would not be met until 2031. Under the scaling up current interventions + PAP, combined with scale-up of current interventions, the WHO’s 0.1% target would be achieved on time or one year in advance if PAP is introduced and the successful interruption coverage is scaled up to 80% or 90% by 2030, respectively.

Conclusions

It is difficult for China to achieve the WHO’s target of 0.1% HBsAg prevalence in children by 2030 by maintaining current interventions. PAP may play an important role to shorten the time to achieve the target. A comprehensive scale-up of available interventions including PAP will ensure that China achieves the target on schedule.
Selected hematological abnormalities and their associated factors among asthmatic patients in Northwest Ethiopia: a cross-sectional study
Authors: Solomon Yenealem , Woldu Berhanu , Mesfin Nebiyu , Enawgaw Bamlaku
Published: June 2022

Background

Asthma is a chronic inflammatory disease that affects the lungs. Variation in whole blood cell lines is caused by the progression and severity of asthma. Common hematological abnormalities encountered during asthma include eosinophilia, neutrophilia, leukocytosis, and increased erythrocyte sedimentation rate. The main aim of this study was to assess the selected hematological abnormalities and their associated factors among asthmatic patients in Northwest Ethiopia from March to May 2021.

Methodology

A hospital-based cross-sectional study was conducted on a total of 320 asthmatic patients in Northwest Ethiopia. A simple random sampling technique was employed to select study participants. A pre-tested structured questionnaire and a checklist were used to collect data. Blood samples were collected from asthmatic patients for complete blood count and erythrocyte sedimentation rate determination. Hematological profiles were analyzed by Unicel DxH 800 (Beckman Coulter, Ireland). The erythrocyte sedimentation rate was determined by using the Westergren method. The data were entered into EpiData version 3.0.4 and analyzed with a statistical package for social science version 20 software. The bi-variable and multi-variable binary logistic regression models were used to assess the factors associated with hematological abnormalities. A p value of less than 0.05 in the multivariable logistic regression analysis was considered statistically significant.

Results

The overall prevalence of neutrophilia, eosinophilia, thrombocytopenia, leukocytosis, and basophilia was 35.3%, 20%, 11.9%, 10.3%, and 4.1%, respectively. Neutrophilia was associated with a lack of physical activity (AOR = 3.25; 95% CI 1.43–7.37) and a history of taking non-asthmatic drugs within the previous three months (AOR = 2.63; 95% CI 1.22–5.65). Being admitted to the emergency department (AOR = 0.27; 95% CI 0.11–5.67) was found to be associated with eosinophilia. In addition, being admitted to the emergency department (AOR = 5.44; 95%CI: 2.6–11.3) was associated with thrombocytopenia.

Conclusion

The current study demonstrated the predominant prevalence of neutrophilia, followed by eosinophilia, among asthma patients. Therefore, hematological abnormalities should be taken into account for proper monitoring and management of asthmatic patients.
Correlates of cervical cancer screening participation, intention and self-efficacy among Muslim women in southern Ghana
Authors: Enyan Nancy Innocentia Ebu , Davies Anita Efua , Opoku-Danso Rita , Annor Francis , Obiri-Yeboah Dorcas
Published: June 2022

Background

The World Health Organisation’s efforts to eliminate cervical cancer by 2030 with a target of 70% screening coverage using a high-performance test demand that women increase participation in screening. Factors that impact uptake of screening must therefore be identified and bottlenecks addressed, especially in lower- and middle-income countries where cervical cancer incidence remains high. This study investigated Muslim women, participation in, intention to engage in and self-efficacy about cervical cancer screening.

Methods

An analytical cross-sectional study was conducted among Muslim women aged 18 years and above in the Cape Coast Metropolis of Ghana using an interviewer-administered questionnaire. Data were analysed using appropriate descriptive statistics, Chi-square test, point biserial correlation and binary logistic regression analysis.

Results

The mean age of participants was approximately 31 years (M = 30.9, SD = 10.4). Out of the 431 women, 21 (4.9%) had ever participated in cervical cancer screening. Participants demonstrated very low knowledge about cervical cancer and screening, with a mean knowledge score of 3.68 out of 15. Knowledge about cervical cancer was associated with increased odds of participating in cervical cancer screening (aOR = 1.32, 95%CI 1.11, 1.56). Concerns about similarity with health provider in terms of gender and faith was associated with decreased odds of cervical cancer screening self-efficacy (aOR = 0.81, 95% CI 0.67). Islamic modesty (aOR = 0.88, 95%CI 0.81, 0.96) was associated with decreased self-efficacy about seeking cervical cancer screening, whereas attitude (aOR = 1.32, 95%CI 1.14, 1.53) was significantly associated with increased self-efficacy about seeking cervical cancer screening. Again, Islamic modesty (aOR = 0.88, 95%CI 0.80, 0.97) was associated with decreased intention to participate in screening, whereas attitude (aOR = 1.42, 95%CI 1.20, 1.68) was associated with increased intention to participate in screening.

Conclusions

There are gaps in knowledge of cervical cancer among Muslim women in this study as less than 5% had participated in screening. A positive attitude was found to influence intention to screen and actual participation in screening programmes. Islamic modesty and commitment to the Islamic faith decreased intention and self-efficacy regarding screening. Therefore, comprehensive and appropriate socio-cultural and religion-specific interventions aimed at addressing the barriers to screening are important in improving uptake among Muslim women.
Behavioral healthcare organizations’ experiences related to use of telehealth as a result of the COVID-19 pandemic: an exploratory study
Authors: Kisicki Abby , Becker Sara , Chaple Michael , Gustafson David H. , Hartzler Bryan J. , Jacobson Nora , Murphy Ann A. , Tapscott Stephanie , Molfenter Todd
Published: June 2022

Background

Due to the COVID-19 pandemic, healthcare providers were forced to shift many services quickly from in-person to virtual, including substance use disorder (SUD) and mental health (MH) treatment services. This led to a sharp increase in telehealth services, with health systems seeing patients virtually at hundreds of times the rate as before the onset of the COVID-19 pandemic.

By analyzing qualitative data about SUD and MH care organizations’ experiences using telehealth, this study aims to elucidate emergent themes related to telehealth use by the front-line behavioral health workforce.

Methods

This study uses qualitative data from large-scale web surveys distributed to SUD and MH organizations between May and August 2020. At the end of these surveys, the following question was posed in free-response form: “Is there anything else you would like to say about use of telehealth during or after the COVID-19 pandemic?” Respondents were asked to answer on behalf of their organizations. The 391 responses to this question were analyzed for emergent themes using a conventional approach to content analysis.

Results

Three major themes emerged: COVID-specific experiences with telehealth, general experiences with telehealth, and recommendations to continue telehealth delivery. Convenience, access to new populations, and lack of commute were frequently cited advantages of telehealth, while perceived ineffectiveness of and limited access to technology were frequently cited disadvantages. Also commonly mentioned was the relaxation of reimbursement regulations. Respondents supported continuation of relaxed regulations, increased institutional support, and using a combination of telehealth and in-person care in their practices.

Conclusions

This study advanced our knowledge of how the behavioral health workforce experiences telehealth delivery. Further longitudinal research comparing treatment outcomes of those receiving in-person and virtual services will be necessary to undergird organizations’ financial support, and perhaps also legislative support, for virtual SUD and MH services.
Mettl14-mediated m6A modification is essential for visual function and retinal photoreceptor survival
Authors: Yang Yeming , Shuai Ping , Li Xiao , Sun Kuanxiang , Jiang Xiaoyan , Liu Wenjing , Le Weidong , Jiang Haisong , Liu Yuping , Zhu Xianjun
Published: June 2022

Background

As the most abundant epigenetic modification of eukaryotic mRNA, N6-methyladenosine (m6A) modification has been shown to play a role in mammalian nervous system development and function by regulating mRNA synthesis and degeneration. However, the role of m6A modification in retinal photoreceptors remains unknown.

Results

We generated the first retina-specific Mettl14-knockout mouse models using the Rho-Cre and HRGP-Cre lines and investigated the functions of Mettl14 in retinal rod and cone photoreceptors. Our data showed that loss of Mettl14 in rod cells causes a weakened scotopic photoresponse and rod degeneration. Further study revealed the ectopic accumulation of multiple outer segment (OS) proteins in the inner segment (IS). Deficiency of Mettl14 in cone cells led to the mislocalization of cone opsin proteins and the progressive death of cone cells. Moreover, Mettl14 depletion resulted in drastic decreases in METTL3/WTAP levels and reduced m6A methylation levels. Mechanistically, transcriptomic analyses in combination with MeRIP-seq illustrated that m6A depletion via inactivation of Mettl14 resulted in reduced expression levels of multiple phototransduction- and cilium-associated genes, which subsequently led to compromised ciliogenesis and impaired synthesis and transport of OS-residing proteins in rod cells.

Conclusions

Our data demonstrate that Mettl14 plays an important role in regulating phototransduction and ciliogenesis events and is essential for photoreceptor function and survival, highlighting the importance of m6A modification in visual function.
Chromosome-level genome assemblies of four wild peach species provide insights into genome evolution and genetic basis of stress resistance
Authors: Cao Ke , Peng Zhen , Zhao Xing , Li Yong , Liu Kuozhan , Arus Pere , Fang Weichao , Chen Changwen , Wang Xinwei , Wu Jinlong , Fei Zhangjun , Wang Lirong
Published: June 2022

Background

Peach (Prunus persica) is an economically important stone fruit crop in Rosaceae and widely cultivated in temperate and subtropical regions, emerging as an excellent material to study the interaction between plant and environment. During its genus, there are four wild species of peach, all living in harsh environments. For example, one of the wild species, P. mira, originates from the Qinghai-Tibet Plateau (QTP) and exhibits strong cold/ultraviolet ray environmental adaptations. Although remarkable progresses in the gene discovery of fruit quality-related traits in peach using previous assembled genome were obtained, genomic basis of the response of these wild species to different geographical environments remains unclear.

Results

To uncover key genes regulating adaptability in different species and analyze the role of genetic variations in resistance formation, we performed de novo genome assembling of four wild relatives of peach (P. persica), P. mira, P. davidiana, P. kansuensis, and P. ferganensis and resequenced 175 peach varieties. The phylogenetic tree showed that the divergence time of P. mira and other wild relatives of peach was 11.5 million years ago, which was consistent with the drastic crustal movement of QTP. Abundant genetic variations were identified in four wild species when compared to P. persica, and the results showed that plant-pathogen interaction pathways were enriched in genes containing small insertions and deletions and copy number variations in all four wild relatives of peach. Then, the data were used to identify new genes and variations regulating resistance. For example, presence/absence variations which result from a hybridization event that occurred between P. mira and P. dulcis enhanced the resistance of their putative hybrid, P. davidiana. Using bulked segregant analysis, we located the nematode resistance locus of P. kansuensis in chromosome 2. Within the mapping region, a deletion in the promoter of one NBS-LRR gene was found to involve the resistance by regulating gene expression. Furthermore, combined with RNA-seq and selective sweeps analysis, we proposed that a deletion in the promoter of one CBF gene was essential for high-altitude adaptation of P. mira through increasing its resistance to low temperature.

Conclusions

In general, the reference genomes assembled in the study facilitate our understanding of resistance mechanism of perennial fruit crops, and provide valuable resources for future breeding and improvement.
Role of circulating polyunsaturated fatty acids on cardiovascular diseases risk: analysis using Mendelian randomization and fatty acid genetic association data from over 114,000 UK Biobank participants
Authors: Borges Maria Carolina , Haycock Philip C. , Zheng Jie , Hemani Gibran , Holmes Michael V. , Davey Smith George , Hingorani Aroon D. , Lawlor Deborah A.
Published: June 2022

Background

Despite early interest in the health effects of polyunsaturated fatty acids (PUFA), there is still substantial controversy and uncertainty on the evidence linking PUFA to cardiovascular diseases (CVDs). We investigated the effect of plasma concentration of omega-3 PUFA (i.e. docosahexaenoic acid (DHA) and total omega-3 PUFA) and omega-6 PUFA (i.e. linoleic acid and total omega-6 PUFA) on the risk of CVDs using Mendelian randomization.

Methods

We conducted the largest genome-wide association study (GWAS) of circulating PUFA to date including a sample of 114,999 individuals and incorporated these data in a two-sample Mendelian randomization framework to investigate the involvement of circulating PUFA on a wide range of CVDs in up to 1,153,768 individuals of European ancestry (i.e. coronary artery disease, ischemic stroke, haemorrhagic stroke, heart failure, atrial fibrillation, peripheral arterial disease, aortic aneurysm, venous thromboembolism and aortic valve stenosis).

Results

GWAS identified between 46 and 64 SNPs for the four PUFA traits, explaining 4.8–7.9% of circulating PUFA variance and with mean F statistics >100. Higher genetically predicted DHA (and total omega-3 fatty acids) concentration was related to higher risk of some cardiovascular endpoints; however, these findings did not pass our criteria for multiple testing correction and were attenuated when accounting for LDL-cholesterol through multivariable Mendelian randomization or excluding SNPs in the vicinity of the FADS locus. Estimates for the relation between higher genetically predicted linoleic acid (and total omega-6) concentration were inconsistent across different cardiovascular endpoints and Mendelian randomization methods. There was weak evidence of higher genetically predicted linoleic acid being related to lower risk of ischemic stroke and peripheral artery disease when accounting by LDL-cholesterol.

Conclusions

We have conducted the largest GWAS of circulating PUFA to date and the most comprehensive Mendelian randomization analyses. Overall, our Mendelian randomization findings do not support a protective role of circulating PUFA concentration on the risk of CVDs. However, horizontal pleiotropy via lipoprotein-related traits could be a key source of bias in our analyses.
Impact of the ACOSOG Z0011 trial on surgical practice in Asian patients: trends in axillary surgery for breast cancer from a Korean Breast Cancer Registry analysis
Authors: Cha Chihwan , Kim Eun Young , Kim Sung Yong , Ryu Jai Min , Park Min Ho , Lee Seokwon , Suh Young-jin , Choi Nayeon , Hong Hanpyo , Kim Hyung Suk , Chung Min Sung ,   Korean Breast Cancer Society
Published: June 2022

Background

Since the publication of the Z0011 trial, practice-changing clinical guidelines for breast surgery have been developed. Although recent studies confirmed the feasibility of the Z0011 strategy in Asian populations, there has been no study on the trends of axillary surgery in Asian cohort. This study aimed to investigate the time trend of axillary surgery for breast cancer from a Korean Breast Cancer Registry to understand the impact of the Z0011 trial in Asian patients.

Methods

We collected prospectively constructed data from the nationwide Korean Breast Cancer Registry (KBCR). We identified patients who underwent sentinel node biopsy followed by breast-conserving surgery from 2011 to 2018 and were found to have pathological stage T1-2N1-3M0 disease. Regression analyses were performed to compare the downward trend of axillary lymph node dissection (ALND) in Korean cohort with that previously reported in a Dutch cohort.

Results

From KBCR data, 7478 patients met the inclusion criteria. The proportion of ALND significantly decreased from 2011 (76.6%) to 2018 (47.5%). Multivariate analysis revealed that earlier years at diagnosis, larger tumor size, and lymphatic invasion were associated with a higher odds ratio of performing ALND. Compared to the Dutch cohort, the downward trend of ALND in Korea was significantly more gradual (annual percent change: 37.2 vs. 5.8%, p < 0.001).

Conclusions

This study demonstrated a downward trend of ALND in Korean patients with breast cancer. However, the rate of decrease was significantly slower than that in the Dutch cohort.
The U.S. Global Gag Rule in Ethiopia: a foreign policy challenging domestic sexual and reproductive health and rights gains
Authors: Vernaelde Jamie M.
Published: June 2022

Background

Ethiopia’s government and civil society have driven crosscutting initiatives in the last 15 years to improve sexual and reproductive health outcomes, including passing a 2005 abortion law that facilitated reduced rates of maternal death due to unsafe abortion. However, both the government and nongovernmental organizations have relied on external funding for sexual and reproductive health and rights, particularly from the U.S. government, which has been Ethiopia’s largest global health donor. This article explores how the implementation and expansion of the 2017–2021 U.S. foreign policy “Protecting Life in Global Health Assistance,” also known as the Global Gag Rule—which attached itself to a nongovernmental organization’s funding—impacted sexual and reproductive health and rights, including safe abortion care, in Ethiopia.

Methods

This article is based on research conducted by PAI staff in Ethiopia in 2018 with follow-up in 2019. PAI held in-depth semistructured interviews with representatives of 30 organizations in Ethiopia’s capital, Addis Ababa. Among these groups were U.S.-based and non-U.S. nongovernmental organizations, including community-based organizations, non-U.S. government donors, and Ethiopian government officials.

Results

Nongovernmental organizations have been essential to sexual and reproductive health service provision and advocacy in Ethiopia. Because of the sector’s reliance on U.S. global health assistance, these organizations; their activities; and, consequently, the wider health system were negatively impacted by the Global Gag Rule. Certain vulnerable groups, particularly adolescents and youth, have traditionally relied on the private sector for sexual and reproductive health services. PAI’s research demonstrates that U.S. policy disrupted activities and service delivery, threatened the closure of private clinics, stalled mobile outreach, and impacted safe abortion training of health personnel. Additionally, the Global Gag Rule dismantled partnerships, affected non-U.S. government donors’ investments, and caused confusion that limited activities permissible under the policy.

Conclusions

The Trump administration’s Global Gag Rule forced non-U.S. organizations to choose between providing comprehensive care or losing U.S. global health assistance, ultimately impacting populations in need of services. Ethiopia provides a clear example of how the Global Gag Rule can threaten a country’s domestic health agenda by targeting nongovernmental organizations that are vital to health service delivery and safe abortion care.