bluuebunny/crossref_metadata_2025 huggingface dataset:
Exploring the attitudes of men who have sex with men on anal self-examination for early detection of primary anorectal syphilis: a qualitative study
Authors: Aung Ei T. , Fairley Christopher K. , Ong Jason J. , Bilardi Jade E. , Chen Marcus Y. , Chow Eric P. F. , Phillips Tiffany R.
Published: September 2021

Background

Studies show men who have sex with men (MSM) practising receptive anal sex are more likely to present with secondary syphilis, suggesting anorectal primary lesions are being missed. Regular anal self-examination might be able to detect anorectal syphilis lesions, hence potentially reducing transmission. This study aimed to explore the attitudes of MSM on performing anal self-examination to detect primary syphilis.

Methods

In this qualitative study, 20 MSM over 18 years of age were purposively sampled from a sexual health clinic to participate in semi-structured interviews. Interviews were recorded, transcribed verbatim and data analysed thematically.

Results

Four major themes and 12 sub-themes were generated from the study: (1) reasons for performing anal self-examination, (2) preferred educational resources for anal self-examination, (3) attitudes towards partner anal examination, and (4) acceptability of anal self-examination. Most participants had performed some form of anal self-examination in the past, and, just over half performed regularly for mostly health-related concerns. Most participants who infrequently or never performed anal self-examination were agreeable to perform regularly if it was recommended by health professionals with appropriate guidance. Participants preferred education on anal self-examination from health professionals and trusted online learning resources.

Conclusion

Our study showed MSM were agreeable to anal self-examination however would like to receive education and training to gain more confidence in conducting anal self-examination as a screening tool. Further studies are required to explore the adherence and acceptability of anal self-examination for syphilis prior to studies examining efficacy. The study provides foundation for any future policy aiming at utilising anal self-examination as a screening tool for syphilis among MSM.
Effect of perceived HIV risk on initiation of antiretroviral therapy during the universal test and treat era in South Africa
Authors: Govere Sabina M. , Galagan Sean , Tlou Boikhutso , Mashamba-Thompson Tivani , Bassett Ingrid V. , Drain Paul K.
Published: September 2021

Background

South Africa has not achieved the 90–90–90 goals, in part due to low rates of antiretroviral therapy (ART) initiation among those aware of their HIV status. Perceived risk of HIV at the time of testing may affect likelihood of rapid ART initiation. The purpose of this study was to evaluate factors associated with perceived risk of HIV and the relationship between perceived HIV risk and rapid ART initiation during the universal test and treat era which was adapted in October 2016.

Methods

We conducted a prospective study of adults undergoing HIV testing from October 2016–February 2019 at Ithembalabantu Clinic in Durban. Eligible participants reported not previously being diagnosed with HIV. Before HIV testing, participants were asked to assess their perceived HIV risk on a four-level scale. We categorized “definitely not” and “probably not going to acquire HIV” as a low perceived risk, and “probably will” and “definitely will become HIV-infected” as a high perceived risk of HIV infection. Participants were followed for up to 14 months following HIV testing to assess ART initiation.

Results

Among 1519 people newly diagnosed with HIV, 55% were female and mean age was 33 years. Among those, 1382 (90.9%) had a high HIV risk perception and 137 (9.1%) reported low HIV risk perception. In the low risk group individuals were more likely to be female (58% vs 55%), unemployed (62% vs 59%), have a partner with unknown HIV status (61% vs 55%) compared to the high risk group. 83.2% of those with low HIV risk perception reported previously HIV testing compared 91.5% of those with high HIV risk perception. In the multivariate model, males were associated with a higher chances of initiating ART compared to females (adjusted hazard ratio (aHR): 1.187, CI 1.187 (1.060–1.329) and being unemployed (aHR 0.767 CI (0.650–0.905). Those with a low HIV risk perception were less likely to initiate ART 125 (91%) vs 1310 (95%) p = 0.022), and took longer to initiate on ART after HIV diagnosis (11 days’ vs 4 days, p = 0.042).

Conclusion

Factors associated with high HIV risk perception included being unemployed, single, and having a partner of unknown HIV status. People living with HIV (PLHIV) in South Africa who had a low self-perceived risk to HIV infection were less likely to initiate ART. Assessing self-perceived risk of HIV infection may help direct counselling and improve ART initiation to achieve universal 90–90–90 goal.
Validation of Mini-Mental Adjustment to Cancer scale in a Moroccan sample of breast cancer women
Authors: Ragala Mohammed El Amine , El Hilaly Jaouad , Amaadour Lamiae , Omari Majid , AsriI Achraf E. L. , Atassi Mariam , Benbrahim Zineb , Mellas Nawfel , Rhazi Karima E. L. , Halim Karima , Zarrouq Btissame
Published: September 2021

Background

The Mini-Mental Adjustment to Cancer Scale (Mini-MAC) instrument is commonly used worldwide by professionals of oncology, but the scale has not, up to date, been validated in Arabic and Moroccan context, and there is an absence of data in the Moroccan population. This study aims to validate the Mini-MAC, translated and adapted to the Arabic language and Moroccan culture, in women with breast cancer.

Methods

Data were analyzed in two successive phases. First, exploratory factor analysis (EFA) was used to assess the factor structure in the pilot sample (N = 158). Then, this structure was confirmed in the validation sample (N = 203) using confirmatory factor analysis (CFA).

Results

Confirmatory factor analysis confirmed Watson’s original structure underlying the Mini-MAC items: Helpless/Hopeless, Anxious Preoccupation, Fighting Spirit, Cognitive Avoidance, and Fatalism. Absolute, incremental, and parsimonious fit indices showed a highly significant level of acceptance confirming a good performance of the measurement model. The instrument showed sufficient reliability and convergent validity demonstrated by acceptable values of composite reliability (CR =0.93–0.97), and average variance extracted (AVE = 0.66–0.93), respectively. The square roots of AVE were higher than factor-factor pairs correlations, and the Heterotrait-Monotrait ratio of correlations values were lesser than 0.85, indicating acceptable discriminant validity.

Conclusions

reliability; and both convergent and discriminant validity tests indicated that the Arabic version of the Mini-MAC had a good performance and may serve as a valid tool measuring psychological responses to cancer diagnosis and treatment.
An individually randomized controlled trial of a mother-daughter HIV/STI prevention program for adolescent girls and young women in South Africa: IMARA-SA study protocol
Authors: Donenberg Geri R. , Atujuna Millicent , Merrill Katherine G. , Emerson Erin , Ndwayana Sheily , Blachman-Demner Dara , Bekker Linda Gail
Published: September 2021

Background

South Africa has the world’s largest HIV epidemic, but South African adolescent girls and young women (AGYW) acquire HIV at twice the rate of and seroconvert on average 5–7 years earlier than their male peers. Female caregivers (FC) are an untapped resource for HIV/STI prevention in South Africa and offer a novel opportunity to strengthen AGYW prevention efforts. This study will evaluate the effectiveness and cost-effectiveness of an evidence-based mother-daughter HIV/STI prevention program tested in the United States and adapted for South Africa, Informed Motivated Aware and Responsible Adolescents and Adults (IMARA), to decrease STI incident infections and increase HIV testing and counseling (HTC) and PrEP uptake in AGYW.

Methods

This is a 2-arm individually randomized controlled trial comparing IMARA to a family-based control program matched in time and intensity with 525 15–19-year-old Black South African AGYW and their FC-dyads in Cape Town’s informal communities. AGYW will complete baseline, 6-, and 12-month assessments. Following randomization, AGYW-FC dyads will participate in a 2-day group workshop (total 10 h) that includes joint and separate mother and daughter activities. Primary outcomes are AGYW STI incidence, HTC uptake, and PrEP uptake at 6 months. Secondary outcomes are AGYW STI incidence, HTC uptake, and PrEP uptake at 12 months, sexual behavior (e.g., condom use, number of partners), HIV incidence, and ART/PrEP adherence and intervention cost-effectiveness. AGYW who test positive for a STI will receive free treatment at the study site. HIV positive participants will be referred to ART clinics.

Discussion

Primary prevention remains the most viable strategy to stem new STI and HIV transmissions. HIV and STI disparities go beyond individual level factors, and prevention packages that include supportive relationships (e.g., FC) may produce greater reductions in HIV-risk, improve HTC and PrEP uptake, and increase linkage, retention, and adherence to care. Reducing new HIV and STI infections among South African AGYW is global public health priority.

Trial registration

ClinicalTrials.gov Number NCT04758390, accepted 02/16/2021.
Older patients’ perspectives on factors contributing to frequent visits to the emergency department: a qualitative interview study
Authors: Kolk Daisy , Kruiswijk Anton F. , MacNeil-Vroomen Janet L. , Ridderikhof Milan L. , Buurman Bianca M.
Published: September 2021

Background

Older patients are at high risk of unplanned revisits to the emergency department (ED) because of their medical complexity. To reduce the number of ED visits, we need more knowledge about the patient-level, environmental, and healthcare factors involved. The aim of this study was to describe older patients’ perspectives and experiences before and after an ED visit, and to identify factors that possibly contribute to frequent ED revisits.

Methods

This was a qualitative description study. We performed semi-structured individual interviews with older patients who frequently visited the ED and were discharged home after an acute visit. Patients were enrolled in the ED of a university medical centre using purposive sampling. Interviews were recorded, transcribed, and coded independently by two researchers. Theoretical analysis was used to identify recurring patterns and themes in the data. Interviews were conducted until thematic saturation was reached.

Results

In-depth interviews were completed with 13 older patients. Three main themes emerged: 1) medical events leading to feelings of crisis, 2) patients’ untreated health problems, and 3) persistent problems in health and daily functioning post discharge. Participants identified problems before and after their ED visit that possibly contributed to further ED visits. These problems included increasing symptoms leading to feelings of crisis, the relationship with the general practitioner, incomplete discharge information at the ED, and inadequate follow-up and lack of recovery after an ED visit.

Conclusions

This qualitative study identified multiple factors that may contribute to frequent ED visits among older patients. Older patients in need of acute care might benefit from hospital-at-home interventions, or acute care provided by geriatric emergency teams in the primary care setting. Identifying frailty in the ED is needed to improve discharge communication and adequate follow-up is needed to improve recovery after an acute ED visit.
Influence of IGF-I serum concentration on muscular regeneration capacity in patients with sarcopenia
Authors: Jarmusch Stefanie , Baber Lisa , Bidlingmaier Martin , Ferrari Uta , Hofmeister Fabian , Hintze Stefan , Mehaffey Stefan , Meinke Peter , Neuerburg Carl , Schoser Benedikt , Tanganelli Fabiana , Drey Michael
Published: September 2021

Background

Previous research has described a neuroprotective effect of IGF-I, supporting neuronal survival, axon growth and proliferation of muscle cells. Therefore, the association between IGF-I concentration, muscle histology and electrophysiological markers in a cohort of patients with sarcopenia dares investigation.

Methods

Measurement of serum concentrations of IGF-I and binding partners, electromyographic measurements with the MUNIX (Motor Unit Number Index) method and muscle biopsies were performed in 31 patients with acute hip fracture older age 60 years. Molecular markers for denervation (neural cell adhesion molecule NCAM) and proliferation markers (Ki67) were assessed by immunofluorescence staining of muscle biopsy tissue. Skeletal muscle mass by bioelectrical impedance analysis and hand-grip strength were measured to assess sarcopenia status according to EWGSOP2 criteria.

Results

Thirty-one patients (20 women) with a mean age of 80.6 ± 7.4 years were included. Concentrations of IGF-I and its binding partners were significantly associated with sarcopenia (ß = − 0.360; p = 0.047) and MUNIX (ß = 0.512; p = 0.005). Further, expression of NCAM (ß = 0.380; p = 0.039) and Ki67 (ß = 0.424; p = 0.022) showed significant associations to IGF-I concentrations.

Conclusions

The findings suggest a pathogenetic role of IGF-I in sarcopenia based on muscle denervation.
Ectopic bronchogenic cyst in the retroperitoneal region: a case report and literature review of adult patients
Authors: Yuan Kaitao , Shu Man , Ma Yan , Feng Weidong , Ye Jinning , Yuan Yujie
Published: September 2021

Background

Bronchogenic cyst is congenital aberration of bronchopulmonary malformation, which is rarely encountered in the abdomen and retroperitoneum. We present a case report and literature review of retroperitoneal bronchogenic cyst.

Case presentation

A 53-year-old female presented to outpatient clinic for a routine checkup of lumbar intervertebral disc herniation. She received a contrast computed tomography scan of the abdomen which revealed a retroperitoneal cystic lesion below the left crura of diaphragm. Afterward, the patient underwent a laparoscopic excision of the cystic lesion and was discharged uneventfully at postoperative day 4. Histopathological findings confirmed the diagnosis of retroperitoneal bronchogenic cyst. Our literature review identified 55 adult cases in recent two decades. The average age at diagnosis was 43.2 (range 17–69) years. 44 (80%) cases had a retroperitoneal cyst on the left side, and 52 (94.5%) cases underwent curative excision through open or laparoscopic surgery. In the available follow up of cases, there was no recurrence after surgery.

Conclusions

Bronchogenic cyst is rare in the retroperitoneal region. It should be considered as one of the differential diagnoses of a retroperitoneal neoplasm.
Ecological determinants of effect of a free pit and fissure sealant program in Shanxi, China, 2017–2018
Authors: Wang Xiangyu , Ren Wenjuan , Li Yufang , Zhao Bin , Yang Tingting , Hou Ruxia , Li Junming , Liu Junyu
Published: September 2021

Background

The aim of this study is to explore the spatial heterogeneity of the retention of PFS in children aged 7–9 years in Shanxi Province, North China and investigate the risk factors associated with PFS retention.

Methods

In this study, 937 children aged 7–9 years from Shanxi Province, China were randomly selected, all of whom had at least one first permanent tooth sealed with PFS in 2016. The children were surveyed after 12 months (in 2017) and 24 months (in 2018). The Geo-detector model was used to explore the spatial heterogeneity of the retention rate of PFS and analyze the influence and interactions of the ecological factors on PFS.

Results

3299 teeth from 937 children were analyzed. The PFS full retention rates after 12 months (in 2017) and 24 months (in 2018) were 81.6% and 75.1%, respectively. The incidence of caries of the first molar was 2.1% after 12 months and 5.4% after 24 months. The spatial heterogeneity of the PFS retention rate after 24 months was significant, which was shown as the retention rate of PFS increased from north to south after 24 months. Remarkably, the natural environmental factors exerted greater influence than the socioeconomic and medical resources factors after 12 months, where the interaction of fluorine in water (FW) had the strongest explanatory power of 52% (P < 0.05). The medical resources were important ecological factors after 24 months, and the percentage of medical technicians (PMT) had the strongest explanatory power of 70% (P < 0.05).

Conclusion

The natural environmental factors and medical resources factors are important ecological factors determining the spatial pattern. The government should strengthen medical and technician construction in North China, comprehensively control fluoride in water, optimize the allocation of medical resources, and promote the balanced development of regional medicine.
Healthcare professionals’ perspectives of patient and family preferences of patient place of death: a qualitative study
Authors: Sathiananthan Manjusha K. , Crawford Gregory B. , Eliott Jaklin
Published: September 2021

Background

Home death is one of the key performance indicators of the quality of palliative care service delivery. Such a measure has direct implications on everyone involved at the end of life of a dying patient, including a patient’s carers and healthcare professionals. There are no studies that focus on the views of the team of integrated inpatient and community palliative care service staff on the issue of preference of place of death of their patients. This study addresses that gap.

Methods

Thirty-eight participants from five disciplines in two South Australian (SA) public hospitals working within a multidisciplinary inpatient and community integrated specialist palliative care service, participated in audio-recorded focus groups and one-on-one interviews. Data were transcribed and thematically analysed.

Results

Two major and five minor themes were identified. The first theme focused on the role of healthcare professionals in decisions regarding place of death, and consisted of two minor themes, that healthcare professionals act to: a) mediate conversations between patient and carer; and b) adjust expectations and facilitate informed choice. The second theme, healthcare professionals’ perspectives on the preference of place of death, comprised three minor themes, identifying: a) the characteristics of the preferred place of death; b) home as a romanticised place of death; and c) the implications of idealising home death.

Conclusion

Healthcare professionals support and actively influence the decision-making of patients and family regarding preference of place of death whilst acting to protect the relationship between the patient and their family/carer. Further, according to healthcare professionals, home is neither always the most preferred nor the ideal place for death. Therefore, branding home death as the ideal and hospital death as a failure sets up families/carers to feel guilty if a home death is not achieved and undermines the need for and appropriateness of death in institutionalised settings.
Towards equity: a retrospective analysis of public sector radiological resources and utilization patterns in the metropolitan and rural areas of the Western Cape Province of South Africa in 2017
Authors: van Zyl Beulah Christina , Barnard Michelle Monique , Cloete Keith , Fernandez Amanda , Mukosi Matodzi , Pitcher Richard Denys
Published: September 2021

Background

The reduction of inequality is a key United Nations 2030 Sustainable Development Goal (WHO, Human Resources for Health: foundation for Universal Health Coverage and the post-2015 development agenda, 2014; Transforming our world: the 2030 Agenda for Sustainable Development .:. Sustainable Development Knowledge Platform, 2020). Despite marked disparities in radiological services globally, particularly between metropolitan and rural populations in low- and middle-income countries, there has been little work on imaging resources and utilization patterns in any setting (Transforming our world: the 2030 Agenda for Sustainable Development .:. Sustainable Development Knowledge Platform, 2020; WHO, Local Production and Technology Transfer to Increase Access to Medical Devices, 2019; European Society of Radiology (ESR), Insights Imaging 6:573-7, 2015; Maboreke et al., An audit of licensed Zimbabwean radiology equipment resources as a measure of healthcare access and equity, 2020; Kabongo et al., Pan Afr Med J 22, 2015; Skedgel et al., Med Decis Making 35:94-105, 2015; Mollura et al., J Am Coll Radiol 913-9, 2014; Culp et al., J Am Coll Radiol 12:475-80, 2015; Mbewe et al., An audit of licenced Zambian diagnostic imaging equipment and personnel, 2020). To achieve equity, a better understanding of the integral components of the so called “imaging enterprise” is important. The aim was to analyse a provincial radiological service in a middle-income country.

Methods

An institutional review board-approved retrospective audit of radiological data for the public healthcare sector of the Western Cape Province of South Africa for 2017, utilizing provincial databases.

We conducted population-based analyses of imaging equipment, personnel, and service utilization data for the whole province, the metropolitan and the rural areas.

Results

Metropolitan population density exceeds rural by a factor of ninety (1682 vs 19 people/km2). Rural imaging facilities by population are double the metropolitan (20 vs 11/106people). Metropolitan imaging personnel by population (112 vs 53/106people) and equipment unit (1.7 vs 0.7/unit) are more than double the rural. Overall population-based utilization of imaging services was 30% higher in the metropole (289 vs 214 studies/103people), with mammography (24 vs 5 studies/103woman > 40 years) and CT (21 vs 6/103people) recording the highest, and plain radiography (203 vs 171/103people) the lowest differences.

Conclusion

Despite attempts to achieve imaging equity through the provision of increased facilities/million people in the rural areas, differential utilization patterns persist.

The achievement of equity must be seen as a process involving incremental improvements and iterative analyses that define progress towards the goal.
Association between cardiac autonomic function and physical activity in patients at high risk of sudden cardiac death: a cohort study
Authors: Sun Xuerong , Zhao Shuang , Chen Keping , Hua Wei , Su Yangang , Liu Xin , Xu Wei , Wang Fang , Fan Xiaohan , Dai Yan , Liu Zhimin , Zhang Shu
Published: September 2021

Background

High levels of physical activity (PA) and heart rate variability (HRV) are associated with cardiovascular benefits in patients with cardiovascular diseases. HRV, representing cardiac autonomic function, is positively associated with PA. However, the impacts of PA and cardiac autonomic function on cardiovascular outcomes were not analysed in the same study population. This lack of evidence supported our hypothesis that PA might contribute to cardiovascular benefits via enhanced cardiac autonomic function.

Methods

Patients with implantable cardioverter defibrillator (ICD) or cardiac resynchronisation therapy defibrillator (CRT-D) implantation were included from the SUMMIT registry. HRV and PA values were assessed during the first 30–60 days post device implantation using a continuous home monitoring system. Causal mediation analysis was conducted to explore the possible mediation function of HRV in the association of PA with long-term cardiac death and all-cause mortality in patients at a high risk of sudden cardiac death.

Results

Over a mean follow-up period of 47.7 months, 63 cardiac deaths (18.9%) and 85 all-cause death events (25.5%) were observed among 342 patients with ICD/CRT-D implantation. A positive linear association between HRV and PA was demonstrated and the β value of HRV was 0.842 (95% confidence interval [CI]: 0.261–1.425, P = 0.005) in the multiple linear regression analysis. Multivariable Cox proportional hazards analysis revealed that high levels of PA (≥11.0%) and HRV (≥75.9 ms) were independent protective factors against cardiac death (PA: hazard ratio [HR] = 0.273; 95% CI, 0.142–0.526, P < 0.001; HRV: HR = 0.224; 95% CI, 0.103–0.489, P < 0.001) and all-cause mortality (PA: HR = 0.299; 95% CI, 0.177–0.505, P < 0.001; HRV: HR = 0.394; 95% CI, 0.231–0.674, P = 0.001). Causal mediation analysis demonstrated partial mediation effects of PA that were mediated through HRV on cardiac death (mediation proportion = 12.9, 95%CI: 2.2–32.0%, P = 0.006) and all-cause mortality (mediation proportion = 8.2, 95%CI: 1.6–20.0%, P = 0.006).

Conclusions

HRV might be a modest mediator in the association between high levels of PA and the reduced risks of cardiac death and all-cause mortality in ICD/CRT-D recipients. This finding supports that enhanced cardiac autonomic function might be one of the underlying mechanisms by which regular PA contributes to cardiovascular benefits.
The role of interferon regulatory factor 8 for retinal tissue homeostasis and development of choroidal neovascularisation
Authors: Zhang Peipei , Schlecht Anja , Wolf Julian , Boneva Stefaniya , Laich Yannik , Koch Jana , Ludwig Franziska , Boeck Myriam , Thien Adrian , Härdtner Carmen , Kierdorf Katrin , Agostini Hansjürgen , Schlunck Günther , Prinz Marco , Hilgendorf Ingo , Wieghofer Peter , Lange Clemens
Published: September 2021

Background

Microglia cells represent the resident innate immune cells of the retina and are important for retinal development and tissue homeostasis. However, dysfunctional microglia can have a negative impact on the structural and functional integrity of the retina under native and pathological conditions.

Methods

In this study, we examined interferon-regulatory factor 8 (Irf8)–deficient mice to determine the transcriptional profile, morphology, and temporospatial distribution of microglia lacking Irf8 and to explore the effects on retinal development, tissue homeostasis, and formation of choroidal neovascularisation (CNV).

Results

Our study shows that Irf8-deficient MG exhibit a considerable loss of microglial signature genes accompanied by a severely altered MG morphology. An in-depth characterisation by fundus photography, fluorescein angiography, optical coherence tomography and electroretinography revealed no major retinal abnormalities during steady state. However, in the laser-induced CNV model, Irf8-deficient microglia showed an increased activity of biological processes critical for inflammation and cell adhesion and a reduced MG cell density near the lesions, which was associated with significantly increased CNV lesion size.

Conclusions

Our results suggest that loss of Irf8 in microglia has negligible effects on retinal homeostasis in the steady state. However, under pathological conditions, Irf8 is crucial for the transformation of resident microglia into a reactive phenotype and thus for the suppression of retinal inflammation and CNV formation.
Social contexts of fertility desire among non-childbearing young men and women aged 15–24 years in Nigeria
Authors: Akinyemi Joshua O. , Odimegwu Clifford O.
Published: September 2021

Background

Reduction in ideal number of children has been suggested as a necessary precursor for fertility decline especially in high fertility countries of Western and Central Africa. In this study, we explored the social contexts of fertility desires by documenting the effects of individual, household as well as contextual characteristics among young men and women in Nigeria.

Methods

Data source was the male and female recode file of 2018 Nigeria Demographic and Health Survey. Analytical sample comprised 2674 males and 9637 females aged 15–24 years. The main outcome variable was desire for large family size (DLFS) defined as ideal number of children greater than four. Analysis involved use of descriptive statistics and random-effect logit models fitted in four stages.

Results

DLFS was 71% among young men and 53% in women. Individual-level factors associated with DLFS among men includes Islam religion (OR = 3.95, CI 2.68–5.83), household size (OR = 1.05) and richer (OR = 0.47, CI 0.29–0.75) or richest wealth index (OR = 0.28, CI 0.16–0.75). Geo-political region and high level of negative attitude to family planning (OR = 1.72, CI 1.23–2.40) were the main contextual factors associated with DLFS. For women, individual-level correlates were education, religion, ethnicity, marital status, household size, and wealth index. Contextual factors include geo-political region, community education (OR = 0.68, CI 0.52–0.89), child mortality experience (OR = 1.29, CI 1.11–1.51) and negative attitude to family planning (OR = 1.36, CI 1.13–1.65). The influence of religion, household wealth and attitude to family planning differ between young men and women.

Conclusion

Active communication and programmatic interventions are needed so that desire for large family size by young men and women do not become a clog for fertility transition in Nigeria.
RNA m6A demethylase FTO-mediated epigenetic up-regulation of LINC00022 promotes tumorigenesis in esophageal squamous cell carcinoma
Authors: Cui Yuanbo , Zhang Chunyan , Ma Shanshan , Li Zhe , Wang Wenjie , Li Ya , Ma Yingchao , Fang Jiarui , Wang Yaping , Cao Wei , Guan Fangxia
Published: September 2021

Background

Long non-coding RNA (LncRNA) controls cell proliferation and plays a significant role in the initiation and progression of esophageal squamous cell carcinoma (ESCC). N6-methyladenosine (m6A) modification now is recognized as a master driver of RNA function to maintain homeostasis in cancer cells. However, how m6A regulates LncRNA function and its role in tumorigenesis of ESCC remain unclear.

Methods

Multiple ESCC datasets were used to analyze gene expression in tumor tissues and normal tissues. Kaplan-Meier method and the ROC curve were conducted to evaluate the prognostic value and diagnostic value of LINC00022 in ESCC, respectively. Both gain-of-function and loss-of-function experiments were employed to investigate the effects of LINC00022 on ESCC growth in vitro and in vivo. Bioinformatics analysis, colorimetric m6A assay, RIP, MeRIP and co-IP was performed to explore the epigenetic mechanism of LINC00022 up-regulation in ESCC.

Results

Here we report that m6A demethylation of LncRNA LINC00022 by fat mass and obesity-associated protein (FTO) promotes tumor growth of ESCC in vivo. Clinically, we revealed that LINC00022 was up-regulated in primary ESCC samples and was predictive of poor clinical outcome for ESCC patients. Mechanistically, LINC00022 directly binds to p21 protein and promotes its ubiquitination-mediated degradation, thereby facilitating cell-cycle progression and proliferation. Further, the elevated FTO in ESCC decreased m6A methylation of LINC00022 transcript, leading to the inhibition of LINC00022 decay via the m6A reader YTHDF2. Over-expression of FTO was shown to drive LINC00022-dependent cell proliferation and tumor growth of ESCC.

Conclusions

Thus, this study demonstrated m6A-mediated epigenetic modification of LncRNA contributes to the tumorigenesis in ESCC and LINC00022, specific target of m6A, serves as a potential biomarker for this malignancy.
Using predicted length of stay to define treatment and model costs in hospitalized adults with serious illness: an evaluation of palliative care
Authors: May Peter , Normand Charles , Noreika Danielle , Skoro Nevena , Cassel J. Brian
Published: September 2021

Background

Economic research on hospital palliative care faces major challenges. Observational studies using routine data encounter difficulties because treatment timing is not under investigator control and unobserved patient complexity is endemic. An individual’s predicted LOS at admission offers potential advantages in this context.

Methods

We conducted a retrospective cohort study on adults admitted to a large cancer center in the United States between 2009 and 2015. We defined a derivation sample to estimate predicted LOS using baseline factors (N = 16,425) and an analytic sample for our primary analyses (N = 2674) based on diagnosis of a terminal illness and high risk of hospital mortality. We modelled our treatment variable according to the timing of first palliative care interaction as a function of predicted LOS, and we employed predicted LOS as an additional covariate in regression as a proxy for complexity alongside diagnosis and comorbidity index. We evaluated models based on predictive accuracy in and out of sample, on Akaike and Bayesian Information Criteria, and precision of treatment effect estimate.

Results

Our approach using an additional covariate yielded major improvement in model accuracy: R2 increased from 0.14 to 0.23, and model performance also improved on predictive accuracy and information criteria. Treatment effect estimates and conclusions were unaffected. Our approach with respect to treatment variable yielded no substantial improvements in model performance, but post hoc analyses show an association between treatment effect estimate and estimated LOS at baseline.

Conclusion

Allocation of scarce palliative care capacity and value-based reimbursement models should take into consideration when and for whom the intervention has the largest impact on treatment choices. An individual’s predicted LOS at baseline is useful in this context for accurately predicting costs, and potentially has further benefits in modelling treatment effects.
Eggerthella lenta bacteremia successfully treated with ceftizoxime: case report and review of the literature
Authors: Jiang Shuming , E Jianfei , Wang Dengchao , Zou Yanjiao , Liu Xiao , Xiao Hualiang , Wen Yuan , Chen Zongyao
Published: September 2021

Eggerthella lenta is a normal human microflora that is anaerobic, non-sporulating, and Gram positive. However, an increasing number of studies have shown that it could also be an important pathogen for humans, even causing life-threatening infection under certain conditions. However, understanding its pathogenic mechanism and treatment options still need to be improved; more clinical data are needed to explore it further. In this article, we report a case of ceftizoxime-cured E. lenta bacteremia and review the recent literature to provide more clinical data for the diagnosis of E. lenta bacteremia. Our report suggests that the frequency of E. lenta bacteremia is increased in patients with hematologic or solid organ cancer, diabetes mellitus and also in those with appendicitis.
Microbial river-to-sea continuum: gradients in benthic and planktonic diversity, osmoregulation and nutrient cycling
Authors: Tee Hwee Sze , Waite David , Lear Gavin , Handley Kim Marie
Published: September 2021

Background

Coastal aquatic ecosystems include chemically distinct, but highly interconnected environments. Across a freshwater-to-marine transect, aquatic communities are exposed to large variations in salinity and nutrient availability as tidal cycles create periodic fluctuations in local conditions. These factors are predicted to strongly influence the resident microbial community structure and functioning, and alter the structure of aquatic food webs and biogeochemical cycles. Nevertheless, little is known about the spatial distribution of metabolic properties across salinity gradients, and no study has simultaneously surveyed the sediment and water environments. Here, we determined patterns and drivers of benthic and planktonic prokaryotic and microeukaryotic community assembly across a river and tidal lagoon system by collecting sediments and planktonic biomass at nine shallow subtidal sites in the summer. Genomic and transcriptomic analyses, alongside a suite of complementary geochemical data, were used to determine patterns in the distribution of taxa, mechanisms of salt tolerance, and nutrient cycling.

Results

Taxonomic and metabolic profiles related to salt tolerance and nutrient cycling of the aquatic microbiome were found to decrease in similarity with increasing salinity, and distinct trends in diversity were observed between the water column and sediment. Non-saline and saline communities adopted divergent strategies for osmoregulation, with an increase in osmoregulation-related transcript expression as salinity increased in the water column due to lineage-specific adaptations to salt tolerance. Results indicated a transition from phosphate limitation in freshwater habitats to nutrient-rich conditions in the brackish zone, where distinct carbon, nitrogen and sulfur cycling processes dominated. Phosphorus acquisition-related activity was highest in the freshwater zone, along with dissimilatory nitrate reduction to ammonium in freshwater sediment. Activity associated with denitrification, sulfur metabolism and photosynthesis were instead highest in the brackish zone, where photosynthesis was dominated by distinct microeukaryotes in water (Cryptophyta) and sediment (diatoms). Despite microeukaryotes and archaea being rare relative to bacteria, results indicate that they contributed more to photosynthesis and ammonia oxidation, respectively.

Conclusions

Our study demonstrates clear freshwater–saline and sediment–water ecosystem boundaries in an interconnected coastal aquatic system and provides a framework for understanding the relative importance of salinity, planktonic-versus-benthic habitats and nutrient availability in shaping aquatic microbial metabolic processes, particularly in tidal lagoon systems.
Identification of the toxic threshold of 3-hydroxybutyrate-sodium supplementation in septic mice
Authors: Weckx Ruben , Goossens Chloë , Derde Sarah , Pauwels Lies , Vander Perre Sarah , Van den Bergh Greet , Langouche Lies
Published: September 2021

Background

In septic mice, supplementing parenteral nutrition with 150 mg/day 3-hydroxybutyrate-sodium-salt (3HB-Na) has previously shown to prevent muscle weakness without obvious toxicity. The main objective of this study was to identify the toxic threshold of 3HB-Na supplementation in septic mice, prior to translation of this promising intervention to human use.

Methods

In a centrally-catheterized, antibiotic-treated, fluid-resuscitated, parenterally fed mouse model of prolonged sepsis, we compared with placebo the effects of stepwise escalating doses starting from 150 mg/day 3HB-Na on illness severity and mortality (n = 103). For 5-day survivors, also the impact on ex-vivo-measured muscle force, blood electrolytes, and markers of vital organ inflammation/damage was documented.

Results

By doubling the reference dose of 150 mg/day to 300 mg/day 3HB-Na, illness severity scores doubled (p = 0.004) and mortality increased from 30.4 to 87.5 % (p = 0.002). De-escalating this dose to 225 mg still increased mortality (p ≤ 0.03) and reducing the dose to 180 mg/day still increased illness severity (p ≤ 0.04). Doses of 180 mg/day and higher caused more pronounced metabolic alkalosis and hypernatremia (p ≤ 0.04) and increased markers of kidney damage (p ≤ 0.05). Doses of 225 mg/day 3HB-Na and higher caused dehydration of brain and lungs (p ≤ 0.05) and increased markers of hippocampal neuronal damage and inflammation (p ≤ 0.02). Among survivors, 150 mg/day and 180 mg/day increased muscle force compared with placebo (p ≤ 0.05) up to healthy control levels (p ≥ 0.3).

Conclusions

This study indicates that 150 mg/day 3HB-Na supplementation prevented sepsis-induced muscle weakness in mice. However, this dose appeared maximally effective though close to the toxic threshold, possibly in part explained by excessive Na+ intake with 3HB-Na. Although lower doses were not tested and thus might still hold therapeutic potential, the current results point towards a low toxic threshold for the clinical use of ketone salts in human critically ill patients. Whether 3HB-esters are equally effective and less toxic should be investigated.
Peierls-Nabarro potential for a confined chain of hard spheres under compression
Authors: Mughal A. , Weaire D. , Hutzler S.
Published: September 2021

Examples of bifurcation diagrams are presented for a chain of hard spheres under compression, which are confined by a transverse potential. The diagrams are modified in the presence of an axial force and show interesting topological rearrangements due to the reconnection of loci of different equilibrium solutions. The corresponding Peierls-Nabarro potential is defined and calculated for various values of compression. This relatively tractable and transparent system can illustrate in detail the general features of such a potential and its relation to experiment.
A study protocol to prepare an RBD protein for vaccine against COVID-19
Authors: Jahangir ZMG Sarwar , Marnik Arleta Helena
Published: September 2021

Background: The SARS-CoV-2 pandemic is a global threat to humans and the world’s economy. Effective and safe vaccines against this virus are essential to control and eradicate the pandemic. The currently applied vaccines carry SARS-CoV-2 spike-protein mRNA/cDNA. These vaccines go through several cellular processes in the recipients for producing antigens. On the contrary, the SARS-CoV-2 RBD (receptor binding domain)-protein is an antigen. It will directly stimulate antibody production against SARS-CoV-2. Hence, we propose to produce SARS-CoV-2 RBD-protein as a fast acting, effective and safe vaccine. 

Methods: We propose to reconstruct a plasmid carrying three types of  DNA sequences: RBD cDNA, FP (fusion peptide) DNA and sfGFP(superfolder green fluorescent protein), cDNA creating the RBD-FP-sfGFP DNA within an orf (open reading frame). Escherichia coli, C2566H, transformed with the reconstructed plasmid will express RBD-FP-sfGFP fusion protein producing green fluorescent cfu (colony forming unit). The RBD-protein will be separated from the sfGFP using an FP specific enterokinase, and eluted by HIC (hydrophobic interaction chromatography), detected with a BioVision Elisa kit, and quantified by spectrophotometry at UV280nm. 

Results: The plasmid reconstruct will carry ampr (ampicillin-resistant) gene as a selective marker and a T7 promoter controlling the expression of RBD-FP-sfGFP fusion protein. The transformed Escherichia coli will efficiently express the RBD-FP-sfGFP fusion protein. The highly efficient sfGFP fused within the RBD-FP-sfGFP will produce green fluorescent cfu. The RBD-FP-sfGFP protein extract from the green cfu, digested by enterokinase and separated by the HIC will produce pure RBD protein. 

Conclusion: A positive BioVision ELISA test detects <10 pg RBD protein/ml of the sample. A larger sample of the purified RBD protein can be used as a vaccine following a standard formulation and safety protocols. Once administered, the RBD protein will stimulate antibody production against the SARS-CoV-2 virus. The RBD protein has no potential to recombine with human genome.
The art of hospitality
Authors: Shitov Viktor
Published: September 2021

The textbook describes the basics of the art and culture of hospitality, hospitality as part of modern business, modern models of hospitality, hospitality as a component of everyday life, hospitality in everyday life, the technology of meeting and greeting guests, the rules of greeting in the premises, on the street, the norms and rules of professional behavior and business etiquette, the basics of departmental etiquette, relations in professional activities, communication by phone, methods of holding various events, presentations and receptions, culinary art of different peoples and much more.
Nine practical works are described in detail, as well as independent work in the study of the discipline of MDK. 01.01 "The art of hospitality".
For students of secondary vocational education institutions. It can be used when mastering the module PM. 01 "Management of household management" for the specialty 43.02.08 "Service of household and communal services".
Surgery
Authors: Cepunov Boris , Gozhenko Konstanciya , Zhilyaev Evgeniy
Published: September 2021

The tutorial consists of two sections. The section "General surgery" covers the issues of prevention of surgical infection, issues of anesthesia, organization of preoperative and postoperative periods and other issues of general surgery (blood transfusion, transfusion, open and closed injuries, types of operative and non-operative surgical techniques, surgical infection, tumors). Attention is paid to general disorders of the vital activity of the body, as well as resuscitation, emergency care in case of accidents.
The section "Specific types of surgical pathology" describes injuries and diseases of the head and neck, chest, abdominal cavity, spine and pelvis, limbs, peripheral vessels and nerves. Much attention is paid to the care of surgical patients at all stages of treatment. The principles and methods of providing first medical and pre-medical care in critical conditions of the patient are described in detail. The final chapter is devoted to the technique of surgical manipulations.
Meets the requirements of the federal state educational standards of secondary vocational education of the latest generation.
It is intended for students of paramedic, obstetric and nursing departments of medical colleges and colleges.
Fundamentals of financial literacy
Authors: Rogulina Marina , Kopalina Tat'yana , Nevedrova Galina , Mitina Natal'ya , Labutina Inessa , Morozova Ol'ga , Ovsyannikova Tat'yana , Kal'ney Valentina , Dodonova Lyudmila
Published: September 2021

The textbook is developed in accordance with the working program of the discipline "Fundamentals of financial literacy". At the present level, the questions devoted to the basics of financial literacy are revealed. The given theoretical material, test and practical tasks contribute to the study of the educational material during independent work, which ensures effective assimilation and practical application of the acquired knowledge.
Meets the requirements of the federal state educational standards of secondary vocational education of the latest generation.
For full-time and distance learning students of educational organizations of secondary vocational education.
Dialectical materialism: the relationship of the categories "matter" and "non-existence"
Authors: Sverguzov Anver
Published: September 2021

From the point of view of the dialectical-materialistic approach, the central ontological problem is analyzed — the problem of the existence of matter.
For researchers specializing in the direction 09.00.01 "Ontology and theory of knowledge", as well as all those interested in philosophy.
Accounting and financial accounting
Authors: Baholdina Irina , Golysheva Nina
Published: September 2021

The textbook consists of 15 chapters, as well as a set of practical (situational) cases for independent work of students of economic universities and faculties.
Each chapter contains methodological guidelines for practical classes and situational tasks that allow integrating the knowledge gained in the process of studying financial accounting. The final part of the textbook contains a cross-cutting task, the solution of which allows the student to complete an internship as an accountant at a conditional enterprise. The complex of practical (situational) cases for students ' independent work consists of 10 options and includes five cases.
Meets the requirements of the federal state educational standards of higher education of the latest generation.
It is intended for undergraduate students studying in the direction of training 38.03.01 "Economics "(profile "Accounting, analysis and audit"), teachers, students of economic specialties of full-time, part-time, correspondence and distance learning, students of the system of additional professional education, practitioners of accounting services, management personnel, audit companies.