bluuebunny/crossref_metadata_2025 huggingface dataset:
Augmented cerclage wire improves the fixation strength of a two-screw construct for humerus split type greater tuberosity fracture: a biomechanical study
Authors: Chang Chao-Jui , Su Wei-Ren , Hsu Kai-Lan , Hong Chih-Kai , Kuan Fa-Chuan , Chang Chih-Hsun , Lin Cheng-Li
Published: April 2021

Background

Poor functional outcome can result from humeral greater tuberosity (GT) fracture if not treated appropriately. A two-screw construct is commonly used for the surgical treatment of such injury. However, loss of reduction is still a major concern after surgery. To improve the biomechanical strength of screw fixation in GT fractures, we made a simple modification of the two-screw construct by adding a cerclage wire to the two-screw construct. The purpose of this biomechanical study was to analyze the effect of this modification for the fixation of GT fractures.

Materials and methods

Sixteen fresh-frozen human cadaveric shoulders were used in this study. The fracture models were arbitrarily assigned to one of two fixation methods. Group A (n = 8) was fixed with two threaded cancellous screws with washers. In group B (n = 8), all screws were set using methods identical to group A, with the addition of a cerclage wire. Horizontal traction was applied via a stainless steel cable fixed directly to the myotendinous junction of the supraspinatus muscle. Displacement of the fracture fixation under a pulling force of 100 N/200 N and loading force to construct failure were measured.

Results

The mean displacements under 100 N and 200 N traction force were both significantly decreased in group B than in group A. (100 N: 1.06 ± 0.12 mm vs. 2.26 ± 0.24 mm, p < 0.001; 200 N: 2.21 ± 0.25 mm vs. 4.94 ± 0.30 mm, p < 0.001) Moreover, the failure load was significantly higher in group B compared with group A. (415 ± 52 N vs.335 ± 47 N, p = 0.01),

Conclusions

The current biomechanical cadaveric study demonstrated that the two-screw fixation construct augmented with a cerclage wire has higher mechanical performance than the conventional two-screw configuration for the fixation of humeral GT fractures.

Trial registration

Retrospectively registered.
Acute colonic pseudo-obstruction and rapid septic progression after transabdominal preperitoneal hernia repair: a case report
Authors: Inagaki Yuki , Matsuo Kohei , Nakano Yoritaka , Kondo Tadashi
Published: April 2021

Background

Acute colonic pseudo-obstruction (ACPO) is a rare condition observed in patients with some underlying medical or surgical conditions. To the best of our knowledge, this is the first case report of a patient with ACPO development and rapid septic progression after laparoscopic inguinal hernia repair.

Case presentation

A 78-year-old man who underwent transabdominal preperitoneal hernia repair (TAPP) for right inguinal hernia presented with difficulty in defecation and abdominal distension. He visited our emergency department on the third postoperative day. Enhanced computed tomography (CT) detected marked enlargement from the cecum to the rectum. There was no evidence of mechanical obstruction, ischemia, or perforation. He was diagnosed with postoperative constipation and received conservative management. He gradually started to improve; however, he suddenly experienced cardiopulmonary arrest 30 h after admission and could not be resuscitated. CT imaging of the abdomen during autopsy did not show any significant change, such as perforation, from the time of admission. Based on the clinical course and examination results, postoperative ACPO was considered the fundamental cause of fulminant obstructive colitis leading to sepsis.

Conclusions

ACPO following minimally invasive surgery is exceedingly rare. However, it is important to consider this disease as one of the differential diagnoses to avoid missing the chance for advanced therapy.
Lithium carbonate as add-on therapy to radioiodine in the treatment on hyperthyroidism: a systematic review and meta-analysis
Authors: Abd-ElGawad Mohamed , Abdelmonem Mohamed , Ahmed Ahmed Eissa , Mohammed Omar Magdy , Zaazouee Mohamed Sayed , Assar Ahmed , Gadelkarim Mohamed , Afifi Ahmed M.
Published: April 2021

Background

The main purpose is to investigate the effect of LiCO3 as an add-on therapy with radioactive iodine in increasing the cure and decreasing the T4 level compared to radioactive iodine alone. The primary outcome is the cure rate as defined by the number of hyperthyroid patients who became euthyroid or hypothyroid. The secondary outcome is the T4 level.

Methods

Four databases were searched (PubMed, Scopus, Web of Science, and Cochrane central library). The inclusion criteria were randomized and non-randomized clinical trials of hyperthyroidism patients receiving LiCO3 with radioiodine compared with hyperthyroidism patients receiving radioactive iodine alone. Included studies were appraised with the risk of bias version 2 tool, according to the Cochrane Handbook for Systematic Reviews of Interventions 5.1.0.

Results

Nine studies were eligible for inclusion in the study, six randomized control trials and three non-randomized control trials. There were 477 patients in the intervention group and 451 patients in the control group. The cure rate was not significantly different between the two groups, while it was significantly increased with 5000 to 6500 mg optimized cumulative dose of LiCO3 compared with the control group, P = 0.0001. The T4 level showed no significant difference between the two groups, P = 0.13.

Conclusions

LiCO3 adjunct to radioactive iodine did not show significant differences compared with radioactive iodine alone in terms of cure rate or decreasing T4 level. However, the dose of 5000 to 6000 mg of LiCO3 may increase the cure rate.
Correction to: Acute and chronic diabetes complications associated with self-reported oral health: a retrospective cohort study
Authors: Parbhakar Kamini Kaura , Rosella Laura C. , Singhal Sonica , Quiñonez Carlos R.
Published: April 2021

An amendment to this paper has been published and can be accessed via the original article.
Knowledge on cervical cancer screening and vaccination among females at Oyibi Community
Authors: Osei Evans Appiah , Appiah Stella , Gaogli Judith Elinam , Oti-Boadi Ezekiel
Published: April 2021

Background

Awareness about cervical cancer screening and vaccination in the developed countries are high as compared to the developing countries. Sixty to eighty percent (60–80%) of the women who develop cervical cancer in sub-Saharan Africa live in the rural areas with inadequate awareness of cervical cancer screening. However, cervical cancer knowledge remained a significant direct predictor of screening behaviors. The study therefore aim to explore the Knowledge on Cervical Cancer Screening and Vaccination among females at Oyibi Community.

Methods

A qualitative exploratory design was employed to purposively recruit 35 participants who were made up of 7 members in a group forming 5 Focus Group discussions in all. Data was retrieved using a semi-structured interview guide.

Results

The study revealed two main themes with 7 subthemes. The two main themes were cervical cancer screening and vaccination knowledge and cervical cancer vaccination effectiveness and cost. The subthemes were; knowledge on cervical cancer screening types, knowledge about cervical cancer screening and vaccination centers, knowledge about how cancer screening is performed, knowledge about cervical cancer vaccination, cervical cancer screening and vaccination sources of information, knowledge about the effectiveness of cervical cancer vaccination and awareness about cervical cancer screening cost and vaccination cost.

Conclusion

Ghanaian women are increasingly becoming aware of cervical cancer, nevertheless low knowledge on screening and vaccination of cervical cancer, and effectiveness was detected with high awareness about the screening and vaccination centers. There is therefore the need for heightened sensitization regarding cervical cancer screening and vaccination in rural communities to help reduce misconceptions and increase patronage rate.
Reliability of simulation-based assessment for practicing physicians: performance is context-specific
Authors: Sinz Elizabeth , Banerjee Arna , Steadman Randolph , Shotwell Matthew S. , Slagle Jason , McIvor William R. , Torsher Laurence , Burden Amanda , Cooper Jeffrey B. , DeMaria Samuel , Levine Adam I. , Park Christine , Gaba David M. , Weinger Matthew B. , Boulet John R.
Published: April 2021

Introduction

Even physicians who routinely work in complex, dynamic practices may be unprepared to optimally manage challenging critical events. High-fidelity simulation can realistically mimic critical clinically relevant events, however the reliability and validity of simulation-based assessment scores for practicing physicians has not been established.

Methods

Standardised complex simulation scenarios were developed and administered to board-certified, practicing anesthesiologists who volunteered to participate in an assessment study during formative maintenance of certification activities. A subset of the study population agreed to participate as the primary responder in a second scenario for this study. The physicians were assessed independently by trained raters on both teamwork/behavioural and technical performance measures. Analysis using Generalisability and Decision studies were completed for the two scenarios with two raters.

Results

The behavioural score was not more reliable than the technical score. With two raters > 20 scenarios would be required to achieve a reliability estimate of 0.7. Increasing the number of raters for a given scenario would have little effect on reliability.

Conclusions

The performance of practicing physicians on simulated critical events may be highly context-specific. Realistic simulation-based assessment for practicing physicians is resource-intensive and may be best-suited for individualized formative feedback. More importantly, aggregate data from a population of participants may have an even higher impact if used to identify skill or knowledge gaps to be addressed by training programs and inform continuing education improvements across the profession.
Recent developments in epigenetic cancer therapeutics: clinical advancement and emerging trends
Authors: Nepali Kunal , Liou Jing-Ping
Published: April 2021

Epigenetic drug discovery field has evidenced significant advancement in the recent times. A plethora of small molecule inhibitors have progressed to clinical stage investigations and are being explored exhaustively to ascertain conclusive benefits in diverse malignancies. Literature precedents indicates that substantial amount of efforts were directed towards the use of epigenetic tools in monotherapy as well as in combination regimens at the clinical level, however, the preclinical/preliminary explorations were inclined towards the identification of prudent approaches that can leverage the anticancer potential of small molecule epigenetic inhibitors as single agents only. This review article presents an update of FDA approved epigenetic drugs along with the epigenetic inhibitors undergoing clinical stage investigations in different cancer types. A detailed discussion of the pragmatic strategies that are expected to steer the progress of the epigenetic therapy through the implementation of emerging approaches such as PROTACS and CRISPR/Cas9 along with logical ways for scaffold fabrication to selectively approach the enzyme isoforms in pursuit of garnering amplified antitumor effects has been covered. In addition, the compilation also presents the rational strategies for the construction of multi-targeting scaffold assemblages employing previously identified pharmacophores as potential alternatives to the combination therapy.
LncRNA ACTA2-AS1 suppress colon adenocarcinoma progression by sponging miR-4428 upregulation BCL2L11
Authors: Pan Qingyun , Huang Ying , Wang Yirui , Li Deke , Lei Changjiang
Published: April 2021

Background

Long non-coding RNA is considered to be essential to modulate the development and progression of human malignant cancers. And long non-coding RNA can act as crucial modulators by sponging the corresponding microRNA in tumorigenesis. We aimed to elucidate the function of ACTA2-AS1 and its molecular mechanism in colon adenocarcinoma.

Materials and methods

The expression of ACTA2-AS1, miR-4428 andBCL2L11in colon adenocarcinoma tissues were detected via qRT-PCR. SW480 and HT29 cells were transfected with shRNA ACTA2-AS1, OE ACTA2-AS1, miRNA mimics of miR-4428, miR-4428 inhibitor, si-BCL2L11and over-expression of si-BCL2L11. Cell proliferation, colony formation and apoptosis were respectively assessed using CCK-8 assay, colony assay and flow cytometry. Luciferase reporter assay was performed to verify the targets of ACTA2-AS1 and miR-4428. Tumor subcutaneous xenograft mode was constructed to explore tumor growth in vivo.

Results

ACTA2-AS1 was obviously downregulated in human colon adenocarcinoma tissues and colon adenocarcinoma cell lines. Silence or over-expression of ACTA2-AS1 promoted or inhibited cell proliferation and colony formation abilities, and regulated apoptosis. The silence of ACTA2-AS1 resulted in the decrease of Bax and increase of Bal2, while restored in OE ACTA2-AS1 group when compared with the control transfected cells. In addition, luciferase reporter assay revealed that ACTA2-AS1 interacted with miR-4428 and suppressed its expression. miR-4428 could bind to 3ʹ untranslated region ofBCL2L11and modulated the expression ofBCL2L11negatively. Knockdown of ACTA2-AS1 and over-expression ofBCL2L11reversed the biological function that ACTA2-AS1 mediated by knockdown ACTA2-AS1 alone.

Conclusion

Our data demonstrated that ACTA2-AS1 could suppress colon adenocarcinoma progression via sponging miR-4428 to regulateBCL2L11expression.
Aspartame and cancer – new evidence for causation
Authors: Landrigan Philip J. , Straif Kurt
Published: April 2021

Background

Aspartame is one of the world’s most widely used artificial sweeteners and is an ingredient in more than 5000 food products globally. A particularly important use is in low-calorie beverages consumed by children and pregnant women.

The Ramazzini Institute (RI) reported in 2006 and 2007 that aspartame causes dose-related increases in malignant tumors in multiple organs in rats and mice. Increased cancer risk was seen even at low exposure levels approaching the Acceptable Daily Intake (ADI). Prenatal exposures caused increased malignancies in rodent offspring at lower doses than in adults.

These findings generated intense controversy focused on the accuracy of RI’s diagnoses of hematopoietic and lymphoid tissue tumors (HLTs). Critics made the claim that pulmonary lesions observed in aspartame-exposed animals were inflammatory lesions caused by Mycoplasma infection rather than malignant neoplasms.

Methods

To address this question, RI subjected all HLTs from aspartame-exposed animals to immunohistochemical analysis using a battery of markers and to morphological reassessment using the most recent Internationally Harmonized Nomenclature and Diagnostic (INHAND) criteria.

Findings

This immunohistochemical and morphological re-evaluation confirmed the original diagnoses of malignancy in 92.3% of cases. Six lesions originally diagnosed as lymphoma (8% of all HLTs) were reclassified: 3 to lymphoid hyperplasia, and 3 to chronic inflammation with fibrosis. There was no evidence of Mycoplasma infection.

Interpretation

These new findings confirm that aspartame is a chemical carcinogen in rodents. They confirm the very worrisome finding that prenatal exposure to aspartame increases cancer risk in rodent offspring. They validate the conclusions of the original RI studies.

These findings are of great importance for public health. In light of them, we encourage all national and international public health agencies to urgently reexamine their assessments of aspartame’s health risks - especially the risks of prenatal and early postnatal exposures. We call upon food agencies to reassess Acceptable Daily Intake (ADI) levels for aspartame. We note that an Advisory Group to the International Agency for Research on Cancer has recommended high-priority reevaluation of aspartame’s carcinogenicity to humans.
Gender differences in risk factors for high plasma homocysteine levels based on a retrospective checkup cohort using a generalized estimating equation analysis
Authors: Zhao Jing , Li Zhihua , Hou Chengbei , Sun Fei , Dong Jing , Chu Xi , Guo Yansu
Published: April 2021

Background

Hyperhomocysteinemia (HHcy) is associated with various health problems, but less is known about the gender differences in risk factors for high plasma homocysteine (Hcy) levels.

Methods

In this study, a retrospective study was carried out on 14,911 participants (7838 males and 7073 females) aged 16–102 years who underwent routine checkups between January 2012 and December 2017 in the Health Management Department of Xuanwu Hospital, China. Anthropometric measurements, including body mass index (BMI) and waist-to-hip ratio, were collected. Fasting blood samples were collected to measure the biochemical indexes. The outcome variable was Hcy level, and a generalized estimating equation (GEE) analysis was used to identify the associations of interest based on gender.

Results

Males exhibited increased Hcy levels (16.37 ± 9.66 vs 11.22 ± 4.76 μmol/L) and prevalence of HHcy (37.0% vs 11.3%) compared with females. Hcy levels and HHcy prevalence increased with age in both genders, except for the 16- to 29-year-old group. GEE analysis indicated that irrespective of gender, aspartate aminotransferase, creatinine, uric acid, low-density lipoprotein cholesterol and high-density lipoprotein cholesterol levels were positively correlated with Hcy levels, and alanine aminotransferase, total cholesterol and glucose were negatively correlated with Hcy levels. However, age, BMI and triglycerides (TGs) were positively correlated with Hcy levels exclusively in females.

Conclusions

Gender differences in risk factors for high plasma Hcy levels were noted. Although common correlational factors existed in both genders, age, BMI and TGs were independent risk factors for Hcy levels specifically in females.
A benchmark for RNA-seq deconvolution analysis under dynamic testing environments
Authors: Jin Haijing , Liu Zhandong
Published: April 2021

Background

Deconvolution analyses have been widely used to track compositional alterations of cell types in gene expression data. Although a large number of novel methods have been developed, due to a lack of understanding of the effects of modeling assumptions and tuning parameters, it is challenging for researchers to select an optimal deconvolution method suitable for the targeted biological conditions.

Results

To systematically reveal the pitfalls and challenges of deconvolution analyses, we investigate the impact of several technical and biological factors including simulation model, quantification unit, component number, weight matrix, and unknown content by constructing three benchmarking frameworks. These frameworks cover comparative analysis of 11 popular deconvolution methods under 1766 conditions.

Conclusions

We provide new insights to researchers for future application, standardization, and development of deconvolution tools on RNA-seq data.
Effects of metformin withdrawal after long and short term treatment in PCOS: observational longitudinal study
Authors: Kravos Nika Aleksandra , Janež Andrej , Goričar Katja , Dolžan Vita , Jensterle Mojca
Published: April 2021

Background

Metformin plays a consolidated role in the management of polycystic ovary syndrome (PCOS). However, there is no clear answer on how long we should treat and on how long its beneficial impact sustain after we stop treatment. We compared the effects of metformin withdrawal after long-term (LT) and short term (ST) treatment in PCOS women that had previously well responded to metformin.

Methods

We conducted observational longitudinal study including 44 PCOS women (31 (28–36) years and BMI 32.5 (27.7–34.9) kg/m2) that were followed for 6 months after metformin withdrawal. Prior inclusion, ST group had been treated with metformin on average for 1.03 ± 0.13 year, LT group for 5.07 ± 2.52 years. We followed anthropometric, metabolic, reproductive parameters and eating behavior as assessed by TFEQ-R18.

Results

After metformin withdrawal, ST group gained significant amount of weight (from 92 (75.5–107.3) kg to 96 (76–116) kg; p = 0.019). Weight tended to increase also in LT users (from 87 (75–103) to 87 (73–105) kg; p = 0.058). More women in LT group maintained stable weight (27% in LT group vs 15% in ST group). Eating behavior deteriorated in both groups. Withdrawal of metformin resulted in a decrease of menstrual frequency (6 (6–6) to 6 (4–6) menstrual bleeds per 6 months; p = 0.027) and in borderline increase of androstenedione (6.4 (4.6–7.6) to 7.8 (4.8–9.6) nmol/L; p = 0.053) in LT group. Waist circumference, HOMA and glucose homeostasis remained stable in both groups. There were no differences between groups at 6-month follow up.

Conclusion

Collectively, present study implies some metabolic and endocrine treatment legacy in both groups as well as some group-specific deteriorations in clinical parameters 6 months after metformin withdrawal.

Trial registration: The study is registered at Clinical Trials with reference No. NCT04566718
Integrative study of EZH2 mutational status, copy number, protein expression and H3K27 trimethylation in AML/MDS patients
Authors: Stomper Julia , Meier Ruth , Ma Tobias , Pfeifer Dietmar , Ihorst Gabriele , Blagitko-Dorfs Nadja , Greve Gabriele , Zimmer Dennis , Platzbecker Uwe , Hagemeijer Anne , Schmitt-Graeff Ingrid , Lübbert Michael
Published: April 2021

Background

Mutations in the EZH2 gene are recurrently found in patients with myeloid neoplasms and are associated with a poor prognosis. We aimed to characterize genetic and epigenetic alterations of EZH2 in 58 patients (51 with acute myeloid leukemia and 7 with myelodysplastic or myeloproliferative neoplasms) by integrating data on EZH2 mutational status, co-occurring mutations, and EZH2 copy number status with EZH2 protein expression, histone H3K27 trimethylation, and EZH2 promoter methylation.

Results

EZH2 was mutated in 6/51 acute myeloid leukemia patients (12%) and 7/7 patients with other myeloid neoplasms. EZH2 mutations were not overrepresented in patients with chromosome 7q deletions or losses. In acute myeloid leukemia patients, EZH2 mutations frequently co-occurred with CEBPA (67%), ASXL1 (50%), TET2 and RAD21 mutations (33% each). In EZH2-mutated patients with myelodysplastic or myeloproliferative neoplasms, the most common co-mutations were in ASXL1 (100%), NRAS, RUNX1, and STAG2 (29% each). EZH2 mutations were associated with a significant decrease in EZH2 expression (p = 0.0002), which was similar in patients with chromosome 7 aberrations and patients with intact chromosome 7. An association between EZH2 protein expression and H3K27 trimethylation was observed in EZH2-unmutated patients (R2 = 0.2, p = 0.01). The monoallelic state of EZH2 was not associated with EZH2 promoter hypermethylation. In multivariable analyses, EZH2 mutations were associated with a trend towards an increased risk of death (hazard ratio 2.51 [95% confidence interval 0.87–7.25], p = 0.09); similarly, low EZH2 expression was associated with elevated risk (hazard ratio 2.54 [95% confidence interval 1.07–6.04], p = 0.04).

Conclusions

Perturbations of EZH2 activity in AML/MDS occur on different, genetic and non-genetic levels. Both low EZH2 protein expression and, by trend, EZH2 gene mutations predicted inferior overall survival of AML patients receiving standard chemotherapy.
Isolation and characterisation of ΦcrAss002, a crAss-like phage from the human gut that infects Bacteroides xylanisolvens
Authors: Guerin Emma , Shkoporov Andrey N. , Stockdale Stephen R. , Comas Joan Colom , Khokhlova Ekaterina V. , Clooney Adam G. , Daly Karen M. , Draper Lorraine A. , Stephens Niamh , Scholz Dimitri , Ross R. Paul , Hill Colin
Published: April 2021

Background

The gut phageome comprises a complex phage community of thousands of individual strains, with a few highly abundant bacteriophages. CrAss-like phages, which infect bacteria of the order Bacteroidales, are the most abundant bacteriophage family in the human gut and make an important contribution to an individual’s core virome. Based on metagenomic data, crAss-like phages form a family, with four sub-families and ten candidate genera. To date, only three representatives isolated in pure culture have been reported: ΦcrAss001 and two closely related phages DAC15 and DAC17; all are members of the less abundant candidate genus VI. The persistence at high levels of both crAss-like phage and their Bacteroidales hosts in the human gut has not been explained mechanistically, and this phage-host relationship can only be properly studied with isolated phage-host pairs from as many genera as possible.

Results

Faeces from a healthy donor with high levels of crAss-like phage was used to initiate a faecal fermentation in a chemostat, with selected antibiotics chosen to inhibit rapidly growing bacteria and selectively enrich for Gram-negative Bacteroidales. This had the objective of promoting the simultaneous expansion of crAss-like phages on their native hosts. The levels of seven different crAss-like phages expanded during the fermentation, indicating that their hosts were also present in the fermenter. The enriched supernatant was then tested against individual Bacteroidales strains isolated from the same faecal sample. This resulted in the isolation of a previously uncharacterised crAss-like phage of candidate genus IV of the proposed Alphacrassvirinae sub-family, ΦcrAss002, that infects the gut commensalBacteroides xylanisolvens. ΦcrAss002 does not form plaques or spots on lawns of sensitive cells, nor does it lyse liquid cultures, even at high titres. In keeping with the co-abundance of phage and host in the human gut, ΦcrAss002 andBacteroides xylanisolvenscan also co-exist at high levels when co-cultured in laboratory media.

Conclusions

We report the isolation and characterisation of ΦcrAss002, the first representative of the proposed Alphacrassvirinae sub-family of crAss-like phages. ΦcrAss002 cannot form plaques or spots on bacterial lawns but can co-exist with its host,Bacteroides xylanisolvens, at very high levels in liquid culture without impacting on bacterial numbers.
Niche partitioning in the Rimicaris exoculata holobiont: the case of the first symbiotic Zetaproteobacteria
Authors: Cambon-Bonavita Marie-Anne , Aubé Johanne , Cueff-Gauchard Valérie , Reveillaud Julie
Published: April 2021

Background

Free-living and symbiotic chemosynthetic microbial communities support primary production and higher trophic levels in deep-sea hydrothermal vents. The shrimpRimicaris exoculata, which dominates animal communities along the Mid-Atlantic Ridge, houses a complex bacterial community in its enlarged cephalothorax. The dominant bacteria present are from the taxonomic groupsCampylobacteria,Desulfobulbia(formerlyDeltaproteobacteria),Alphaproteobacteria,Gammaproteobacteria, and some recently discovered iron oxyhydroxide-coatedZetaproteobacteria. This epibiotic consortium uses iron, sulfide, methane, and hydrogen as energy sources. Here, we generated shotgun metagenomes fromRimicaris exoculatacephalothoracic epibiotic communities to reconstruct and investigate symbiotic genomes. We collected specimens from three geochemically contrasted vent fields, TAG, Rainbow, and Snake Pit, to unravel the specificity, variability, and adaptation ofRimicaris–microbe associations.

Results

Our data enabled us to reconstruct 49 metagenome-assembled genomes (MAGs) from the TAG and Rainbow vent fields, including 16 with more than 90% completion and less than 5% contamination based on single copy core genes. These MAGs belonged to the dominantCampylobacteria,Desulfobulbia,Thiotrichaceae, and some novel candidate phyla radiation (CPR) lineages. In addition, most importantly, two MAGs in our collection were affiliated toZetaproteobacteriaand had no close relatives (average nucleotide identity ANI < 77% with the closest relativeGhiorsea bivoraisolated from TAG, and 88% with each other), suggesting potential novel species. Genes for Calvin-Benson Bassham (CBB) carbon fixation, iron, and sulfur oxidation, as well as nitrate reduction, occurred in both MAGs. However, genes for hydrogen oxidation and multicopper oxidases occurred in one MAG only, suggesting shared and specific potential functions for these two novelZetaproteobacteriasymbiotic lineages. Overall, we observed highly similar symbionts co-existing in a single shrimp at both the basaltic TAG and ultramafic Rainbow vent sites. Nevertheless, further examination of the seeming functional redundancy among these epibionts revealed important differences.

Conclusion

These data highlight microniche partitioning in theRimicarisholobiont and support recent studies showing that functional diversity enables multiple symbiont strains to coexist in animals colonizing hydrothermal vents.
Risk factors for developing severe COVID-19 in China: an analysis of disease surveillance data
Authors: Geng Meng-Jie , Wang Li-Ping , Ren Xiang , Yu Jian-Xing , Chang Zhao-Rui , Zheng Can-Jun , An Zhi-Jie , Li Yu , Yang Xiao-Kun , Zhao Hong-Ting , Li Zhong-Jie , He Guang-Xue , Feng Zi-Jian
Published: April 2021

Background

COVID-19 has posed an enormous threat to public health around the world. Some severe and critical cases have bad prognoses and high case fatality rates, unraveling risk factors for severe COVID-19 are of significance for predicting and preventing illness progression, and reducing case fatality rates. Our study focused on analyzing characteristics of COVID-19 cases and exploring risk factors for developing severe COVID-19.

Methods

The data for this study was disease surveillance data on symptomatic cases of COVID-19 reported from 30 provinces in China between January 19 and March 9, 2020, which included demographics, dates of symptom onset, clinical manifestations at the time of diagnosis, laboratory findings, radiographic findings, underlying disease history, and exposure history. We grouped mild and moderate cases together as non-severe cases and categorized severe and critical cases together as severe cases. We compared characteristics of severe cases and non-severe cases of COVID-19 and explored risk factors for severity.

Results

The total number of cases were 12 647 with age from less than 1 year old to 99 years old. The severe cases were 1662 (13.1%), the median age of severe cases was 57 years [Inter-quartile range(IQR): 46–68] and the median age of non-severe cases was 43 years (IQR: 32–54). The risk factors for severe COVID-19 were being male [adjusted odds ratio (aOR) = 1.3, 95% CI: 1.2–1.5]; fever (aOR = 2.3, 95% CI: 2.0–2.7), cough (aOR = 1.4, 95% CI: 1.2–1.6), fatigue (aOR = 1.3, 95% CI: 1.2–1.5), and chronic kidney disease (aOR = 2.5, 95% CI: 1.4–4.6), hypertension (aOR = 1.5, 95% CI: 1.2–1.8) and diabetes (aOR = 1.96, 95% CI: 1.6–2.4). With the increase of age, risk for the severity was gradually higher [20–39 years (aOR = 3.9, 95% CI: 1.8–8.4), 40–59 years (aOR = 7.6, 95% CI: 3.6–16.3), ≥ 60 years (aOR = 20.4, 95% CI: 9.5–43.7)], and longer time from symtem onset to diagnosis [3–5 days (aOR = 1.4, 95% CI: 1.2–1.7), 6–8 days (aOR = 1.8, 95% CI: 1.5–2.1), ≥ 9 days(aOR = 1.9, 95% CI: 1.6–2.3)].

Conclusions

Our study showed the risk factors for developing severe COVID-19 with large sample size, which included being male, older age, fever, cough, fatigue, delayed diagnosis, hypertension, diabetes, chronic kidney diasease. Based on these factors, the severity of COVID-19 cases can be predicted. So cases with these risk factors should be paid more attention to prevent severity.
Distribution and factors associated with urogenital schistosomiasis in the Tiko Health District, a semi-urban setting, South West Region, Cameroon
Authors: Green Adeline Enjema , Anchang-Kimbi Judith Kuoh , Wepnje Godlove Bunda , Ndassi Vicky Daonyle , Kimbi Helen Kuokuo
Published: April 2021

Background

Increased risk of schistosomiasis in peri-urban and urban towns is not uncommon. An epidemiological survey was carried out in the Tiko Health District (THD), an unmapped transmission focus for urogenital schistosomiasis (UGS), to assess the distribution, intensity, and risk factors associated with the occurrence of UGS.

Methods

In this cross-sectional survey, 12 communities were purposively selected from four health areas (HAs) (Likomba, Holforth, Holforth-Likomba, and Mutengene) in South West Region of Cameroon between June and August 2018. Consenting individuals were enrolled using a convenient sampling technique and administered a semi-structured questionnaire to document information on socio-demographic and water contact behaviour. Urine samples were examined for Schistosomahaematobium infection using test strip, filtration, and microscopy methods. Bivariate and binary logistic regression analyses were used to identify predictors of infection.

Results

The overall prevalence of UGS in Likomba, Holforth-Likomba and Holforth was 31.5% [95% confidence interval (CI): 28.3–34.8] with geometric mean (GM) egg count of 28.7 (range: 2–450) eggs per 10 ml of urine. S.haematobium infection was not found in Mutengene HA. Infection was unevenly distributed among the HAs, Holforth-Likomba and Holforth being the most and least affected, respectively. The prevalence of infection varied (P < 0.001) among the affected communities, ranging from 12.0 to 56.9%. Infection status of the community related positively (P < 0.001) with proximity to stream (< 100 m), the degree of contact with water and number of improved water sources. Younger age group (5–14 years) [adjusted odds ratio (aOR): 3.7, 95% CI: 1.1–12.2] and intense water contact (degree II) (aOR: 5.2, 95% CI: 3.4–8.1) were associated with increased risk of infection. Similarly, significantly higher egg load was observed among younger aged groups (P = 0.02) and those who carried out intense water contact activities (P < 0.001).

Conclusions

Generally, THD is a moderate risk endemic focus for UGS but prevalence higher than 50.0% was observed in some communities. These findings warrant immediate mass chemotherapy with praziquantel to reduce morbidity. Provision of portable water and health education are proposed measures to reduce and eventually eliminate transmission in the area.

Graphic abstract
Genetic polymorphism of IDOL gene was associated with the susceptibility of coronary artery disease in Han population in Xinjiang, China
Authors: Adi Dilare , Abuzhalihan Jialin , Tao Jing , Wu Yun , Wang Ying-Hong , Liu Fen , Yang Yi-Ning , Ma Xiang , Li Xiao-Mei , Xie Xiang , Fu Zhen-Yan , Ma Yi-Tong
Published: April 2021

Background

Coronary artery disease (CAD) is the leading cause of death worldwide. In this study, we aimed to explore whether some genetic variants of the human IDOL gene were associated with CAD among Chinese population in Xinjiang.

Methods

We designed two independent case–control studies. The first one included in the Han population (448 CAD patients and 343 controls), and the second one is the Uygur population (304 CAD patients and 318 controls). We genotyped three SNPs (rs2072783, rs2205796, and rs909562) of the IDOL gene.

Results

Our results revealed that, in the Han female subjects, for rs2205796, the distribution of alleles, dominant model (TT vs. GG + GT) and the additive model (GG + TT vs. GT) showed significant differences between CAD patients and the control subjects (P = 0.048, P = 0.014, and P = 0.032, respectively).

Conclusions

The rs2205796 polymorphism of the IDOL gene is associated with CAD in the Chinese Han female population in Xinjiang, China.
Economic burden of childhood diarrhea in Burundi
Authors: Niyibitegeka Fulgence , Riewpaiboon Arthorn , Youngkong Sitaporn , Thavorncharoensap Montarat
Published: April 2021

Background

In 2016, diarrhea killed around 7 children aged under 5 years per 1000 live births in Burundi. The objective of this study was to estimate the economic burden associated with diarrhea in Burundi and to examine factors affecting the cost to provide economic evidence useful for the policymaking about clinical management of diarrhea.

Methods

The study was designed as a prospective cost-of-illness study using an incidence-based approach from the societal perspective. The study included patients aged under 5 years with acute non-bloody diarrhea who visited Buyenzi health center and Prince Regent Charles hospital from November to December 2019. Data were collected through interviews with patients’ caregivers and review of patients’ medical and financial records. Multiple linear regression was performed to identify factors affecting cost, and a cost model was used to generate predictions of various clinical and care management costs. All costs were converted into international dollars for the year 2019.

Results

One hundred thirty-eight patients with an average age of 14.45 months were included in this study. Twenty-one percent of the total patients included were admitted. The average total cost per episode of diarrhea was Int$109.01. Outpatient visit and hospitalization costs per episode of diarrhea were Int$59.87 and Int$292, respectively. The costs were significantly affected by the health facility type, patient type, health insurance scheme, complications with dehydration, and duration of the episode before consultation. Our model indicates that the prevention of one case of dehydration results in savings of Int$16.81, accounting for approximately 11 times of the primary treatment cost of one case of diarrhea in the community-based management program for diarrhea in Burundi.

Conclusion

Diarrhea is associated with a substantial economic burden to society. Evidence from this study provides useful information to support health interventions aimed at prevention of diarrhea and dehydration related to diarrhea in Burundi. Appropriate and timely care provided to patients with diarrhea in their communities and primary health centers can significantly reduce the economic burden of diarrhea. Implementing a health policy to provide inexpensive treatment to prevent dehydration can save significant amount of health expenditure.
Clinical ethnography in severe mental illness: a clinical method to tackle social determinants and structural racism in personalised care
Authors: Bhui Kamaldeep , Dein Simon , Pope Catherine
Published: April 2021

Ethnic inequalities in the experiences and outcomes of severe mental illness are well established. These include a higher incidence of severe mental illnesses (psychoses), adverse pathways into and through care, including crisis care, police and criminal justice systems involvement, and care under the powers of the Mental Health Act. The situation persists despite awareness and is driven by a mixture of the social determinants of poor health, societal disadvantage and structural racism, as well as conflictual interactions with care systems, which themselves are configured in ways that sustain or deepen these inequalities. Although training and education are often proposed, this is not shown to have sustained effects. Clinical processes (interviewing/assessment/formulation/intervention) need to address systemic influences and improve the cultural precision with which care is delivered, organised and commissioned. We discuss clinical ethnography and present evidence of its value in addressing systemic as well as individual care needs for diverse communities.
Limited English Proficiency and Disparities in Health Care Engagement Among Patients With Breast Cancer
Authors: Roy Mohana , Purington Natasha , Liu Mina , Blayney Douglas W. , Kurian Allison W. , Schapira Lidia
Published: April 2021

PURPOSE:

Race and ethnicity have been shown to affect quality of cancer care, and patients with low English proficiency (LEP) have increased risk for serious adverse events. We sought to assess the impact of primary language on health care engagement as indicated by clinical trial screening and engagement, use of genetic counseling, and communication via an electronic patient portal.

METHODS:

Clinical and demographic data on patients with breast cancer diagnosed and treated from 2013 to 2018 within the Stanford University Health Care system were compiled via linkage of electronic health records, an internal clinical trial database, and the California Cancer Registry. Logistic and linear regression models were used to evaluate for association of clinical trial engagement and patient portal message rates with primary language group.

RESULTS:

Patients with LEP had significantly lower rates of clinical trial engagement compared with their English-speaking counterparts (adjusted odds ratio [OR], 0.29; 95% CI, 0.16 to 0.51). Use of genetic counseling was similar between language groups. Rates of patient portal messaging did not differ between English-speaking and LEP groups on multivariable analysis; however, patients with LEP were less likely to have a portal account (adjusted OR, 0.89; 95% CI, 0.83 to 0.96). Among LEP subgroups, Spanish speakers were significantly less likely to engage with the patient portal compared with English speakers (estimated difference in monthly rate: OR, 0.43; 95% CI, 0.24 to 0.77).

CONCLUSION:

We found that patients with LEP had lower rates of clinical trial engagement and odds of electronic patient portal enrollment. Interventions designed to overcome language and cultural barriers are essential to optimize the experience of patients with LEP.
The Human Islet: Mini-Organ With Mega-Impact
Authors: Walker John T , Saunders Diane C , Brissova Marcela , Powers Alvin C
Published: April 2021

This review focuses on the human pancreatic islet—including its structure, cell composition, development, function, and dysfunction. After providing a historical timeline of key discoveries about human islets over the past century, we describe new research approaches and technologies that are being used to study human islets and how these are providing insight into human islet physiology and pathophysiology. We also describe changes or adaptations in human islets in response to physiologic challenges such as pregnancy, aging, and insulin resistance and discuss islet changes in human diabetes of many forms. We outline current and future interventions being developed to protect, restore, or replace human islets. The review also highlights unresolved questions about human islets and proposes areas where additional research on human islets is needed.
Η ιωνική στοά του Ασκληπιείου της Επιδαύρου το λεγόμενον άβατον
Authors: Μαυρομματίδης Ιωάννης
Published: April 2021

Η ιωνική στοά βρίσκεται στο κέντρο του ιερού του Ασκληπιού στην Επίδαυρο. Οικοδομήθηκε σε δύο κατασκευαστικές περιόδους, με την πρώτη περί το 370 π. Χ., πρόκειται για τη μονώροφη στοά. Αργότερα, επεκτάθηκε η μονώροφη στοά σχηματίζοντας τη διώροφη στοά (τέλος 4ου- αρχή 3ου αι. π. Χ.). Η διώροφη στοά αντιγράφει πιστά τον ρυθμό, τον τύπο και τη μορφή της μονώροφης στοάς. Το συγκρότημα των δύο στοών αποτελεί τη συνέχεια ενός ακόμη παλαιότερου κτηρίου, του Κτηρίου Κ΄, (τέλος 5ου- αρχή 4ου αι. π. Χ.). Στην αρχιτεκτονική μελέτη του κτηρίου γίνεται αναφορά στα υλικά και τον τρόπο δομής τους που χρησιμοποιήθηκαν στο κτηριακό συγκρότημα καθώς επίσης στο αρχαίο κατασκευαστικό μέτρο, το οποίο χρησιμοποιήθηκε αποκλειστικά στη μελέτη του κτηρίου. Μελετήθηκαν και ερμηνεύτηκαν όλα τα αρχιτεκτονικά στοιχεία του κτηρίου όπως οι κίονες, τα λίθινα διαφράγματα, τα κιονόκρανα, ο δωρικός θριγκός του ισογείου, τμήματα του κτηρίου όπως ο στερεοβάτης, η κρηπίς, τοιχοποιίες ανωδομής, η στέγη, οι πεσσοστοιχίες, το ξύλινο πάτωμα. Στη μονώροφη στοά, ερμηνεύτηκαν όλες οι κατασκευαστικές ιδιαιτερότητες του στερεοβάτη και της κρηπίδος καθώς και η προέλευση και εφαρμογή του τύπου και του ρυθμού που εφαρμόστηκε, βάσει ενός θεωρητικού σχεδίου, το οποίο λόγω της αρτιότητας που το διακρίνει, πιθανότατα να είναι το αρχικό σχέδιο της μονώροφης στοάς. Από τα αρχιτεκτονικά στοιχεία που προέκυψαν από τη μελέτη του κτηρίου, σε συνδυασμό με τις αρχαιολογικές μαρτυρίες της εποχής που αποκαλύφθηκε το κτήριο, το έτος 1884, προκύπτει ότι το άβατο δεν ήταν ούτε βρισκόταν στην ιωνική στοά, όπως υποδείχθηκε τότε από τον Παναγή Καββαδία. Σε ολόκληρο το κτηριακό αυτό συγκρότημα οι ασθενείς παραμένουν προκειμένου να θεραπευθούν. Υπάρχουν μάλιστα διακριτοί οι χώροι στους οποίους οι ασθενείς κατακλίνονται, το εγκοιμητήριο, χώροι όπου διημερεύουν καθώς και χώροι ευρύτερης κοινής χρήσης.
Knowledge and compliance with Covid-19 infection prevention and control measures among health workers in regional referral hospitals in northern Uganda: a cross-sectional online survey
Authors: Amanya Sharon Bright , Nyeko Richard , Obura Bonniface , Acen Joy , Nabasirye Caroline , Nakaziba Rebecca , Oyella Florence , Afayo Victor , Okwir Mark
Published: April 2021

Background: Infection prevention and control (IPC) has increasingly been underscored as a key tool for limiting the transmission of coronavirus disease 2019 (Covid-19) and safeguarding health workers from infections during their work. Knowledge and compliance with IPC measures is therefore essential in protecting health workers. However, this has not been established among health workers in northern Uganda in light of the Covid-19 pandemic. The objective of this study was to determine the knowledge and compliance with Covid-19 infection prevention and control measures among health workers in regional referral hospitals in northern Uganda. 

Methods: An online cross-sectional descriptive study was conducted among health workers in regional referral hospitals within northern Uganda. A structured questionnaire was distributed to health workers via WhatsApp messenger. Sufficient knowledge was considered at a correct response score of ≥80%, while adequate compliance was rated ≥75% of the maximum score. Data were analyzed using SPSS v21.  

Results: Of the 213 health workers approached, 75 (35%) participated in the study. The majority were males, 39(52%) and the mean age was 36.92 years. Of the 75 participants, 52(69%) had sufficient knowledge of Covid-19 IPC while 51(68%) had adequate compliance with Covid-19 IPC.   Adequate compliance was significantly associated with training in Covid-19 IPC (OR, 2.86; 95% CI, (1.04-7.88); p=0.039), access to Covid-19 IPC materials at workstations (OR, 2.90; 95% CI, (1.06 - 8.09); p=0.036), and having strong institutional support (OR, 3.08; 95% CI, (1.08 – 8.74); p=0.031). However, there was no significant relationship between knowledge and compliance with IPC (p=0.07). The socio-demographic characteristics of health workershad no statistically significant relationship with Covid-19 IPC knowledge or compliance. 

Conclusion: Our results show fairly good knowledge and compliance with Covid-19 IPC among health workers in northern Uganda. There is need for more training and provision of guidelines to promote compliance with Covid-19 IPC.