bluuebunny/crossref_metadata_2025 huggingface dataset:
Prognostic factors and outcomes of COVID-19 cases in Ethiopia: multi-center cohort study protocol
Authors: Abdella Saro , Tessema Masresha , Tasew Geremew , Defar Atkure , Deressa Asefa , Regasa Feyisa , Teka Frehiwot , Tigabu Eyasu , Nigussie Dereje , Belachew Tefera , Molla Million , Deribew Amare , Abebe Workeabeba , Yigzaw Tegbar , Nigatu Tsinuel , Mitike Getnet , Haile Tewodros , Taame Haftom , Ahmed Muhammed , Nigatu Frehiwot , Tolesa Tola , Wolka Eskinder , Amogne Wondwossen , Laillou Arnaud , Amare Misker , Fufa Yaregal , Argaw Alemayehu , Waganew Woldesenbet , Azazh Akilili , Worku Aschalew , Redae Berhane , Sultan Menbeu , Walelegn Miraf , Tefera Muluwork , Yifru Sisay , Argaw Rahel , Brehau Natinael , Teklu Sisay , Demoz Getachew , Seman Yakob , Salasibew Mihretab , Ejeta Eshetu , Whiting Susan J. , Wolday Dawit , Tollera Getachew , Abate Ebba , Duguma Dereje
Published: September 2021

Background

The coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus (SARS-CoV-2) and became pandemic after emerging in Wuhan, China, in December 2019. Several studies have been conducted to understand the key features of COVID-19 and its public health impact. However, the prognostic factors of COVID-19 are not well studied in the African setting. In this study, we aim to determine the epidemiological and clinical features of COVID-19 cases, immunological and virological courses, interaction with nutritional status, and response to treatment for COVID-19 patients in Ethiopia.

Methods

A multi-center cohort study design will be performed. Patients with confirmed COVID-19 infection admitted to selected treatment centers will be enrolled irrespective of their symptoms and followed-up for 12 months. Baseline epidemiological, clinical, laboratory and imaging data will be collected from treatment records, interviews, physical measurements, and biological samples. Follow-up data collection involves treatment and prognostic outcomes to be measured using different biomarkers and clinical parameters. Data collection will be done electronically using the Open Data Kit (ODK) software package and then exported to STATA/SPSS for analysis. Both descriptive and multivariable analyses will be performed to assess the independent determinants of the treatment outcome and prognosis to generate relevant information for informed prevention and case management. The primary outcomes of this study are death/survival and viral shedding. Secondary outcomes include epidemiological characteristics, clinical features, genetic frequency shifts (genotypic variations), and nutritional status.

Discussion

This is the first large prospective cohort study of patients in hospitals with COVID-19 in Ethiopia. The results will enable us to better understand the epidemiology of SARS-CoV-2 in Africa. This study will also provide useful information for effective public health measures and future pandemic preparedness and in response to outbreaks. It will also support policymakers in managing the epidemic based on scientific evidence.

Trial Registration:The Protocol prospectively registered in ClinicalTrials.gov (NCT04584424) on 30 October, 2020.
COVID-19 mRNA vaccine and antibody response in lactating women: a prospective cohort study
Authors: Charepe Nadia , Gonçalves Juliana , Juliano A. Margarida , Lopes David G. , Canhão Helena , Soares Helena , Serrano e Fátima
Published: September 2021

Background

Immunological protection via breastfeeding is well known. The immunological profile of human milk changes during lactation. No clinical trials have been conducted in lactating women with the newest mRNA vaccines against SARS- CoV-2. A Few studies have shown the presence of antibodies in breastmilk after vaccination. The aim of this work is to study possible antibodies transfer via breastmilk and also the immunological characteristics of lactating women compared to non-lactating women, after using the BNT162b2 Pfizer vaccine.

Methods

This is a prospective cohort study with a convenience homogenous sample of 24 healthcare workers (14 lactating and 10 non-lactating women) enrolled at the time of COVID-19 vaccination. Clinical data was registered in a questionnaire. Titers of SARS-CoV-2 spike IgG, IgA and IgM were quantified in post vaccination blood and human milk. Antibody quantification was performed by an in-house ELISA to SARS-CoV-2 trimeric spike protein.

Results

All women showed immunity after vaccination with positive antibodies for IgM, IgA and IgG antibodies. The dominant serum antibody response was IgG. Modest levels of antibodies in breastmilk of lactating mothers were observed in this study, especially IgG in 42.9%. There was a moderate association between higher titers of IgG and a longer duration of breastfeeding (R= 0.55, p=0.041).

Conclusions

Evidence of antibody transfer in human milk after COVID-19 vaccination is scarce. The presence of antibodies in human milk is reported, but immunization through breastfeeding is still to be established.
Incorporating Aboriginal women’s voices in improving care and reducing risk for women with diabetes in pregnancy - A phenomenological study
Authors: Wood Anna J , Graham Sian , Boyle Jacqueline A , Marcusson-Rababi Beverley , Anderson Shonada , Connors Christine , McIntyre Harold D , Maple-Brown Louise , Kirkham Renae
Published: September 2021

Background

There is a high burden of gestational diabetes (GDM) and type 2 diabetes in pregnancy for Aboriginal and Torres Strait Islander women. Postpartum diabetes programs have the potential to prevent recurrent GDM and improve management of type 2 diabetes. However, data on such programs are limited, particularly in the Indigenous context. We aimed to explore Aboriginal Australian women’s and health providers’ preferences for a program to prevent and improve diabetes after pregnancy.

Methods

A phenomenological methodology underpinned semi-structured in-depth interviews with eleven Aboriginal women and seven health professionals across the Northern Territory from October 2019- February 2020. Interviews were analysed using an inductive analysis framework to address the barriers and enablers of proposed diabetes prevention programs identified by participants.

Results

Identified structural barriers to lifestyle change included: food insecurity, persuasive marketing of unhealthy food options, lack of facilities and cultural inappropriateness of previous programs. Enablers to lifestyle change included: a strong link between a healthy lifestyle and connection with Country, family and community. Suggested strategies to improve lifestyle included: co-designed cooking classes or a community kitchen, team sports and structural change (targeting the social determinants of health). Lifestyle change was preferred over metformin to prevent and manage diabetes after pregnancy by participants and health care providers.

Conclusions

We recommend individual level programs be designed alongside policies that address systemic inequalities. A postpartum lifestyle program should be co-designed with community members and grounded in Aboriginal conceptions of health to adequality address the health disparities experienced by Aboriginal people in remote communities.
Comprehensive analysis of the transcriptional expressions and prognostic value of S100A family in pancreatic ductal adenocarcinoma
Authors: Li Hong-Bin , Wang Jian-Li , Jin Xiao-Dong , Zhao Lei , Ye Hui-Li , Kuang Yan-bei , Ma Yong , Jiang Xiang-Yan , Yu Ze-Yuan
Published: September 2021

Background

Pancreatic ductal adenocarcinoma (PDAC) remains a treatment-refractory malignancy with poor prognosis. It is urgent to identify novel and valid biomarkers to predict the progress and prognosis of PDAC. The S100A family have been identified as being involved in cell proliferation, migration and differentiation progression of various cancer types. However, the expression patterns and prognostic values of S100As in PDAC remain to be analyzed.

Methods

We investigated the transcriptional expressions, methylation level and prognostic value of S100As in PDAC patients from the Oncomine, GEPIA2, Linkedomics and cBioPortal databases. Real-time PCR was used to detect the expressions of S100A2/4/6/10/14/16 in four pancreatic cancer cell lines and pancreatic cancer tissues from PDAC patients undergoing surgery. To verify the results further, immunohistochemistry was used to measure the expression of S100A2/4/6/10/14/16 in 43 PDAC patients’ tissue samples. The drug relations of S100As were analyzed by using the Drugbank database.

Results

The results suggested that, the expression levels of S100A2/4/6/10/14/16 were elevated to PDAC tissues than in normal pancreatic tissues, and the promoter methylation levels of S100A S100A2/4/6/10/14/16 in PDAC (n = 10) were lower compared with normal tissue (n = 184) (P < 0.05). In addition, their expressions were negatively correlated with PDAC patient survival.

Conclusions

Taken together, these results suggest that S100A2/4/6/10/14/16 might be served as prognostic biomarkers for survivals of PDAC patients.
Characteristics of childhood allergic diseases in outpatient and emergency departments in Shanghai, China, 2016–2018: a multicenter, retrospective study
Authors: Qi Yuanyuan , Shi Peng , Chen Renjie , Zhou Yufeng , Liu Lijuan , Hong Jianguo , Cao Lanfang , Lu Yanming , Dong Xiaoyan , Li Jing , Shi Yu , Xia Min , Ding Bo , Qian Liling , Wang Libo , Zhou Wenhao , Gui Yonghao , Zhang Xiaobo
Published: September 2021

Background

The prevalence of allergic diseases (ADs), such as asthma and allergic rhinitis (AR), is increasing worldwide in both adults and children. Although ADs are common and frequently coexist in outpatient care, city-level data regarding the characteristics of childhood AD remain limited in China. This study aimed to assess the profile and characteristics of ADs in the city of Shanghai.

Methods

A multicenter retrospective study was designed to collect routine administrative data from outpatient and emergency departments from 66 hospitals in Shanghai, China, from 2016 to 2018. Children with asthma, AR, allergic conjunctivitis (AC), and allergic skin diseases were investigated. Demographic characteristics, patients visit pattern, spectrum of diagnosis, and comorbidities were analyzed.

Results

A total of 2,376,150 outpatient and emergency visits for ADs were included in the period from 2016 to 2018. Allergic skin diseases accounted for 38.9%, followed by asthma (34.8%), AR (22.9%), and AC (3.3%), with a male predominance in all four diseases. Asthma and allergic skin diseases were most frequent in the 1 to < 4 years of age group, while AR and AC were more common in the 4 to < 7 years of age group. Asthma accounted for the greatest number of annual and emergency visits. The most frequent comorbidity of asthma was lower respiratory tract infection (LRTI) (49.3%), followed by AR (20.5%) and upper respiratory tract infection (14.1%). The most common comorbidities of AR were otitis media (23.4%), adenoid hypertrophy/obstructive sleep apnea (22.1%), followed by LRTI (12.1%), asthma (9.4%) and chronic pharyngitis (8.9%).

Conclusions

Asthma and allergic skin diseases were the most common ADs in outpatient and emergency departments in the study period. Respiratory tract infection was the most common comorbidity of asthma in children. More attention should be devoted to the treatment of comorbidities to improve childhood AD outcomes with a better understanding of the characteristics of ADs in outpatient care.
Depression, post-traumatic stress, anxiety, and fear of COVID-19 in the general population and health-care workers: prevalence, relationship, and explicative model in Peru
Authors: Villarreal-Zegarra David , Copez-Lonzoy Anthony , Vilela-Estrada Ana L. , Huarcaya-Victoria Jeff
Published: September 2021

Background

This study has two aims. First, determine the fit of the fear model to COVID-19, anxiety, and post-traumatic stress in the general population and health-care workers. Second, determine which model best explains the relationship between depression and the triad of fear, anxiety, and post-traumatic stress in both groups.

Method

A cross-sectional study was conducted using self-reported questionnaires for anxiety, fear of COVID-19, depression, and post-traumatic stress. Information was collected from adults living in Lima, the capital and the most populous city in Peru. The explanatory models were evaluated using a structural equation model.

Results

A total of 830 participants were included, including general population (n = 640) and health-care workers (n = 190). A high overall prevalence of depressive symptoms (16%), anxiety (11.7%), and post-traumatic stress (14.9%) were identified. A higher prevalence of depressive, anxious, or stress symptoms was identified in the general population (28.6%) compared to health-care workers (17.9%). The triad model of fear of COVID-19, anxiety, and stress presented adequate goodness-of-fit indices for both groups. A model was identified that manages to explain depressive symptoms in more than 70% of the general population and health-care workers, based on the variables of the triad (CFI = 0.94; TLI = 0.94; RMSEA = 0.06; SRMR = 0.06). In the general population post-traumatic stress mediated the relationship between anxiety and depression (β = 0.12; 95%CI = 0.06 to 0.18) which was significant, but the indirect effect of post-traumatic stress was not significant in health care workers (β = 0.03; 95%CI = − 0.11 to 0.19).

Limitations

The prevalence estimates relied on self-reported information. Other variables of interest, such as intolerance to uncertainty or income level, could not be evaluated.

Conclusions

Our study proposes and tests one model that explains more than 70% of depressive symptoms. This explanatory model can be used in health contexts and populations to determine how emotional factors can affect depressive symptoms.
Primary school students’ poetic malaria messages from Jimma zone, Oromia, Ethiopia: a qualitative content analysis
Authors: Kebede Yohannes , Hayder Abdu , Girma Kasahun , Abamecha Fira , Alemayehu Guda , Abebe Lakew , Sudhakar Morankar , Birhanu Zewdie
Published: September 2021

Background

The engagement of schools in malaria control is an emerging strategy. Little is known about the involvement of students in the development of malaria messages. This study evaluated the message content of primary school students’ malaria poems.

Methods

A qualitative content analysis was conducted to explore malaria messages conveyed in poems produced by students. Twenty poems were purposively selected from twenty schools across rural villages in five districts of the Jimma Zone. Data were analyzed using Atlas.ti version 7.1.4 software. The message contents were quantified in terms of frequency, and including metaphors, presented using central themes, categories, and supportive quotations.

Results

A total of 602 malarial contents were generated, and organized into 21 categories under five central themes. 1) Malaria-related knowledge (causation and modes of transmission, mosquito breeding and biting behavior, signs and symptoms, care for insecticide-treated nets (ITNs), and prevention methods), 2) Perceived threats from malaria, 3)The effectiveness of prevention methods (i.e., related to the adaption of ITNs, environmental cleaning, indoor residual spray (IRS), treatment for fever, and drug adherence practices), 4) Misconceptions, beliefs, and malpractices regarding the cause of malaria and drug use) and 5) Direct calls to the adopt ITN, IRS, clean surroundings, treatment, and drug use. The most commonly conveyed message contents were about the severity of malaria, distinguishable signs and symptoms, calls for community participation for malaria elimination, knowledge of preventive methods, and effectiveness of ITN use. Metaphoric expressions (war and death) were used to convey messages about the severity and the need to manage the prognosis of malaria through the active ITN use, which itself was metaphorically represented as ‘a trap’ to mosquitoes.

Conclusions

The poetic analysis indicated that the students developed and disseminated rich malarial messages, especially on malarial knowledge, and perceptions, beliefs, norms and practices of the local community to prevent and control malaria. Therefore, primary school students can be a source of information and would effectively communicate knowledge, perceptions, and promote malaria related practices, particularly in rural settings.
Nutritional status and concomitant factors of stunting among pre-school children in Malda, India: A micro-level study using a multilevel approach
Authors: Sk Rayhan , Banerjee Anuradha , Rana Md Juel
Published: September 2021

Background

Malnutrition was the main cause of death among children below 5 years in every state of India in 2017. Despite several flagship programmes and schemes implemented by the Government of India, the latest edition of the Global Nutrition Report 2018 addressed that India tops in the number of stunted children, which is a matter of concern. Thus, a micro-level study was designed to know the level of nutritional status and to study this by various disaggregate levels, as well as to examine the risk factors of stunting among pre-school children aged 36–59 months in Malda.

Method

A primary cross-sectional quantitative survey was conducted using structured questionnaires following a multi-stage, stratified simple random sampling procedure in 2018. A sum of 731 mothers with at least one eligible child aged 36–59 months were the study participants. Anthropometric measures of children were collected following the WHO child growth standard. Children were classified as stunted, wasted, and underweight if their HAZ, WHZ, and WAZ scores, respectively, were less than −2SD. The random intercept multilevel logistic regression model has been employed to estimate the effects of possible risk factors on childhood stunting.

Results

The prevalence of stunting in the study area is 40% among children aged 36–59 months, which is a very high prevalence as per the WHO’s cut-off values (≥40%) for public health significance. Results of the multilevel analysis revealed that preceding birth interval, low birth weight, duration of breastfeeding, mother’s age at birth, mother’s education, and occupation are the associated risk factors of stunting. Among them, low birth weight (OR 2.22, 95% CI: 1.44–3.41) and bidi worker as mothers’ occupation (OR 1.92, 95% CI: 1.18–3.12) are the most influencing factors of stunting. Further, about 14 and 86% variation in stunting lie at community and child/household level, respectively.

Conclusion

Special attention needs to be placed on the modifiable risk factors of childhood stunting. Policy interventions should direct community health workers to encourage women as well as their male partners to increase birth interval using various family planning practices, provide extra care for low birth weight baby, that can help to reduce childhood stunting.
HIV continuum of care: expanding scope beyond a cross-sectional view to include time analysis: a systematic review
Authors: Vourli Georgia , Katsarolis Ioannis , Pantazis Nikos , Touloumi Giota
Published: September 2021

Introduction

The continuum of care (CoC) model has been used to describe the main pillars of HIV care. This study aims to systematically review methods and elucidate gaps in the CoC analyses, especially in terms of the timing of the progression through steps, recognized nowadays as a critical parameter for an effective response to the epidemic.

Methods

A PubMed and EMBASE databases search up to December 2019 resulted in 1918 articles, of which 209 were included in this review; 84 studies presented in major HIV conferences were also included. Studies that did not provide explicit definitions, modelling studies and those reporting only on metrics for subpopulations or factors affecting a CoC stage were excluded. Included articles reported results on 1 to 6 CoC stages.

Results

Percentage treated and virally suppressed was reported in 78%, percentage diagnosed and retained in care in 58%, percentage linked to care in 54% and PLHIV in 36% of the articles. Information for all stages was provided in 23 studies. Only 6 articles use novel CoC estimates:

One presents a dynamic CoC based on multistate analysis techniques, two base their time-to-next-stage estimates on a risk estimation method based on the cumulative incidence function, weighted for confounding and censoring and three studies estimated the HIV infection time based on mathematical modelling.

Conclusion

A limited number of studies provide elaborated time analyses of the CoC. Although time analyses lack the straightforward interpretation of the cross-sectional CoC, they provide valuable insights for the timely response to the HIV epidemic. A future goal would be to develop a model that retains the simplicity of the cross-sectional CoC but also incorporates timing between stages.
A nomogram to predict stricture-free survival in patients with ureteral stricture after balloon dilation
Authors: Hu Jintao , Lai Cong , Gao Mingchao , Li Kaiwen , He Wang , Zhu Dingjun , Xie Wenlian , Wu Haihua , Xu Meijuan , Huang Jian , Han Jinli
Published: September 2021

Background

Balloon dilation is a commonly used minimally invasive endourological treatment of ureteral stricture, but the postoperative recurrence rate is relatively high. And factors contributing to recurrence after treatment are poorly understood. Herein, we sought to develop a novel clinical nomogram to predict ureteral stricture-free survival in patients suffering from ureter stricture and performed balloon dilation.

Methods

The nomogram was established based on a retrospective analysis of 321 patients who received endoscopic balloon dilation alone for ureter strictures from January 2016 to January 2020 in Sun Yat-sen Memorial Hospital using the Cox regression model. Perioperative clinical data and disease outcomes were analyzed. The primary endpoint was the onset of ureteral re-stricture after ureter balloon dilation. Discrimination of the nomogram was assessed by the concordance index (C-index) and the calibration curve. The results were internally validated using bootstrap resampling.

Results

Overall, 321 patients with a median follow-up of 590 days were enrolled in the study, among which 97 patients (30.2%) developed recurrence of ureteral stricture during follow-up. Five variables remained significant predictors of ureteral re-stricture after multivariable analyses: stricture nature (P < 0.001), urinary nitrite (P = 0.041), CKD (P = 0.005), stent retention time (P < 0.001), and balloon size (P = 0.029). The calibration craves for the probability of 1-, 3-, and 5-years stricture-free survival (SFS) presented satisfied with the consistency of nomogram prediction and actual observation. The C-index of the model was 0.74 (95% CI 0.70–0.79).

Conclusions

Our study developed the first nomogram to effectively predict stricture-free survival in patients suffering from ureter stricture after balloon dilation. It is helpful to identify the optimal patients with ureter stricture for balloon dilation and improve treatment outcomes. However, further external validation of the nomogram is warranted.
Clinical relevance of interdental papilla biopsy in chronic erosive gingivitis (desquamative gingivitis): retrospective bicentric study of 148 specimens
Authors: Gaultier Frédérick , Ejeil Anne-laure , Jungo Sébastien , Ingen-Housz-Oro Saskia , de Clatigny François Le Pelletier , Bruno Gogly , Pirnay Philippe , Bellakhdar Fadel , Dridi Sophie-Myriam
Published: September 2021

Background

Chronic erosive gingivitis, also called desquamative gingivitis, defines a clinical picture that can be generated by several inflammatory and immune diseases. Pathology is therefore essential for the differential diagnosis. However, when the gingival lesion is initial, exclusive or predominant, selecting the biopsy site and protocol may be problematic due to tissue fragility. Especially since there are few studies on the subject, the aim of our study was to assess the protocol, diagnostic relevance and tolerance of an original protocol using interdental papilla biopsy.

Methods

We conducted a retrospective bicentric study, from October 2011 to July 2019, including all patients with a chronic erosive gingivitis who had received, for diagnostic purposes, a interdental papilla biopsy.

Results

The contribution levels for the two hospital departments were 94.7% and 97.1%, respectively. No postoperative complication was recorded in the short or long term.

Conclusion

The interdental papilla biopsy protocol is perfectly adapted to the anatomopathological examinations required to establish differential diagnosis of chronic erosive gingivitis. This surgical protocol is simple to perform, non iatrogenic with a very good tolerance and and accessible to all clinicians. It is highly efficient with an excellent contribution level.

ClinicalTrials NCT04293718 (March 3, 2020). Health Data Hub N° F20201109083211 (November 9, 2020).
An automated data cleaning method for Electronic Health Records by incorporating clinical knowledge
Authors: Shi Xi , Prins Charlotte , Van Pottelbergh Gijs , Mamouris Pavlos , Vaes Bert , De Moor Bart
Published: September 2021

Background

The use of Electronic Health Records (EHR) data in clinical research is incredibly increasing, but the abundancy of data resources raises the challenge of data cleaning. It can save time if the data cleaning can be done automatically. In addition, the automated data cleaning tools for data in other domains often process all variables uniformly, meaning that they cannot serve well for clinical data, as there is variable-specific information that needs to be considered. This paper proposes an automated data cleaning method for EHR data with clinical knowledge taken into consideration.

Methods

We used EHR data collected from primary care in Flanders, Belgium during 1994–2015. We constructed a Clinical Knowledge Database to store all the variable-specific information that is necessary for data cleaning. We applied Fuzzy search to automatically detect and replace the wrongly spelled units, and performed the unit conversion following the variable-specific conversion formula. Then the numeric values were corrected and outliers were detected considering the clinical knowledge. In total, 52 clinical variables were cleaned, and the percentage of missing values (completeness) and percentage of values within the normal range (correctness) before and after the cleaning process were compared.

Results

All variables were 100% complete before data cleaning. 42 variables had a drop of less than 1% in the percentage of missing values and 9 variables declined by 1–10%. Only 1 variable experienced large decline in completeness (13.36%). All variables had more than 50% values within the normal range after cleaning, of which 43 variables had a percentage higher than 70%.

Conclusions

We propose a general method for clinical variables, which achieves high automation and is capable to deal with large-scale data. This method largely improved the efficiency to clean the data and removed the technical barriers for non-technical people.
Comparative analysis reveals within-population genome size variation in a rotifer is driven by large genomic elements with highly abundant satellite DNA repeat elements
Authors: Stelzer C. P. , Blommaert J. , Waldvogel A. M. , Pichler M. , Hecox-Lea B. , Mark Welch D. B.
Published: September 2021

Background

Eukaryotic genomes are known to display an enormous variation in size, but the evolutionary causes of this phenomenon are still poorly understood. To obtain mechanistic insights into such variation, previous studies have often employed comparative genomics approaches involving closely related species or geographically isolated populations within a species. Genome comparisons among individuals of the same population remained so far understudied—despite their great potential in providing a microevolutionary perspective to genome size evolution. The rotifer Brachionus asplanchnoidis represents one of the most extreme cases of within-population genome size variation among eukaryotes, displaying almost twofold variation within a geographic population.

Results

Here, we used a whole-genome sequencing approach to identify the underlying DNA sequence differences by assembling a high-quality reference genome draft for one individual of the population and aligning short reads of 15 individuals from the same geographic population including the reference individual. We identified several large, contiguous copy number variable regions (CNVs), up to megabases in size, which exhibited striking coverage differences among individuals, and whose coverage overall scaled with genome size. CNVs were of remarkably low complexity, being mainly composed of tandemly repeated satellite DNA with only a few interspersed genes or other sequences, and were characterized by a significantly elevated GC-content. CNV patterns in offspring of two parents with divergent genome size and CNV patterns in several individuals from an inbred line differing in genome size demonstrated inheritance and accumulation of CNVs across generations.

Conclusions

By identifying the exact genomic elements that cause within-population genome size variation, our study paves the way for studying genome size evolution in contemporary populations rather than inferring patterns and processes a posteriori from species comparisons.
Lung disease network reveals impact of comorbidity on SARS-CoV-2 infection and opportunities of drug repurposing
Authors: Das Asim Bikas
Published: September 2021

Background

Higher mortality of COVID-19 patients with lung disease is a formidable challenge for the health care system. Genetic association between COVID-19 and various lung disorders must be understood to comprehend the molecular basis of comorbidity and accelerate drug development.

Methods

Lungs tissue-specific neighborhood network of human targets of SARS-CoV-2 was constructed. This network was integrated with lung diseases to build a disease–gene and disease-disease association network. Network-based toolset was used to identify the overlapping disease modules and drug targets. The functional protein modules were identified using community detection algorithms and biological processes, and pathway enrichment analysis.

Results

In total, 141 lung diseases were linked to a neighborhood network of SARS-CoV-2 targets, and 59 lung diseases were found to be topologically overlapped with the COVID-19 module. Topological overlap with various lung disorders allows repurposing of drugs used for these disorders to hit the closely associated COVID-19 module. Further analysis showed that functional protein–protein interaction modules in the lungs, substantially hijacked by SARS-CoV-2, are connected to several lung disorders. FDA-approved targets in the hijacked protein modules were identified and that can be hit by exiting drugs to rescue these modules from virus possession.

Conclusion

Lung diseases are clustered with COVID-19 in the same network vicinity, indicating the potential threat for patients with respiratory diseases after SARS-CoV-2 infection. Pathobiological similarities between lung diseases and COVID-19 and clinical evidence suggest that shared molecular features are the probable reason for comorbidity. Network-based drug repurposing approaches can be applied to improve the clinical conditions of COVID-19 patients.
The opportunities and challenges of social media in interstitial lung disease: a viewpoint
Authors: Grewal Japnam S. , Kawano-Dourado Leticia , Ryerson Christopher J.
Published: September 2021

Social media is an increasingly popular source of health information, and the rarity and complexity of interstitial lung disease (ILD) may particularly draw patients with ILD to social media for information and support. The objective of this viewpoint is to provide an overview of social media, explore the benefits and limitations of ILD-related social media use, and discuss future development of healthcare information on social media. We describe the value of integrating social media into the practice of ILD health professionals, including its role in information dissemination, patient engagement, knowledge generation, and formation of health policy. We also describe major challenges to expanded social media use in ILD, including limited access for some individuals and populations, abundance of misinformation, and concerns about patient privacy. Finally, for healthcare professionals looking to join social media, we provide practical guidance and considerations to optimize the potential benefits and minimize the potential pitfalls of social media.
Circ-SFMBT2 drives the malignant phenotypes of esophageal cancer by the miR-107-dependent regulation of SLC1A5
Authors: Chang Zhiwei , Fu Yang , Jia Yongxu , Gao Ming , Song Lijie , Zhang Weijie , Zhao Ruihua , Qin Yanru
Published: September 2021

Background

Increasing studies focused on the regulatory roles of circular RNAs (circRNAs) in diverse cancers. This study was to evaluate the function and mechanism of circRNA Scm-like with four malignant brain tumor domains 2 (circ-SFMBT2) in esophageal cancer (EC).

Methods

The circ-SFMBT2, microRNA-107 (miR-107) and solute-linked carrier family A1 member 5 (SLC1A5) levels were analyzed by quantitative real-time polymerase chain reaction (qRT-PCR). Cell proliferation was evaluated by 3-(4, 5-dimethylthiazol-2-y1)-2, 5-diphenyl tetrazolium bromide (MTT) assay, colony formation assay and EdU assay. Cell apoptosis and invasion were detected by flow cytometry and transwell assay. Glutamine metabolism was assessed by the corresponding kits for glutamine consumption, α-ketoglutarate production and glutamate production. Western blot was used for protein quantification. The binding analysis was performed using dual-luciferase reporter assay, RNA immunoprecipitation (RIP) and pull-down assays. The functional research of circ-SFMBT2 in vivo was performed by xenograft tumor assay. Exosomes were identified by morphological observation and protein detection.

Results

Circ-SFMBT2 was overexpressed in EC samples and cells. Circ-SFMBT2 downregulation inhibited EC cell proliferation, invasion and glutamine metabolism. Circ-SFMBT2 targeted miR-107 and the regulation of circ-SFMBT2 was achieved by sponging miR-107. SLC1A5 was a target of miR-107, and it worked as an oncogene in EC cells. MiR-107 retarded the EC progression by downregulating SLC1A5. Circ-SFMBT2 could affect the SLC1A5 expression by targeting miR-107. Circ-SFMBT2 regulated EC progression in vivo by miR-107/SLC1A5 axis. Circ-SFMBT2 was transferred by exosomes in EC cells.

Conclusion

These results suggested that circ-SFMBT2 upregulated the SLC1A5 expression to promote the malignant development of EC by serving as a miR-107 sponge.
Investigation on heroin and cocaine quality in Luxembourg
Authors: Bourmaud Adèle , Dahm Georges , Meys François , Gengler Nicolas , Origer Alain , Schneider Serge
Published: September 2021

Background

Heroin and cocaine are among the most dangerous illicit drugs available and their presence on the market is increasing. These facts have led to the investigation of the quality of heroin and cocaine samples seized in Luxembourg by police and customs but also collected at the national supervised drug consumption facilities.

Methods

Samples obtained from 2019 to 2020 were analyzed to determine their composition and content using GC–MS, HPLC-UV and LC-Q-ToF. The statistical evaluation of concentration changes depending on the source of collection is based on an ANOVA single factor test and a two-tailed t test.

Results

Results showed important differences between seizure and collection sources. For both drugs, customs samples had significantly higher concentrations than police samples and the latter had significantly higher concentrations than samples from drug consumption facilities, whereas for heroin two cutting steps were identified, for cocaine samples only one appears to occur on the local market. Indeed, cocaine samples seized by police consisted of a mixture of low and high concentration samples.

Conclusion

The results show that extensive adulteration with pharmacological active and inactive compounds takes place at local levels, which, however, are different for heroin and cocaine. This knowledge on variability of quality of drugs should be considered in the elaboration of drug and harm prevention strategies.
De-escalation strategies for non-pharmaceutical interventions following infectious disease outbreaks: a rapid review and a proposed dynamic de-escalation framework
Authors: El Bcheraoui Charbel , Müller Sophie Alice , Vaughan Eleanor C , Jansen Andreas , Cook Robert , Hanefeld Johanna
Published: September 2021

Background

The severity of COVID-19, as well as the speed and scale of its spread, has posed a global challenge. Countries around the world have implemented stringent non-pharmaceutical interventions (NPI) to control transmission and prevent health systems from being overwhelmed. These NPI have had profound negative social and economic impacts. With the timeline to worldwide vaccine roll-out being uncertain, governments need to consider to what extent they need to implement and how to de-escalate these NPI. This rapid review collates de-escalation criteria reported in the literature to provide a guide to criteria that could be used as part of de-escalation strategies globally.

Methods

We reviewed literature published since 2000 relating to pandemics and infectious disease outbreaks. The searches included Embase.com (includes Embase and Medline), LitCovid, grey literature searching, reference harvesting and citation tracking. Over 1,700 documents were reviewed, with 39 documents reporting de-escalation criteria included in the final analysis. Concepts retrieved through a thematic analysis of the included documents were interlinked to build a conceptual dynamic de-escalation framework.

Results

We identified 52 de-escalation criteria, the most common of which were clustered under surveillance (cited by 43 documents, 10 criteria e.g. ability to actively monitor confirmed cases and contact tracing), health system capacity (cited by 30 documents, 11 criteria, e.g. ability to treat all patients within normal capacity) and epidemiology (cited by 28 documents, 7 criteria, e.g. number or changes in case numbers).

De-escalation is a gradual and bi-directional process, and resurgence of infections or emergence of variants of concerns can lead to partial or full re-escalation(s) of response and control measures in place. Hence, it is crucial to rely on a robust public health surveillance system.

Conclusions

This rapid review focusing on de-escalation within the context of COVID-19 provides a conceptual framework and a guide to criteria that countries can use to formulate de-escalation plans.
The validity and reliability of Persian version of smartphone addiction questionnaire in Iran
Authors: Shaahmadi Zahra , Jouybari Touraj Ahmadi , Lotfi Bahare , Aghaei Abbas , Gheshlagh Reza Ghanei
Published: September 2021

Background

Smartphone addiction is one of the most important forms of technology addiction that has attracted the attention of all countries around the world. Many studies have been conducted in Iran on cellphone addiction among different groups. There is a necessity to have a native scale for measuring smartphone addiction in particular. Therefore, this study aimed to localize the smartphone addiction questionnaire in Iran (in the Persian language).

Methods

To assess the validity and reliability of the Persian version of the smartphone addiction scale (SAS), the questionnaire was first provided based on the standard back-translation method. Next, content validity ratio (CVR), content validity index (CVI), and face validity was evaluated for translated questionnaire. After making the necessary changes, the questionnaire was given to the community samples and was then reviewed using confirmatory factor analysis of questions grouping. Finally, the reliability of the questionnaire was investigated by the test-retest method.

Results

The CVR and CVI values of all questions were within the acceptable range. Only some of the questions in the original SAS version titled Twitter and Facebook were changed to Instagram and telegram according to experts. Internal consistency and concurrent validity of the questionnaire were confirmed by Cronbach’s alpha of 0.951. The mean correlation coefficient between the responses of the subjects, who received the questionnaire twice, was 0.946 (0.938–0.954). The grouping of questions in the subscales was changed from the original SAS version because the fitting indexes, obtained from the confirmatory factor analysis test (for example CMIN/DF greater than 5 units and RMSEA of approximately 0.07), were not acceptable.

Conclusion

The results showed that the Iranian version of the cellphone addiction questionnaire can be used as a valid, with minimal modification, tool for determining the level of smartphone addiction among Persian speakers.
Sanctioned countries in the global COVID-19 vaccination campaign: the forgotten 70%
Authors: Blanchet Karl , Mallard Grégoire , Moret Erica , Sun Jin
Published: September 2021

COVAX, the global initiative on COVID-19 vaccines, has set the target of achieving a COVID-19 vaccination coverage of up to 30% of the population of 135 countries in 2 years. Here, we argue that COVAX should anticipate important and unforeseen challenges with regard to sanctioned countries. For those, COVAX needs to provide a higher percentage of the vaccines. Otherwise, the problems of vaccination will linger, risking the advent of new variants and preventing an effective global response in reigning the pandemic under control.
Pre-hospital management of penetrating neck injuries: a scoping review of current evidence and guidance
Authors: Simpson Christopher , Tucker Harriet , Hudson Anthony
Published: September 2021

Penetrating injuries to the neck pose a unique challenge to clinicians due to the proximity of multiple significant anatomical structures with little protective soft tissue coverage. Injuries to this area, whilst low in incidence, are potentially devastating. Respiratory, vascular, gastro-oesophageal and neurological structures may all be involved, either in isolation or combination. These injuries are particularly difficult to manage in the resource poor, often austere and/or remote, pre-hospital environment. A systematic scoping review of the literature was conducted to evaluate the current available research pertaining to managing this injury profile, prior to the patient arriving in the emergency department. The available research is discussed in sections based on the commonly used trauma management acronym ‘cABCD’ (catastrophic haemorrhage, Airway, Breathing, Circulation, Disability) to facilitate a systematic approach and clinical evaluation familiar to clinicians. Based on the available reviewed evidence, we have proposed a management algorithm for this cohort of patients. From this we plan to instigate a Delphi process to develop a consensus statement on the pre-hospital management of this challenging presentation.
Early versus late awake prone positioning in non-intubated patients with COVID-19
Authors: Kaur Ramandeep , Vines David L. , Mirza Sara , Elshafei Ahmad , Jackson Julie A. , Harnois Lauren J. , Weiss Tyler , Scott J. Brady , Trump Matthew W. , Mogri Idrees , Cerda Flor , Alolaiwat Amnah A. , Miller Amanda R. , Klein Andrew M. , Oetting Trevor W. , Morris Lindsey , Heckart Scott , Capouch Lindsay , He Hangyong , Li Jie
Published: September 2021

Background

Awake prone positioning (APP) is widely used in the management of patients with coronavirus disease (COVID-19). The primary objective of this study was to compare the outcome of COVID-19 patients who received early versus late APP.

Methods

Post hoc analysis of data collected for a randomized controlled trial (ClinicalTrials.gov NCT04325906). Adult patients with acute hypoxemic respiratory failure secondary to COVID-19 who received APP for at least one hour were included. Early prone positioning was defined as APP initiated within 24 h of high-flow nasal cannula (HFNC) start. Primary outcomes were 28-day mortality and intubation rate.

Results

We included 125 patients (79 male) with a mean age of 62 years. Of them, 92 (73.6%) received early APP and 33 (26.4%) received late APP. Median time from HFNC initiation to APP was 2.25 (0.8–12.82) vs 36.35 (30.2–75.23) hours in the early and late APP group (p < 0.0001), respectively. Average APP duration was 5.07 (2.0–9.05) and 3.0 (1.09–5.64) hours per day in early and late APP group (p < 0.0001), respectively. The early APP group had lower mortality compared to the late APP group (26% vs 45%,p = 0.039), but no difference was found in intubation rate. Advanced age (OR 1.12 [95% CI 1.0–1.95],p = 0.001), intubation (OR 10.65 [95% CI 2.77–40.91],p = 0.001), longer time to initiate APP (OR 1.02 [95% CI 1.0–1.04],p = 0.047) and hydrocortisone use (OR 6.2 [95% CI 1.23–31.1],p = 0.027) were associated with increased mortality.

Conclusions

Early initiation (< 24 h of HFNC use) of APP in acute hypoxemic respiratory failure secondary to COVID-19 improves 28-day survival.

Trial registrationClinicalTrials.gov NCT04325906.
Four-factor prothrombin complex concentrate to reduce allogenic blood product transfusion in patients with major trauma, the PROCOAG trial: study protocol for a randomized multicenter double-blind superiority study
Authors: Bouzat Pierre , Bosson Jean-Luc , David Jean-Stéphane , Riou Bruno , Duranteau Jacques , Payen Jean-François ,   on behalf of the PROCOAG study group, Levrat Albrice , Abback Paër-Selim , Duranteau Jacques , Riou Bruno , Garrigue Delphine , Marcotte Guillaume , David Jean-Stéphane , Charbit Jonathan , Asehnoune Karim , Leone Marc , Pottecher Julien , Bouzat Pierre
Published: September 2021

Background

Optimal management of severe trauma patients with active hemorrhage relies on adequate initial resuscitation. Early administration of coagulation factors improves post-traumatic coagulation disorders, and four-factor prothrombin complex concentrate (PCC) might be useful in this context. Our main hypothesis is that four-factor PCC in addition to a massive transfusion protocol decreases blood product consumption at day 1 in severe trauma patients with major bleeding.

Methods

This is a prospective, randomized, multicenter, double-blind, parallel, controlled superiority trial. Eligible patients are trauma patients with major bleeding admitted to a French level-I trauma center. Patients randomized in the treatment arm receive 1 mL/kg (25 IU/ml of Factor IX/Kg) four-factor PCC within 1-h post-admission while patients randomized in the controlled group receive 1 mL/kg of saline solution 0.9% as a placebo. Treatments are given as soon as possible using syringe pumps (120 mL/h). The primary endpoint is the amount of blood products transfused in the first 24 h post-admission (including red blood cells, frozen fresh plasma, and platelets). The secondary endpoints are the amount of each blood product transfused in the first 24 h, time to achieve prothrombin time ratio < 1.5, time to hemostasis, number of thrombo-embolic events at 28 days, mortality at 24 h and 28 days, number of intensive care unit-free days, number of ventilator-free days, number of hospital-free days within the first 28 days, hospitalization status at day 28, Glasgow outcome scale extended for patients with brain lesions on initial cerebral imaging, and cost of each strategy at days 8 and 28. Inclusions have started in December 2017 and are expected to be complete by June 2021.

Discussion

If PCC reduces total blood consumption at day 1 after severe trauma, this therapy, in adjunction to a classic massive transfusion protocol, may be used empirically on admission in patients at risk of massive transfusion to enhance coagulation. Moreover, this treatment may decrease blood product-related complications and may improve clinical outcomes after post-traumatic hemorrhage.

Trial registration

ClinicalTrials.govNCT03218722. Registered on July 14, 2017