bluuebunny/crossref_metadata_2025 huggingface dataset:
Biodegradation of Atrazine and Ligninolytic Enzyme Production by Basidiomycete Strains
Authors: Henn Caroline , Monteiro Diego Alves , Boscolo Mauricio , Silva Roberto da , Gomes Eleni
Published: August 2020

BackgroundAtrazine is one of the most widespread chlorinated herbicides, leaving large bulks in soils and groundwater. The biodegradation of atrazine by bacteria is well described, but many aspects of the fungal metabolism of this compound remain unclear. Thus, we investigated the toxicity and degradation of atrazine by 13 rainforest basidiomycete strains.ResultsIn liquid medium, Pluteus cubensis SXS320, Gloelophyllum striatum MCA7, and Agaricales MCA17 removed 30, 37, and 38%, respectively, of initial 25 mg/l of the herbicide within 20 days. Deficiency of nitrogen drove atrazine degradation by Pluteus cubensis SXS320; this strain removed 30% of atrazine within 20 days in a culture medium with 2.5 mM of N, raising three metabolites; in a medium with 25 mM of N, only 21% of initial atrazine were removed after 40 days, and two metabolites appeared in culture extracts. This is the first report of such different outcomes linked to nitrogen availability during the biodegradation of atrazine by basidiomycetes. The herbicide also induced synthesis and secretion of extracellular laccases by Datronia caperata MCA5, Pycnoporus sanguineus MCA16, and Polyporus tenuiculus MCA11. Laccase levels produced by of P. tenuiculus MCA11 were 13.3-fold superior in the contaminated medium than in control; the possible role on this enzyme on atrazine biodegradation was evaluated, considering the strong induction and the removal of 13.9% of the herbicide in vivo . Although 88% of initial laccase activity remained after 6 h, no evidence of in vitro degradation was observed, even though ABTS was present as mediator.ConclusionsThis study revealed a high potential for atrazine biodegradation among tropical basidiomycete strains. Further investigations, focusing on less explored ligninolytic enzymes and cell-bound mechanisms, could enlightens key aspects of the atrazine fungal metabolism and the role of the nitrogen in the process.
Disability-adjusted Life Years for respiratory syncytial virus in children under 2 years
Authors: buendia jefferson , Polack Fernando , Villamil Juana Patricia Sanchez
Published: August 2020

BACKGROUND: Respiratory syncytial virus infection is the leading cause of bronchiolitis worldwide. However, little is known about the real impact of Respiratory syncytial virus on society in terms of years of life lost due to this condition. The objective of the present study is to determine the Disability-Adjusted Life Years for respiratory syncytial virus in children under 2 years in Colombia METHODS: Data from the national epidemiological surveillance system were used to estimate DALYs, calculated from the sum of years of life lost and years lived with disability due to RSV infection in Colombia. A bootstrapped method with 10000 iterations was used to estimate each statistical parameter using the package DALY calculator in R. RESULTS: In 2019, 260 873 years of life (CI95% 208 180- 347 023) were lost due to RSV bronchiolitis in Colombian children under 2 years. The estimated rate was 20 DALYs / 1000 person-year (95% CI 16 – 27). CONCLUSION: This is the first report estimating the impact of RSV bronchiolitis morbidity and mortality in Colombia. The findings of the present study suggest that the actual burden and cost of bronchiolitis due to RSV is high. Prevention strategies, such as RSV vaccination, to reduce morbidity associated with RSV infection should be encouraged in our country.
Severe Acute Respiratory Syndrome Coronavirus-2 and Pulmonary Tuberculosis Coinfection: Double Trouble
Authors: Singh Abhijeet , Gupta Ayush , Das Kamanashish
Published: August 2020

Background: The ongoing pandemic of novel coronavirus disease 2019 (COVID-19) has received worldwide attention by becoming a major global health threat. We encountered one case with COVID-19 and tuberculosis (TB) coinfection which has not been frequently reported. Case presentation: A 76 year old female presented with acute respiratory symptoms superimposed on chronic symptoms, suggestive to have pneumonia. Oropharyngeal throat swab sample for COVID-19 was positive as detected by real-time reverse-transcriptase–polymerase-chain-reaction (RT-PCR) assay. GeneXpert Ultra detected Mycobacterium tuberculosis complex with Rifampicin resistance indeterminate. Patient was treated with appropriate management. Conclusion: Clinicians should suspect coinfection with TB during ongoing pandemic of COVID-19 as therapeutic strategies need to be determined timely to improve outcome and prevent transmission in community.
Low molecular weight serum cell-free DNA concentration is associated with clinicopathologic indices of poor prognosis in women with uterine cancer
Authors: Gressel Gregory M. , Maggi Elaine C. , Harmon Bryan E. , Ye Kenny Q. , Kuo D.Y.S. , Dolan Siobhan M. , Montagna Cristina
Published: August 2020

Background

Serum cell-free DNA (cfDNA) holds promise as a non-invasive cancer biomarker. The objective of this study was to evaluate the association of cfDNA concentration with clinicopathologic variables of poor prognosis and overall survival among women with uterine cancer compared to benign cancer-free controls.

Methods

cfDNA was extracted from the serum of 91 women with multiple uterine cancer histologies and 22 post-menopausal controls without cancer. Low molecular weight (LMW) cfDNA was separated from contaminating genomic high molecular weight cfDNA using paramagnetic bead purification and its concentration was measured using fluorometric quantification. Clinicopathologic data was abstracted from the electronic medical record. The association between serum cfDNA concentration, clinicopathologic variables, and overall survival was assessed using linear regression modelling, Cox proportional hazards modelling, and the Kaplan-Meier method.

Results

Median total serum cfDNA concentration for the cohort was 69.2 ng/mL (IQR 37.4, 132.3) and median LMW cfDNA concentration was 23.8 ng/mL (IQR 14.9, 44.4). There were no significant differences in total serum cfDNA concentration with any clinicopathologic variables. However, LMW cfDNA concentration was significantly higher in serum of women with cancer (25.8 ng/mL IQR 16.0, 49.6) compared to benign controls (15.5 ng/mL IQR 9.3, 25.8 ng/mL) (p <0.01). It is also significantly higher among women with early stage cancer than benign controls (p < 0.01). There were also significant associations between LMW cfDNA concentration and stage of cancer (p = 0.01) and histology (p = 0.02). Patients with leiomyosarcoma and carcinosarcoma had higher cfDNA concentrations than those with endometrioid cancer. Over a median follow-up of 51.9 months, 75th percentile for overall survival for women with cancer was 24.0 months. Higher LMW cfDNA concentrations is associated with lower survival among women with cancer (p < 0.01).

Conclusions

Serum LMW cfDNA concentration is associated with overall survival in women with uterine cancer, and it is higher among women with uterine cancer compared to those of controls.
A translation and preliminary validation of the Dutch Wound-QoL questionnaire
Authors: Amesz Stella Felicia , Klein Toni , Meulendijks Audrey , Nguyen Tuong-Vi , Blome Christine , Roobol Petrie , Montfrans Catherine van
Published: August 2020

BackgroundChronic wounds have a major impact on patients’ health-related quality of life (HRQoL). Therefore, measuring HRQoL is an indispensable part of the treatment of patients with chronic wounds. The aim of this study was to translate and validate the Wound-QoL, a wound-specific HRQoL questionnaire, in a Dutch population. MethodsThe Wound-QoL was translated into Dutch according to the international standards. Patients with chronic wounds were asked to complete questionnaires at baseline (T0) and after 6 weeks (T1), including Wound-QoL, EQ-5D-3L (a generic questionnaire to measure HRQoL) and a visual analogue scale (VAS) measuring wound pain. If patients were not able to complete the questionnaire by themselves, it was read out to them by a nurse. Further data were obtained from medical records.ResultsOf the 120 patients included, 64 (53.3%) completed the questionnaire by themselves. To 55 patients (45.8%), the questionnaire was read out. The internal consistency of the Wound-QoL global score was high at both time points (T0: Cronbach’s α=0.89, T1: Cronbach’s α=0.92). The item selectivity for global score ranged from r=0.25 to r=0.77 at T0 and from r=0.40 to r=0.79 at T1. Overall, the self-completion and read-out subgroups showed similar internal consistency and item selectivity scores. With regard to convergent validity, significant correlations were found between Wound-QoL and EQ-5D-3L (T0: r=-0.45, p<0.001, T1: r=-0.50, p<0.001) as well as between Wound-QoL and pain VAS (T0: r=0.23, p=0.012, T1: r=0.37, p=0.001) at both time points. Responsiveness analyses showed significant correlations between changes in Wound-QoL and changes in EQ-5D-3L (r=-0.37, p<0.001), pain VAS (r=0.24, p=0.044) and wound size (r=0.24, p=0.013). The self-completion and read-out subgroups showed differences in convergent validity and responsiveness. ConclusionsThe results indicate that the Dutch version of the Wound-QoL has positive psychometric properties. However, more research is needed to further explore the differences between self-completed and read-out questionnaires.
Embryonic stem cell microenvironment enhances proliferation of human retinal pigment epithelium cells by activating the PI3K signaling pathway
Authors: Liu Jiahui , Yang Liu , Wang Xiaoran , Wang Shoubi , Huang Zheqian , Li Chaoyang , Liu Ying , Cheng Yaqi , Liu Chengxiu , Wang Zhichong
Published: August 2020

Background: Retinal pigment epithelium (RPE) replacement has been proposed as an efficacious treatment for Age-related macular degeneration (AMD), which is the primary causes of vision loss in the elderly worldwide. The embryonic stem cell (ESC) microenvironment has been demonstrated to enable mature cells to gain a powerful proliferative ability and even enhance the stem/progenitor phenotype via activation of the phosphoinositide 3-kinase (PI3K) signaling pathway. As the PI3K signaling pathway plays a pivotal role in proliferation and homeostasis of RPE, we hypothesize that the stemness and proliferative capability of RPE can be enhanced by the ESC microenvironment via activation of the PI3K signaling pathway.Methods: To investigate whether the ESC microenvironment improves the stem cell phenotype and proliferation properties of human RPE (hRPE) cells by regulating the PI3K signaling pathway, primary hRPE cells were cocultured with either ESCs or human corneal epithelial cells (CECs) for 72 hours, after which their proliferation, apoptosis, cell cycle progression, and colony formation were assayed to evaluate changes in their biological characteristics. Gene expression was detected by real-time PCR and protein levels were determined by western blotting or immunofluorescence. LY294002, an antagonist of the PI3K signaling pathway, was used to further confirm the mechanism involved.Results: In comparison to hRPE cells cultured alone, hRPE cells cocultured with ESCs had an increased proliferative capacity, reduced apoptotic rate, and higher colony-forming efficiency. The expression of the stem cell-associated marker KLF4 and the differentiation marker CRALBP increased and decreased, respectively, in hRPE cells isolated from the ESC coculture. Furthermore, PI3K pathway-related genes were significantly up-regulated in hRPE cells after exposure to ESCs. LY294002 reversed the pro-proliferative effect of ESCs on hRPE cells. In contrast, CECs did not share the ability of ESCs to influence the biological behavior and gene expression of hRPE cells.Conclusions: Our findings indicate that the ESC microenvironment enhances stemness and proliferation of hRPE cells, partially via activation of the PI3K signaling pathway. This study may have a significant impact and clinical implication on cell therapy in regenerative medicine, specifically for age-related macular degeneration.
Palliative care delivery in residential aged care: Bereaved family member experiences of the Supportive Hospice Aged Residential Exchange (SHARE) intervention
Authors: Frey Rosemary Ann , Barham Sophia , Balmer Deborah , Boyd Michal , Robinson Jackie , Gott Merryn
Published: August 2020

Background: The supportive hospice aged residential exchange (SHARE) is a new model of palliative care education that has been designed for residential aged care. The goal of SHARE is to help clinical staff improve palliative care within residential aged care facilities and to improve specialist palliative care nurses' knowledge and skill to care for frail older people. Method: The experiences of 18 bereaved families concerning the palliative care journey (both at the start and finish of a one-year implementation of SHARE) were explored using semi-structured interviews.Results: Three themes were important to bereaved families’ experience: communication with staff, systems of care, and hospice involvement. Sub-themes indicating changes in these three components of care between the start and finish of SHARE was identified. A fourth theme highlighted challenges (relationship with GP, staff shortages, and turnover) that continued across SHARE.Conclusion: Findings indicated that SHARE benefited families (improved communication and support) through the end of life journey of their relatives, but challenges remained.
Alpha-1 antitrypsin deficient individuals have circulating extracellular vesicles with profibrogenic cargo 
Authors: Khodayari Nazli , Oshins Regina , Holliday Shannon , Clark Virginia , Xiao Qiang , Marek George , Mehrad Borna , Brantly Mark
Published: August 2020

Background: Alpha-1 antitrypsin deficiency (AATD)-mediated liver disease is a toxic “gain-of-function” inflammation in the liver associated with intracellular retention of mutant alpha-1 antitrypsin. The clinical presentation of the disease includes fibrosis, cirrhosis and liver failure. However, the pathogenic mechanism of AATD-mediated liver disease is not well understood. Here, we investigated the role of plasma extracellular vesicles (EVs) in progression of AATD-mediated liver disease. Methods: EVs were isolated from plasma of AATD individuals with liver disease and healthy controls. Their cytokines and miRNA content were examined by multiplex assay and small RNA sequencing. The bioactivity of EVs was assessed by qPCR, western blot analysis and immunofluorescent experiments using human hepatic stellate cells (HSCs) treated with EVs isolated from control or AATD plasma samples.Results: We have found that AATD individuals have a distinct population of EVs with pathological cytokine and miRNA contents. When HSCs were cultured with AATD plasma derived-EVs, the expression of genes related to the development of fibrosis were significantly amplified compared to those treated with healthy control plasma EVs. Conclusion: AATD individuals have a distinct population of EVs with abnormal cytokine and miRNA contents and the capacity to activate HSCs and mediate fibrosis. Better understanding of the components which cause liver inflammation and fibrogenesis, leading to further liver injury, has the potential to lead to the development of new treatments or preventive strategies to prevent AATD-mediated liver disease.
Integrated Puncture Score: Force-Displacement Weighted Rind Penetration Tests Improve Stalk Lodging Resistance Estimations in Maize
Authors: Stubbs Christopher J , McMahan Christopher , Seegmiller Will , Cook Douglas D , Robertson Daniel J
Published: August 2020

Background: Stalk lodging (breaking of agricultural plant stalks prior to harvest) is a multi-billion dollar a year problem. Rind penetration resistance tests have been used by plant scientists and breeders to estimate the stalk lodging resistance of maize for nearly a hundred years. However, the rind puncture method has two key limitations: (1) the predictive power of the test decreases significantly when measuring elite or pre-commercial hybrids, and (2) using rind penetration measurements as a breeding metric does not necessarily create stronger stalks. In this study, we present a new rind penetration method called the Integrated Puncture Score, which uses a modified rind penetration testing protocol and a physics-based model to provide a robust measure of stalk lodging resistance.

Results: Two datasets, one with a diverse array of maize hybrids and one with only elite hybrids, were evaluated by comparing traditional rind penetration testing and the Integrated Puncture Score method to measurements of stalk bending strength. When evaluating the diverse set of hybrids, both methods were good predictors of stalk bending strength (R2 values of 0.67). However, when evaluating elite hybrids, the Integrated Puncture Score had an R2 value of 0.74 whereas the traditional method had an R2 value of 0.48. Additionally, the Integrated Puncture Score was able to differentiate between the strongest and weakest hybrids in the elite hybrid data set whereas the traditional rind penetration method was not. Additional experiments revealed strong evidence in favor of the data aggregation steps utilized to compute the Integrated Puncture Score.

Conclusions: This study presents a new method for evaluating rind penetration resistance that highly correlates with stalk bending strength and can possibly be used as a breeding index for assessing stalk lodging resistance. This research lays the foundation required to develop a field-based high-throughput phenotyping device for stalk lodging resistance.
High Smad7 in the early post-operative recurrence of Crohn’s disease
Authors: Zorzi Francesca , Calabrese Emma , Fusco Davide Di , De Cristofaro Elena , Biancone Livia , Casella Sara , Palmieri Giampiero , Monteleone Giovanni
Published: August 2020

Background: In Crohn’s disease (CD), one of the major inflammatory bowel disease (IBD) in human beings, there is over-expression of Smad7, an intracellular inhibitor of the suppressive cytokine TGF-β1. The aim of this study was to assess whether Smad7 over-expression occurs in the early and/or late phases of CD. Methods: Mucosal samples were taken from the neo-terminal ileum of CD patients undergoing ileocolonic resection, with or without (early CD) post-operative endoscopic recurrence, and terminal ileum of CD patients with long-standing disease undergoing intestinal resection (late CD). Smad7 was examined by immunohistochemistry and cytokine expression was analysed by flow-cytometry. Results: Before the appearance of endoscopic lesions, the mucosa of the neo-terminal ileum contained high number of Smad7-expressing cells in both the epithelial and lamina propria compartments. Transition from this stage to endoscopic recurrence was marked by persistence of high number of Smad7-positive cells, which reduced significantly in the late stages of the disease, where Smad7 expression remained, however, greater than that seen in normal controls. In samples with early lesions, Smad7 expression positively correlated with the number of interferon-g-secreting cells. Conclusions: Smad7 induction is an early event in the inflammatory sequence occurring in CD, thus suggesting that knockdown of Smad7 can help prevent post-operative recurrence.
Identification of peach growth regulating-factors and their expression under UVB
Authors: Sun MingYue , Li Shaoxuan , Meng Xiangguang , Liu Li , Wang Ning , He Huajie , Li Dongmei , Chen Xiude , Li Ling
Published: August 2020

Background: Growth-regulating factors (GRFs) are one of the most important plant-specific transcription factors with vital roles in multiple biological processes. GRFs have been identified in a variety of plant species, but a handful of research has addressed GRF genes in peach (Prunus persica).Results: Here, we report 46 members of the GRF family in four Rosaceae, divided into six subfamilies according to phylogeny, gene structure, and motif composition. We detected three collinear gene pairs generated from peach by whole-genome duplication or segmental duplication, but no tandem repeats were detected. Expression pattern analysis found that most PpGRFs were preferentially expressed in young tissues, At the sametime, multiple types cis-elements were observed in PpGRF promoters, and PpGRFs could positively respond to ultraviolet B-rays (UVB) and gibberellin (GA)treatments at the transcriptional level. Also, the content of GA3 and indole-3-acetic acid (IAA) changed significantly after UVB irradiation, indicating that GRFs might be involved in new shoot development in peach.Conclusions: This study identified 10 GRF genes in the peach genome and systematically analyzed their properties, thereby providing a foundation for researchers to have a better understanding of this gene family in peach. PpGRF 3, 4, 5, 6, 7, 9, and 10 positive responses to UVB and GA3 signals indicate that they can serve as candidate functional genes to further study how tree potential is regulated in peach.
Patients’ experiences with the advanced practice nurse role in Swiss family practices: a qualitative study
Authors: Schönenberger Nicole , Sottas Beat , Merlo Christoph , Essig Stefan , Gysin Stefan
Published: August 2020

Background: Considering shortages of general practitioners (GP) and strategies for improving the quality of health care provision, many countries have implemented interprofessional care models with advanced practice nurses (APN). International evidence suggests that APN care results in high patient satisfaction. In Switzerland, the role is still new, and the patient perspective has not yet been researched. Our aim was therefore to explore patients’ experiences with the APN role in Swiss family practices.Methods: We conducted 22 semi-structured interviews in four different family practices with patients aged 18 to 97 suffering from minor acute to multiple chronic diseases, and who had at least one consultation with an APN. All interviews were audiotaped, transcribed verbatim, and analysed using qualitative content analysis.Results: The analysis resulted in five themes: Despite the unfamiliarity, all patients were willing to be consulted by an APN because it was recommended by their GP (1); after several encounters, most participants perceived differences between the APN and the GP consultation in terms of the length and approach of the consultations as well as the complexity of their tasks (2); the interviewees emphasised coaching, guidance, care coordination, and GP-assisting tasks as APN core competencies and attributed the characteristics empathetic, trustworthy, and competent to the APN role (3); most patients especially valued home visits and the holistic approach of the APNs, but they also noticed that in certain cases GP supervision was required (4); and due to the close collaboration between the APN and the GP, patients felt safe, well cared for and experienced improvements in physical and psychological well-being as well as in daily activities (5). Conclusion: Our results suggest that patients value the APNs’ competencies, despite their initial lack of role knowledge. Trust in the GP seems to be the most important factor for patients’ receptiveness toward the APN role. Overall, patients perceived an added value due to the enlargement of the scope of practice offered by APNs. The patient perspective might provide valuable insights for further APN role implementation in Swiss family practices.
Multi-model seascape genomics identifies distinct environmental drivers of selection among sympatric marine species
Authors: Nielsen Erica , Henriques Romina , Beger Maria , Toonen Robert , Heyden Sophie von der
Published: August 2020

Background: As global change and anthropogenic pressures continue to increase, conservation and management increasingly needs to consider species’ potential to adapt to novel environmental conditions. Therefore, it is imperative to characterise the main selective forces acting on ecosystems, and how these may influence the evolutionary potential of populations and species. Using a multi-model seascape genomics approach, we compare putative environmental drivers of selection in three sympatric southern African marine invertebrates with contrasting ecology and life histories: Cape urchin (Parechinus angulosus ), Common shore crab (Cyclograpsus punctatus), and Granular limpet (Scutellastra granularis ). Results: Using pooled (Pool-seq), restriction-site associated DNA sequencing (RAD-seq), and seven outlier detection methods, we characterise genomic variation between populations along a strong biogeographical gradient. Of the three species, only S. granularis showed significant isolation-by-distance, and isolation-by-environment driven by sea surface temperatures (SST). In contrast, sea surface salinity (SSS) and range in air temperature correlated more strongly with genomic variation in C. punctatus and P. angulosus. Differences were also found in genomic structuring between the three species, with outlier loci contributing to two clusters in the East and West Coasts for S. granularis and P. angulosus, but not for C. punctatus . Conclusion: The findings illustrate distinct evolutionary potential across species, suggesting that species-specific habitat requirements and responses to environmental stresses may be better predictors of evolutionary patterns than the strong environmental gradients within the region. We also found large discrepancies between outlier detection methodologies, and thus offer a novel multi-model approach to identifying the principal environmental selection forces acting on species. Overall, this work highlights how adding a comparative approach to seascape genomics (both with multiple models and species) can elucidate the intricate evolutionary responses of ecosystems to global change.
Serum Neutrophil Gelatinase-associated Lipocalin at 3 Hours after Return of Spontaneous Circulation in Patients with Cardiac Arrest and Therapeutic Hypothermia: Early Predictor of Acute Kidney Injury
Authors: Choi Yoon Hee , Lee Dong Hoon , Lee Jae Hee
Published: August 2020

Background: Serum neutrophil gelatinase-associated lipocalin (NGAL) could be used as a predictive marker of acute kidney injury (AKI) in patients with return of spontaneous circulation (ROSC) after out-of-hospital cardiac arrest (OHCA) who are managed with targeted temperature management (TTM). However, the NGAL measurement timepoints vary from immediately after ROSC to several days later. The primary objective of this study was to determine an association between AKI and NGAL, both immediately (ROSC-NGAL) and 3 hours after ROSC (3h-NGAL), in OHCA patients with TTM. The secondary objective was to ascertain the association between NGAL levels in the early post-ROSC phase and the neurologic outcomes at discharge.Methods: This prospective observational study was conducted between January 2016 and December 2018 and enrolled adult OHCA patients (≥18 years) with TTM after ROSC. The serum NGAL level was measured both immediately and 3 hours after ROSC. Univariate and multivariate analyses were performed to identify the associations between AKI, poor neurologic outcome, and NGAL.Results: Among 861 OHCA patients, 89 patients were enrolled. AKI occurred in 48 (55.1%) patients. On multivariate logistic regression analysis, 3h-NGAL was significantly associated with AKI (odds ratio [OR] 1.022; 95% confidence interval [CI] 1.009–1.035; p = 0.001). The area under the receiver operating characteristic curve of 3h-NGAL for AKI was 0.910 (95% CI 0.830–0.960), and a cut-off value of 178 ng/mL was identified. Both ROSC-NGAL and 3h-NGAL were not significantly associated with poor neurologic outcome on multivariate logistic regression analysis (ROSC-NGAL; OR 1.017; 95% CI 0.998–1.036; p = 0.084, 3h-NGAL; OR 0.997; 95% CI 0.992–1.001; p = 0.113) Conclusions: The serum NGAL concentration measured 3 hours after ROSC is an excellent early predictive marker for AKI in OHCA patients treated with TTM. Future research is needed to identify the optimal measurement timepoint to establish NGAL as a predictor of neurologic outcome and to validate the findings of this research.
Treatment patterns and comorbid burden of patients newly diagnosed with multiple sclerosis in the United States
Authors: Kern David , Cepeda M. Soledad
Published: August 2020

Background: The treatment landscape for multiple sclerosis (MS) is quickly evolving. Understanding real-world treatment patterns of patients is necessary to identifying potential gaps in care.Methods: Patients with incident MS were identified from a large national claims database during 1/1/2014-6/30/2019. Patients had ≥2 diagnoses for MS or an inpatient hospitalization with a primary diagnosis of MS. Patients were required to have enrollment in the database ≥1 year prior to and ≥1 year following their first MS diagnosis. Treatment sequences were captured for all available disease modifying therapies (DMTs) during all available follow-up. Presence of comorbid conditions were captured during the one year prior to and following (and including) the index date; absolute change in prevalence from the pre- to post-index periods was calculated. Results: We identified 5,691 patients with incident MS. Common comorbidities included physical symptoms (e.g., pain, weakness, fatigue), mental health conditions (anxiety, depression), and cardiovascular/metabolic conditions (hypertension, hyperlipidemia, diabetes, obesity). Just 1,994 (35.0%) of patients received a DMT at any time during follow-up. Of those receiving a DMT, 28.2% went on to receive a second line of therapy, 5.8% received a third, and just 0.9% went on to a fourth line. Use of more than one DMT concomitantly occurred in just 1.8% of all treated patients. Glatiramer and dimethyl fumarate were by far the most common first-line treatments received accounting for nearly 62% of patients receiving a DMT. Conclusion: Approximately two-thirds of patients newly diagnosed with MS did not receive a DMT and the disease is accompanied by a significant comorbid burden.
A Prolonged Cholera Outbreak Caused by Drinking Contaminated Water from a Stream, Kyangwali Refugee Settlement, Hoima District, Western Uganda: February-May 2018
Authors: Monje Fred , Ario Alex Riolexus , Musewa Angella , Bainomugisha Kenneth , Mirembe Bernadette Basuta , Aliddeki Dativa Maria , Eurien Daniel , Nsereko Godfrey , Nanziri Carol , Kisaakye Esther , Ntono Vivian , Kweiga Benon , Kadobera Daniel , Bulage Lilian , Bwire Godfrey , Tusiime Patrick , Harris Julie , Zhu Bao-Ping
Published: August 2020

Background: On 23 February 2018, the Uganda Ministry of Health (MOH) declared a cholera outbreak affecting more than 60 persons in Kyangwali Refugee Settlement, Hoima District, bordering the Democratic Republic of Congo (DRC). We investigated to determine the outbreak scope and risk factors for transmission, and recommend evidence-based control measures.Methods: We defined a suspected case as sudden onset of watery diarrhoea in a person aged ≥2 years in Hoima District, 1 February-9 May 2018. A confirmed case was a suspected case with V. cholerae cultured from a stool sample. We found cases by active community search and record reviews at Cholera Treatment Centres. We calculated case-fatality rates (CFR) and attack rates (AR) by sub-county and nationality. In a case-control study, we compared exposure factors among case- and control-households. We conducted an environmental assessment in the refugee settlement, including testing samples of stream water, tank water, and spring water for presence of fecal coliforms. We tested suspected cholera cases using cholera Rapid Diagnostic Test (RDT) kits followed by culture for confirmation. Results: We identified 2,122 case-patients and 44 deaths (CFR=2.1%). Case-patients originating from DRC were the most affected (AR=15/1000). The overall attack rate in Hoima District was 3.2/1,000, with Kyangwali sub-county being the most affected (AR=13/1,000). The outbreak lasted 4 months, which was a multiple point-source. Environmental assessment showed that a stream separating two villages in Kyangwali Refugee Settlement was a site of open defecation for refugees. Among three water sources tested, only stream water was feacally-contaminated, yielding >100 CFU/100ml. Of 130 stool samples tested, 124 (95%) yielded V. cholerae by culture. Stream water was most strongly associated with illness (OR=14.2; CI=1.5-133), although tank water also appeared to be independently associated with illness (OR=11.6; CI=1.4-94). Persons who drank tank and stream water had a 17-fold higher odds of illness compared with persons who drank from other sources (OR=17.3, CI=2.2-137). Conclusions: Our investigation demonstrated that this was a prolonged cholera outbreak that affected 4 sub-counties and 2 divisions in Hoima District and was associated with drinking of contaminated stream water. In addition, tank water also appears to be unsafe. We recommended boiling drinking water, increasing latrine coverage, and provision of safe water by the District and entire High Commission for refugees.
Impact of sugarcane irrigation on malaria vector Anopheles mosquito fauna, abundance and seasonality in Arjo-Didessa, Ethiopia
Authors: Shifera Assalif Demissew , Hawaria Dawit , Kibret Solomon , Animut Abebe , Tsegaye Arega , Lee Ming-Cheih , Yan Guiyun , Yewhalaw Delenasaw
Published: August 2020

Background: Despite extensive irrigation development in Ethiopia, limited studies assessed the impact of irrigation on malaria vector mosquito composition, abundance and seasonality. This study aimed at evaluating the impact of sugarcane irrigation on species composition, abundance and seasonality of malaria vectors. Methods: Adult Anopheles mosquitoes were collected using CDC light traps from three irrigated and three non-irrigated clusters in and around Arjo-Didessa sugarcane irrigation scheme in southwestern Ethiopia. Mosquitoes were surveyed in four seasons: two wet and two dry, in 2018 and 2019. Mosquito species composition, abundance and seasonality were compared between irrigated and non-irrigated clusters. Anopheles mosquitoes were sorted out to species using morphological keys and molecular techniques. Chi-square was used to test the relationships between Anopheles species occurrence, and environmental and seasonal parameters. Results: Overall, 2,108 female Anopheles mosquitoes comprising of six species were collected. Of these, 92.7% (n=1954) were from irrigated clusters and 7.3% (n=154) from the non-irrigated. An. gambiae s.l was the most abundant (67.3%) followed by An. coustani complex (25.3 %) and An. pharoensis (5.7%). PCR based identification revealed that 74.7% (n=168) of the An. gambiae s.l were An. arabiensis and 22.7% (n=51) An. amharicus. Density of An. gambiae s.l. (both indoor and outdoor) was higher in irrigated than non-irrigated clusters. The overall anopheline mosquito abundance during the wet seasons (87.2%; n=1837) was higher than the dry seasons (12.8%; n=271).Conclusion: The ongoing sugarcane irrigation activities in Arjo-Didessa created conditions suitable for malaria transmitting Anopheles species diversity and abundance. This could drive malaria transmission in Arjo-Didessa and its environs in both dry and wet seasons. Thus, currently practiced malaria vector interventions need to be strengthened by including larval source management to reduce vector abundance in the irrigated areas.
Human myeloid-derived suppressor cells derived from the bone marrow maintain their functional ability with aging but have a reduced frequency of induction
Authors: Magri Sara , Masetto Elena , Solito Samantha , Francescato Samuela , Belluzzi Elisa , Pozzuoli Assunta , Berizzi Antonio , Ruggieri Pietro , Mandruzzato Susanna
Published: August 2020

Myeloid-derived suppressor cells (MDSCs) are a heterogeneous population of immunosuppressive cells developing from myeloid progenitors, which are enriched in pathological conditions such as cancer, and are known to inhibit the functions of effector T cells. During aging, several changes occur both at the adaptive and innate immune system level, in a process defined as immunoscenescence. In particular, the low-grade inflammation state observed in the elderly appears to affect hematopoiesis. We previously demonstrated that the combination of GM-CSF and G-CSF drives the in vitro generation of bone marrow-derived MDSCs (BM-MDSCs) from precursors present in human bone marrow aspirates of healthy donors, and that these cells are endowed with a strong immune suppressive ability, resembling that of cancer-associated MDSCs. In the present work we investigated BM-MDSCs induction and functional ability in a cohort of pediatric versus elderly donors. To this aim, we analyzed the differences in maturation stages and ability to suppress T cell proliferation. We found that the ex vivo distribution of myeloid progenitors is similar between pediatric and elderly individuals, whereas after cytokine treatment a significant reduction in the more immature compartment is observed in the elderly. Despite the decreased frequency, BM-MDSCs maintain their suppressive capacity in aged donors. Taken together, these results indicate that in vitro induction of MDSCs from the BM is reduced with aging and opens new hypotheses on the role of age-related processes in myelopoiesis.
Changes in the Gut Microbiome Community of Nonhuman Primate Following Radiation Injury
Authors: Kalkeri Raj , Walters Kevin , Pol William Van Der , McFarland Braden C. , Fisher Nathan , Koide Fusataka , Morrow Casey D. , Singh Vijay K.
Published: August 2020

Background: Composition and maintenance of the microbiome is vital to gut homeostasis. However, there is limited knowledge regarding the impact of high doses of radiation, which can occur as a result of cancer radiation therapy, nuclear accidents or intentional release of a nuclear or radioactive weapon, on the composition of the gut microbiome. Therefore, we sought to analyze alterations to the gut microbiome of nonhuman primates (NHPs) exposed to high doses of radiation. Fecal samples were collected from 19 NHPs (Chinese rhesus macaques, Macaca mulatta) one day prior and one and four days after exposure to 7.4 Gy cobalt-60 gamma-radiation (LD70-80/60). The 16S V4 rRNA sequences were extracted from each sample, followed by bioinformatics analysis using the QIIME platform. Results: Alpha Diversity (Shannon Diversity Index), revealed no major difference between pre- and post-irradiation, whereas Beta diversity analysis showed significant differences in the microbiome after irradiation (day +4) compared to baseline (pre-irradiation). The Firmicutes/Bacteriodetes ratio, a factor known to be associated with disruption of metabolic homeostasis, decreased from 1.2 to less than 1 post-radiation exposure. Actinobacillus, Bacteroides, Prevotella (Paraprevotellaceae family) and Veillonella genera were significantly increased by more than 2-fold and Acinetobacter and Aerococcus genus were decreased by more than 10-fold post-irradiation. Fifty-two percent (10/19) of animals exposed to radiation demonstrated diarrhea at day 4 post-irradiation. Comparison of microbiome composition of feces from animals with and without diarrhea at day 4 post-irradiation revealed an increase in Lactobacillus reuteri associated with diarrhea and a decrease of Lentisphaerae and Verrucomicrobioa phyla and Bacteroides in animals exhibiting diarrhea. Conclusions: Our findings demonstrate that substantial alterations in the microbiome composition of NHPs occur following radiation injury and provide insight into early changes with high-dose, whole-body radiation exposure. Future studies will help identify microbiome biomarkers of radiation exposure and develop effective therapeutic intervention to mitigate the radiation injury.
Methods and Effectiveness of Communication Between Hospital Allied Health and Primary Care Practitioners: a Systematic Narrative Review
Authors: Sheehan Jacinta , Laver Kate , Bhopti Anoo , Rahja Miia , Usherwood Tim , Clemson Lindy , Lannin Natasha A
Published: August 2020

Background There is a compelling rationale that effective communication between hospital allied health professionals and primary care practitioners could improve quality and continuity of patient care. It is not known which methods of communication are used, nor how effectively they facilitate the transition of care when a patient is discharged home from hospital. Our systematic review aims to investigate the methods and effectiveness of communication between hospital allied health professionals and primary care practitioners. Method Systematic review of quantitative and qualitative studies with narrative synthesis. Medline, CINAHL, EMBASE, PsycInfo and Proquest Nursing and Allied Health Sources were searched from January 2003 until January 2020 for studies that examined hospital allied health professionals communicating with primary care practitioners. Risk of bias in the different study designs were appraised using recognised tools and a content analysis conducted of the methodologies used. Results From the located 12,281 papers (duplicates removed), 24 studies met the inclusion criteria with hospital allied health professionals communicating in some form with primary care practitioners. There was, however, limited literature investigating the methods and/or the effectiveness of communication between hospital allied health professionals and primary care practitioners.Conclusion There is currently no 'gold standard' method or measure of communication between hospital allied health professionals and primary care practitioners. There is an urgent need to develop and evaluate multidisciplinary communication with enhanced health information technologies to improve collaboration across healthcare settings and facilitate continuity of integrated people-centred care.Registration: www.crd.york.uk PROSPERO CRD42019120410
‘I decided to go back to work so I can afford to buy her formula’: a longitudinal qualitative study to explore how women in informal work balance the challenges of infant feeding and childcare while working to provide for their family
Authors: Luthuli Silondile , Haskins Lyn , Mapumulo Sphindile , Rollins Nigel , Horwood Christiane
Published: August 2020

Background
In South Africa almost 2 million women work informally. Informal work is characterised by poor job security, low earnings, and unsafe working conditions, with high rates of poverty and food insecurity. The peripartum period is a vulnerable time for many working women. This study explored how mothers navigate the tension between the need to work and needing to take care of a newborn baby, and how this affects their feeding plans and practices.
Methods
A mixed methods longitudinal cohort method was employed. Informal workers were recruited in the last trimester of pregnancy during an antenatal visit at two clinics in Durban, South Africa. Data were collected using in-depth interviews and quantitative questionnaires at three time points: pre-delivery, post-delivery and after returning to work. Framework analysis was used to analyse qualitative data in NVIVO v12.4. Quantitative analysis used SPSSv26.
Results
Twenty-four participants were enrolled and followed-up for a period of up to one year. Informal occupations included domestic work, home-based work, informal trading, and hairdressing, and most women earned < R3000 (US$175) per month. Participants had good knowledge of the importance of breastfeeding for child health. Most women planned to take time off work after the birth of their babies, supporting themselves during this time with the child support grant (CSG) received for older children, their savings, and support from the baby’s father and other family members. However, financial pressures forced many mothers to return to work earlier than planned, resulting in changes to infant feeding practices. Several mothers tried expressing breastmilk, but only one was able to sustain this while away from the baby. Most participants introduced formula, other foods and fluids to their babies when they returned to work or stopped breastfeeding entirely, but some were able to change their work or adapt their working hours to accommodate breastfeeding.
Conclusions
Interventions are needed within the social and work environment to support mothers with breastfeeding while they continue earning an income in the informal economy. The extension of the CSG to the antenatal period could assist mothers to stay at home longer post-delivery to breastfeed their babies.
Developing Targeted Client Communication Messages to Women in Bangladesh: A Qualitative Approach Based on Women’s and Family Members’ Perceptions and Knowledge of Antenatal Care
Authors: Pervin Jesmin , Sarker Bidhan Krishna , Nu U Tin , Khatun Fatema , Rahman A M Quaiyum , Venkateswaran Mahima , Rahman Anisur , Frøen J. Fredrik , Friberg Ingrid K.
Published: August 2020

Background: Timely and appropriate evidence-based practices during antenatal care improve maternal and neonatal health. There is a lack of information on how pregnant women and families perceive antenatal care in Bangladesh. This study explores their perceptions towards developing targeted client communication via text messages for increasing antenatal care utilization, as part of an implementation of an electronic registry for maternal and child health.Methods: We conducted this qualitative study between May and June 2017 in two sub-districts of Chandpur district, Bangladesh. We selected study participants by purposive sampling. A total of 24 in-depth interviews were conducted with pregnant women (n=10), lactating women (n=5), husbands (n=5), and mothers-in-law (n=4). The health belief model was used to guide data collection and analysis. Thematic analysis was carried out manually. We used behavior change techniques to inform the development of targeted client communications based on the thematic results.Results: Almost no respondents mentioned antenatal care as a preventive form of care, and only perceived it as necessary if any complications developed during pregnancy. Knowledge of the content of antenatal care and pregnancy complications was low. Women reported a variety of reasons for not attending ANC, including the lack of information on the timing of ANC; lack of decision-making power; long-distance to access care; being busy with household chores and not being satisfied with the treatment by health care providers. Study participants recommended phone calls as their preferred communication strategy when asked to choose between the phone call and text message, but saw text messages as a feasible option. We developed a library of 43 automatically customizable text messages to increase ANC utilization. Conclusions: Pregnant women and family members had limited knowledge about antenatal care and pregnancy complications. Effective health information through text messages could increase awareness of antenatal care among study participants. This study presents an example of designing targeted client communication to increase antenatal care utilization within formal scientific frameworks, including a taxonomy of behavior change techniques.