bluuebunny/crossref_metadata_2025 huggingface dataset:
Women empowerment and health insurance utilisation in Rwanda: a nationwide cross-sectional survey
Authors: Kawuki Joseph , Gatasi Ghislaine , Sserwanja Quraish
Published: September 2022

Background

Health insurance coverage is one of the several measures being implemented to reduce the inequity in access to quality health services among vulnerable groups. Although women’s empowerment has been viewed as a cost-effective strategy for the reduction of maternal and child morbidity and mortality, as it enables women to tackle the barriers to accessing healthcare, its association with health insurance usage has been barely investigated. Our study aims at examining the prevalence of health insurance utilisation and its association with women empowerment as well as other socio-demographic factors among Rwandan women.

Methods

We used Rwanda Demographic and Health Survey (RDHS) 2020 data of 14,634 women aged 15–49 years, who were selected using multistage sampling. Health insurance utilisation, the outcome variable was a binary response (yes/no), while women empowerment was assessed by four composite indicators; exposure to mass media, decision making, economic and sexual empowerment. We conducted multivariable logistic regression to explore its association with socio-demographic factors, using SPSS (version 25).

Results

Out of the 14,634 women, 12,095 (82.6%) (95% CI 82.0–83.2) had health insurance, and the majority (77.2%) were covered by mutual/community organization insurance. Women empowerment indicators had a negative association with health insurance utilisation; low (AOR = 0.85, 95% CI 0.73–0.98) and high (AOR = 0.66, 95% CI 0.52–0.85) exposure to mass media, high decision making (AOR = 0.78, 95% CI 0.68–0.91) and high economic empowerment (AOR = 0.63, 95% CI 0.51–0.78). Other socio-demographic factors found significant include; educational level, wealth index, and household size which had a negative association, but residence and region with a positive association.

Conclusions

A high proportion of Rwandan women had health insurance, but it was negatively associated with women’s empowerment. Therefore, tailoring mass-media material considering the specific knowledge gaps to addressing misinformation, as well as addressing regional imbalance by improving women’s access to health facilities/services are key in increasing coverage of health insurance among women in Rwanda.
Opportunities and considerations for the design of decentralized delivery of antiretroviral therapy for female sex workers living with HIV in South Africa
Authors: Comins Carly A. , Guddera Vijayanand , Parmley Lauren E. , Young Katherine , Mcingana Mfezi , Mulumba Ntambue , Mishra Sharmistha , Phetlhu Deliwe R. , Hausler Harry , Schwartz Sheree , Baral Stefan
Published: September 2022

Background

In South Africa, 60% of female sex workers (FSW) are living with HIV, many of whom experience structural and individual barriers to antiretroviral therapy (ART) initiation and adherence. Community-based decentralized treatment provision (DTP) may mitigate these barriers. To characterize optimal implementation strategies, we explored preferences for DTP among FSW living with HIV in Durban, South Africa.

Methods

Thirty-nine semi-structured in-depth interviews were conducted with FSW living with HIV (n = 24), and key informants (n = 15) including HIV program implementers, security personnel, and brothel managers. Participants were recruited using maximum variation and snowball sampling. Interviews were conducted in English or isiZulu between September–November 2017 and analyzed using grounded theory in Atlas.ti 8.

Results

DTP was described as an intervention that could address barriers to ART adherence and retention, minimizing transport costs, time and wage loss from clinic visits, and act as a safety net to address FSW mobility and clinic access challenges. Respondents highlighted contextual considerations for DTP and suggested that DTP should be venue-based, scheduled during less busy times and days, and integrate comprehensive health services including psychological, reproductive, and non-communicable disease services. ART packaging and storage were important for community-based delivery, and participants suggested DTP should be implemented by sex work sensitized staff with discrete uniform and vehicle branding.

Conclusions

Incorporating FSW preferences may support implementation optimization and requires balancing of tensions between preferences and feasibility. These data suggest the potential utility of DTP for FSW as a strategy to address those most marginalized from current ART programs in South Africa.
Twenty-year trends in racial and ethnic enrollment in large diabetes randomized controlled trials
Authors: Zhang Jingyi , Van Spall Harriette G. C. , Wang Yaoyao , Thabane Lehana , Wang Ruoting , Li Guowei
Published: September 2022

Background

Lack of representativeness in Black, Indigenous, and People of Colour (BIPOC) enrollment could compromise the generalizability of study results and health equity. This study aimed to examine trends in BIPOC groups enrollment in diabetes randomized controlled trials (RCTs) and to explore the association between trial factors and high-enrollment of BIPOC groups.

Methods

We systematically searched the literature on large diabetes RCTs with a sample size of ≥ 400 participants published between 2000 and 2020. We assessed temporal trends in enrollment of racial and ethnic groups in the included trials. Logistic and linear regression analyses were used to explore the relationship between trial factors and the high-enrollment defined by median enrollment rate.

Results

A total of 405 RCTs were included for analyses. The median enrollment rate of BIPOC groups was 24.0%, with 6.4% for the Black group, 11.2% for Hispanic, 8.5% for Asian, and 3.0% for other BIPOC groups respectively. Over the past 20 years, the BIPOC enrollment showed an increased trend in the diabetes RCTs, ranging from 20.1 to 28.4% (P for trend = 0.041). A significant trend towards increased enrollment for Asian group was observed. We found that weekly or daily intervention frequency (OR = 0.48, 95% CI: 0.26, 0.91) and duration of intervention > 6.5 month (OR = 0.59, 95% CI: 0.37, 0.95) were significantly related to decreased odds of high-enrollment, while type 2 diabetes (OR = 1.44, 95% CI: 1.04, 1.99) was associated with high-enrollment of BIPOC groups.

Conclusions

The enrollment of BIPOC was found to increase in large diabetes RCTs over the past two decades; some trial factors may be significantly associated with BIPOC enrollment. These findings may highlight the importance of enrollment of BIPOC groups and provide insights into the design and implementation of future clinical trials in diabetes.
DNA-PKcs participated in hypoxic pulmonary hypertension
Authors: Liu Ying-ying , Zhang Wei-yun , Zhang Meng-lan , Wang Yu-ji , Ma Xi-yan , Jiang Jung-hong , Wang Ran , Zeng Da-xiong
Published: September 2022

Background

Hypoxic pulmonary hypertension (HPH) is a common complication of chronic lung disease, which severely affects the survival and prognosis of patients. Several recent reports have shown that DNA damage and repair plays a crucial role in pathogenesis of pulmonary arterial hypertension. DNA-dependent protein kinase catalytic subunit (DNA-PKcs) as a part of DNA-PK is a molecular sensor for DNA damage that enhances DSB repair. This study aimed to demonstrate the expression and potential mechanism of DNA-PKcs on the pathogenesis of HPH.

Methods

Levels of DNA-PKcs and other proteins in explants of human and rats pulmonary artery from lung tissues and pulmonary artery smooth muscle cells (PASMC) were measured by immunohistochemistry and western blot analysis. The mRNA expression levels of DNA-PKcs and NOR1 in PASMCs were quantified with qRT-PCR. Meanwhile, the interaction among proteins were detected by Co-immunoprecipitation (Co-IP) assays. Cell proliferation and apoptosis was assessed by cell counting kit-8 assay(CCK-8), EdU incorporation and flow cytometry. Rat models of HPH were constructed to verify the role of DNA-PKcs in pulmonary vascular remodeling in vivo.

Results

DNA-PKcs protein levels were both significantly up-regulated in explants of pulmonary artery from HPH models and lung tissues of patients with hypoxemia. In human PASMCs, hypoxia up-regulated DNA-PKcs in a time-dependent manner. Downregulation of DNA-PKcs by targeted siRNA or small-molecule inhibitor NU7026 both induced cell proliferation inhibition and cell cycle arrest. DNA-PKcs affected proliferation by regulating NOR1 protein synthesis followed by the expression of cyclin D1. Co-immunoprecipitation of NOR1 with DNA-PKcs was severely increased in hypoxia. Meanwhile, hypoxia promoted G2 + S phase, whereas the down-regulation of DNA-PKcs and NOR1 attenuated the effects of hypoxia. In vivo, inhibition of DNA-PKcs reverses hypoxic pulmonary vascular remodeling and prevented HPH.

Conclusions

Our study indicated the potential mechanism of DNA-PKcs in the development of HPH. It might provide insights into new therapeutic targets for pulmonary vascular remodeling and pulmonary hypertension.
Xeno-free induced pluripotent stem cell-derived neural progenitor cells for in vivo applications
Authors: Rust Ruslan , Weber Rebecca Z. , Generali Melanie , Kehl Debora , Bodenmann Chantal , Uhr Daniela , Wanner Debora , Zürcher Kathrin J. , Saito Hirohide , Hoerstrup Simon P. , Nitsch Roger M. , Tackenberg Christian
Published: September 2022

Background

Currently, there is no regenerative therapy for patients with neurological and neurodegenerative disorders. Cell-therapies have emerged as a potential treatment for numerous brain diseases. Despite recent advances in stem cell technology, major concerns have been raised regarding the feasibility and safety of cell therapies for clinical applications.

Methods

We generated good manufacturing practice (GMP)-compatible neural progenitor cells (NPCs) from transgene- and xeno-free induced pluripotent stem cells (iPSCs) that can be smoothly adapted for clinical applications. NPCs were characterized in vitro for their differentiation potential and in vivo after transplantation into wild type as well as genetically immunosuppressed mice.

Results

Generated NPCs had a stable gene-expression over at least 15 passages and could be scaled for up to 1018 cells per initially seeded 106 cells. After withdrawal of growth factors in vitro, cells adapted a neural fate and mainly differentiated into active neurons. To ensure a pure NPC population for in vivo applications, we reduced the risk of iPSC contamination by applying micro RNA-switch technology as a safety checkpoint. Using lentiviral transduction with a fluorescent and bioluminescent dual-reporter construct, combined with non-invasive in vivo bioluminescent imaging, we longitudinally tracked the grafted cells in healthy wild-type and genetically immunosuppressed mice as well as in a mouse model of ischemic stroke. Long term in-depth characterization revealed that transplanted NPCs have the capability to survive and spontaneously differentiate into functional and mature neurons throughout a time course of a month, while no residual pluripotent cells were detectable.

Conclusion

We describe the generation of transgene- and xeno-free NPCs. This simple differentiation protocol combined with the ability of in vivo cell tracking presents a valuable tool to develop safe and effective cell therapies for various brain injuries.
Adherence to spinal imaging guidelines and utilization of lumbar spine diagnostic imaging for low back pain at a Canadian Chiropractic College: a historical clinical cohort study
Authors: Smith Ali , Kumar Varsha , Cooley Jeffrey , Ammendolia Carlo , Lee Joyce , Hogg-Johnson Sheilah , Mior Silvano
Published: September 2022

Background

Diagnostic imaging is useful for assessing low back pain (LBP) when a clinician suspects a specific underlying pathology. Evidence-based imaging guidelines assist clinicians in appropriately determining the need for imaging when assessing LBP. A previous study reported high adherence to three clinical guidelines, with utilization rate of 12.3% in imaging of LBP patients attending a chiropractic teaching clinic. A new imaging guideline for spinal disorders has been published and used in teaching. Thus, the aims of our study were to assess the adherence to the new guideline and X-ray utilization in new episodes of LBP.

Methods

We conducted a historical clinical cohort study using patient electronic health record audits at seven teaching clinics over a period of 20 months. Records of patients who were at least 18 years of age, presented with a new onset of LBP, and consented to data collection were included. Abstracted data included patient demographics, the number and type of red flags, and the decision to image. Rate of guideline adherence (proportion of those not recommended for imaging, given no red flags) and rate of image utilization were descriptively analyzed.

Results

We included 498 patients in this study. At least 81% of included patients had one or more red flags reported. The most commonly reported individual red flag was age ≥ 50 (43.8%) followed by pain at rest (15.7%). In those referred for imaging, age ≥ 50 (93.3%) was the most frequently reported red flag. No red flag(s) were identified in 93 patient records, and none were referred for imaging of their LBP, yielding an adherence rate of 100% (95% CI 96, 100%). A total of 17 of 498 patients were recommended for imaging for their low back pain, resulting in an imaging utilization rate of 3.4% (95% CI 1.8, 5.0%).

Conclusion

The imaging utilization rate was 3.4%, lower than 12.3% previously reported at a chiropractic teaching clinic. None without red flags were referred for imaging, yielding a 100%, adherence rate to current LBP imaging guidelines. Future research should consider currency of guideline, accuracy of red flags and factors influencing clinicians’ decision, when assessing imaging adherence rates.
Protocol: a simple method for biosensor visualization of bacterial quorum sensing and quorum quenching interaction on Medicago roots
Authors: Rosier Amanda , Bais Harsh P.
Published: September 2022

Background

Defining interactions of bacteria in the rhizosphere (encompassing the area near and on the plant root) is important to understand how they affect plant health. Some rhizosphere bacteria, including plant growth promoting rhizobacteria (PGPR) engage in the intraspecies communication known as quorum sensing (QS). Many species of Gram-negative bacteria use extracellular autoinducer signal molecules called N-acyl homoserine lactones (AHLs) for QS. Other rhizobacteria species, including PGPRs, can interfere with or disrupt QS through quorum quenching (QQ). Current AHL biosensor assays used for screening and identifying QS and QQ bacteria interactions fail to account for the role of the plant root.

Methods

Medicago spp. seedlings germinated on Lullien agar were transferred to soft-agar plates containing the broad-range AHL biosensor Agrobacterium tumefaciens KYC55 and X-gal substrate. Cultures of QS and QQ bacteria as well as pure AHLs and a QQ enzyme were applied to the plant roots and incubated for 3 days.

Results

We show that this expanded use of an AHL biosensor successfully allowed for visualization of QS/QQ interactions localized at the plant root. KYC55 detected pure AHLs as well as AHLs from live bacteria cultures grown directly on the media. We also showed clear detection of QQ interactions occurring in the presence of the plant root.

Conclusions

Our novel tri-trophic system using an AHL biosensor is useful to study QS interspecies interactions in the rhizosphere.
The extracellular matrix alteration, implication in modulation of drug resistance mechanism: friends or foes?
Authors: Jurj Ancuta , Ionescu Calin , Berindan-Neagoe Ioana , Braicu Cornelia
Published: September 2022

The extracellular matrix (ECM) is an important component of the tumor microenvironment (TME), having several important roles related to the hallmarks of cancer. In cancer, multiple components of the ECM have been shown to be altered. Although most of these alterations are represented by the increased or decreased quantity of the ECM components, changes regarding the functional alteration of a particular ECM component or of the ECM as a whole have been described. These alterations can be induced by the cancer cells directly or by the TME cells, with cancer-associated fibroblasts being of particular interest in this regard. Because the ECM has this wide array of functions in the tumor, preclinical and clinical studies have assessed the possibility of targeting the ECM, with some of them showing encouraging results. In the present review, we will highlight the most relevant ECM components presenting a comprehensive description of their physical, cellular and molecular properties which can alter the therapy response of the tumor cells. Lastly, some evidences regarding important biological processes were discussed, offering a more detailed understanding of how to modulate altered signalling pathways and to counteract drug resistance mechanisms in tumor cells.
The clinical characteristics and treatment of ovarian malignant mesoderm mixed tumor: a systematic review
Authors: Wang Xin , Wang Shiyuan , Yao Shujuan , Shi Wei , Ma Ke
Published: September 2022

Background

Ovarian malignant mesoderm mixed tumor (OMMMT) is a rare clinical entity. To provide reference for the treatment and prognosis of OMMMT, we analyzed the clinical features, pathology and molecular biology characteristic of published cases.

Methods

The English and Chinese reported cases of OMMMT were selected from PubMed, Clinical Trials.gov and CNKI database from 2000 to December 15th, 2021 following the PRISMA guidelines.

Results

A total of 63 literatures including 199 OMMMT cases were included. The average age of patients at diagnosis was 56.46 years, the highest incidence age was 60-65 years, and 82% of them were menopausal women. Most patients were diagnosed in FIGO III stage (59.64%). The most common symptom of OMMMT was abdominal pain (60.5%). 61.6% of patients were accompanied by ascites, while ascites was not associated with metastatic tumor and local recurrence. The CA125 of 88.68% patients increased. The most common reported carcinomatous component and sarcomatous component were serous adenocarcinoma (44.96%) and chondrosarcoma (24.81%), respectively. Initial treatment included surgery (94.97%) and taxanes-based (55.10%) or platinum-based (85.71%) chemotherapy regimens. The median survival time of patients was 20 months. Heterologous sarcoma component did not shorten life expectancy. The optimal ovarian tumor cell debulking surgery (OOTCDS), radiotherapy and chemotherapy could significantly prolong the median survival time of patients. Furthermore, platinum drugs could significantly prolong the survival time after comparing various chemotherapy schemes. Besides, the combination of platinum and taxanes was therapeutically superior to the combination of platinum and biological alkylating agents.

Conclusion

The OOTCDS and platinum-based chemotherapy regimen can improve the prognosis of OMMMT. Targeted therapy might become a new research direction in the future. Since the elderly patients are the majority, the toxicity of new drugs on the elderly patients is more noteworthy.
Behavior-based user authentication on mobile devices in various usage contexts
Authors: Progonov Dmytro , Cherniakova Valentyna , Kolesnichenko Pavlo , Oliynyk Andriy
Published: September 2022

Reliable and non-intrusive user identification and authentication on mobile devices, such as smartphones, are topical tasks today. The majority of state-of-the-art solutions in this domain are based on “device unlock” scenario—checking of information (authentication factors) provided by the user for unlocking a smartphone. As such factors, we may use either single strong authentication factor, for example, password or PIN, or several “weaker” factors, such as tokens, biometrics, or geolocation data. However, these solutions require additional actions from a user, for example, password typing or taking a fingerprint, that may be inappropriate for on-the-fly authentication. In addition, biometric-based user authentication systems tend to be prone to presentation attack (spoofing) and typically perform well in fixed positions only, such as still standing or sitting.

We propose BehaviorID solution that is passwordless (transparent) user-adaptive context-dependent authentication method. The feature of BehaviorID is usage of new “device lock” scenario—smartphone is stayed unlocked and can be fast locked if non-owner’s actions are detected. This is achieved by tracking of user’s behavior with embedded sensors after triggering events, such as actions in banking apps, e-mails, and social services. The advanced adaptive recurrent neural network (A-RNN) is used for accurate estimation and adaptation of behavioral patterns to a new usage context. Thus, proposed BehaviorID solution allows reliable user authentication in various usage contexts by preserving low battery consumption.

Performance evaluation of both state-of-the-art and proposed solutions in various usage contexts proved the effectiveness of BehaviorID in real situations. Proposed solution allows reducing error levels up to three times in comparison with modern Abuhamad’s solutions (Abuhamad et al., IEEE Internet Things J 7(6):5008–5020, 2020) (about $$0.3\%$$

0.3
%

 false acceptance rate (FAR) and $$1.3\%$$

1.3
%

 false rejection rate (FRR)) by preserving high robustness to spoofing attack ($$2.5\%$$

2.5
%

 spoof acceptance rate (SAR)). In addition, BehaviorID showed low drift of error level in case of long-term usage in contrast to modern solutions. This makes the proposed BehaviorID solution an attractive candidate for next-generation behavior-based user authentication systems on mobile devices.
Clinical significance of 18F-FDG PET/CT imaging in 32 cases of gastrointestinal stromal tumors
Authors: Du Wen , Cui Guojin , Wang Kaiping , Li Shaojie
Published: September 2022

Objectives

To explore the clinical significance of 18F-FDG metabolic imaging in the diagnosis and biological risk assessment of gastrointestinal stromal tumors (GIST).

Methods

This study is a clinical retrospective study. The research subjects were patients with GIST who were admitted to our hospital from January 2014 to December 2019 and underwent 18F-FDG metabolic imaging, and the relationship between biological risk and FDG metabolism was analyzed retrospectively.

Results

A total of 32 patients with GIST were included in this study, of which 17 patients had very low and low-risk lesions, and the FDG metabolism level did not increase; five patients had moderate-risk gastric lesions, and the FDG metabolism level was abnormally increased; 10 patients had high-risk lesions, and except for one patient with multiple lesions, the FDG metabolism level of these patients was increased.

Conclusions

The level of glucose metabolism is abnormally increased in tumor cells with vigorous mitosis and has higher biological risk. The 18F-FDG metabolism level can determine the biological risk of GIST and whether high-risk lesions involve other tissues and organs, as it more comprehensively reflects the distribution of lesions, the activity of tumor cells and the stage of the disease.
General anesthesia with remimazolam for a pediatric patient with MELAS and recurrent epilepsy: a case report
Authors: Yamadori Yusuke , Yamagami Yuki , Matsumoto Yukihisa , Koizumi Mari , Nakamura Akiyo , Mizuta Daiskuke , Yasuda Kyoko , Shirakami Gotaro
Published: September 2022

Background

Mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes (MELAS) is a mitochondrial disease. We report here the safe use of remimazolam in a pediatric MELAS patient.

Case presentation

A 10-year-old girl (118 cm, 16 kg) was scheduled for an open gastrostomy to improve nutrition and epileptic seizure control. We induced and maintained general anesthesia with remimazolam, remifentanil, fentanyl, and rocuronium. We also performed a bilateral subcostal transversus abdominis plane block before the surgery. The surgery finished uneventfully. After we discontinued remimazolam administration, the patient woke up immediately but calmly without flumazenil. Epileptic seizures did not occur during intra- and early post-operative periods.

Conclusion

Remimazolam enabled us to provide a pediatric MELAS patient with general anesthesia without causing delayed emergence or epileptic seizures.
Validity evidence of the Brazilian version of the Perceived Motivational Climate in Sports Questionnaire-2 (PMCSQ-2BR)
Authors: Arthur Daniel Perez , Paes Mayara Juliana , do Amaral Machado Thais , Stefanello Joice Mara Facco
Published: September 2022

In sports context, the motivational climate has been widely studied since 2000, when the Perceived Motivational Climate in Sports Questionnaire-2 (PMCSQ-2) was published. Evaluating athletes’ perceptions of the motivational climate created by the coach, this questionnaire has been validated and adapted for different countries, including Brazil. However, important psychometric properties of the Brazilian version present problems, such as poor fit indices and the almost exclusively male samples, make it unfeasible for use in future research. Thus, this study aimed to achieve a new process of cross-cultural adaptation, and search for validity evidence of the PMCSQ-2 for the Brazilian sports context to correct distortions, expand the sources of evidence of validity and ecological validity, and make it suitable for application in future research. The sample consisted of 501 athletes (349 males, 152 females) from different sports. The findings of the current study support the multidimensional hierarchical characteristic of the instrument, its factorial structure, and internal consistency. We concluded that the 33-item PMCSQ-2BR, distributed in two high-order scales (ego-involving and task-involving) with three subscales each, can be used to assess athletes’ perceived motivational climate in the Brazilian sports context.
Neisseria meningitidis carriage rate, antibiotic susceptibility profile, and associated factors among prisoners at Jimma zonal correction facility in Jimma Town, Southwestern Ethiopia: a cross-sectional study
Authors: Assefa Samuel , Abdissa Alemseged , Alemu Yared , Girma Lencho , Sahlu Degemu
Published: September 2022

Background

Neisseria meningitidis causes severe life-threatening meningococcal disease with a case fatality rate of 10–15% even with proper treatment. In Ethiopia, particularly in our study area, inadequate information is found on meningococcal disease. So, this study aimed to assess N. meningitidis carriage rate, antibiotic susceptibility profile, and associated factors among prisoners in Jimma Town, Southwestern Ethiopia.

Methods

A cross-sectional study was conducted in Jimma town, Southwest Ethiopia, from May to October 2019. A stratified sampling technique was used and proportional allocation was done. A total of 550 oropharyngeal swabs were collected, processed, isolated, and identified N. meningitidis using standard microbiological techniques. Antibiotics susceptibility test was done for isolates using the disk diffusion method. Data on demographic and associated factors for carriage were collected using a structured questionnaire. Data were summarized using frequency, percentage, graph, and table. A logistic regression model was used to see the association between the dependent and independent variables. Variables with a p-value < 0.25 during bivariate analysis were included in multivariate analysis to identify factors significantly associated with the meningococcal carriage and, a p-value < 0.05 was considered statistically significant.

Result

Out of the 550 study participants, 76(13.8%) with (CI: 7.20–18.20) were found carriers of N meningitidis. The predominant isolates were non-serogroupable 26(34.2%) and serogroup W/Y 22(28.9%), respectively. N. meningitidis isolates showed highest sensitivity to chloramphenicol 74(97.4%). Meningococcal carriage rate was significantly associated with being age group of 16–20 years; having respiratory symptoms within 3 months and active cigarette smoking within 3 months.

Conclusions

The majority of participants harbor most of the serogroups responsible for invasive cases of meningococcal disease. Respiratory symptoms, active cigarette smoking, and age group of 16–20 years increased the risk of N. meningitidis pharyngeal carriage rate. This study suggests providing better health education to control respiratory symptoms, smoking, and providing antibiotic prophylaxis for prisoners.
Translation, linguistic validation and reliability of FACT-H&N questionnaire in Oral Cancer patients in Sudan
Authors: Sheikh M. El , Suleiman A. , Satti A. , O’Sullivan E. M.
Published: September 2022

Background

This study aimed to translate and validate an Arabic version of the Functional Assessment of Cancer Therapy Head and Neck Scale (FACT-H&N, v-4) for use among Sudanese oral cancer patients.

Methods

The instrument underwent translation and validation following the standard FACT translation methodology. The translated instrument was pre-tested for face validity and content validity using semi-structured, in-depth interviews with ten oral cancer patients to assess acceptability. The questionnaire was pilot tested with 60 patients; reliability was tested for internal consistency with Cronbach’s alpha while construct validity was tested using ‘known-group validity’.

Results

The pre-test study revealed no major issues, apart from a reluctance to answer questions on sexual satisfaction. The FACT-H&N demonstrated good internal consistency, it considered five particular constructs: PWB, SWB, EWB, FWB and FACT-H&N, their Cronbach’s α values were positive and close to 1 with values of 0.85, 0.788, 0.86, 0.895 and 0.703 respectively, indicating that the questionnaire was valid and the responses consistent. Sixty patients were asked the global health-related quality of life item, 36.3% rated their QOL as very good or good (36.3%), while 41.7% rated it as average, and 21.7% as poor or very poor. Then FACT subscale mean scores were tabulated against three categories; patients with very poor/poor recorded significantly lower scores indicating construct validity. Some psychometric properties were consistent with other FACT-H&N translations such as the Chinese, French, Pakistani and Malaysian.

Conclusions

This study validates the Arabic version of the FACT-H&N. It is a reliable tool and, will assist further QoL research in other Arabic-speaking countries.
Granulosa Cell Dysfunction Is Associated With Diminished Ovarian Response in FMR1 Premutation Carriers
Authors: Boustanai Ilana , Raanani Hila , Aizer Adva , Orvieto Raoul , Elizur Shai E
Published: September 2022

Context

FMR1 premutation (PM) carriers are at increased risk of ovarian impairment resulting in diminished ovarian response (DOR) to exogenous follicle-stimulating hormone (FSH) stimulation. Expanded CGG repeat transcript and RAN-associated protein (FMRpolyG) have been shown to accumulate in cellular aggregates and sequester proteins, thus impairing their function. Sam68 is a multifunctional RNA-binding protein highly expressed in the gonads involved in FSH receptor (FSHR) transcript maturation during FSH-dependent follicular development.

Objective

The present study examined a possible pathophysiological explanation for DOR to exogenous FSH stimulation in FMR1 PM carriers.

Methods

We used both a human granulosa cell (GC) line model and human GCs from FMR1 PM carriers to evaluate whether Sam68 is sequestered with expanded CGG repeat transcript.

Results

We show that Sam68 is sequestered in GCs, most likely by interaction with the expanded CGG repeat transcript. The sequestration may lead to reduced levels of free Sam68 available for FHSR precursor transcript processing, causing dysregulation of FSHR transcript maturation, and a consequent decrease in FSHR protein levels.

Conclusion

Sam68 sequestration may underlie the diminished ovarian response to FSH stimulation in FMR1 PM carriers.
Cervical MUC5B and MUC5AC are Barriers to Ascending Pathogens During Pregnancy
Authors: Ueda Yusuke , Mogami Haruta , Kawamura Yosuke , Takakura Masahito , Inohaya Asako , Yasuda Eriko , Matsuzaka Yu , Chigusa Yoshitsugu , Ito Shinji , Mandai Masaki , Kondoh Eiji
Published: September 2022

Context

Cervical excision is a risk factor for preterm birth. This suggests that the cervix plays an essential role in the maintenance of pregnancy.

Objective

We investigated the role of the cervix through proteomic analysis of cervicovaginal fluid (CVF) from pregnant women after trachelectomy surgery, the natural model of a lack of cervix.

Methods

The proteome compositions of CVF in pregnant women after trachelectomy were compared with those in control pregnant women by liquid chromatography–tandem mass spectrometry and label-free relative quantification. MUC5B/AC expression in the human and murine cervices was analyzed by immunohistochemistry. Regulation of MUC5B/AC expression by sex steroids was assessed in primary human cervical epithelial cells. In a pregnant mouse model of ascending infection, Escherichia coli or phosphate-buffered saline was inoculated into the vagina at 16.5 dpc, and the cervices were collected at 17.5 dpc.

Results

The expression of MUC5B/5AC in cervicovaginal fluid was decreased in pregnant women after trachelectomy concomitant with the anatomical loss of cervical glands. Post-trachelectomy women delivered at term when MUC5B/AC abundance was greater than the mean normalized abundance of the control. MUC5B levels in the cervix were increased during pregnancy in both humans and mice. MUC5B mRNA was increased by addition of estradiol in human cervical epithelial cells, whereas MUC5AC was not. In a pregnant mouse model of ascending infection, E. coli was trapped in the MUC5B/AC-expressing mucin of the cervix, and neutrophils were colocalized there.

Conclusion

Endocervical MUC5B and MUC5AC may be barriers to ascending pathogens during pregnancy.
Acute Sleep Disruption Does Not Diminish Pulsatile Growth Hormone Secretion in Pubertal Children
Authors: Calvert Madison E , Molsberry Samantha A , Kangarloo Tairmae , Amin Md Rafiul , Genty Valentina , Faghih Rose T , Klerman Elizabeth B , Shaw Natalie D
Published: September 2022

Context

In children, growth hormone (GH) pulses occur after sleep onset in association with slow-wave sleep (SWS). There have been no studies in children to quantify the effect of disrupted sleep on GH secretion.

Objective

This study aimed to investigate the effect of acute sleep disruption on GH secretion in pubertal children.

Methods

Fourteen healthy individuals (aged 11.3-14.1 years) were randomly assigned to 2 overnight polysomnographic studies, 1 with and 1 without SWS disruption via auditory stimuli, with frequent blood sampling to measure GH.

Results

Auditory stimuli delivered during the disrupted sleep night caused a 40.0 ± 7.8% decrease in SWS. On SWS-disrupted sleep nights, the rate of GH pulses during N2 sleep was significantly lower than during SWS (IRR = 0.56; 95% CI, 0.32-0.97). There were no differences in GH pulse rates during the various sleep stages or wakefulness in disrupted compared with undisrupted sleep nights. SWS disruption had no effect on GH pulse amplitude and frequency or basal GH secretion.

Conclusion

In pubertal children, GH pulses were temporally associated with episodes of SWS. Acute disruption of sleep via auditory tones during SWS did not alter GH secretion. These results indicate that SWS may not be a direct stimulus of GH secretion.
Patterns of Panethnic Intermarriage in the United States, 1980–2018
Authors: Gullickson Aaron
Published: September 2022

Intermarriage among ethnic groups belonging to the same panethnic category (e.g., Asian, Latino) is an important indicator of the strength of panethnicity. Yet, most of the research on panethnic intermarriage uses older samples with significant data limitations. In this article, I use data on recently married couples from the 2014–2018 American Community Surveys and the 1980 U.S. Census to analyze the likelihood of ethnic exogamy within the panethnic categories of Latino, East/Southeast Asian, and South Asian. I utilize a counterfactual marriage model that accounts for group size within local marriage markets, eliminates immigrants married abroad from analysis, and controls for birthplace and language endogamy. The results show that birthplace and language diversity are significant barriers to ethnic exogamy among Asians but not Latinos. Once birthplace and language endogamy are held constant, panethnic intermarriage is far more likely among Asians than among Latinos. East/Southeast Asian ethnic exogamy has increased over time, while Latino ethnic exogamy has not. Furthermore, East/Southeast Asian and South Asian intermarriage remains rare, suggesting that panethnic intermarriage among Asians occurs within two separate melting pots.
Interactive CLV3, CLE16, and CLE17 signaling mediates stem cell homeostasis in the Arabidopsis shoot apical meristem
Authors: Dao Thai Q. , Weksler Naama , Liu Hannah M.-H. , Leiboff Samuel , Fletcher Jennifer C.
Published: September 2022

The ability of plants to grow and form organs throughout their lifetime is dependent on their sustained stem cell activity. These stem cell populations are maintained by intricate networks of intercellular signaling pathways. In Arabidopsis thaliana, the small secreted peptide CLAVATA3 (CLV3) controls shoot apical meristem (SAM) maintenance by activating a signal transduction pathway that modulates the expression of the homeodomain transcription factor WUSCHEL (WUS). Here, we demonstrate that two CLV3-related peptides, CLE16 and CLE17, restrict stem cell accumulation in the absence of CLV3. CLE16 and CLE17 contribute independently to SAM maintenance and organ production in clv3 plants at all stages of development. We show that CLE16 and CLE17 signal through a subset of CLV3 receptors, the BARELY ANY MERISTEM (BAM) receptor kinases, and act upstream of WUS. Our study reveals that CLE16 and CLE17 function in a mechanism that partially compensates for CLV3 to maintain stem cell homeostasis and plant resiliency, and expands the potential targets for enhancing yield traits in crop species.
MLL regulates the actin cytoskeleton and cell migration by stabilising Rho GTPases via the expression of RhoGDI1
Authors: Chinchole Akash , Lone Kaisar Ahmad , Tyagi Shweta
Published: September 2022

Attainment of proper cell shape and the regulation of cell migration are essential processes in the development of an organism. The mixed lineage leukemia (MLL or KMT2A) protein, a histone 3 lysine 4 (H3K4) methyltransferase, plays a critical role in cell-fate decisions during skeletal development and haematopoiesis in higher vertebrates. Rho GTPases – RhoA, Rac1 and CDC42 – are small G proteins that regulate various key cellular processes, such as actin cytoskeleton formation, the maintenance of cell shape and cell migration. Here, we report that MLL regulates the homeostasis of these small Rho GTPases. Loss of MLL resulted in an abnormal cell shape and a disrupted actin cytoskeleton, which lead to diminished cell spreading and migration. MLL depletion affected the stability and activity of Rho GTPases in a SET domain-dependent manner, but these Rho GTPases were not direct transcriptional targets of MLL. Instead, MLL regulated the transcript levels of their chaperone protein RhoGDI1 (also known as ARHGDIA). Using MDA-MB-231, a triple-negative breast cancer cell line with high RhoGDI1 expression, we show that MLL depletion or inhibition by small molecules reduces tumour progression in nude mice. Our studies highlight the central regulatory role of MLL in Rho/Rac/CDC42 signalling pathways.

This article has an associated First Person interview with the first author of the paper.
High duty cycle moth sounds jam bat echolocation: bats counter with compensatory changes in buzz duration
Authors: Fernández Yohami , Dowdy Nicolas J. , Conner William E.
Published: September 2022

Tiger moth species vary greatly in the number of clicks they produce and the resultant duty cycle. Signals with higher duty cycles are expected to more effectively interfere with bat sonar. However, little is known about the minimum duty cycle of tiger moth signals for sonar jamming. Is there a threshold that allows us to classify moths as acoustically aposematic versus sonar jammers based on their duty cycles? We performed playback experiments with three wild-caught adult male bats, Eptesicus fuscus. Bat attacks on tethered moths were challenged using acoustic signals of Bertholdia trigona with modified duty cycles ranging from 0 to 46%. We did not find evidence for a duty cycle threshold; rather, the ability to jam the bat's sonar was a continuous function of duty cycle consistent with a steady increase in the number of clicks arriving during a critical signal processing time window just prior to the arrival of an echo. The proportion of successful captures significantly decreased as the moth duty cycle increased. Our findings suggest that moths cannot be unambiguously classified as acoustically aposematic or sonar jammers based solely on duty cycle. Bats appear to compensate for sonar jamming by lengthening the duration of their terminal buzz and they are more successful in capturing moths when they do so. In contrast to previous findings for bats performing difficult spatial tasks, the number of sonar sound groups decreased in response to high duty cycles and did not affect capture success.
Evaluating the ‘cost of generating force’ hypothesis across frequency in human running and hopping
Authors: Allen Stephen P. , Beck Owen N. , Grabowski Alena M.
Published: September 2022

The volume of active muscle and duration of extensor muscle force well explain the associated metabolic energy expenditure across body mass and velocity during level-ground running and hopping. However, if these parameters fundamentally drive metabolic energy expenditure, then they should pertain to multiple modes of locomotion and provide a simple framework for relating biomechanics to metabolic energy expenditure in bouncing gaits. Therefore, we evaluated the ability of the ‘cost of generating force’ hypothesis to link biomechanics and metabolic energy expenditure during human running and hopping across step frequencies. We asked participants to run and hop at 85%, 92%, 100%, 108% and 115% of preferred running step frequency. We calculated changes in active muscle volume, duration of force production and metabolic energy expenditure. Overall, as step frequency increased, active muscle volume decreased as a result of postural changes via effective mechanical advantage (EMA) or duty factor. Accounting for changes in EMA and muscle volume better related to metabolic energy expenditure during running and hopping at different step frequencies than assuming a constant EMA and muscle volume. Thus, to ultimately develop muscle mechanics models that can explain metabolic energy expenditure across different modes of locomotion, we suggest more precise measures of muscle force production that include the effects of EMA.
Women physicians, their social issues & Barriers to their success in Academic Medicine
Authors: Jawaid Shaukat Ali
Published: September 2022

doi: https://doi.org/10.12669/pjms.38.8.7047

How to cite this:Jawaid SA. Women physicians, their social issues & Barriers to their success in Academic Medicine. Pak J Med Sci. 2022;38(8):2049-2052. doi: https://doi.org/10.12669/pjms.38.8.7047

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Policy Brief 10: Using anti-money laundering frameworks to fight illegal wildlife trade in Uganda
Authors: Walugembe Tom
Published: September 2022

In February 2020, Uganda made a high-level political commitment to work with the Financial Action Task Force (FATF) and Eastern and Southern Africa Anti-Money Laundering Group (ESAAMLG) to strengthen the effectiveness of its anti-money laundering (AML) regime. Among other commitments, Uganda undertook to demonstrate that law enforcement agencies and judicial authorities apply the money laundering offence consistent with the identified risks. 

Studies show that Uganda has high risks for cross-border movement of illegally obtained wildlife and wildlife products, both as a source and transit country. In addition, Uganda and the East African region in general have made some massive seizures of illegal wildlife products, which points to organised criminal activity. Notably, no money laundering prosecutions have to date arisen out of illegal wildlife trade (IWT) as a predicate offence in Uganda, Kenya and Tanzania.

This short Policy Brief provides an outline of how the AML framework (intelligence, investigations and prosecutions) can be utilised to help combat IWT and the corruption that facilitates it. The insights are drawn from the Ugandan context, but can be applied with appropriate adjustments to other jurisdictions seeking to strengthen efforts to combat IWT and related corruption/money laundering.
Working Paper 40: Developing anti-corruption interventions addressing social norms
Authors: Baez Camargo Claudia
Published: September 2022

This Working Paper provides guidance on developing anti-corruption interventions based on a Social Norms and Behaviour Change (SNBC) approach. Still a relatively nascent field, SNBC interventions typically address social norms that make corruption acceptable or expected, and attempt to influence behaviours away from corrupt practices. 

The guidance is based on lessons learned from a largely successful pilot project in Tanzania that targeted social norms fuelling bribery ("gift giving") in health facilities and attempted to change the behaviours of both health care providers and users away from exchanging gifts. Survey results showed a 14–44% decrease in gift-giving intentions, attitudes and positive beliefs among hospital users following the pilot intervention.

The guidance covers:

How to identify when a SNBC approach is suitable

Essential background research needed to design anti-corruption SNBC interventions

Frameworks to formulate theories of change

Specific elements to build into SNBC interventions

What practitioners should expect when embarking on an SNBC intervention

Ways they can help build evidence and understanding of SNBC approaches in the anti-corruption field.

About and acknowledgements

This publication was supported by the Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ) GmbH on behalf of the Federal Ministry for Economic Cooperation and Development (BMZ). The contents of this publication do not represent the official position of either BMZ or GIZ.

The pilot intervention that serves as the basis for most of the reflections included in this document was funded by the Global Integrity Anti-Corruption Evidence Programme (GI-ACE), funded with UK aid from the UK government.
Characteristics phetoplacental complex change in women with pulmonary tuberculosis, complicated by iron deficiency anemia
Authors: Zadorozhnyi O. , Rozhkovskaya N. , Zadorozhnaya O. , Tarnovska G.
Published: September 2022

87 pregnant women have been examined, 57 of them had pulmonary form of TB, complicated by IDA (main group). The control group consisted of 30 conditionally somatic-healthy patients with physiological pregnancy. Changes in the parameters of erythron, increased metabolic acidosis, development of placental dysfunction (93%), violation of hemodynamics in the utero-placental-fetal basin, and low biophysical profile of the fetus were found. The main group patients received comprehensive anti-anemic, antihypoxic, detoxificative, antioxidant and membrane-stabilizing therapy. After the pathogenetic treatment, the general condition of  mother and fetus improved, e. g. the total index of biophysical profile of fetus in the pregnant women of the main group increased from (6.87 ± 0.18) points to (8.73 ± 0.12) points Women with pulmonary tuberculosis and iron-deficiency anemia require complex pathogenetic therapy, which significantly improves the erythron signs, fetal, newborn and general  mother’s condition.