bluuebunny/crossref_metadata_2025 huggingface dataset:
Optimisation of Sample Storage and DNA Extraction for Human Gut Microbiome Studies
Authors: Kazantseva Jekaterina , Malv Esther , Kaleda Aleksei , Kallastu Aili , Meikas Anne
Published: December 2020

Background: New developments in next-generation sequencing technologies and massive data received from this approach open wide prospects for personalised medicine and nutrition studies. Metagenomic analysis of the gut microbiota is paramount for the characterization of human health and wellbeing. Despite the intensive research, there is a huge gap and inconsistency between different studies due to the non-standardised and biased pipeline. Methodical and systemic understanding of every stage in the process is necessary to overcome all bottlenecks and grey zones of gut microbiome studies, where all details and interactions between processes are important. Results: Here we show that an inexpensive, but reliable iSeq 100 platform is an excellent tool to perform the metagenomic analysis of the human gut. Two commercial kits and different starting materials performed similarly regarding the taxonomic distribution of identified bacteria. DNA/RNA Shield preservation reagent proved to be a trustworthy solution for stool samples collection and storage, as the storage of faecal material in DNA/RNA Shield for three weeks at different temperatures and thawing cycles had a low impact on the bacterial distribution. Conclusion: Altogether, a thoroughly elaborated pipeline with close attention to details ensures high reproducibility with significant biological but not technical variations.
Bacterial Colonization and Th17 Immunity are Shaped by Intestinal Sialylation in Neonatal Mice
Authors: Irons Eric E , Gomez Eduardo Cortes , Andersen Valerie , Lau Joseph
Published: December 2020

Background: Interactions between the neonate host and its gut microbiome are central to the development of a healthy immune system. However, the mechanisms by which animals alter early colonization of microbiota for their benefit remain unclear. Host-derived carbohydrates, which can serve as metabolic substrates for the expansion of specific commensal and pathogenic bacteria, are one method by which the host may influence interspecies competition in the microbiome. Here, we investigated the role of early-life expression of the α2,6-sialyltransferase ST6GAL1 in microbiome phylogeny and mucosal immunity. Methods: Intestinal sialylation was characterized by RT-qPCR, immunoblot, microscopy, and sialyltransferase enzyme assays in genetic mouse models at rest or with glucocorticoid receptor modulators. The fecal, upper respiratory, and oral microbiomes of pups expressing or lacking St6gal1 were analyzed by 16S rRNA sequencing. Pooled fecal microbiomes from syngeneic donors were transferred to antibiotic-treated wild-type mice, before analysis of recipient mucosal immune responses by flow cytometry, RT-qPCR, microscopy, and ELISA. Results: ST6GAL1 was highly expressed in duodenal enterocytes between birth and weaning, driving temporary sialylation of the associated glycocalyx and secretion of active ST6GAL1 into the intestinal lumen, with subsequent uptake by colonic goblet cells. Expression was mediated by the P1 promoter of the St6gal1 gene, which was efficiently inhibited by intraperitoneal dexamethasone. At weaning, the fecal microbiome of St6gal1-KO pups was unchanged in diversity but exhibited reductions in Clostridium, Coprobacillus, and Adlercreutzia, along with increased Helicobacter and Bilophila. Transfer of St6gal1-KO microbiome induced an AhR-dependent Th17 response, with expression of T-bet and IL-17, and IL-22-dependent gut lengthening. Conclusions: Intestinal sialylation by the sialyltransferase ST6GAL1 in the neonatal period is a developmentally regulated host mechanism coordinating bacterial colonization in the early gut microbiome. The inability to produce α2,6-sialyl ligands results in microbiome-dependent Th17 inflammation, highlighting a pathway by which intestinal epithelium regulates mucosal immunity. Considering the prevalence of intestinal fucosylation in adult animals, sialic acid may promote an early stage of ecological succession in the developing gut. Trial registration: N/A
The Predictive Factor for Favorable Outcome after Surgical Treatment of Benign Prostate Hyperplasia Performed by Young Urologist - Is Surgical Modality Important in Beginner Urologists?
Authors: Kim Ki Hong , Kim Si Hyun , Yang Hee Jo , Kim Doo Sang , Lee Chang Ho , Jeon Youn Soo
Published: December 2020

Background: To identify predictive factors for favorable outcomes after surgical treatments that were performed by beginner urologists in patients with benign prostate hyperplasia (BPH), we retrospectively evaluated outcomes after holmium laser enucleation of the prostate (HoLEP) and transurethral resection of prostate (TURP) that were performed by two young urologists.Methods: Of 80 patients who were treated with HoLEP or TURP, 31 (HoLEP) and 36 (TURP) patients who were followed up for 3 months were enrolled in this study. Preoperative and perioperative variables were evaluated to identify predictive factors for favorable outcome after surgical treatment for BPH.Results: At 3 months postoperative after HoLEP or TURP, the median decrease in IPSS was 13.0. Patients whose IPSS decreased by over 13 points were categorized into a favorable response group after HoLEP or TURP. Univariate and multivariate logistic regression analyses were performed to identify predictors of favorable outcomes at 3 months after HoLEP or TURP, and the preoperative IPSS was identified as an independent predictor for favorable outcomes. Conclusions: When young urologists plan to perform surgical treatment for BPH, they should consider that the severity of symptoms is the most important factor for favorable outcomes. The type of surgical modality for managing BPH is less important. Trial registration : Soonchunhyang university institutional review board approval (No. 2017-07-022)
Association of Gestational Diabetes Mellitus With Adverse Pregnancy Outcomes and Its Interaction With Maternal Age in Chinese Urban Women
Authors: Wang Xueyin , Zhang Xiaosong , Zhou Min , Juan Juan , Wang Xu
Published: December 2020

Background: The prevalence of gestational diabetes mellitus (GDM) has been dramatically increasing worldwide. The aims of this study were to examine associations of GDM with pregnancy outcomes in Chinese urban women, and to evaluate the interaction between GDM and other major risk factors for the risk of adverse pregnancy outcomes. Methods: A retrospective analysis included 8,844 women who delivered live singletons at ≥28 weeks of gestation between June 2012 and March 2013 among Chinese urban women. Structured questionnaires were used to collect the information on demographic characteristics, lifestyle behavior, medical history and pregnancy outcomes. The diagnosis of GDM was made between 24 and 28 gestational weeks according to the International Association of Diabetes and Pregnancy Study Groups criteria. Logistic regression models were used to assess the association of GDM with pregnancy outcomes, and to examine the interaction between GDM and other major risk factors including maternal age, prepregnancy body mass index and gestational weight gain for the risk of pregnancy outcomes. Results: 13.9% of women were diagnosed with GDM. We found that GDM was associated with higher risk of cesarean delivery (Odds Ratio [OR] =1.69, 95% CI [confidence interval]: 1.48-1.92), preterm birth (OR=1.32, 95% CI: 1.07-1.64), macrosomia (OR=1.69, 95% CI: 1.34-2.13) and large-for-gestational age (LGA, OR=1.43, 95% CI: 1.18-1.73) after adjustment for potential confounders. We also observed the interaction between GDM and maternal age for the risk of cesarean delivery (P for interaction = 0.025), and the prevalence of cesarean delivery was higher in women with GDM than those unaffected of GDM regardless of maternal age (age <35 years: 58.5% vs. 44.3%; age ≥35 years: 67.7% vs. 64.3%). Women aged ≥35 years and above and having GDM had a 2.10-fold increased risk of cesarean delivery compared to those who was under 35 years old and did not having GDM (OR=2.10, 95% CI: 1.48-2.93).Conclusions: GDM was associated with increased risk of cesarean delivery, preterm birth, macrosomia and LGA in Chinese urban women, and there was the interaction between GDM and maternal age for the risk of cesarean delivery.
Implementing an education program for nurse-midwives focused on early essential care for breast milk expression among mothers of preterm infants
Authors: Tanaka Rie , Horiuchi Shigeko
Published: December 2020

BackgroundAlthough breastfeeding guidelines for infants admitted to the neonatal intensive care unit (NICU) have been introduced in Japan, these guidelines have not been reflected in practice. To improve this situation, it is important for nurses and nurse-midwives to acquire knowledge of appropriate care. This study examined changes in the knowledge of appropriate care of nurse-midwives after implementing an educational program focused on early essential care for breast milk expression among mothers of preterm infants. MethodsThis before-after study using a single group enrolled 36 nurse-midwives in one perinatal medical center. The educational program content included nurses’ roles in early essential care for milk expression and the necessary care to promoting breast milk production among mothers of preterm infants. The nurse-midwives' knowledge and attitude on care were investigated three months before (pre-1), just before (pre-2), just after (post-1), and three months after (post-2) the program. The nurse-midwives’ care implementation was investigated at pre-1, pre-2, and post-2. During this time, 11 mothers (before: 7, after: 4) reported the status of milk expression for 10 days after birth. ResultsThe mean knowledge scores of the nurse-midwives at post-1 and post-2 were significantly higher than that at pre-2 (post-1: p < 0.001, post-2: p < 0.001). The attitude on care scores at post-1 and post-2 were significantly higher than that at pre-2 (post-1: p < 0.001, post-2: p = 0.010). The care implementation score at post-2 was significantly higher than that at pre-2 in eight items (e.g., Q7 Explain about the effect of initiating milk expression early and assist mothers in it). However, the educational program did not cause any changes in the mothers’ initiation and frequency of milk expression, and breast milk volume after birth. ConclusionsThe significant increases in the knowledge, attitude on care, and care implementation scores of the nurse-midwives suggest the beneficial effects of the educational program. Further detailed examination of the effects of the program on nurses and nurse-midwives, and identification of methods to reduce barriers to the practice of best evidence in the clinical setting are warranted to improve mothers’ status of milk expression.
Task-shifting to Improve Asthma Education for Malawian Children: a Qualitative Analysis
Authors: Nkhalamba Lovemore , Rylance Sarah , Muula Adamson S. , Mortimer Kevin , Limbani Felix
Published: December 2020

Background:Asthma education, a key component of long-term asthma management, is challenging in resource-limited settings with shortages of clinical staff. Task-shifting educational roles to lay (non-clinical) staff is a potential solution. We conducted a randomised controlled trial of an enhanced asthma care intervention for children in Malawi, which included reallocation of asthma education tasks to lay-educators. In this qualitative sub-study, we explored the experiences of asthmatic children, their families and lay-educators, to assess the acceptability, facilitators and barriers, and perceived value of the task-shifting asthma education intervention.Methods:We conducted 6 focus group discussions, including 15 children and 28 carers, and individual interviews with 4 lay-educators and a senior nurse. Translated transcripts were coded independently by three researchers and key themes identified. Results:Prior to the intervention, participants reported challenges in asthma care including the busy and sometimes hostile clinical environment, lack of access to information and the erratic supply of medication. The education sessions were well received: participants reported greater understanding of asthma and their treatment and confidence to manage symptoms. The lay-educators appreciated pre-intervention training, written guidelines, , and access to clinical support. Low education levels among carers presented challenges, requiring an open, non-critical and individualised approachDiscussion:Asthma education can be successfully delivered by lay-educators with adequate training, supervision and support, with benefits to the patients, their families and the community. Wider implementation could help address human resource shortages and support progress towards Universal Health Coverage.Trial Registration:The RCT was registered in the Pan African Clinical Trials Registry: PACTR201807211617031
A Situational Analysis of the Specialist Anaesthesia Workforce of East, Central and Southern Africa
Authors: Asingei Juventine , O'Flynn Eric , O'Donovan Diarmuid , Masuka Sophia , Mashava Doreen , Akello Faith , Ulisubisya Mpoki
Published: December 2020

Background: An accurate account of the distribution of qualified anaesthesiologists in East, Central and Southern Africa has been lacking with most of the current publications being estimates of headline figures. As university training programmes, and more recently the College of Anaesthesiologists of East, Central and Southern Africa (CANECSA), work to scale up the anaesthesiology workforce, it is crucial to understand the scope of the need by carrying out an extensive survey. This is key to informing policymakers and stakeholders for tackling the problem of human resources for anaesthesia.Methods: The anaesthesiologist distribution in the eight CANECSA member countries was determined using a combination existing databases and collection of new data from sources such as CANECSA records, national medical council registers, national anaesthesiology society records, as well as data validation through direct and indirect contact with the anaesthesiologists. Data collation and analysis was performed using Microsoft Excel Spreadsheets and SPSS by assessing relevant frequencies and crosstabulations. Data was stored in a cloud-based database managed by CANECSA.Results: 411 qualified anaesthesiologists were identified within the CANECSA member countries, a rate of 0.21 anaesthesiologists per 100,000 population compared to 333 (0.17 anaesthesiologists per 100,000 population) reported by the World Federation of Societies of Anaesthesiology (WFSA) in 2015/2016. Newly quantified details on the distribution of anesthesiologists in the region include: the majority (89.5%) of anaesthesiologists perform clinical work and most (69.3%) are based in the main commercial cities of their countries of practice; only about one third (35.5%) are female; the majority are employed by government institutions (61.6%) and medical-training institutions (59.4%); and almost half (49.2%) of anaesthesiologists whose age was recorded ranged from 30 to 39 years. Conclusion: The numbers of anaesthesiologists in CANECSA member countries are still far below all international recommendations constituting only about 5% of the minimum recommended figures for LMICs. Anaesthesiologist are highly concentrated in the major cities of the region, with few in provincial and rural areas. Nonetheless, all trends suggest huge opportunities for advancing training of more anaesthesiologists through collaborative efforts.
Citizen workshops in public libraries to disseminate and discuss primary care research results: a scaling-up study
Authors: Massougbodji José , Zomahoun Hervé Tchala Vignon , Adisso Evehouenou Lionel , Sawadogo Jasmine , Borde Valérie , Cameron Cynthia , Moisan Hélène , Paquette Jean-Sébastien , Akbaraly Zamzam , Châteauneuf Lëa-Kim , David Geneviève , Légaré France
Published: December 2020

Background

Little is known about engaging patients and stakeholders in the process of scaling up effective knowledge translation interventions targeting the general public. Using an integrated knowledge translation approach, we aimed to scale up and evaluate an effective pilot program of disseminating research results in public libraries.
Methods

We conducted a scaling-up study targeting the general public. Based on our successful pilot project, we co-developed and implemented a larger-scale program of free citizen workshops in public libraries, this time in close research partnership with stakeholders and patient representatives. Citizen workshops, each facilitated by one participating physician and one science communicator, consisted of a 45-min computer-assisted presentation and a 45-min open exchange. Additional scale-up costs included offering financial incentives to stakeholders involved and the purchase of audio-visual equipment. The intervention outcome was knowledge gained. Scale-up outcomes were satisfaction, appropriateness, coverage, time and costs. An evaluation questionnaire was used to collect data of interest. Both quantitative and qualitative analyses were performed.
Results

The workshop theme chosen by patient and stakeholder representatives was the high prevalence of medication overuse among people over 65 years of age. From April to May 2019, 26 workshops were given in 25 public libraries reaching 362 people. Eighteen participating physicians and six science communicators facilitated the workshops. Participants reported significant knowledge gain (mean difference 2.1, 95% CI 2.0–2.2, P < .001). Median score for overall public satisfaction was 9/10 (IQR 8–10). A high level of appropriateness of the workshops was globally rated by the public participants Coverage was 92.6% of the total number of public libraries targeted. Costs were $6,051.84 CAD for workshop design and $22,935.41 CAD for scaling them up.
Conclusion

This project successfully established a large-scale and successful KT bridge between researchers, clinicians, and citizens via public libraries. This study provides a model for a dissemination practice that benefits the general public by both engaging them in the dissemination process and by targeting them directly.
Effectiveness of Decontamination protocols when Analyzing Ancient DNA Preserved in Dental Calculus
Authors: Farrer Andrew , Wright Sterling , Skelly Emily , Eisenhofer Raphael , Dobney Keith , Weyrich Laura
Published: December 2020

Ancient DNA analysis of human oral microbial communities within calcified dental plaque (calculus) has revealed key insights into human health, paleodemography, and cultural behaviors. However, contamination imposes a major concern for paleomicrobiological samples due to their low endogenous DNA content and exposure to environmental sources, calling into question some published results. Decontamination protocols (e.g. an ethylenediaminetetraacetic acid (EDTA) pre-digestion or ultraviolet radiation (UV) and bleach immersion treatments) aim to minimize the exogenous content of the outer surface of ancient calculus samples prior to DNA extraction. While these protocols are efficient, no one has systematically compared them. Here, we compare untreated dental calculus samples to four previously published decontamination protocols: a UV only treatment; a 5% sodium hypochlorite (bleach) immersion treatment; a pre-digestion in EDTA treatment; and a combined UV irradiation and 5% bleach immersion treatment. We examine their efficacy in ancient oral microbiota recovery by applying 16S rRNA gene amplicon and shotgun sequencing to ancient calculus samples from a single site. We identify ancient oral microbiota, as well as soil and skin contaminants. Overall, both the EDTA and UVB treatments are effective at reducing the proportion of environmental taxa while increasing oral taxa in relation to untreated samples.
Metformin extended-release versus metformin immediate-release for adults with type 2 diabetes mellitus: a systematic review and meta-analysis of randomized controlled trials
Authors: Abrilla Aedrian A. , Pajes A. Nico Nahar I. , Jimeno Cecilia A.
Published: December 2020

This systematic review aimed to compare the efficacy and tolerability of metformin extended-release (MXR) and the conventional metformin immediate-release (MIR) in adults with type 2 diabetes mellitus (T2DM). PubMed, the Cochrane Library and ClinicalTrials.gov, from database inception to 15 October 2020, and other sources were searched for randomized controlled trials (RCTs) that compared equal daily doses of MXR and MIR in adults with T2DM. Random-effects model meta-analysis was performed to obtain pooled mean difference (MD) of change from baseline for continuous outcomes (glycemic and serum lipid control and anthropometrics) and risk ratio (RR) for dichotomous outcomes (gastrointestinal and serious adverse events). Statistical analysis involving 9 published RCTs with 2609 subjects revealed that MIR was associated with better HbA1c lowering (MD 0.09% [95% confidence interval, 0.02%, 0.17%]) and serum lipid control except LDL-C lowering, while MXR reduced only the cumulative incidence of dyspepsia (RR 0.58 [0.34, 0.98]). MXR and MIR were similar in all other considered outcomes. The use of MXR over MIR among adults with T2DM was associated with statistically worse but likely clinically insignificant HbA1c lowering, similar plasma glucose lowering, and minimal improvement of metformin intolerance. This information may guide patient-physician discussions in choosing between the two formulations.
Two Novel Mouse Models Mimicking Minor Deletions in 22q11.2 Deletion Syndrome Revealed the Contribution of Each Deleted Region to Psychiatric Disorders
Authors: Saito Ryo , Miyoshi Chika , Koebis Michinori , Kushima Itaru , Nakao Kazuki , Mori Daisuke , Ozaki Norio , Funato Hiromasa , Yanagisawa Masashi , Aiba Atsu
Published: December 2020

22q11.2 deletion syndrome (22q11.2DS) is a disorder caused by the segmental deletion of human chromosome 22. This chromosomal deletion is known as high genetic risk factors for various psychiatric disorders. The different deletion types are identified in 22q11.2DS patients, including the most common 3.0-Mb deletion, and the less-frequent 1.5-Mb and 1.4-Mb deletions. In previous animal studies of psychiatric disorders associated with 22q11.2DS mainly focused on the 1.5-Mb deletion and model mice mimicking the human 1.5-Mb deletion have been established with diverse genetic backgrounds, which resulted in the contradictory phenotypes. On the other hand, the contribution of the genes in 1.4-Mb region to psychiatric disorders is poorly understood. In this study, we generated two mouse lines that reproduced the 1.4-Mb and 1.5-Mb deletions of 22q11.2DS [Del(1.4Mb)/+ and Del(1.5Mb)/+] on the pure C57BL/6N genetic background. These mutant mice were analyzed comprehensively by behavioral tests, such as measurement of locomotor activity, sociability, prepulse inhibition and fear-conditioning memory. Del(1.4Mb)/+ mice displayed decreased locomotor activity, which possibly reproduces the negative symptoms of schizophrenia. Del(1.5Mb)/+ mice showed reduction of prepulse inhibition and impairment of contextual- and cued-dependent fear memory, which is consistent with previous reports. Furthermore, apparently intact social recognition in Del(1.4Mb)/+ and Del(1.5Mb)/+ mice suggests that the impaired social recognition requires mutations both in 1.4-Mb and 1.5 Mb regions. Our previous study has shown that Del(3.0Mb)/+ mice mimicking the human 3.0-Mb deletion presented disturbance of behavioral circadian rhythm. Therefore, we further evaluated sleep/wakefulness cycles in Del(3.0Mb)/+ mice by electroencephalogram (EEG) and electromyogram (EMG) recording. EEG/EMG analysis revealed the disturbed wakefulness and non-rapid eye moving sleep (NREMS) cycles in Del(3.0Mb)/+ mice, suggesting that Del(3.0Mb)/+ mice may be unable to maintain their wakefulness. Together, our mouse models deepen our understanding of genetic contributions to schizophrenic phenotypes related to 22q11.2DS.
Intersection between ageing-related Genes and SARS-CoV-2 Interactome: Is it higher than expected?
Authors: Guzzi Pietro Hiram , Pedace Elisabetta , Giorgi Federico Manuel
Published: December 2020

Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection (coronavirus disease, 2019; COVID-19) is associated with adverse outcomes in patients. It has been observed that lethality seems to be related to the age of patients. Moreover, it has been demonstrated that ageing causes some modiﬁcations at a molecular level.Objective: The study aims to investigate a possible link between the increased COVID-19 lethality and the molecular changes that occur in elderly people.Methods: We considered publicly available datasets on ageing-related genes and SARS-CoV-2 interactors. Then, for each SARS-CoV-2 protein interactor, we tested for the enrichment of ageing-related proteins. Finally, we performed a network-based analysis to identify which molecular mechanisms could play a role in the SARS-CoV-2 molecular aetiology and ultimately affect COVID-19 outcome.Results: We observed a signiﬁcant intersection between some SARS-CoV-2 interactors and ageing-related genes. Our analysis evidenced that virus infection particularly affects ageing molecular mechanisms centred around proteins EEF2, NPM1, HMGA1, HMGA2, APEX1, CHEK1, PRKDC, and GPX4.Conclusion: Our study generated a mechanistic framework aiming at explaining the correlation between COVID-19 incidence in elderly patients and molecular mechanisms of ageing. This will provide testable hypotheses for future investigation on the mechanism of action of coronaviruses and pharmacological solutions tailored on speciﬁc age ranges.
A Primitive-Based Reverse Modeling Method for Obtaining the Editable CAD model of Reversed Parts
Authors: Jin Hui , Wei Xiaoling , Liu Huilan , Zhang Jinping , Yao Jin
Published: December 2020

By the traditional inversion methods, the model of the part reversed is obtained in mesh feature , which is hard to edit and redesign. In the paper, for the revised part, a modeling method to obtain the editable CAD mode was proposed. Firstly, an approach to construct the primitive structure tree used to describe the geometric structure of a part was proposed, by which the all the basic geometry primitives and their Boolean operations are logically arranged in tree format. Then, for each basic geometry primitive, a method to calculate the characteristics parameters and position and posture was proposed, which could be used to guide reversion measurement and modeling. For the basic primitives made of quadratic surface, a method for modeling the torus surface, whose model little research has been carried on, was proposed in which the torus surface equation is deduced by coordinate transformation method, has 8 independent parameters. Last, based on the guidance of primitive structure tree, a process for the characteristics parameters, minimum measuring points, forward modeling, positioning and assembly process was proposed, which could be used to direct measurements and to forward modeling. The example showed that the method proposed could be used to reverse the parts in the editable CAD model and provide for subsequent optimization design services.
Accuracy Improvements for Cold-Start Recommendation Problem using Indirect Relations in Social Networks
Authors: Tey Fu Jie , Wu Tin-Yu , Lin Chiao-Ling , Chen Jiann-Liang
Published: December 2020

Recent advances on Internet applications have facilitated information spreading. Thanks to a wide variety of mobile devices and the burgeoning 5G networks, users gain access easily and quickly to information. Also, the great amount of digital information has contributed to the emergence of recommender systems that help information filtering. As the rise of mobile networks has pushed forward the growth of social media networks, users have gotten used to posting whatever they do and wherever they visit on the Web. Nevertheless, quick social media updates can make it difficult for users to find historical data. For this reason, this paper presents a social network-based recommender system. Our purpose is to build a user-centered recommender system to exclude the products that users are disinterested in according to user preferences and their friends' shopping experiences so as to make recommendations effective. There is normally no corresponding reference value for new products or services, so we use the indirect relations between friends and "friends’ friends" as well as sentinel friends to improve the recommendation accuracy. Our proposed mechanism has been proven efficient in enhancing recommendation accuracy.
External validity of phase III trials on vaccines against SARS-CoV-2 to a middle-aged and elderly Western European population
Authors: Terzikhan Natalie , Hofman Albert , Goudsmit Jaap , Ikram M. Arfan
Published: December 2020

Background: Initial results from various phase-III trials on vaccines against SARS-CoV-2 are promising. For proper translation of these results to clinical guidelines, it is essential to determine how well the general population is reflected in the study populations of these trials.Methods: This study was conducted among 7162 participants (age-range: 51-106 years; 58% women) from the Rotterdam Study. We quantified the proportion of participants that would be eligible for the nine ongoing phase-III trials. We further quantified the eligibility among participants at high risk to develop severe COVID-19. Since many trials were not explicit in their exclusion criterion with respect to ‘acute’ or ‘unstable preexisting’ diseases, we performed two analyses. First, we included all participants irrespective of this criterion. Second, we excluded persons with acute or ‘unstable preexisting’ diseases.Results: 97% of 7162 participants was eligible for any trial with eligibility for separate trials ranging between 11%-97%. For high-risk individuals the corresponding numbers were 96% for any trial with separate trials ranging from 5%-96%. Importantly, considering persons ineligible due to ‘acute’ or ‘unstable pre-existing’ disease drastically dropped the eligibilities for all trials below 43% for the total population and below 36% for high-risk individuals.Conclusion: The generalisability of phase-III trials to the general population depends largely on the interpretation and application of the criterion ‘acute’ or ‘unstable pre-existing’ disease, which reduces the generalisability by half. This indicates the importance of developing clinical recommendations applicable to the appropriate target populations and cautions against ad hoc wide-spread use of any effective vaccine.
Zimbabwe’s Indigenous SME policy Framework, a tool for black empowerment
Authors: Musabayana Godfrey Tambudzayi , Mutambara Emmanuel
Published: December 2020

Small to Medium Enterprise (SMEs) play a pivotal role in growing the economy as well as alleviating poverty across the marginalised citizens, especially in an economy such has Zimbabwe, which has experienced indiscriminate closure of large corporates to advance the indigenisation thrust of the government. In response to the closure of large corporates, Zimbabwe focused on SMEs as an alternative to close the gap. The Zimbabwe Industrial Development Policy (IDP) and the Indigenisation and Empowerment Policy (IEP) were put in place as the vehicles of economic transformation. This article analyses the impact of these two policies on the performance Zimbabwean SMEs. The article contributes knowledge on how African governments respond to economic crisis through the policies that they enact targeting the enterprises of the local citizens. Methodologically, the study critically analyses the literature on SME policies and performance in Zimbabwe. The article drew insights from both the IDP and IEP as well as form findings from other secondary studies.
Effect of activity level after a posterior-stabilized TKA on the relative bone mineral density measured on standard radiographs in periprosthetic tibial bone
Authors: Liu Yong , He Peiheng , Li Xing , Ye Yongheng , Liu Minghao , Chen Weizhi , XU Dongliang
Published: December 2020

Background: The aim of this study was to evaluate the effect of activity level after a posterior-stabilized total knee arthroplasty (TKA) on the relative bone mineral density (rBMD) measured on standard radiographs in periprosthetic tibial bone. Methods: A retrospective review identified 110 patients (110 knees，20 men/90 women) who underwent PS TKA with 5 years follow-up. Patients activity level was evaluated by University of California Los Angeles (UCLA) activity score, and the rBMD in periprosthetic tibial bone was measured on anteroposterior X-ray images. Clinical assessments included Western Ontario and McMaster Universities (WOMAC), Knee Society score (KSS) and visual analogue scale (VAS). Nonlinear regression analysis was used to assess the impact of activity levels on periprosthesis bone density.Results: During 5-year follow-up period, the bone density in the medial, lateral and distal areas decreased compared with that before surgery (p<0.0001). There was a U-shaped distribution between UCLA activity rating and rBMD loss, with the lowest rBMD loss when the UCLA activity score was between 6-8 at 1 and 3 years. The curve fitting of UCLA activity level and rBMD% showed there was a parabolic relationship between UCLA activity level and rBMD% at 1 and 3 years after surgery (P<0.001, P=0.001), while there was no significant relationship between UCLA activity level and rBMD% at 5 years after surgery (P=0.436).Conclusions: We found that physical activity had a significant effect on radiographic measurements of BMD at 1 and 3 years but not at 5 years. Moderate activity may be associated with less proximal tibial BMD loss after TKA, therefore it may be the most appropriate activity intensity for patients with TKA.
A qualitative meta-synthesis of facilitators and barriers to tuberculosis diagnosis and treatment in Nigeria
Authors: Oga-Omenka Charity , Wakdet Lawrence , Menzies Dick , Zarowsky Christina
Published: December 2020

Background Despite progress in tuberculosis (TB) control globally, TB continues to be a leading cause of death from infectious diseases, claiming 1.2 million lives in 2018; 214,000 of these deaths were due to drug resistant strains. Of the estimated 10 million cases globally in 2018, 24% were in Africa, with Nigeria and South Africa making up most of these numbers. Nigeria ranks 6th in the world for TB burden, with an estimated 4.3% multi-drug resistance in new cases. However, the country had one of the lowest case detection rates, estimated at 24% of incident cases in 2018 - well below the WHO STOP TB target of 84%. This rate highlights the need to understand contextual issues influencing tuberculosis management in Nigeria. Our synthesis was aimed at synthesizing qualitative evidence on factors influencing TB care in Nigeria. Methods A three-stage thematic meta-synthesis of qualitative studies was used to identify barriers and facilitators to tuberculosis case finding and treatment in Nigeria. A purposive search of eleven databases was conducted. The date of publication was limited to 2006 to June 2020. We analyzed articles using a three-stage process, resulting in coding, descriptive subthemes and analytical themes. Results Our final synthesis of 10 articles resulted in several categories including community and family involvement, education and knowledge, attitudes and stigma, alternative care options, health system factors (including coverage and human resource), gender, and direct and indirect cost of care. These were grouped into three major themes: individual factors; interpersonal influences; and health system factors. Conclusion Case finding and treatment for TB in Nigeria currently depends more on individual patients presenting voluntarily to the hospital for care, necessitating an understanding of patient behaviors towards TB diagnosis and treatment. Our synthesis has identified several related factors that shape patients’ behavior towards TB management at individual, community and health system levels that can inform future interventions.
Sex differences and Psychological Stress: Responses to the COVID-19 epidemic in China
Authors: Yan Shiyan , Xu Rui , Stratton Terry D. , Kavcic Voyko , Luo Dan , Hou Fengsu , Bi Fengying , Jiao Rong , Song Kangxing , Jiang Yang
Published: December 2020

Background About 83,000 COVID-19 patients were confirmed in China up to May 2020. Amid the well-documented threats to physical health, the effects of this public health crisis - and the varied efforts to contain its spread - have altered individuals’ “normal” daily functioning. These impacts on social, psychological, and emotional well-being remain relatively unexplored – in particular, the ways in which Chinese men and women experience and respond to potential behavioral stressors. Our study investigated sex differences in psychological stress, emotional reactions, and behavioral responses to COVID-19 and related threats among Chinese residents. Methods In late February (2020), an anonymous online questionnaire was disseminated via WeChat, a popular social media platform in China. The cross-sectional study utilized a non-probabilistic “snowball” or convenience sampling of residents from various provinces and regions of China. Basic demographic characteristics (e.g., age and gender) – along with residential living arrangements and conditions – were measured along with psychological stress and emotional responses to the COVID-19 pandemic.Results 3,088 questionnaires were returned: 1,749 females (56.6%) and 1,339 males (43.4%). The mean stress level,as measured by a visual analog scale, was 3.4 (SD=2.4) - but differed significantly by sex. Besides sex, factors positively associated with stress included: age (<45 years), employment (unsteady income, unemployed), risk of infection (exposureto COVID-19，completed medical observation), difficulties encountered (diseases, work/study, financial, mental), and related behaviors (higher desire for COVID-19 knowledge, more time concerning on the COVID-19 outbreak). “Protective” factors included frequent contact with colleagues, calmness of mood comparing with the pre-pandemic, and psychological resilience. Males and females also differed significantly in adapting to current living/working, conditions, responding to run a fever, and needing psychological support services. Conclusions The self-reported stress of Chinese residents related to the COVID-19 pandemic was significantly related to sex, age, employment, resilience and coping styles. Future responses to such public health threats may wish to provide sex- and/or age-appropriate supports for psychological health and emotional well-being to those at greatest risk of experiencing stress.
Comprehensiveness of Distributed Medical Education Systems: A Regional Population-Based Perspective
Authors: Burrows Andrea , Laupland Kevin
Published: December 2020

Background: The core business of medical schools includes clinical (education and service) and academic (research) activities. Our objective was to assess the degree to which these activities exist in a distributed medical education system in Canada.Methods: A population-based design was utilized. Programs were contacted and public records were searched for medical trainees and faculty positions within a province in Canada during the 2017/2018 academic year. Data were expressed as positions per 100,000 residents within the Lower Mainland, Island, and Northern and Southern interior regions.Results: Substantial differences in the distribution of medical students by region was observed with the highest observed in the Northern region at 45.5 per 100,000 as compared to Lower Mainland, Island, and Southern regions of 25.4, 16.8, 16.0 per 100,000, respectively. The distribution of family medicine residents was less variable with 14.9, 10.7, 8.9, and 5.8 per 100,000 in the Northern, Island, Southern, and Lower Mainland regions, respectively. In contrast, there was a marked disparity in distribution of specialty residents with 40.8 per 100,000 in the Lower Mainland as compared to 7.5, 3.2, and 1.3 per 100,000 in the Island, Northern, and Southern regions, respectively. Clinical faculty were distributed with the highest observed in the Northern region at 180.4 per 100,000 as compared to Southern, Island, and Lower Mainland regions of 166.9, 138.5, and 128.4, respectively. In contrast, academic faculty were disproportionately represented in the Lower Mainland and Island regions (92.8 and 50.7 per 100,000) as compared to the Northern and Southern (1.4 and 1.2 per 100,000) regions, respectively. Conclusion: While there has been successful redistribution of medical students, family medicine residents, and clinical faculty, this has not been the case for specialty residents and academic faculty.
Chromosomal painting of the sandpiper (Actitis macularius) detects several fissions for the Scolopacidae family (Charadriiformes)
Authors: Pinheiro Melquizedec Luiz Silva , Nagamachi Cleusa Yoshiko , Ribas Talita Fernanda Augusto , Diniz Cristovam Guerreiro , O´Brien Patricia Caroline Mary , Ferguson-Smith Malcolm Andrew , Yang Fengtang , Pieczarka Julio Cesar
Published: December 2020

Background: The Scolopacidae family (Suborder Scolopaci, Charadriiformes) is composed of sandpipers and snipes; these birds are long-distance migrants that show great diversity in their behavior and habitat use. Cytogenetic studies in the Scolopacidae family show the highest diploid numbers for order Charadriiformes. This work analyzes for the first time the karyotype of Actitis macularius by classic cytogenetics and chromosome painting. Results: The species has a diploid number of 92, composed mostly of telocentric pairs. This high 2n is greater than the proposed 80 for the avian ancestral putative karyotype (a common feature among Scolopaci), suggesting that fission rearrangements have formed smaller macrochromosomes and microchromosomes. Fluorescence In Situ Hybridization using Burhinus oedicnemus whole chromosome probes confirmed the fissions in pairs 1, 2, 3, 4 and 6 of macrochromosomes. Conclusion: Comparative analysis with other species of Charadriiformes studied by chromosome painting together with the molecular phylogenies for the order allowed us to raise hypotheses about the chromosomal evolution in suborder Scolopaci. From this, we can establish a clear idea of ​​how chromosomal evolution occurred in this suborder.
Possible association of polymorphisms in ubiquitin specific peptidase 46 gene with post-traumatic stress disorder
Authors: Seo Jun-ho , Kim Tae-yong , Kim Se-joo , Choi Jin-hee , So Hyung-seok , Kang Jee In
Published: December 2020

Background: Dynamic proteolysis, through the ubiquitin-proteasome system, has an important role in DNA transcription and cell cycle, and is considered to modulate cell stress response and synaptic plasticity. We investigated whether genetic variants in the ubiquitin carboxyl-terminal hydrolase 46 (USP46) would be associated with posttraumatic stress disorder (PTSD) in people with exposure to combat trauma using a case-control candidate gene association design. Methods: Korean male veterans exposed to the Vietnam War were grouped into those with (n = 128) and without (n = 128) PTSD. Seven tagging SNPs of USP46 were selected, and single-marker and haplotype-based association analyses were performed. All analyses were adjusted for sociodemographic factors and levels of combat exposure severity and alcohol problem. Results: One single-marker (rs2244291) showed nominal evidence of association with PTSD status and with the ‘re-experiencing’ cluster, although the association was not significant after Bonferroni correction. No significant association with the other SNPs or the haplotypes was detected. Conclusion: The present finding suggests preliminarily that genetic vulnerability regarding the ubiquitin-proteasome system may be related to fear memory processes and the development of PTSD symptoms after trauma exposure. Further studies with a larger sample size will be needed to examine the role of the ubiquitin-proteasome system including USP46 in PTSD.
Financial Inclusion and the Growth of Small Medium Enterprises in Uganda: Empirical Evidence from Selected Districts in Lango Sub Region
Authors: Eton Marus - , Mwosi Fabian - , Okello-Obura Constant - , Turyehebwa Abanis - , Uwonda Gilbert -
Published: December 2020

The growth and failure of small and medium enterprises has been a topic of discussions world over amongst policy makers and researchers. This study was guided by the following objectives: To examine the contributions of Small Medium Enterprises (SMEs), to determine the challenges affecting Small Medium Enterprises, to examine how financial inclusiveness supports the growth of Small medium enterprises and to establish the relationship between financial inclusion and Small Medium Enterprises. The study used a cross sectional research design. Descriptive design was used and supplemented by inferential statistics. Correlation and regression analysis were adopted. The study revealed that financial inclusion is significant in supporting SMEs growth. The study also revealed that cost of acquiring and servicing financial services are high, there is also difficulty in using some of the financial services, and the way financial providers treat financial users, some lacked some degree of respect and dignity. The study recommends that financial providers should continue sensitizing the public on the available financial services beyond credit services, which are common and known. Digital financial service providers should encourage their clientele to use digitalized financial services which are cheap, secure and risk averse. Cost of capital should also be reduced to encourage borrowing while SMEs should innovatively produce goods that can be competitive at both domestic and international markets.
Artificial Pneumothorax Improves Radiofrequency Ablation of Pulmonary Metastases of Hepatocellular Carcinoma close to Mediastinum
Authors: Zuo Taiyang , Lin Wenli , Liu Fengyong , Xu Jinshun
Published: December 2020

Background: To investigate the feasibility, safety and efficacy of percutaneous radiofrequency ablation (RFA) of pulmonary metastases from hepatocellular carcinoma (HCC) contiguous with the mediastinum using the artificial pneumothorax technique.Method: A total of 40 lesions in 32 patients with pulmonary metastases from HCC contiguous with the mediastinum accepted RFA treatment from August 2014 to May 2018 via the artificial pneumothorax technique. After ablation, clinical outcomes were followed up by contrast enhanced CT. Technical success, local tumor progression (LTP), intrapulmonary distant recurrence (IDR), and adverse events were evaluated. Overall survival (OS) and local tumor progression free survival (LTPFS) were recorded for each patient. Results: The tumor size was 1.4 ± 0.6 cm in diameter. RFA procedures were all successfully performed without intra-ablative complications. Technical success was noted in 100% of the patients. 5 cases of LTP and 8 cases of IDR occurred following the secondary RFA for treatment. Slight pain was reported in all patients. No major complications were observed. The 1, 2, and 3-year LTPFS rates were 90.6%, 81.2%, and 71.8%, and the 1, 2, and 3-year OS rates were 100%, 100% and 87.5%, respectively.Conclusion: Artificial pneumothorax adjuvant RFA is a feasible, safe, and efficient method for treatment of pulmonary metastases from HCC contiguous with the mediastinum.