bluuebunny/crossref_metadata_2025 huggingface dataset:
Spiroplasma species as a rare cause of congenital cataract and uveitis: a case series
Authors: Farassat Navid , Reich Michael , Serr Annerose , Küchlin Sebastian , Erwemi Marwa , Auw-Hädrich Claudia , Krastel Hermann , Lagrèze Wolf Alexander
Published: December 2021

Background

To date, only four cases of ocular spiroplasma infection have been reported in the entire ophthalmic literature. We add two more cases to raise awareness of this sight-threatening congenital disease that manifests as cataract with ocular inflammation.

Case presentation

Both infants were referred for cataracts associated with ocular inflammation. Case 1, a 3-week-old neonate presented with unilateral cataract, ocular inflammation and elevated intraocular pressure. Case 2 was a 3-month-old infant with bilateral cataract and panuveitis. Lensectomies with or without vitrectomy and subsequent analyses of the specimens were performed. Transmission electron microscopy and multiplex polymerase chain reaction or 16 s rRNA gene polymerase chain reaction revealed spiroplasma species.

Conclusions

Spiroplasma as a very rare cause for congenital cataract might be underdiagnosed. We recommend performing polymerase chain reaction to probe for spiroplasma species in congenital cataracts with an inflammatory component.
Visual acuity and anatomical changes following vitrectomy for epiretinal membrane foveoschisis: a case series
Authors: Photcharapongsakul Chaiyaphot , Chokesuwattanaskul Susama , Choovuthayakorn Janejit , Chaikitmongkol Voraporn , Kunavisarut Paradee , Watanachai Nawat , Patikulsila Direk
Published: December 2021

Purpose

To evaluate the visual outcome and macular anatomic structures on spectral-domain optical coherence tomography (SD-OCT) of patients with epiretinal membrane (ERM) foveoschisis who underwent vitrectomy.

Methods

A retrospective cohort, interventional, case series.

Participants

Fourteen patients (14 eyes) with central vision loss from an ERM foveoschisis underwent vitrectomy at Chiang Mai University Hospital from 2017 to 2018 and had a follow-up period of 12 months.

Interventions

The 23G vitrectomy with ERM and internal limiting membrane (ILM) peeling was performed by a single surgeon.

Main outcomes

Best-corrected visual acuity (BCVA) and anatomic appearance on SD-OCT were assessed at the time of preoperative evaluations and post-operative follow-ups at 1, 3, 6, and 12 months.

Results

Fourteen patients with a mean (SD) age of 67.9 (7.9) years and a mean (SD) visual acuity (VA) of 0.6 (0.1) LogMAR units were included in this study. Significant VA improvements were observed at the 3-month (0.43 (0.14) LogMAR unit), 6-month (0.45 (0.16) LogMAR unit) and 12-month (0.37 (0.21) LogMAR unit) post-operative visits compared to baseline, all with P-values < 0.001. At month 12, there were vision improvements of ≥3 lines in 8 (57.2%) patients, vision improvements of 1 or 2 lines in 2 (14.3%) patients, vision remained at the same line of pre-operation in 3 (21.4%) patients, and vision decreased by 1 line in 1 (7.1%) patient. Regarding the anatomical outcomes, 13 (92.9%) patients achieved anatomical foveal restoration, while one had persistent intraretinal schisis at the 12-month follow-up. The median time to achieve a foveal restoration was 3 months. No significant visual impairments were observed post-operatively.

Conclusion

In patients with central vision loss from ERM foveoschisis, vitrectomy with ILM stripping tended to improve both visual and anatomical outcomes.
A rare case of fetus in fetu in the sacrococcygeal region: CT and MRI findings
Authors: Lu Tao , Ma Junmei , Yang Xudan
Published: December 2021

Background

Fetus in fetu is a rare condition in which a malformed fetus is found in the body of a living twin. The retroperitoneum is the most common location of this condition. However, the sacrococcygeal region is a rare site of the disease. The presence of vertebral bodies and limbs differentiates FIF from teratoma. Imaging modalities are important for diagnosing FIF.

Case presentation

A 12-months old boy was hospitalized because of a mass in the sacrococcygeal region. CT showed a large, complex mass with bony structure resembling sacrococcygeal bone, hip bone and the femur in the sacrococcygeal region of the boy. The blood supply of the mass was from the aorta of the host. MRI revealed the mass was connected with the dilated sacral canal of the host, which resulted in tethered cord. A preoperative diagnosis of FIF was made and surgery was performed to remove the mass. Surgical removal and subsequent pathological examination revealed the anencephalic fetus had limb buds and a sacrum but no axial skeleton, which supported the diagnosis of FIF. Conclusions CT and MRI played important roles in diagnosing FIF based on the location of the lesion.
Trend on dental caries status and its risk indicators in children aged 12 years in China: a multilevel analysis based on the repeated national cross-sectional surveys in 2005 and 2015
Authors: Li Fei , Wu Si-Cheng , Zhang Zhi-Yuan , Lo Edward Chin Man , Gu Wen-Jia , Tao Dan-Ying , Wang Xing , Tai Bao-Jun , Hu De-Yu , Lin Huan-Cai , Wang Bo , Si Yan , Wang Chun-Xiao , Zheng Shu-Guo , Liu Xue-Nan , Rong Wen-Sheng , Wang Wei-Jian , Feng Xi-Ping , Lu Hai-Xia
Published: December 2021

Background

This study aimed to explore the trend and risk indicators for dental caries of children aged 12 years in China based on national oral health survey data in 2005 and 2015.

Methods

Research data were from the two latest national oral health surveys conducted in mainland China, including 30 and 31 provinces, autonomous regions, and municipalities in 2005 and 2015, respectively. Children aged 12 years were clinically examined for dental caries and dental fluorosis according to the World Health Organization criteria. Sociodemographic characteristics and oral health-related behaviours were collected using questionnaires. Multilevel zero-inflated negative binomial regression model was used to investigate the association between dental caries severity and dental fluorosis, sociodemographic characteristics, and oral health-related behaviours.

Results

The final analyses included 12,350 and 27,818 children surveyed in 2005 and 2015, respectively. The standardized prevalence of dental caries increased from 27.05% (95% confidence interval [CI], 24.25-28.85) in 2005 to 37.92% (95% CI, 34.94-40.90) in 2015, and the respective standardized mean decayed, missing, filled teeth (DMFT) index scores increased from 0.50 (standard deviation [SD], 1.04) to 0.83 (SD, 1.45) (P < 0.001). Fujian province had the highest increase in dental caries, followed by Liaoning, Heilongjiang, Hainan, and Yunnan. Results revealed that children who were girls, more frequently experienced dental pain, and had more recent dental visits, had significantly higher DMFT scores after adjusting for the survey year and other variables (all P < 0.05).

Conclusions

Dental caries of 12-year-old children in China deteriorated from 2005 to 2015, particularly in the northeast and southwest regions. Dental caries was associated with sex, dental pain, and dental service utilization.
Human-centered design process and solutions to promote malaria testing and treatment seeking behavior in Guyana hinterlands
Authors: Yan Shirley D. , Simpson Joann , Mitchum Lyndsey , Orkis Jennifer , Davis TrishAnn , Wilson Sean , Trotman Neil , Imhoff Helen , Cox Horace , Hunter Gabrielle , Olapeju Bolanle , Adams Camille , Storey J. Douglas
Published: December 2021

Background

Malaria is a persistent public health challenge among miners and other hard-to-reach populations in Guyana’s hinterland, specifically in Regions 1, 7, 8, and 9. Despite an overall decrease in malaria prevalence throughout Guyana, it remains common among mining populations whose work conditions both contribute toward malaria transmission and make it difficult to seek timely, Ministry of Health (MoH) approved malaria testing and treatment services. In an effort to develop innovative approaches to address this public health challenge, an interdisciplinary team of public health professionals, designers, and mining organizations collaborated using a human-centered design (HCD) process facilitated by the USAID-funded Breakthrough ACTION Guyana project in partnership with the MoH.

Methods

This paper describes two phases: [1] Define and [2] Design & Test. In the Define phase, following a literature review, we conducted 108 qualitative interviews with miners, camp managers, trained malaria testers, health workers, and other key stakeholders to understand experiences and challenges when seeking malaria testing and treatment services. These interviews were synthesized into 11 insights on issues such as risk perception, malaria knowledge, preventive behaviors, traditional and self-treatment, adherence to the correct treatment, testing, and coordination and communication gaps. From these insights, during the Design & Test phase, we developed 33 “How might we…?” questions which led to 792 ideas, of which eight emergent concepts were prototyped and refined in the field with 145 miners, camp managers, and stakeholders.

Results

The five final prototypes included: “Little Mosquito, Big Problem” social behavior change campaign; rapid counseling cards; branded malaria testing and treatment services; innovations in treatment adherence; and a participants, content, and logistics approach.

Conclusion

When applying HCD to public health issues, there are both opportunities and challenges to reconcile gaps that may exist between the two disciplines. However, HCD provides additional tools and mindsets to generatively work with migrant and mobile mining communities to encourage malaria testing and treatment services.
Occupational risk factors for meniscal lesions: a systematic review and meta-analysis
Authors: Bahns Carolin , Bolm-Audorff Ulrich , Seidler Andreas , Romero Starke Karla , Ochsmann Elke
Published: December 2021

Background

Meniscal lesions are common and are associated with the development of knee osteoarthritis. Knee-straining activities at work such as kneeling or squatting cause high biomechanical stresses on the knee joints that can lead to acute or chronic injuries. The objective of this systematic review is to update the evidence on the potential relationship between occupational risk factors and meniscal lesions.

Methods

We searched the Medline, Embase and Web of Science databases until August 2021 to identify epidemiological observational studies on the association between occupational risk factors and meniscal lesions. Study selection, data extraction and risk of bias assessment were performed independently by two reviewers. Effect measures were extracted from individual studies and pooled with random effects meta-analysis. Heterogeneity analyses were conducted. We used GRADE (Grades of Recommendations, Assessment, Development and Evaluation) to assess the overall quality of evidence.

Results

The database search resulted in 11,006 references, and 46 additional studies were identified through hand search. Twenty-two studies (represented in 25 publications) met the predefined eligibility criteria and nine records were included in the meta-analysis. There was only one study with an overall low risk of bias. Significant associations between occupational risk factors and the development of meniscal lesions were found for kneeling (effect size (ES) 2.15, 95% CI 1.67–2.76), squatting (ES 2.01, 95% CI 1.34–3.03), climbing stairs (ES 2.28, 95% CI 1.58–3.30), lifting and carrying weights ≥ 10 kg (ES 1.63, 95% CI 1.35–1.96), lifting and carrying weights ≥ 25 kg (ES 1.56, 95% CI 1.08–2.24), playing football on a professional level (ES 5.22, 95% CI 3.24–8.41), working as a hard coal miner (ES 5.23, 95% CI 2.16–12.69) and floor layers (ES 1.99, 95% CI 1.43–2.78). The overall quality of evidence according GRADE was moderate to low.

Conclusion

We found consistent evidence of an increased risk of meniscal lesions by occupational knee-straining exposures. Our findings are important for the development of preventive strategies to reduce work-related knee disorders and work absence.

Trial registration

PROSPERO (registration no.CRD42020196279).
Polymicrobial synergy stimulates Porphyromonas gingivalis survival and gingipain expression in a multi-species subgingival community
Authors: Davies Julia R. , Kad Trupti , Neilands Jessica , Kinnby Bertil , Prgomet Zdenka , Bengtsson Torbjörn , Khalaf Hazem , Svensäter Gunnel
Published: December 2021

Background

Dysbiosis in subgingival microbial communities, resulting from increased inflammatory transudate from the gingival tissues, is an important factor in initiation and development of periodontitis. Dysbiotic communities are characterized by increased numbers of bacteria that exploit the serum-like transudate for nutrients, giving rise to a proteolytic community phenotype. Here we investigate the contribution of interactions between members of a sub-gingival community to survival and development of virulence in a serum environment—modelling that in the subgingival pocket.

Methods

Growth and proteolytic activity of three Porphyromonas gingivalis strains in nutrient broth or a serum environment were assessed using A600 and a fluorescent protease substrate, respectively. Adherence of P. gingivalis strains to serum-coated surfaces was studied with confocal microscopy and 2D-gel electrophoresis of bacterial supernatants used to investigate extracellular proteins. A model multi-species sub-gingival community containing Fusobacterium nucleatum, Streptococcus constellatus, Parvimonas micra with wild type or isogenic mutants of P. gingivalis was then created and growth and proteolytic activity in serum assessed as above. Community composition over time was monitored using culture techniques and qPCR.

Results

The P. gingivalis strains showed different growth rates in nutrient broth related to the level of proteolytic activity (largely gingipains) in the cultures. Despite being able to adhere to serum-coated surfaces, none of the strains was able to grow alone in a serum environment. Together in the subgingival consortium however, all the included species were able to grow in the serum environment and the community adopted a proteolytic phenotype. Inclusion of P. gingivalis strains lacking gingipains in the consortium revealed that community growth was facilitated by Rgp gingipain from P. gingivalis.

Conclusions

In the multi-species consortium, growth was facilitated by the wild-type and Rgp-expressing strains of P. gingivalis, suggesting that Rgp is involved in delivery of nutrients to the whole community through degradation of complex protein substrates in serum. Whereas they are constitutively expressed by P. gingivalis in nutrient broth, gingipain expression in the model periodontal pocket environment (serum) appeared to be orchestrated through signaling to P. gingivalis from other members of the community, a phenomenon which then promoted growth of the whole community.
Relationship between DMFT index and number of pregnancies: a cross-sectional study on enrollment phase of the Tabari Cohort Study
Authors: Gorji Nadia Elyassi , Nasiri Pegah , Shafaroudi Ali Malekzadeh , Shahhosseini Zohreh , Hamzehgardeshi Zeinab , Moosazadeh Mahmood
Published: December 2021

Background

People of all age and gender groups are at risk of dental diseases; however, some groups, such as pregnant women, are more vulnerable than others due to their specific physiological situations. The protection of maternal and fetal is critical. Therefore, the present study intended to investigate the relationship between the Decayed, Missing, and Filled Teeth (DMFT) index and the number of pregnancies.

Methods

The present cross-sectional study was performed using the Tabari Cohort Study (T.C.S.) data. Data of 5,496 women enrolled in the T.C.S. were included in the study. After obtaining the approval of the Ethics Committee, the related data on the variables of age, age at the first pregnancy, number of pregnancies, total number of teeth at the time of examination, number of DMFT, employment status, socioeconomic status, educational level, residence location, body mass index, and the status of diabetes mellitus, hypertension, and cardiovascular diseases were extracted. Finally, data analysis was performed in the STATA software (version 14).

Results

The mean DMFT index in women with 1, 2, 3, 4, 5, 6, and more than six pregnancies were obtained at 12.74 ± 7.11, 13.09 ± 7.06, 14.80 ± 7.81, 17.07 ± 8.11, 19.82 ± 9.02, 22.89 ± 8.98, and 26.17 ± 8.01, respectively (P < 0.001). Using the multivariate linear regression and adjusting the effect of potential confounding variables, it was found that the DMFT index increased by 34% for each unit increase in the number of pregnancies (β = 0.34, P < 0.001).

Conclusions

According to our results, there was a significant relationship between the DMFT index and the number of pregnancies. The DMFT index was increased with an increased number of pregnancies. Therefore, oral healthcare promotion should receive special attention in healthcare planning and related policies by raising awareness and providing easy access to dental services for women of childbearing age, especially pregnant women.
Maintenance of low driving pressure in patients with early acute respiratory distress syndrome significantly affects outcomes
Authors: Chang Hui-Chun , Ho Chung-Han , Kung Shu-Chen , Chen Wan-Lin , Wang Ching-Min , Cheng Kuo-Chen , Liu Wei-Lun , Hsu Han-Shui
Published: December 2021

Background

Driving pressure (∆P) is an important factor that predicts mortality in acute respiratory distress syndrome (ARDS). We test the hypothesis that serial changes in daily ΔP rather than Day 1 ΔP would better predict outcomes of patients with ARDS.

Methods

This retrospective cohort study enrolled patients admitted to five intensive care units (ICUs) at a medical center in Taiwan between March 2009 and January 2018 who met the criteria for ARDS and received the lung-protective ventilation strategy. ∆P was recorded daily for 3 consecutive days after the diagnosis of ARDS, and its correlation with 60-day survival was analyzed.

Results

A total of 224 patients were enrolled in the final analysis. The overall ICU and 60-day survival rates were 52.7% and 47.3%, respectively. ∆P on Days 1, 2, and 3 was significantly lower in the survival group than in the nonsurvival group (13.8 ± 3.4 vs. 14.8 ± 3.7, p = 0.0322, 14 ± 3.2 vs. 15 ± 3.5, p = 0.0194, 13.6 ± 3.2 vs. 15.1 ± 3.4, p = 0.0014, respectively). The patients were divided into four groups according to the daily changes in ∆P, namely, the low ∆P group (Day 1 ∆P < 14 cmH2O and Day 3 ∆P < 14 cmH2O), decrement group (Day 1 ∆P ≥ 14 cmH2O and Day 3 ∆P < 14 cmH2O), high ∆P group (Day 1 ∆P ≥ 14 cmH2O and Day 3 ∆P ≥ 14 cmH2O), and increment group (Day 1 ∆P < 14 cmH2O and Day 3 ∆P ≥ 14 cmH2O). The 60-day survival significantly differed among the four groups (log-rank test, p = 0.0271). Compared with the low ΔP group, patients in the decrement group did not have lower 60-day survival (adjusted hazard ratio 0.72; 95% confidence interval [CI] 0.31–1.68; p = 0.4448), while patients in the increment group had significantly lower 60-day survival (adjusted hazard ratio 1.96; 95% CI 1.11–3.44; p = 0.0198).

Conclusions

Daily ∆P remains an important predicting factor for survival in patients with ARDS. Serial changes in daily ΔP might be more informative than a single Day 1 ΔP value in predicting survival of patients with ARDS.
Delta radiomics analysis of Magnetic Resonance guided radiotherapy imaging data can enable treatment response prediction in pancreatic cancer
Authors: Tomaszewski M. R. , Latifi K. , Boyer E. , Palm R. F. , El Naqa I. , Moros E. G. , Hoffe S. E. , Rosenberg S. A. , Frakes J. M. , Gillies R. J.
Published: December 2021

Background

Magnetic Resonance Image guided Stereotactic body radiotherapy (MRgRT) is an emerging technology that is increasingly used in treatment of visceral cancers, such as pancreatic adenocarcinoma (PDAC). Given the variable response rates and short progression times of PDAC, there is an unmet clinical need for a method to assess early RT response that may allow better prescription personalization. We hypothesize that quantitative image feature analysis (radiomics) of the longitudinal MR scans acquired before and during MRgRT may be used to extract information related to early treatment response.

Methods

Histogram and texture radiomic features (n = 73) were extracted from the Gross Tumor Volume (GTV) in 0.35T MRgRT scans of 26 locally advanced and borderline resectable PDAC patients treated with 50 Gy RT in 5 fractions. Feature ratios between first (F1) and last (F5) fraction scan were correlated with progression free survival (PFS). Feature stability was assessed through region of interest (ROI) perturbation.

Results

Linear normalization of image intensity to median kidney value showed improved reproducibility of feature quantification. Histogram skewness change during treatment showed significant association with PFS (p = 0.005, HR = 2.75), offering a potential predictive biomarker of RT response. Stability analyses revealed a wide distribution of feature sensitivities to ROI delineation and was able to identify features that were robust to variability in contouring.

Conclusions

This study presents a proof-of-concept for the use of quantitative image analysis in MRgRT for treatment response prediction and providing an analysis pipeline that can be utilized in future MRgRT radiomic studies.
WNT11/ROR2 signaling is associated with tumor invasion and poor survival in breast cancer
Authors: Menck Kerstin , Heinrichs Saskia , Wlochowitz Darius , Sitte Maren , Noeding Helen , Janshoff Andreas , Treiber Hannes , Ruhwedel Torben , Schatlo Bawarjan , von der Brelie Christian , Wiemann Stefan , Pukrop Tobias , Beißbarth Tim , Binder Claudia , Bleckmann Annalen
Published: December 2021

Background

Breast cancer has been associated with activation of the WNT signaling pathway, although no driver mutations in WNT genes have been found yet. Instead, a high expression of the alternative WNT receptor ROR2 was observed, in particular in breast cancer brain metastases. However, its respective ligand and downstream signaling in this context remained unknown.

Methods

We modulated the expression of ROR2 in human breast cancer cells and characterized their gene and protein expression by RNA-Seq, qRT-PCR, immunoblots and reverse phase protein array (RPPA) combined with network analyses to understand the molecular basis of ROR2 signaling in breast cancer. Using co-immunoprecipitations, we verified the interaction of ROR2 with the identified ligand, WNT11. The functional consequences of WNT11/ROR2 signaling for tumor cell aggressiveness were assessed by microscopy, impedance sensing as well as viability and invasion assays. To evaluate the translational significance of our findings, we performed gene set enrichment, expression and survival analyses on human breast cancer brain metastases.

Results

We found ROR2 to be highly expressed in aggressive breast tumors and associated with worse metastasis-free survival. ROR2 overexpression induced a BRCAness-like phenotype in a cell-context specific manner and rendered cells resistant to PARP inhibition. High levels of ROR2 were furthermore associated with defects in cell morphology and cell-cell-contacts leading to increased tumor invasiveness. On a molecular level, ROR2 overexpression upregulated several non-canonical WNT ligands, in particular WNT11. Co-immunoprecipitation confirmed that WNT11 indeed interacts with the cysteine-rich domain of ROR2 and triggers its invasion-promoting signaling via RHO/ROCK. Knockdown of WNT11 reversed the pro-invasive phenotype and the cellular changes in ROR2-overexpressing cells.

Conclusions

Taken together, our study revealed a novel auto-stimulatory loop in which ROR2 triggers the expression of its own ligand, WNT11, resulting in enhanced tumor invasion associated with breast cancer metastasis.
Epidemiological and clinical aspects of immunoglobulin A vasculitis in childhood: a retrospective cohort study
Authors: Breda Luciana , Carbone Ilaria , Casciato Isabella , Gentile Cristina , Grasso Eleonora Agata , di Donato Giulia , Chiarelli Francesco , Verrotti Alberto
Published: December 2021

Background

A retrospective study was conducted in order to investigate and describe the characteristics of Immunoglobulin A vasculitis (IgAV), previously known as Henoch-Schӧnlein purpura, in the paediatric population of a community-based healthcare delivery system in the Italian region of Abruzzo.

Methods

This is a population-based retrospective chart review of the diagnosis of IgAV in children ages 0 to 18, admitted to the Department of Paediatrics of Chieti and Pescara between 1 January 2000 and 31 December 2016. All children enrolled presented with clinical symptoms and laboratory findings and met the EULAR/PRINTO/PRES 2008 criteria.

Results

Two-hundred-eight children met the criteria for IgAV, with the highest incidence reported among children below 7-years of age. A correlation with recent infections was found in 64% of the cohort; the onset was more frequently during the winter and fall. Purpura had a diffuse distribution in the majority of patients; joint impairment was the second most frequent symptom (43%), whereas the gastrointestinal tract was involved in 28% of patients.

Conclusions

Hereby, we confirm the relative benignity of IgAV in a cohort of Italian children; with regards to renal involvement, we report a better outcome compared to other studies. However, despite the low rate of renal disease, we observed a wide use of corticosteroids, especially for the treatment of persistent purpura.
Plastidial wax ester biosynthesis as a tool to synthesize shorter and more saturated wax esters
Authors: Vollheyde Katharina , Hornung Ellen , Herrfurth Cornelia , Ischebeck Till , Feussner Ivo
Published: December 2021

Background

Wax esters (WE) are neutral lipids that consist of a fatty alcohol esterified to a fatty acid. WE are valuable feedstocks in industry for producing lubricants, coatings, and cosmetics. They can be produced chemically from fossil fuel or plant-derived triacylglycerol. As fossil fuel resources are finite, the synthesis of WE in transgenic plants may serve as an alternative source. As chain length and desaturation of the alcohol and acyl moieties determine the physicochemical properties of WE and their field of application, tightly controlled and tailor-made WE synthesis in plants would be a sustainable, beneficial, and valuable commodity. Here, we report the expression of ten combinations of WE producing transgenes inArabidopsis thaliana. In order to study their suitability for WE productionin planta, we analyzed WE amount and composition in the transgenic plants.

Results

The transgenes consisted of different combinations of aFATTY ACYL-COA/ACP REDUCTASE(FAR) and twoWAX SYNTHASES/ACYL-COA:DIACYLGLYCEROLO-ACYLTRANSFERASES(WSD), namelyWSD2andWSD5from the bacteriumMarinobacter aquaeoleoi. We generated constructs with and without plastidial transit peptides to access distinct alcohol and acyl substrate pools withinA. thalianacells. We observed WE formation with plastid and cytosol-localized FAR and WSD in seeds. A comparative WE analysis revealed the production of shorter and more saturated WE by plastid-localized WE biosynthesis compared to cytosolic WE synthesis.

Conclusions

A shift of WE formation into seed plastids is a suitable approach for tailor-made WE production and can be used to synthesize WE that are mainly derived from mid- and long-chain saturated and monounsaturated substrates.
Improved methanol tolerance of Rhizomucor miehei lipase based on N‑glycosylation within the α-helix region and its application in biodiesel production
Authors: Tian Miao , Yang Lingmei , Wang Zhiyuan , Lv Pengmei , Fu Junying , Miao Changlin , Li Ming , Liu Tao , Luo Wen
Published: December 2021

Background

Liquid lipases are widely used to convert oil into biodiesel. Methanol-resistant lipases with high catalytic activity are the first choice for practical production. Rhizomucor miehei lipase (RML) is a single-chain α/β-type protein that is widely used in biodiesel preparation. Improving the catalytic activity and methanol tolerance of RML is necessary to realise the industrial production of biodiesel.

Results

In this study, a semi-rational design method was used to optimise the catalytic activity and methanol tolerance of ProRML. After N-glycosylation modification of the α-helix of the mature peptide in ProRML, the resulting mutants N218, N93, N115, N260, and N183 increased enzyme activity by 66.81, 13.54, 10.33, 3.69, and 2.39 times than that of WT, respectively. The residual activities of N218 and N260 were 88.78% and 86.08% after incubation in 50% methanol for 2.5 h, respectively. In addition, the biodiesel yield of all mutants was improved when methanol was added once and reacted for 24 h with colza oil as the raw material. N260 and N218 increased the biodiesel yield from 9.49% to 88.75% and 90.46%, respectively.

Conclusions

These results indicate that optimising N-glycosylation modification in the α-helix structure is an effective strategy for improving the performance of ProRML. This study provides an effective approach to improve the design of the enzyme and the properties of lipase mutants, thereby rendering them suitable for industrial biomass conversion.
Congenital ureterovaginal fistula: a rare case of single-system ectopic ureter with ipsilateral ectopic kidney managed by vaginal approach: a case report
Authors: Amenu Demisew , Asmare Andebet , Siraj Ahmed
Published: December 2021

Background

Diagnosing urinary incontinence from organic causes such as ectopic ureter is particularly important because of the potential for cure by surgical correction. The prevalence of ectopic ureter is uncertain because many are asymptomatic and the diagnosis is usually overlooked. Eighty percent of ectopic ureters in females are often associated with duplex kidney. However, an ectopic ureter draining a single-system ectopic dysplastic/atrophic but functioning kidney is rare, especially in females. The overall long-term continence rate after successful correction of ectopic ureter is satisfactory.

Case presentation

This case is reported to highlight a rare situation, where a 22-year-old nulligravid Ethiopian women presented with a complaint of continuous wetting of her underwear since childhood, but she had normal voiding pattern. Localized right pelvic kidney ultrasound and computed tomography scan with contrast revealed right ectopic ureter and atrophied ipsilateral pelvic kidney with good function. Surgical reimplantation through vaginal approach was performed, and the outcome was good. The patient’s subsequent follow-ups were uneventful.

Conclusion

An extramural vaginal ectopic ureter is better accessed through transvaginal approach than abdominal, especially when it is associated with pelvic ectopic kidney. This modified approach is less invasive and has lower morbidity and better success rate than a transabdominal approach.
Impact of the COVID-19 pandemic on the mental health and wellbeing of parents with young children: a qualitative interview study
Authors: Dawes Jo , May Tom , McKinlay Alison , Fancourt Daisy , Burton Alexandra
Published: December 2021

Background

Parents have faced unique challenges during the coronavirus disease 2019 (COVID-19) pandemic, including mobility constraints, isolation measures, working from home, and the closure of schools and childcare facilities. There is presently a lack of in-depth qualitative research exploring how these changes have affected parents’ mental health and wellbeing.

Methods

Semi-structured qualitative interviews with 29 parents of young children. Interviews were analysed using reflexive thematic analysis.

Results

We identified five superordinate themes affecting participant mental health and wellbeing: (1) navigation of multiple responsibilities and change inside the home; (2) disruption to home life; (3) changes to usual support networks; (4) changes in personal relationships; and (5) use of coping strategies. Participants described stress and exhaustion from navigating multiple pressures and conflicting responsibilities with home, schooling, and work, without their usual support networks and in the context of disrupted routines. Family roles and relationships were sometimes tested, however, many parents identified coping strategies that protected their wellbeing including access to outdoor space, spending time away from family, and avoiding conflict and pandemic-related media coverage.

Conclusions

Employers must be cognisant of the challenges that the pandemic has placed on parents, particularly women and lone parents. Flexible working arrangements and support might therefore relieve stress and increase productivity. Coping strategies identified by parents in this study could be harnessed and encouraged by employers and policymakers to promote positive wellbeing during times of stress throughout the pandemic and beyond.
A graphical method of cumulative differences between two subpopulations
Authors: Tygert Mark
Published: December 2021

Comparing the differences in outcomes (that is, in “dependent variables”) between two subpopulations is often most informative when comparing outcomes only for individuals from the subpopulations who are similar according to “independent variables.” The independent variables are generally known as “scores,” as in propensity scores for matching or as in the probabilities predicted by statistical or machine-learned models, for example. If the outcomes are discrete, then some averaging is necessary to reduce the noise arising from the outcomes varying randomly over those discrete values in the observed data. The traditional method of averaging is to bin the data according to the scores and plot the average outcome in each bin against the average score in the bin. However, such binning can be rather arbitrary and yet greatly impacts the interpretation of displayed deviation between the subpopulations and assessment of its statistical significance. Fortunately, such binning is entirely unnecessary in plots of cumulative differences and in the associated scalar summary metrics that are analogous to the workhorse statistics of comparing probability distributions—those due to Kolmogorov and Smirnov and their refinements due to Kuiper. The present paper develops such cumulative methods for the common case in which no score of any member of the subpopulations being compared is exactly equal to the score of any other member of either subpopulation.
Dietary supplements consumption and its association with socioeconomic factors, obesity and main non-communicable chronic diseases in the north of Iran: the PERSIAN Guilan Cohort Study (PGCS)
Authors: Mahdavi-Roshan Marjan , Rezazadeh Arezoo , Joukar Farahnaz , Khorshidi Yasaman , Naghipour Mohammadreza , Mansour-Ghanaei Fariborz
Published: December 2021

Background

Dietary supplements (DSs) use have become a growing trend worldwide, and it may be affected by demographic and sociocultural factors. Some people use supplements with the thought that they can improve their health, reduce symptoms and prevent disease. The aim of the present study was to define the frequency of DS use and its association with socioeconomic factors among participants with selected main non-communicable chronic diseases (NCDs) (diabetes, cardiovascular disease (CVD), hypertension (HTN), cancers, and obesity in the north of Iran.

Methods

This large cross-sectional study was conducted as a part of the PERSIAN Guilan cohort study. Supplement use during last year and its type, demographic factors, socioeconomic status, lifestyle habits were asked by face-to-face interview. The history of chronic disease was defined by a trained team. Data were analyzed using SPSS. The chance of supplement use according to demographic, socioeconomic, and lifestyle variables and history of chronic disease was analyzed by logistic regression.

Results

10,520 men and women aged 35–70 years in Some’e Sara County (including urban regions and 39 villages) were studied. About 25% of participants consumed DSs. The highest consumption of DS was calcium/vitamin D (11.1%), ferrous sulfate (8.8%), and vitamin D pearl or ampoule (7.7%). The highest percent of the history of chronic disease was central obesity (62.7%), HTN (43.2%), and general obesity (32.7), respectively. After adjustment for confounders, those with female gender, the highest age ranges (55–65 and > 65 years), high academic education, living in urban regions, and good economic status were more likely to be DSs consumers; however, married and smoker subjects were more likely to consume DS. Participants who had a history of diabetes, HTN, CVD, Obesity, and Central Obesity were more likely to intake DS in comparison with healthy subjects.

Conclusion

This study showed that a quarter of the participants were DS users. Female sex, older age groups, and higher educated participants, and among chronic disease, patients with HTN, CVD, and diabetes were more likely to be users of any DS.
A mobile cesarean birth center as a solution to improve access to surgical birth in rural Ethiopia: a mixed methods research protocol
Authors: Harrison Margo S. , Yarinbab Teklemariam , Dorsey-Holliman Brooke , Aarons Gregory A. , Betran Ana Pilar , Goldenberg Robert L. , Muldrow Margaret
Published: December 2021

Background

As an evidence-based intervention to prevent maternal and neonatal morbidity and mortality, cesarean birth at rates of under 2%, which is the case in rural Southwest Ethiopia, is an unacceptable public health problem and represents an important disparity in the use of this life-saving treatment compared to more developed regions. The objective of this study is to explore an innovative clinical solution (a mobile cesarean birth center) to low cesarean birth rates resulting from the Three Delays to emergency obstetric care in isolated and underserved regions of Ethiopia, and the world.

Methods

We will use mixed but primarily qualitative methods to explore and prepare the mobile cesarean birth center for subsequent implementation in communities in Bench Sheko and West Omo Zones. This will involve interviews and focus groups with key stakeholders and retreat settings for user-centered design activities. We will present stakeholders with a prototype surgical truck that will help them conceive of the cesarean birth center concept and discuss implementation issues related to staffing, supplies, referral patterns, pre- and post-operative care, and relationship to locations for vaginal birth.

Discussion

Completion of our study aims will allow us to describe participants’ perceptions about barriers and facilitators to cesarean birth and their attitudes regarding the appropriateness, acceptability, and feasibility of a mobile cesarean birth center as a solution. It will also result in a specific, measurable, attainable, relevant, and timely (SMART) implementation blueprint(s), with implementation strategies defined, as well as recruitment plans identified. This will include the development of a logic model and process map, a timeline for implementation with strategies selected that will guide implementation, and additional adaptation/adjustment of the mobile center to ensure fit for the communities of interest.

Trial registration

There is no healthcare intervention on human participants occurring as part of this research, so the study has not been registered.
Computational modeling of atrial fibrillation
Authors: Kwon Oh-Seok , Hwang Inseok , Pak Hui-Nam
Published: December 2021

With the aging society, the prevalence of atrial fibrillation (AF) continues to increase. Nevertheless, there are still limitations in antiarrhythmic drugs (AAD) or catheter interventions for AF. If it is possible to predict the outcome of AF management according to various AADs or ablation lesion sets through computational modeling, it will be of great clinical help. AF computational modeling has been utilized for in-silico arrhythmia research and enabled high-density entire chamber mapping, reproducible condition control, virtual intervention, not possible clinically or experimentally, in-depth mechanistic research. With the recent development of computer science and technology, more sophisticated and faster computational modeling has become available for clinical application. In particular, it can be applied to determine the extra-PV target of persistent AF catheter ablation or to select the AAD with the best effect. AF computational modeling combined with artificial intelligence is expected to contribute to precision medicine for more diverse uses in the future. Therefore, in this review, we will deal with the history, development, and various applications of computation modeling.
Using laboratory data to understand how pore aspect ratio influences elastic parameters and amplitude variation with offset
Authors: Moravej Kamal , Malcolm Alison
Published: December 2021

Pore geometry is an important parameter in reservoir characterization that affects the permeability of reservoirs and can also be a controlling factor on the impact of pressure and saturation on reservoirs elastic properties. We have used selective laser sintering 3D printing technology to build physical models to experimentally investigate the impacts of pore aspect ratio on compressional (P-) and shear wave (S-wave) velocities and amplitude variation with offset (AVO). We printed six models to study the effects of the pore aspect ratio of prolate and oblate pore structures on elastic properties and AVO signatures. We found that the P-wave velocity is reduced by decreasing the pore aspect ratio (flatter pore structure), whereas the S-wave velocity is less sensitive to the pore aspect ratio. This effect is reduced when the samples are water saturated. We developed new experimental and processing techniques to extract realistic AVO signatures from our experimental data and found that the pore aspect ratio has similar effects on AVO as fluid compressibility. This indicated that not considering the pore aspect ratio in AVO analysis can lead to misleading interpretations. We also found that these effects are reduced in water-saturated samples.
Reverse time migration with an exact two-way illumination compensation
Authors: Liu Yuzhu , Liu Weigang , Wu Zheng , Yang Jizhong
Published: December 2021

Reverse time migration (RTM) has been widely used for imaging complex subsurface structures in oil and gas exploration. However, because only the adjoint of the forward Born modeling operator is applied to the seismic data in RTM, the output migration profile is biased in terms of amplitude. To help partially balance the amplitude performance, the RTM image can be preconditioned with the inverse of the diagonal of the Hessian operator. Yet, existing preconditioning methods do not correctly consider receiver-side effects, assuming that the receiver coverage is infinite or the velocity model is constant. Therefore, we have provided a comparative study aiming to give a clearer understanding on the importance of incorporating receiver-side effects by developing a frequency-domain scattering-integral reverse time migration (SI-RTM). In our SI-RTM, the diagonal of the Hessian operator is explicitly computed in its exact formulation, and the source-side wavefield and receiver-side Green’s functions are obtained by solving the two-way wave equation. The computational cost is relatively affordable when compared with the more expensive least-squares RTM. In the comparative counterpart, the diagonal of the Hessian operator is approximated by the source-side illumination. We perform two synthetic numerical examples using an overthrust model and a complex reservoir model; the final migration images were significantly improved when receiver-side effects were accurately considered. A third application of SI-RTM on one field data set acquired from the East China Sea further demonstrates the importance of incorporating receiver-side effects in normalizing the RTM image. Our findings are expected to provide a theoretical basis for improving the ability of RTM imaging of subsurface structures, thereby critically advancing the application of geophysical techniques for imaging complex environments.
Experimental quantification of the evolution of the static mechanical properties of tight sedimentary rocks during increasing-amplitude load and unload cycling
Authors: Wang Yang , Zhao Luanxiao , Han De-Hua , Wei Qianqian , Zhang Yonghao , Yuan Hemin , Geng Jianhua
Published: December 2021

Understanding the linearly and nonlinearly elastic behaviors of tight reservoir rocks is crucial for numerous geophysical and geomechanical applications in hydrocarbon exploration and production, geologic repositories for greenhouse gases, and geothermal energy exploitation. We have performed a suite of triaxial load and unload cycling tests with increasing stress amplitudes on three tight sedimentary rocks to explore the evolution of their static mechanical properties (Young’s modulus and Poisson’s ratio). We intend to depict the transition from linear to nonlinear elasticity by combining static measurements with dynamic measurements. The experimental results suggest that static mechanical properties increase upon load stress cycling, but they decrease upon unload stress cycling. Upon the increasing-amplitude unload cycling, static mechanical properties gradually decrease from values approaching dynamic properties to values closer to static properties upon load cycling. By quadratically fitting the static mechanical properties as functions of the strain amplitude in the process of unload cycling, we define a characteristic strain amplitude of approximately 5 × 10−5 to distinguish the linearly elasticity-dominated and nonlinearly elasticity-dominated behaviors for three tight rocks. Such transitional behavior in tight sedimentary rocks can be microscopically explained by the gradual activation of friction-controlled sliding from the beginning of the cyclic stress unload. These observations provide direct experimental evidence of the transition from linear to nonlinear elasticity for tight sedimentary rocks during the laboratory static measurements, which will facilitate understanding of the dynamic-static parameter correlation and the modeling of rock deformations in geoscience or geoengineering applications.