bluuebunny/crossref_metadata_2025 huggingface dataset:
Reconciliationism – a forgotten evangelical doctrine of hell
Authors: Saville Andy
Published: May 2021

Over the last 30 years there has been a growing debate within the evangelical world between traditionalists and annihilationists over the doctrine of hell. However there has been very little discussion of an alternative doctrine of hell proposed by evangelicals in the late nineteenth and early twentieth centuries, in which the damned remain in hell but cease to sin. It is a modified version of the traditional doctrine, but for the sake of clarity I refer to it by the title ‘reconciliationism’. In this article I want to expound the position of its chief advocate, T. R. Birks, as well as the similar position of the contemporary French evangelical theologian, Henri Blocher, who offers the most satisfactory form of this doctrine.
Approaching an Evangelical Anglican concept of authority
Authors: Heaney Robert S.
Published: May 2021

Underlying much of the controversy within the Anglican Communion in relation to the debate on human sexuality is the issue of authority. Indeed, The Windsor Report identifies authority as ‘the key’ to resolving the issues. This article seeks to approach a definition of evangelical Anglicanism with specific reference to the issue of authority and to identify four practical principles arising from such a definition. It is argued that an evangelical understanding of apostolicity will be inherently dialogic. Diversity is accepted in the light of the cross. Receptionism will be practiced, not on the basis of a temporal progressivism, but on the basis of a transformative mission. Catholicity genuinely takes into account the lived experiences and insights of other traditions preventing counterproductive innovation and protecting those who are vulnerable to prejudice.
The fall of man and the failure of Jonathan Edwards
Authors: Beck Peter
Published: May 2021

Creating a coherent doctrine of the fall of man requires of theologians, both past and present, an intellectual effort of Herculean proportions. Jonathan Edwards, regularly described as America’s greatest theologian, struggled to present a coherent interpretation of events in the Garden of Eden that led to Adam’s rejection of God’s righteous plan in favor of an inferior alternative. In light of Edwards’ profound work, Freedom of the Will, this theological dilemma becomes all the more complex. The key to Edwards’ understanding of Adam’s Edenic purity and his mysterious choice of rebellion is found in the doctrine of self-love wherein Adam responded to the innate principle of self-love, choosing that which appeared most pleasurable at that time.
Mission in post-Christendom: Anabaptist and Free Church perspectives
Authors: Randall Ian M.
Published: May 2021

The idea that the missional context in the West is a ‘post-Christendom’ context is increasingly seen as something not only to be acknowledged but celebrated. For several influential writers, Christian identity in the post-Christendom world is clarified when the church loses official power. This article examines how ‘post-Christendom’ thinking has evolved, looking at the influence of views drawn from the sixteenth-century Anabaptists, who rejected the Christendom model. The recovery of Anabaptist perspectives means more attention has been given to mission in pre-Christendom. The article then explores what the Free Church tradition offers when thinking about contemporary mission. While the Free Church view has been that church and state should be separate, the Free Church story includes many examples of mission that seeks to transform society. Finally, the article argues that the growth of non-Western Christianity suggests that Christian communities in non-Christendom settings can increase their influence – without state power.
Theology as queen of hospitality
Authors: Boersma Hans
Published: May 2021

This essay presents an appeal for theology to reassume her regal position by realigning herself with the classical Platonist-Christian synthesis. Both St. Thomas’s highlighting of theology as a science and his at times emphatic naturegrace distinction led to a move ‘from symbolism to dialectic’ (Henri de Lubac). The thirteenth and fourteenth centuries witnessed an even stronger erosion of a Platonic participatory framework through the univocal theology of Duns Scotus, the voluntarism of William of Ockham and Gabriel Biel, and the nominalist epistemology of Ockham and others. Later Neo-Thomist scholastic theologians (Cajetan, Suárez) entrenched the separation between nature and the supernatural with their putative realm of ‘pure nature’. Contemporary evangelicalism’s embrace of nominalism and postmodernism as its logical philosophical conclusion must be countered by a ressourcement of the Platonist-Christian synthesis, (1) reasserting theology’s role as queen of divine hospitality; (2) re-envisioning a sacramental ontology; and (3) reintroducing spiritual biblical interpretation.
Primitive communism in Acts?
Authors: Walton Steve
Published: May 2021

This article assesses the widespread scepticism about the historical value of the portrait of the earliest Christians sharing their possessions in the early chapters of Acts, and criticises two key claims: first, that Luke believes the earliest believers practised compulsory pooling of possessions by those who became Christians; and second, the assertion that sharing possessions disappears once the mission spreads into Gentile circles. A careful reading of the key passages (Acts 2:44-45; 4:32-5:11; 6:1-6) shows that, while there was a remarkable readiness among the believers to share with those in need, there was no compulsion about this. Rather, the principle of holding possessions lightly as God’s stewards guided practice, and this principle also underpins later almsgiving among Christians reported in Acts.
Reply to Kevin Giles
Authors: Letham Robert
Published: May 2021

Giles has made some valuable criticisms of language and arguments used by evangelicals who defend the idea that the Son is eternally subordinate to the Father in what they call ‘role’. He defends the full equality of the trinitarian persons and correctly opposes hierarchical relations. However, he neglects the point that the relations of sending and being sent are irreversible. Moreover, in accusing scholars like Grudem of Arianism he has misrepresented what Grudem wrote. His accusations of implicit Arianism and tritheism are unfounded. Giles fails to consider the conciliar development of Christology; Jesus is the eternal Son incarnate. Ironically, he reads back fallen human structures into the Trinity and misses the self-giving love at its heart, whereby the Son’s submission is an expression of his omnipotence and union with the Father.
The non-canonical gospels and the historical Jesus
Authors: Gregory Andrew
Published: May 2021

This essay offers a brief introduction to selected non-canonical gospels as potential evidence for the historical Jesus. I argue (contra N. T. Wright) that many of these texts may be referred to appropriately as gospels, and that historians should approach both canonical and non-canonical gospels in precisely the same way. I then survey six texts to show what this might mean. I conclude that the non-canonical gospels offer little evidence about the historical Jesus, but that reading them can teach New Testament scholars useful lessons about the way in which we approach the canonical gospels.
The dead letter?
Authors: Sargent Benjamin
Published: May 2021

This essay discusses the use of the Bible in contemporary Christian spiritual practice suggesting that its potential to provide an experiential ‘encounter with God’ is underestimated. This is due to a cultural prejudice against written texts in favour of other media. The essay goes on to study the various ways in which the text in Psalm 119, referred to as ‘law’, ‘statutes’ etc., is related to the individual in the psalm. What becomes clear is that there is not a single simple relation between the text and the individual, but rather a range of relations suggesting the individual’s sense of ‘indexicality’. Moreover, the text is seen to act upon the individual and is not seen merely as a passive object of study. Such an understanding of the written text has much in common with the work of Roland Barthes, in particular his sense of the text of ‘bliss’, the text that subsumes the reader and confronts him in force. These notions of the written text ought to place the Bible in a more central position in spiritual practice. Finally, some suggestions of how such views of the text might be reflected in practice are offered.
Post-war evangelical theology: a generational perspective
Authors: Tidball Derek
Published: May 2021

This paper uses the Hansen/Herberg thesis of immigration as a model of the changing relationship between three generations of postwar evangelical theologians and the academy. The process has been one of gradual, but uneven, assimilation, as proposed by the Hansen/Herberg thesis, and raises questions about the challenge faced by the fourth generation. For this generation the historical roots of postwar evangelical scholarship are more distant, causing them to face the challenge of what distinguishes evangelical scholarship from other contemporary biblical or theological scholarship more acutely than for their predecessors.
‘It’s all about Jesus’:
Authors: Goodliff Andrew
Published: May 2021

This article examines the songs of four contemporary worship songwriters in regard to the christology they present. The article argues that although the majority of songs are focused on Jesus, they fail to articulate a sufficient christology. It is claimed that this is due to an inadequate attention given to the doctrine of the trinity and to Christ’s priestly and prophetic offices. The article concludes by suggesting that the broader context and expectations of contemporary worship songwriters means that it is difficult for a richer christology to be developed.
A re-examination of the intermediate state of unbelievers
Authors: Cunnington Ralph
Published: May 2021

This article seeks to provide a re-examination of the intermediate state of unbelievers against the backdrop of the response of individuals at the final judgment. The first part examines Scripture’s teaching concerning the expectation of believers and unbelievers at the final judgment. It is shown that Scripture consistently teaches that some unbelievers, including those who have died prior to the parousia, will be surprised by the outcome of the final judgment. This is incompatible with the Reformed understanding of the intermediate state because, if unbelievers have already experienced conscious punishment following death, there is no reason why the outcome of the final judgment would be unexpected. In the second part, the Scriptural basis for the Reformed understanding of the intermediate state of unbelievers is critically examined and found to be lacking. In conclusion, it is argued that unbelievers exist in a somnolent coma-like existence as they await the final judgment.
John Wesley as a theologian:
Authors: Noble Thomas A.
Published: May 2021

The twentieth century saw a revival of interest in John Wesley as a theologian, but whereas the standard treatments of his theology have arranged his thought in the customary shape of Systematic Theologies, this article takes the shape of Wesley’s theology from the way he arranged and prioritized his doctrines pastorally in his Standard Sermons. This demonstrates that he began with the evangelical doctrine of the Reformation on Justification and the Atonement (focusing on Christ), understood regeneration and assurance in relation to the Holy Spirit, and saw the sovereign grace of God the Father as extending to ‘all his works’. The underlying structure is Trinitarian. His much misunderstood doctrine of ‘perfection’ was inherited from the Fathers and was his most creative contribution to Evangelical theology, but needs further development and clarification.
David and the fulfilment of 1 Samuel 2:35: faithful priest, sure house, and a man after God’s own heart
Authors: Diffey Daniel S.
Published: May 2021

After the rejection of Eli and his family as priests God declared that he will raise up a faithful priest. The identification of this priest has been a point of difficulty among scholars. The most widely held view is that 1 Kgs. 2, with the installation of Zadok as priest, gives the identity of the faithful priest. This essay proposes a different solution. The books of 1 and 2 Sam. offer both thematic and linguistic connections between the faithful priest of 1 Sam. 2:35 and David. The promise of the faithful priest, therefore, is to be viewed through a Davidic lens.
Multicultural dimensions of the Bible
Authors: Patten Malcolm
Published: May 2021

Amidst the contemporary challenge of multicultural ministry in our cities, this article explores the multicultural dimensions of the Bible to prepare a biblical and theological foundation for developing and supporting multicultural ministry. It maps out the multi-ethnic composition of Israel and its means of accommodating those of other ethnic and cultural backgrounds. It considers the multicultural context of the New Testament world and the cross-cultural ministry of both Jesus and Paul. It concludes that there is indeed resonance between the biblical world and the contemporary context and that this exploration prepares the ground for further reflection on the significance and relevance of these dimensions of scripture for multicultural ministry today.
Allium muratozelii (Amaryllidaceae), a new species from Turkey

Authors: ARMAĞAN METİN
Published: May 2021

Allium muratozelii is described here as a new species. Diagnostic morphological characters, a full description, and detailed illustrations are given. Allium muratozelii is known from Tunceli province in eastern Anatolia, Turkey. According to its morphological features, the new species belongs to Allium subg. Melanocrommyum sect. Melanocrommyum. It is distinguished from the morphologically similar A. colchicifolium mainly by scape and leaf length, leaf shape, margins of tepal, and filament color. IUCN red list category, notes on biogeography and ecology of the new species are also given.
A replacement name for Acrapex albicostata Hampson, 1916 (Lepidoptera: Noctuidae)
Authors: DE PRINS WILLY
Published: May 2021

In 1905, O. B. Lower described Sesamia albicostata from Australia, based on one male specimen taken at Ocean Grange, near Sale, Victoria in January (Lower 1905: 175). Apart from the bibliographical records in the series Zoological Record (Sharp 1906: 262) and Archiv für Naturgeschichte (Lucas 1910: 613), the name Sesamia albicostata occurred only in two other subsequent publications. G. F. Hampson (1910: 327) repeated the short description of Lower without further comments, though he had seen the type specimen which was at that time preserved in the private collection of Lower. He depicted the specimen on plate 144 in fig. 21 [https://www.biodiversitylibrary.org/page/32600328] (Fig. 1).
Heteragrion lencionii (Odonata: Heteragrionidae) sp. nov. from Serra de Itabaiana National Park, Northeastern Brazil
Authors: VILELA DIOGO SILVA , FARIAS ANTONIO BRUNO SILVA , SANTOS JEAN CARLOS
Published: May 2021

The Neotropical genus Heteragrion Selys, 1862 is one of the most speciose among Zygoptera. Notwithstanding, most of its species are poorly known, especially those from undersampled areas such as Northeastern Brazil. Here, we describe Heteragrion lencionii sp. nov., from protected areas of Sergipe state (Holotype ♂, Brazil, Sergipe, Areia Branca, Serra de Itabaiana National Park, -10.7484, -37.3390, 179 m, 7.xii.2020, A.B. Farias & A.E. dos Santos leg., in UFS). This is only the second Heteragrion species discovered as new for the Northeastern region of Brazil, separated from other congeners by cercus morphology and thoracic coloration pattern.
Atmospheric Circumglobal Teleconnection Triggered by Spring Land Thermal Anomalies Over West Asia and Its Possible Impacts on Early Summer Climate Over Northern China
Authors: Yang Jingqiu , Chen Haishan , Song Yidi , Zhu Siguang , Zhou Botao , Zhang Jie
Published: May 2021

Eurasian continent experienced significant warming during the past decades. West Asia locates in arid/semi-arid zone and its warming amplification has drawn lots of attention. However, the climatic effect of such a warming is not clear yet. In this study, we explored the possible impacts of recent land surface warming over West Asia on the atmospheric general circulation and climate. Results show that abnormal spring land surface warming over West Asia tends to increase precipitation over North China but decrease (increase) precipitation (air temperature) over Northeast China in early summer (June). It is noted that the precipitation anomalies are much stronger over the eastern region of North/Northeast China. Further analysis suggests abnormal spring land surface warming can trigger eastward-propagating disturbance via diabatic heating, which benefits intensified the atmospheric circumglobal teleconnection (CGT) pattern, causing anomalous circulation and climate in early summer over northern China. Sensitivity experiments demonstrate that abnormal spring land surface warming can increase the atmospheric baroclinic instability and trigger Rossby waves that propagate along the westerly jet stream (WJS), resulting in the formation of CGT. Due to persistent land surface thermal forcing and the interaction between the basic flow (especially WJS) and CGT, the CGT tends to be intensified. The anomalous wave center over East Asia in early summer is responsible for the precipitation increases (decreases) over North (Northeast) China and the evident warming in Northeast China. Our results suggest that the spring land surface thermal anomalies over West Asia can be a potential signal for short-term prediction of early summer climate over northern China.
Ensemble Kalman Filter Updates Based on Regularized Sparse Inverse Cholesky Factors
Authors: Boyles Will , Katzfuss Matthias
Published: May 2021

The ensemble Kalman filter (EnKF) is a popular technique for data assimilation in high-dimensional nonlinear state-space models. The EnKF represents distributions of interest by an ensemble, which is a form of dimension reduction that enables straightforward forecasting even for complicated and expensive evolution operators. However, the EnKF update step involves estimation of the forecast covariance matrix based on the (often small) ensemble, which requires regularization. Many existing regularization techniques rely on spatial localization, which may ignore long-range dependence. Instead, our proposed approach assumes a sparse Cholesky factor of the inverse covariance matrix, and the nonzero Cholesky entries are further regularized. The resulting method is highly flexible and computationally scalable. In our numerical experiments, our approach was more accurate and less sensitive to misspecification of tuning parameters than tapering-based localization.
GADD45g acts as a novel tumor suppressor, and its activation suggests new combination regimens for the treatment of AML
Authors: Guo Dan , Zhao Yangyang , Wang Nan , You Na , Zhu Wenqi , Zhang Peiwen , Ren Qian , Yin Jing , Cheng Tao , Ma Xiaotong
Published: May 2021

Acute myeloid leukemia (AML) is an aggressive hematopoietic malignancy for which there is an unmet need for novel treatment strategies. Here, we characterize the growth arrest and DNA damage-inducible gene gamma (GADD45g) as a novel tumor suppressor in AML. We show that GADD45g is preferentially silenced in AML, especially in AML with FMS-like tyrosine kinase 3–internal tandem duplication (FLT3-ITD) mutations and mixed-lineage leukemia (MLL)-rearrangements, and reduced expression of GADD45g is correlated with poor prognosis in patients with AML. Upregulation of GADD45g impairs homologous recombination DNA repair, leading to DNA damage accumulation, and dramatically induces apoptosis, differentiation, and growth arrest and increases sensitivity of AML cells to chemotherapeutic drugs, without affecting normal cells. In addition, GADD45g is epigenetically silenced by histone deacetylation in AML, and its expression is further downregulated by oncogenes FLT3-ITD and MLL-AF9 in patients carrying these genetic abnormalities. Combination of the histone deacetylase 1/2 inhibitor romidepsin with the FLT3 tyrosine kinase inhibitor AC220 or the bromodomain inhibitor JQ1 exerts synergistic antileukemic effects on FLT3-ITD+ and MLL-AF9+ AML, respectively, by dually activating GADD45g. These findings uncover hitherto unreported evidence for the selective antileukemic role of GADD45g and provide novel strategies for the treatment of FLT3-ITD+ and MLL-AF9+ AML.
A PSGL-1 glycomimetic reduces thrombus burden without affecting hemostasis
Authors: Wong Daniel J. , Park Diane D. , Park Simon S. , Haller Carolyn A. , Chen Jiaxuan , Dai Erbin , Liu Liying , Mandhapati Appi R. , Eradi Pradheep , Dhakal Bibek , Wever Walter J. , Hanes Melinda , Sun Lijun , Cummings Richard D. , Chaikof Elliot L.
Published: May 2021

Events mediated by the P-selectin/PSGL-1 pathway play a critical role in the initiation and propagation of venous thrombosis by facilitating the accumulation of leukocytes and platelets within the growing thrombus. Activated platelets and endothelium express P-selectin, which binds P-selectin glycoprotein ligand-1 (PSGL-1) that is expressed on the surface of all leukocytes. We developed a pegylated glycomimetic of the N terminus of PSGL-1, PEG40-GSnP-6 (P-G6), which proved to be a highly potent P-selectin inhibitor with a favorable pharmacokinetic profile for clinical translation. P-G6 inhibits human and mouse platelet-monocyte and platelet-neutrophil aggregation in vitro and blocks microcirculatory platelet-leukocyte interactions in vivo. Administration of P-G6 reduces thrombus formation in a nonocclusive model of deep vein thrombosis with a commensurate reduction in leukocyte accumulation, but without disruption of hemostasis. P-G6 potently inhibits the P-selectin/PSGL-1 pathway and represents a promising drug candidate for the prevention of venous thrombosis without increased bleeding risk.
A flow cytometric assay to detect platelet-activating antibodies in VITT after ChAdOx1 nCov-19 vaccination
Authors: Handtke Stefan , Wolff Martina , Zaninetti Carlo , Wesche Jan , Schönborn Linda , Aurich Konstanze , Ulm Lena , Hübner Nils-Olaf , Becker Karsten , Thiele Thomas , Greinacher Andreas
Published: May 2021

Vaccination is crucial in combatting the severe acute respiratory syndrome coronavirus 2 pandemic. The rare complication of thrombocytopenia and thrombotic complications at unusual sites after ChAdOx1 nCov-19 vaccination is caused by platelet-activating antibodies directed against platelet factor 4 (PF4). We present a widely applicable whole-blood standard flow cytometric assay to identify the pathogenic antibodies associated with vaccine-induced immune-mediated thrombotic thrombocytopenia (VITT) after ChAdOx1 nCov-19 vaccination. This assay will enable rapid diagnosis by many laboratories. This trial was registered at www.clinicaltrials.gov as #NCT04370119.
DeepNetBim: deep learning model for predicting HLA-epitope interactions based on network analysis by harnessing binding and immunogenicity information
Authors: Yang Xiaoyun , Zhao Liyuan , Wei Fang , Li Jing
Published: May 2021

Background

Epitope prediction is a useful approach in cancer immunology and immunotherapy. Many computational methods, including machine learning and network analysis, have been developed quickly for such purposes. However, regarding clinical applications, the existing tools are insufficient because few of the predicted binding molecules are immunogenic. Hence, to develop more potent and effective vaccines, it is important to understand binding and immunogenic potential. Here, we observed that the interactive association constituted by human leukocyte antigen (HLA)-peptide pairs can be regarded as a network in which each HLA and peptide is taken as a node. We speculated whether this network could detect the essential interactive propensities embedded in HLA-peptide pairs. Thus, we developed a network-based deep learning method called DeepNetBim by harnessing binding and immunogenic information to predict HLA-peptide interactions.

Results

Quantitative class I HLA-peptide binding data and qualitative immunogenic data (including data generated from T cell activation assays, major histocompatibility complex (MHC) binding assays and MHC ligand elution assays) were retrieved from the Immune Epitope Database database. The weighted HLA-peptide binding network and immunogenic network were integrated into a network-based deep learning algorithm constituted by a convolutional neural network and an attention mechanism. The results showed that the integration of network centrality metrics increased the power of both binding and immunogenicity predictions, while the new model significantly outperformed those that did not include network features and those with shuffled networks. Applied on benchmark and independent datasets, DeepNetBim achieved an AUC score of 93.74% in HLA-peptide binding prediction, outperforming 11 state-of-the-art relevant models. Furthermore, the performance enhancement of the combined model, which filtered out negative immunogenic predictions, was confirmed on neoantigen identification by an increase in both positive predictive value (PPV) and the proportion of neoantigen recognition.

Conclusions

We developed a network-based deep learning method called DeepNetBim as a pan-specific epitope prediction tool. It extracted the attributes of the network as new features from HLA-peptide binding and immunogenic models. We observed that not only did DeepNetBim binding model outperform other updated methods but the combination of our two models showed better performance. This indicates further applications in clinical practice.
Transcriptional profile of oil palm pathogen, Ganoderma boninense, reveals activation of lignin degradation machinery and possible evasion of host immune response
Authors: Dhillon Braham , Hamelin Richard C. , Rollins Jeffrey A.
Published: May 2021

Background

The white-rot fungi in the genus Ganoderma interact with both living and dead angiosperm tree hosts. Two Ganoderma species, a North American taxon, G. zonatum and an Asian taxon, G. boninense, have primarily been found associated with live palm hosts. During the host plant colonization process, a massive transcriptional reorganization helps the fungus evade the host immune response and utilize plant cell wall polysaccharides.

Results

A publicly available transcriptome of G. boninense - oil palm interaction was surveyed to profile transcripts that were differentially expressed in planta. Ten percent of the G. boninense transcript loci had altered expression as it colonized oil palm plants one-month post inoculation. Carbohydrate active enzymes (CAZymes), particularly those with a role in lignin degradation, and auxiliary enzymes that facilitate lignin modification, like cytochrome P450s and haloacid dehalogenases, were up-regulated in planta. Several lineage specific proteins and secreted proteins that lack known functional domains were also up-regulated in planta, but their role in the interaction could not be established. A slowdown in G. boninense respiration during the interaction can be inferred from the down-regulation of proteins involved in electron transport chain and mitochondrial biogenesis. Additionally, pathogenicity related genes and chitin degradation machinery were down-regulated during the interaction indicating G. boninense may be evading detection by the host immune system.

Conclusions

This analysis offers an overview of the dynamic processes at play in G. boninense - oil palm interaction and provides a framework to investigate biology of Ganoderma fungi across plantations and landscape.
Deviations in the gut microbiota of neonates affected by maternal group B Streptococcus colonization
Authors: Li Yue-feng , Gong Xue-lei , Chen Su-xiang , Wang Kejian , Jiang Yan-hua
Published: May 2021

Background

Group B Streptococcus (GBS) infection is the leading cause of septicemia, meningitis, and pneumonia in neonates. Aberrant gut colonization in early life may predispose children to various diseases in adulthood. However, the associations between gut microbial changes and GBS colonization is still unclear.

Results

The composition and diversity of meconium microbiota in GBS group were similar to that of healthy controls. However, we identified several specific taxa that were differentially abundant between the two groups (linear discriminant analysis (LDA) effect size (LEfSe): p < 0.05, LDA > 2.0). Particularly, the relative abundance of Lactobacillus paracasei was significantly reduced, indicating a role in GBS colonization.

Conclusions

Our study presented a series of bacterial species colonized by GBS, thus providing novel evidence in support of initial intestinal microbiota dysbiosis in the neonates with mother’s GBS colonization.
Molecular characterization and epidemiology of Streptococcus pneumoniae serotype 8 in Denmark
Authors: Hansen Camilla Bülow , Fuursted Kurt , Valentiner-Branth Palle , Dalby Tine , Jørgensen Charlotte Sværke , Slotved H-C
Published: May 2021

Background

Streptococcus pneumoniae serotype 8 incidence has increased in Denmark after the introduction of pneumococcal conjugated vaccines (PCV). The mechanism behind the serotype 8 replacement is not well understood. In this study, we aimed to present epidemiological data on invasive pneumococcal disease (IPD) and molecular characterization of 96 serotype 8 clinical isolates.

Methods

IPD data from 1999 to 2019 were used to calculate the incidence and age distribution. Whole-genome sequencing (WGS) analysis was performed on 96 isolates (6.8% of the total serotype 8 IPD isolates in the period) to characterize the isolates with respect to pneumococcal lineage traits, a range of genes with potential species discrimination, presence of colonization and virulence factors, and molecular resistance pattern.

Results

The serotype 8 IPD incidence increased significantly (P < 0.05) for the age groups above 15 years after the introduction of PCV13, primarily affecting the elderly (65+). All isolates were phenotypically susceptible to penicillin, erythromycin and clindamycin.

Molecular characterization revealed seven different MLST profiles with ST53 as the most prevalent lineage (87.5%) among the analyzed serotype 8 isolates. The genes covering the cell-surface proteins: lytA, rspB, pspA, psaA & Xisco and the pneumococcal toxin pneumolysin = ply were present in all isolates, while genes for the membrane transporter proteins: piaA/piaB/piaC; the capsular genes: cpsA (wzg) & psrP; the metallo-binding proteins zmpB & zmpC; and the neuroamidase proteins: nanA/nanB were variably present. Surprisingly, the putative transcriptional regulator gene SP2020 was not present in all isolates (98%). Susceptibility to penicillin, erythromycin and clindamycin was molecularly confirmed.

Conclusion

The observed serotype 8 replacement was not significantly reflected with a change in the MLST profile or changes in antibiotic resistance- or virulence determinants.
Human papillomavirus and Chlamydia trachomatis in oral and genital mucosa of women with normal and abnormal cervical cytology
Authors: Mosmann J. P. , Zayas S. , Kiguen A. X. , Venezuela R. F. , Rosato O. , Cuffini C. G.
Published: May 2021

Background

HPV and C.trachomatis are the most prevalent, viral and bacterial STI worldwide. Both commonly have an asymptomatic development and can evolve into a persistent infection which, added to coinfections, may be important cofactors for the oncogenic transformation.

Objective

Evaluate the prevalence of oral and genital HPV and C.trachomatis infection in women with normal and abnormal cervical cytology.

Study design

The cross-sectional study included 200 swabs, 100 oral and 100 cervical from 50 women with normal and 50 with abnormal cervical cytology. HPV and C.trachomatis infections were detected using PCR with specific primers.

Results

HPV DNA was detected in 27% (n = 27/100) of women with normal and abnormal cytology. Out of 100 genital samples we detected HPV DNA in 18% (n = 18/100) and 14% (n = 14/100) out of 100 oral samples. HPV genotypes detected were genotype 6 of low-risk and 16, 31, 52, 58 and 16–31 coinfection of high-risk. C.trachomatis DNA was detected in 49% (n = 49/100) of patients. Out of 100 genital samples we detected C.trachomatis in 35% (n = 35/100) and 31% (n = 31) out of 100 oral samples. There is statistically significant (p < 0.05) between cytology and HPV and C.trachomatis infection but there is no statistically significant between cytology and the other characteristics.

Conclusions

Since the histology of oral mucosa resembles that of the uterine cervix, we can anticipate the presence of HPV and other STI which are detected in different lesions of genital areas and the oral mucosa. Therefore, is important C.trachomatis detection and specific treatment in asymptomatic women because this infection may increase the risk of HPV persistence and coinfection induces a pro-inflammatory environment that may promote the carcinogenesis.
Giving women WOICE postpartum: prevalence of maternal morbidity in high-risk pregnancies using the WHO-WOICE instrument
Authors: Lamus M. N. , Pabon S. , MPoca C. , Guida J. P. , Parpinelli M. A. , Cecatti J. G. , Vidarte M. F. , Costa M. L.
Published: May 2021

Background

There are no accurate estimates of the prevalence of non-severe maternal morbidities. Given the lack of instruments to fully assess these morbidities, the World Health Organization (WHO) developed an instrument called WOICE. We aimed to evaluate the prevalence of non-severe maternal morbidities in puerperal women and factors associated to impaired clinical, social and mental health conditions.

Method

A cross-sectional study with postpartum women at a high-risk outpatient clinic in southeast Brazil, from November 2017 to December 2018. The WOICE questionnaire included three sections: the first with maternal and obstetric history, sociodemographic data, risk and environment factors, violence and sexual health; the second considers functionality and disability, general symptoms and mental health; and the third includes data on physical and laboratory tests. Data collection was supported by Tablets with REDCAP software. Initially, a descriptive analysis was performed, with general prevalence of all variables contained in the WOICE, including scales on anxiety and depression (GAD-7 and PHQ-9- impaired if ≥10), functionality (WHODAS- high disability scores when ≥37.4) and data on violence and substance use. Subsequently, an evaluation of cases with positive findings was performed, with a Poisson regression to investigate factors associated to impaired non-clinical and clinical conditions.

Results

Five hundred seventeen women were included, majority (54.3%) multiparous, between 20 and 34 years (65.4%) and with a partner (75,6%). Over a quarter had (26.2%) preterm birth. Around a third (30.2%) reported health problems informed by the physician, although more than 80% considered having good or very good health. About 10% reported any substance use and 5.9% reported exposure to violence. Anxiety was identified in 19.8% of cases, depression in 36.9% and impaired functioning in 4.4% of women. Poisson regression identified that poor overall health rating was associated to increased anxiety/depression and impaired functioning. Having a partner reduced perception of women on the presence of clinical morbidities.

Conclusion

During postpartum care of a high-risk population, over one third of the considered women presented anxiety and depression; 10% reported substance use and around 6% exposure to violence. These aspects of women’s health need further evaluation and specific interventions to improve quality of care.
Associations of specific-age and decade recall body mass index trajectories with obesity-related cancer
Authors: Watson Charlotte , Renehan Andrew G. , Geifman Nophar
Published: May 2021

Background

Excess body fatness, commonly approximated by a one-off determination of body mass index (BMI), is associated with increased risk of at least 13 cancers. Modelling of longitudinal BMI data may be more informative for incident cancer associations, e.g. using latent class trajectory modelling (LCTM) may offer advantages in capturing changes in patterns with time. Here, we evaluated the variation in cancer risk with LCTMs using specific age recall versus decade recall BMI.

Methods

We obtained BMI profiles for participants from the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial. We developed gender-specific LCTMs using recall data from specific ages 20 and 50 years (72,513 M; 74,837 W); decade data from 30s to 70s (42,113 M; 47,352 W) and a combination of both (74,106 M, 76,245 W). Using an established methodological framework, we tested 1:7 classes for linear, quadratic, cubic and natural spline shapes, and modelled associations for obesity-related cancer (ORC) incidence using LCTM class membership.

Results

Different models were selected depending on the data type used. In specific age recall trajectories, only the two heaviest classes were associated with increased risk of ORC. For the decade recall data, the shapes appeared skewed by outliers in the heavier classes but an increase in ORC risk was observed. In the combined models, at older ages the BMI values were more extreme.

Conclusions

Specific age recall models supported the existing literature changes in BMI over time are associated with increased ORC risk. Modelling of decade recall data might yield spurious associations.
Consultation-liaison psychiatry in Japan: a nationwide retrospective observational study
Authors: Shinjo Daisuke , Tachimori Hisateru , Maruyama-Sakurai Keiko , Fujimori Kenji , Inoue Norihiko , Fushimi Kiyohide
Published: May 2021

Background

Consultation-liaison psychiatry (CLP)—professional psychiatric care provided to coordinate with surgical or medical treatment of inpatients with psychiatric disorders—was included in universal health coverage in Japan in 2012. Despite evidence of benefits of CLP, basic data and geographic distribution information regarding CLP at the national level remain unclear. This study aimed to 1) identify the geographic disparity of CLP in Japan and 2) investigate the association between number of consultations per CLP patient and region.

Methods

We retrospectively analyzed anonymized data retrieved from the Japanese administrative inpatient database regarding inpatients who were provided CLP between April 2012 and March 2017. Demographic characteristics were summarized and geographic disparity by prefecture was visualized for fiscal years 2012 and 2016; we also summarized the data according to region. Multivariate linear regression analysis was used to investigate association between the number of consultations per CLP patient and region after adjusting for covariates.

Results

Data from a total of 46,171 patients who received 138,866 CLP services were included. Results revealed more patients aged 75–84 years received CLPs than any other age group (29.7%) and the overall male/female ratio was 53:47 in 2016. In 2012 and 2016, 24.2 and 30.7% of CLP patients, respectively, were transferred to other hospitals; 9.7 and 8.8%, respectively, discharged due to the death. CLP services were provided in 14 prefectures in 2012 and 33 by 2016; 14 prefectures had no available CLP services. After adjusting for covariates, Tohoku (β = − 0.220, p < 0.034), Chugoku (β = − 0.160, p < 0.026), and Shikoku (β = − 0.555, p < 0.001) had a significant negative correlation with the number of consultations per CLP patient compared with Hokkaido region (an adjusted R square (R2) = 0.274).

Conclusions

Our study clarified the characteristics of patients in Japan who received CLPs and the geographic disparity in CLP services. Although 5 years had passed since CLP was introduced, the results imply wide availability of CLP nationally. The analysis data provided may inform future policies to improve CLP services.
Associations between neighborhood violence during pregnancy and birth outcomes: evidence from São Paulo’s Western Region Birth Cohort
Authors: dos Santos Angélica Carreira , Brentani Alexandra , Fink Günther
Published: May 2021

Background

Low birth weight and prematurity remain leading causes of infant mortality and morbidity globally. Although extensive literature has highlighted the importance of socioenvironmental characteristics for birth outcomes, the role of indirect violence on health remains fairly understudied.

Methods

Using geocoded birth records from the ongoing Western Region Birth Cohort (Região Oeste Coorte – ROC-Cohort) of infants born between 2012 and 2014 and geocoded crime reports, we assessed the associations between exposure to violent crimes during pregnancy within a 1-km radius of the mother’s residence and low birth weight, preterm delivery, and being born small-for-gestational-age. Violent crime exposure was categorized into quintiles. Multivariate logistic regressions were used to examine the associations between violence exposure and birth outcomes. Models were adjusted for sex, maternal age and education, socioeconomic status, and risk factors such as hypertension, diabetes, smoking, and drinking during pregnancy.

Results

Among the 5268 children included, the average crime exposure during the first two trimesters of pregnancy ranged from 0.44 violent crimes in the least exposed quintile to 12.74 crimes in the most exposed. Compared to children with the lowest violence exposure, children in the highest exposure quintile had higher odds of being born small-for-gestational-age (1.41[1.06–1.89]), preterm (1.35[1.01–1.80]), and low birth weight (1.42[1.03–1.98]). While socioeconomic status and maternal education were positively associated with lower violence exposure, no associations were found between these characteristics and birth outcomes.

Conclusions

Higher exposure to violent crimes in the close vicinity of pregnant women’s residence is associated with substantial increases in the odds of adverse birth outcomes. Policies to improve neighborhood safety can potentially contribute not only to the short-term wellbeing of populations but may also have large social, economic, and health benefits in the long term.
Sex, drugs and techno – a qualitative study on finding the balance between risk, safety and pleasure among men who have sex with men engaging in recreational and sexualised drug use
Authors: Dennermalm Nicklas , Scarlett Julia , Thomsen Sarah , Persson Kristina Ingemarsdotter , Alvesson Helle Mølsted
Published: May 2021

Background

Recreational and sexual drug use among men who have sex with men may result in increased risk of poor health. The aim of this study was to better understand drug use and harm reduction techniques among Swedish men who have sex with men traveling to Berlin in order to improve the health of this population and inform public health strategies.

Methods

A qualitative study based on semi-structured interviews with 15 Swedish men aged 23–44 with experience of drug use were recruited through network sampling. Interviews were conducted in Stockholm and Berlin and analysed using content analysis. The interview guide included questions on drug use, context, health and safety.

Results

The participants engaged in drug use in both settings and in various contexts. Participants saw themselves as capable of finding a balance between pleasure, safety and risk with the aim to maximize positive effects while minimizing negative ones. The different risks of drug use were known, and participants relied on knowledge, harm reduction strategies and self-defined rules of intake to stay safe and healthy in a broad sense, both short term (i.e. during each session) and long term. Choice of drug and, frequency of intake, multi-use, risk of overdose, risk of HIV, purpose and context of use, how often, etc. were all part of the overall strategy. Knowledge of these methods was spread within the community and on-line rather than from counsellors or other health care providers. However, it did not always translate perfectly into practice and some had experienced overdoses and problematic use.

Conclusions

The findings of this study point to the need for increased adoption of harm reduction techniques in this population focusing on mitigating harm and prevention of risk of problematic use or starting injection drugs. Existing traditional services require adaptations to become more accessible and acceptable to sub-groups of drug users, including low-threshold services providing non-judgemental, evidence-based information. This will require funding of alternative providers such as STI/HIV clinics, among others, and health care providers to increase adoption of prevention strategies, specifically pre-exposure prophylaxis for HIV.
Risk of stroke and myocardial infarction after influenza-like illness in New York State
Authors: Kulick Erin R. , Alvord Trevor , Canning Michelle , Elkind Mitchell S. V. , Chang Bernard P. , Boehme Amelia K.
Published: May 2021

Background

Influenza may be associated with increased stroke and myocardial infarction (MI) risk. We hypothesized that risk of stroke and MI after influenza-like illness (ILI) would be higher in patients in New York State. We additionally assessed whether this relationship differed across a series of sociodemographic factors.

Methods

A case-crossover analysis of the 2012–2014 New York Statewide Planning and Research Cooperative System (SPARCS) was used to estimate odds of ischemic stroke and MI after ILI. Each patient’s case window (the time period preceding event) was compared to their control windows (same dates from the previous 2 years) in conditional logistic regression models used to estimate odds ratios and 95% confidence intervals (OR, 95% CI). We varied the case windows from 15 to 365 days preceding event as compared to control windows constructed using the same dates from the previous 2 years. Analyses were stratified by sex, race, and urban-rural status based on residential zip code.

Results

A total of 33,742 patients were identified as having ischemic stroke and 53,094 had MI. ILI events in the 15 days prior were associated with a 39% increase in odds of ischemic stroke (95% CI 1.09–1.77), increasing to an almost 70% increase in odds when looking at ILI events over the last year (95% CI 1.56, 1.83). In contrast, the effect of ILI hospitalization on MI was strongest in the 15 days prior (OR = 1.24, 95% CI 1.06–1.44). The risk of ischemic stroke after ILI was higher among individuals living in rural areas in the 90 days prior to stroke and among men in the year prior to event. In contrast, the association between ILI and MI varied only across race with whites having significantly higher ILI associated MI.

Conclusion

This study highlights risk period differences for acute cardiovascular events after ILI, indicating possible differences in mechanism behind the risk of stroke after ILI compared to the risk of MI. High risk populations for stroke after ILI include men and people living in rural areas, while whites are at high risk for MI after ILI. Future studies are needed to identify ways to mitigate these risks.