bluuebunny/crossref_metadata_2025 huggingface dataset:
Interstitial lung disease in a veterans affairs regional network; a retrospective cohort study
Authors: Bedoya Armando , Pleasants Roy A. , Boggan Joel C. , Seaman Danielle , Reihman Anne , Howard Lauren , Kundich Robert , Welty-Wolf Karen , Tighe Robert M.
Published: March 2021

Background

The epidemiology of Interstitial Lung Diseases (ILD) in the Veterans Health Administration (VHA) is presently unknown.

Research question

Describe the incidence/prevalence, clinical characteristics, and outcomes of ILD patients within the Veteran’s Administration Mid-Atlantic Health Care Network (VISN6).

Study design and methods

A multi-center retrospective cohort study was performed of veterans receiving hospital or outpatient ILD care from January 1, 2008 to December 31st, 2015 in six VISN6 facilities. Patients were identified by at least one visit encounter with a 515, 516, or other ILD ICD-9 code. Demographic and clinical characteristics were summarized using median, 25th and 75th percentile for continuous variables and count/percentage for categorical variables. Characteristics and incidence/prevalence rates were summarized, and stratified by ILD ICD-9 code. Kaplan Meier curves were generated to define overall survival.

Results

3293 subjects met the inclusion criteria. 879 subjects (26%) had no evidence of ILD following manual medical record review. Overall estimated prevalence in verified ILD subjects was 256 per 100,000 people with a mean incidence across the years of 70 per 100,000 person-years (0.07%). The prevalence and mean incidence when focusing on people with an ILD diagnostic code who had a HRCT scan or a bronchoscopic or surgical lung biopsy was 237 per 100,000 people (0.237%) and 63 per 100,000 person-years respectively (0.063%). The median survival was 76.9 months for 515 codes, 103.4 months for 516 codes, and 83.6 months for 516.31.

Interpretation

This retrospective cohort study defines high ILD incidence/prevalence within the VA. Therefore, ILD is an important VA health concern.
Pooled prevalence and determinants of modern contraceptive utilization in East Africa: A Multi-country Analysis of recent Demographic and Health Surveys
Authors: Tessema Zemenu Tadesse , Teshale Achamyeleh Birhanu , Tesema Getayeneh Antehunegn , Yeshaw Yigizie , Worku Misganaw Gebrie
Published: March 2021

Background

According to the 2017 estimate, around 214 million reproductive-age women in developing regions who want to avoid pregnancy do not use a modern contraceptive method. Although there are studies done on factors associated with modern contraceptive utilization in individual East African countries, as to our search of the literature, there is limited evidence on the pooled prevalence and determinants of modern contraceptive utilization in the East African region. Therefore, this study aimed to estimate the pooled prevalence and determinants of modern contraceptive utilization in the East African region.

Methods

The pooled prevalence of modern contraceptive utilization and the strength of determinants were estimated using STATA version 14. Intra-class Correlation Coefficient (ICC), Median Odds Ratio (MOR), Proportional Change in Variance (PCV), and deviance were used for model fitness and comparison. The multilevel logistic regression model was fitted to identify determinants of modern contraceptive use in the region. Adjusted Odds Ratio with its 95% Confidence Interval was presented, and variables with a p-value ≤of 0.05 were declared significant determinants of modern contraceptive utilization.

Results

Overall, about 20.68% (95%CI:-20.46.,20.91)of women used modern contraceptive, ranging from 9.08% in Mozambique to 61.49% in Comoros. In the multilevel logistic regression model; maternal age group 25–34 (AOR: 0.79, 95%CI:0.76,0.82) and 35–49 (AOR:0.49, 95%CI:0.46,0.51). Being married (AOR:0.85, 95%CI:0.82,0.88), mothers with primary education (AOR:1.48, 95%CI:1.43,1.54) and secondary and above education level (AOR:1.60, 95%CI:1.52,1.69), husbands with primary education (AOR:2.43, 95%CI:2.35,2.51) and secondary and above education level (AOR:2.92, 95%CI:2.76,3.05). The mothers who had occupation (AOR:2.11, 95%CI:1.23,1.33), mothers from households with middle wealth index (AOR:1.23, 95%CI:1.19,1.28) and rich wealth index (AOR:1.28, 95%CI:1.23,1.33) were found to be significant determinants of modern contraceptive use.

Conclusion

We found that modern contraceptive utilization in the 12 East Africa countries was low compared to SDG target 2030(75%). The governmental and non-governmental organizations should scale up their public health programs to the poor and marginalized communities to scale up modern contraceptive utilization uptake in the region. In addition, reforming the health system and reproductive health education through mass media to create awareness of modern contraceptive use benefits are effective strategies to improve modern contraceptive use among East Africa women.
Spatial determinants of farmers’ interest in European Union’s pro-investment programs in Poland
Authors: Kiryluk-Dryjska Ewa , Więckowska Barbara , Sadowski Arkadiusz
Published: March 2021

The purpose of the paper is to investigate spatial determinants of farmers’ interest in pro-investment programs co-financed by the EU, by identifying and describing the territorial clusters of rural areas in Poland where the applications rates for these programs were above or below the national average. We tested for spatial autocorrelation using Moran’s global spatial autocorrelation index, while the search for clusters was done using a local version of Moran’s statistics. The results show significant regional variation in the farmers’ interest in these programs in Poland. This interest was higher in regions with a greater level of agricultural development and better agrarian structure. In Poland, both of these factors are related not only to natural conditions, but also to strong historical context. We conclude that the pro-investment programs contribute to the deepening of development differences in Polish agriculture in the territorial dimension, which is not in line with the basic assumptions of cohesion policy.
Diagnostic and prognostic ability of salivary MMP-9 for oral squamous cell carcinoma: A pre-/post-surgery case and matched control study
Authors: Shin Yoo-Jin , Vu Huong , Lee Jong-Ho , Kim Hyun-Duck
Published: March 2021

Over 90% of oral cancers are oral squamous cell carcinoma (OSCC). Hitherto, early detection marker for OSCC has not been available. Hence, this study aimed to evaluate the diagnostic and prognostic ability of salivary matrix-metalloproteinase-9 (MMP-9) and 8-hydroxydeoxyguanosine (8-OHdG) for OSCC. Total of 318 participants with 106 cases and 212 controls were included: OSCC cases were from Seoul National University Dental Hospital and age, sex, and smoking matched controls were from Yangpyeong cohort. Unstimulated saliva was collected to determine MMP-9 and 8-OHdG using sensitive enzyme-linked immunosorbent assay. Multivariable linear regression and analysis of covariance (ANCOVA) were applied to evaluate the adjusted association of markers with OSCC. Wilcoxon sign rank sum test and Friedman test for median were applied to evaluate follow-up level of MMP-9 after surgery. Receiver operating characteristic curve was obtained for diagnostic ability. Salivary MMP-9 was associated with OSCC (ANCOVA and multivariable linear regression, p<0.05), while 8-OHdG was not. The diagnostic ability of MMP-9 was area under curve of 0.96 (100% specificity and 89.6% sensitivity, p<0.001). MMP-9 decreased dramatically after tumor surgery (p<0.05). Salivary MMP-9 could be a critical diagnostic and prognostic marker for OSCC.
Associating ridesourcing with road safety outcomes: Insights from Austin, Texas
Authors: Kontou Eleftheria , McDonald Noreen
Published: March 2021

Improving road safety and setting targets for reducing traffic-related crashes and deaths are highlighted as part of the United Nations sustainable development goals and worldwide vision zero efforts. The advent of transportation network companies and ridesourcing expands mobility options in cities and may impact road safety outcomes. We analyze the effects of ridesourcing use on road crashes, injuries, fatalities, and driving while intoxicated (DWI) offenses in Travis County, Texas. Our approach leverages real-time ridesourcing volume to explain variation in road safety outcomes. Spatial panel data models with fixed-effects are deployed to examine whether the use of ridesourcing is significantly associated with road crashes and other safety metrics. Our results suggest that for a 10% increase in ridesourcing trips, we expect a 0.12% decrease in road crashes, a 0.25% decrease in road injuries, and a 0.36% decrease in DWI offenses in Travis County. On the other hand, ridesourcing use is not significantly associated with road fatalities. This study augments existing work because it moves beyond binary indicators of ridesourcing availability and analyzes crash and ridesourcing trips patterns within an urbanized area rather than their metropolitan-level variation. Contributions include developing a data-rich approach for assessing the impacts of ridesourcing use on the transportation system’s safety, which may serve as a template for future analyses for other cities. Our findings provide feedback to policymakers by clarifying associations between ridesourcing use and traffic safety and uncover the potential to achieve safer mobility systems with transportation network companies.
Unsupervised cluster analysis of patients with recovered left ventricular ejection fraction identifies unique clinical phenotypes
Authors: Perry Andrew , Loh Francis , Adamo Luigi , Zhang Kathleen W. , Deych Elena , Foraker Randi , Mann Douglas L.
Published: March 2021

Background

Patients with heart failure (HF) with recovered ejection fraction (HFrecEF) are a recently identified cohort that are phenotypically and biologically different from HFrEF and HFpEF patients. Whether there are unique phenotypes among HFrecEF patients is not known.

Methods

We studied all patients at a large medical center, who had an improvement in LVEF from ≤ 35% to ≥ 50% (LVrecEF) between January 1, 2005 and December 31, 2013. We identified a set of 11 clinical variables and then performed unsupervised clustering analyses to identify unique clinical phenotypes among patients with LVrecEF, followed by a Kaplan-Meier analysis to identify differences in survival and the proportion of LVrecEF patients who maintained an LVEF ≥ 50% during the study period.

Results

We identified 889 patients with LVrecEF who clustered into 7 unique phenotypes ranging in size from 37 to 420 patients. Kaplan-Meier analysis demonstrated significant differences in mortality across clusters (logrank p<0.0001), with survival ranging from 14% to 87% at 1000 days, as well as significant differences in the proportion of LVrecEF patients who maintained an LVEF ≥ 50%.

Conclusion

There is significant clinical heterogeneity among patients with LVrecEF. Clinical outcomes are distinct across phenotype clusters as defined by clinical cardiac characteristics and co-morbidities. Clustering algorithms may identify patients who are at high risk for recurrent HF, and thus be useful for guiding treatment strategies for patients with LVrecEF.
Analysis of survey on menstrual disorder among teenagers using Gaussian copula model with graphical lasso prior
Authors: Wang Jiali , Westveld Anton H. , Welsh A. H. , Parker Melissa , Loong Bronwyn
Published: March 2021

A high prevalence of menstrual disturbance has been reported among teenage girls, and research shows that there are delays in diagnosis of endometriosis among young girls. Using data from the Menstrual Disorder of Teenagers Survey (administered in 2005 and 2016), we propose a Gaussian copula model with graphical lasso prior to identify cohort differences in menstrual characteristics and to predict endometriosis. The model includes random effects to account for clustering by school, and we use the extended rank likelihood copula model to handle variables of mixed-type. The graphical lasso prior shrinks the elements in the precision matrix of a Gaussian distribution to encourage a sparse graphical structure, where the level of shrinkage is adaptable based on the strength of the conditional associations among questions in the survey. Applying our proposed model to the menstrual disorder data set, we found that menstrual disturbance was more pronouncedly reported over a decade, and we found some empirical differences between those girls with higher risk of developing endometriosis and the general population.
SARS-CoV-2 is associated with high viral loads in asymptomatic and recently symptomatic healthcare workers
Authors: McEllistrem M. Catherine , Clancy Cornelius J. , Buehrle Deanna J. , Singh Nina , Lucas Aaron , Sirianni Valerie , Decker Brooke K.
Published: March 2021

Background

Healthcare workers (HCW) are at increased risk of SARS-CoV-2 infection from both patients and other HCW with coronavirus disease 2019 (COVID-19). RT-PCR cycle threshold (Ct) values of SARS-CoV-2 ≤ 34 and the first 7–9 days of symptoms are associated with enhanced infectivity. We determined Ct values and duration of symptoms of HCW with a positive SARS-CoV-2 test. As HCW often assume their greatest risk of acquiring SARS-CoV-2 is working on a COVID-19 unit, we also determined Ct values and symptom duration of inpatients with a positive SARS-CoV-2 test.

Methods

From 6/24/2020-8/23/2020, Ct values and duration of symptoms from 13 HCW, 12 outpatients, and 28 inpatients who had a positive nasopharyngeal swab for SARS-CoV-2 were analyzed.

Results

Among HCW with a positive SARS-CoV-2 test, 46.2% (6/13) were asymptomatic and requested testing due to an exposure to someone with COVID-19; 83.3% (5/6) of those exposures occurred in the community rather than in the hospital. The median Ct value of HCW was 23.2, and 84.6% (11/13) had a Ct value ≤ 34. The median Ct value of 29.0 among outpatients with COVID-19 did not significantly differ from HCW. In contrast, inpatients with a positive SARS-CoV-2 test had a median Ct value of 34.0 (p = 0.003), which translated into a median ~1,000-fold lower viral load than observed in HCW. Among those with symptoms related to COVID-19, no (0/6) HCW compared to 50% (6/12) of inpatients had symptoms for at least one week (p = 0.04).

Conclusions

At our institution, asymptomatic COVID-19 accounted for nearly half of the cases among HCW. Symptomatic HCW had high viral loads and short duration of symptoms, both of which are associated with peak infectivity. Infection prevention programs should educate HCW on these findings in an effort to increase adherence to the requirement to maintain six feet separation in workspaces and breakrooms, in addition to consistently wearing personal protection equipment.
Simulating the next steps in badger control for bovine tuberculosis in England
Authors: Smith Graham C. , Budgey Richard
Published: March 2021

Industry-led culling of badgers has occurred in England to reduce the incidence of bovine tuberculosis in cattle for a number of years. Badger vaccination is also possible, and a move away from culling was “highly desirable” in a recent report to the UK government. Here we used an established simulation model to examine badger control option in a post-cull environment in England. These options included no control, various intermittent culling, badger vaccination and use of a vaccine combined with fertility control. The initial simulated cull led to a dramatic reduction in the number of infected badgers present, which increased slowly if there was no further badger management. All three approaches led to a further reduction in the number of infected badgers, with little to choose between the strategies. We do note that of the management strategies only vaccination on its own leads to a recovery of the badger population, but also an increase in the number of badgers that need to be vaccinated. We conclude that vaccination post-cull, appears to be particularly effective, compared to vaccination when the host population is at carrying capacity.
Health-related quality of life and associated factors among patients with stroke at tertiary level hospitals in Ethiopia
Authors: Zemed Ashenafi , Nigussie Chala Kalkidan , Azeze Eriku Getachew , Yalew Aschalew Andualem
Published: March 2021

Introduction

Evidence on a patient-centered assessment of outcome among patients with stroke is limited in Ethiopia. Therefore, this study aimed to assess the level of health-related quality of life (HRQOL) and associated factors in Ethiopia’s tertiary level hospitals.

Methods

A cross-sectional study was conducted at three tertiary level hospitals (Felege Hiwot comprehensive specialized hospital, University of Gondar comprehensive specialized hospital, and Dessie referral hospital) from April 1 to May 31, 2019. A total of 180 patients with stroke were included, and a consecutive sampling method was employed to recruit the participants. RAND 36-Item Health Survey was used to measure the HRQOL. A generalized linear model with a gamma distribution and log-link function was used to investigate potential predictors, and variables with aPvalue of <0.05 were considered statistically significant.

Results

Out of the participants, 50.56% were female. The average age and average duration of illness were 59.04 (12.71) and 1.5 (1.46) years, correspondingly. The physical health domain score was higher than the mental health domain score. Education (P= 0.041), social support (P= 0.050), disability (P<0.001), co-morbidity (P= 0.011), depression (P= 0.015) and income (<1000 ETBP= 0.002; 1000–4000 ETBP= 0.009) were associated with physical health domain. Whereas, ischemic stroke (P= 0.014), education (P= 0.020), disability (P<0.001), and depression (P<0.001) were associated with the mental health domain.

Conclusion

The HRQOL of the patients was low. Social support and lower disability status were associated with higher HRQOL, whereas disability and depression were associated with higher HRQOL. Therefore, attention should be given to strengthening social support; health professionals should focus on reducing disability/physical dependency and depression, as these are vital factors for improving HRQOL.
Development of entrustable professional activities for paediatric intensive care fellows: A national modified Delphi study
Authors: Hennus Marije P. , Nusmeier Anneliese , van Heesch Gwen G. M. , Riedijk Maaike A. , Schoenmaker Nikki J. , Soeteman Marijn , Wildschut Enno D. , Fawns Tim , Ten Cate Olle
Published: March 2021

Entrustable professional activities (EPAs), as a focus of learner assessment, are supported by validity evidence. An EPA is a unit of professional practice requiring proficiency in multiple competencies simultaneously, that can be entrusted to a sufficiently competent learner. Taken collectively, a set of EPAs define and inform the curriculum of a specialty training. The goal of this study was to develop a set of EPAs for Dutch PICU fellows. A multistage methodology was employed incorporating sequential input from task force members, a medical education expert, PICU fellowship program directors, and PICU physicians and fellows via a modified three-round Delphi study. In the first modified Delphi round, experts rated indispensability and clarity of preliminary EPAs. In the subsequent rounds, aggregated scores for each EPA and group comments were provided. In round two, respondents rated indispensability and clarity of revised EPAs. Round three was used to gain explicit confirmation of suitability to implement these EPAs. Based on median ratings and content validity index (CVI) analysis for indispensability in the first two rounds, all nine preliminary EPAs covered activities that were deemed essential to the clinical practice of PICU physicians. Based on median ratings and CVI analysis for clarity however, four EPAs needed revision. With an agreement percentage of 93–100% for all individual EPAs as well as the set as a whole, a high degree of consensus among experts was reached in the third round. The resulting nine PICU EPAs provide a succinct overview of the core tasks of Dutch PICU physicians. These EPAs were created as an essential first step towards developing an assessment system for PICU fellows, grounded in core professional activities. The robust methodology used, may have broad applicability for other (sub)specialty training programs aiming to develop specialty specific EPAs.
On the analysis of mortality risk factors for hospitalized COVID-19 patients: A data-driven study using the major Brazilian database
Authors: de Souza Fernanda Sumika Hojo , Hojo-Souza Natália Satchiko , Batista Ben Dêivide de Oliveira , da Silva Cristiano Maciel , Guidoni Daniel Ludovico
Published: March 2021

Background

Brazil became the epicenter of the COVID-19 epidemic in a brief period of a few months after the first officially registered case. The knowledge of the epidemiological/clinical profile and the risk factors of Brazilian COVID-19 patients can assist in the decision making of physicians in the implementation of early and most appropriate measures for poor prognosis patients. However, these reports are missing. Here we present a comprehensive study that addresses this demand.

Methods

This data-driven study was based on the Brazilian Ministry of Health Database (SIVEP-Gripe) regarding notified cases of hospitalized COVID-19 patients during the period from February 26th to August 10th, 2020. Demographic data, clinical symptoms, comorbidities and other additional information of patients were analyzed.

Results

The hospitalization rate was higher for male gender (56.56%) and for older age patients of both sexes. Overall, the lethality rate was quite high (41.28%) among hospitalized patients, especially those over 60 years of age. Most prevalent symptoms were cough, dyspnoea, fever, low oxygen saturation and respiratory distress. Cardiac disease, diabetes, obesity, kidney disease, neurological disease, and pneumopathy were the most prevalent comorbidities. A high prevalence of hospitalized COVID-19 patients with cardiac disease (65.7%) and diabetes (53.55%) and with a high lethality rate of around 50% was observed. The intensive care unit (ICU) admission rate was 39.37% and of these 62.4% died. 24.4% of patients required invasive mechanical ventilation (IMV), with high mortality among them (82.98%). The main mortality risk predictors were older age and IMV requirement. In addition, socioeconomic conditions have been shown to significantly influence the disease outcome, regardless of age and comorbidities.

Conclusion

Our study provides a comprehensive overview of the hospitalized Brazilian COVID-19 patients profile and the mortality risk factors. The analysis also evidenced that the disease outcome is influenced by multiple factors, as unequally affects different segments of population.
Impact of routine Newcastle disease vaccination on chicken flock size in smallholder farms in western Kenya
Authors: Otiang Elkanah , Thumbi Samuel M. , Campbell Zoë A. , Njagi Lucy W. , Nyaga Philip N. , Palmer Guy H.
Published: March 2021

Background

Poultry represent a widely held economic, nutritional, and sociocultural asset in rural communities worldwide. In a recent longitudinal study in western Kenya, the reported mean number of chickens per household was 10, with increases in flock size constrained principally by mortality. Newcastle disease virus is a major cause of chicken mortality globally and hypothesized to be responsible for a large part of mortality in smallholder flocks. Our goal was to determine the impact of routine Newcastle disease virus (NDV) vaccination on flock size and use this data to guide programs to improve small flock productivity.

Methods

We conducted a factorial randomized controlled trial in 537 households: in 254 households all chickens were vaccinated every 3 months with I-2 NDV vaccine while chickens in 283 households served as unvaccinated controls. In both arms of the trial, all chickens were treated with endo- and ecto parasiticides every 3 months. Data on household chicken numbers and reported gains and losses were collected monthly for 18 months.

Results

Consistent with prior studies, the overall flock size was small but with increases in both arms of the study over time. The mean number of chickens owned at monthly census was 13.06±0.29 in the vaccinated households versus 12.06±0.20 in the control households (p = 0.0026) with significant gains in number of chicks (p = 0.06), growers (p = 0.09), and adults (p = 0.03) in the vaccinated flocks versus the controls. Household reported gains were 4.50±0.12 total chickens per month when vaccinated versus 4.15±0.11 in the non-vaccinated controls (p = 0.03). Gains were balanced by voluntary decreases, reflecting household decision-making for sales or household consumption, which were marginally higher, but not statistically significant, in vaccinated households and by involuntary losses, including mortality and loss due to predation, which were marginally higher in control households.

Conclusion

Quarterly NDV vaccination and parasiticidal treatment resulted in an increase in flock size by a mean of one bird per household as compared to households where the flock received only parasiticidal treatment. While results suggest that the preventable fraction of mortality attributable to Newcastle disease is comparatively small relatively to all-cause mortality in smallholder households, there was a significant benefit to vaccination in terms of flock size. Comparison with previous flock sizes in the study households indicate a more significant benefit from the combined vaccination and parasiticidal treatment, supporting a comprehensive approach to improving flock health and improving household benefits of production in the smallholder setting.
Decentralizing PrEP delivery: Implementation and dissemination strategies to increase PrEP uptake among MSM in Toronto, Canada
Authors: Charest Maxime , Sharma Malika , Chris Allison , Schnubb Alexandre , Knox David C. , Wilton James , Shahin Rita , Chan Arlene , Mishra Sharmistha , Grace Daniel , Bayoumi Ahmed M. , Maxwell John , Bogoch Isaac I. , Tan Darrell H. S.
Published: March 2021

Pre-exposure prophylaxis (PrEP) is traditionally prescribed by HIV specialist physicians. Given finite specialist resources, there is a need to scale up PrEP delivery by decentralizing services via other healthcare professionals. We aimed to assess the feasibility of delivering PrEP to men who have sex with men (MSM) through primary care physicians and sexual health clinic nurses. We piloted a multi-component, implementation and dissemination research program to increase provision of PrEP through primary care physicians and sexual health clinic nurses in Toronto, Canada. Community-based organizations (CBOs) provided prospective participants with information cards that contained links to an online module on engaging providers in a conversation about PrEP. In our patient-initiated continuing medical education (PICME) strategy, participants saw their family doctors and gave them the card, which also contained a link to a Continuing Medical Education module. In the nurse-led strategy, participants visited one of two participating clinics to obtain PrEP. We administered an optional online questionnaire to patients and providers at baseline and six months. CBOs distributed 3043 cards. At least 339 men accessed the online module and 196 completed baseline questionnaires. Most (55%) intended to visit nurses while 21% intended to consult their physicians. Among 45 men completing follow-up questionnaires at 6 months, 31% reported bringing cards to their physicians and obtaining PrEP through them; sexual health clinics delivered PrEP to 244 patients. Participants who went through the PICME approach reported no changes in relationships with their providers. Nurses showed fidelity to PrEP prescribing guidelines. Nurse-led PrEP and patient-initiated continuing medical education (PICME) for primary care physicians are feasible strategies to increase PrEP uptake. Nurse-led PrEP delivery was preferred by most patients.
Genetic diversity and population structure in the Ryukyu flying fox inferred from remote sampling in the Yaeyama archipelago
Authors: Taki Yuto , Vincenot Christian E. , Sato Yu , Inoue-Murayama Miho
Published: March 2021

The Ryukyu flying fox (Pteropus dasymallus) is distributed throughout the island chain spanning across southern Japan, Taiwan, and possibly the Philippines. AlthoughP.dasymallusis listed as VU (vulnerable) in the IUCN Red List, only few genetic works have been conducted to support its conservation. In this study we analyzed 19 markers (mtDNA haplotypes and 18 microsatellite markers) to evaluate genetic diversity and investigate the genetic structure of this species. mtDNA analysis was conducted with 142 DNA remote samples, mostly from faeces, and wing tissues collected on eight islands (Miyako, Ishigaki, Kohama, Kuroshima, Hateruma, Taketomi, Iriomote, Yonaguni). 39 haplotypes were identified in 526bp of the control region, and haplotype network showed no clear genetic structure. Microsatellite analysis was also conducted with 155 samples collected on six islands (Miyako, Ishigaki, Kohama, Taketomi, Iriomote, Yonaguni). It showed that the Yonaguni population exhibits low genetic diversity, high inbreeding, and clear genetic differentiation from other populations. Gene flow between Ishigaki and Miyako through small stepstone islands might be preventing inbreeding of the Miyako population. We provide for the first time indirect proof of long-distance inter-island dispersal in the Ryukyu flying fox and revealed genetic diversity, gene flow and genetic differentiation among the archipelago’s populations. These results will be useful for delineating conservation units and designing specific conservation policies for each island based on metapopulation genetic structure.
The effect of age on the clinical and immune characteristics of critically ill patients with COVID-19: A preliminary report
Authors: Hu Chunling , Li Junlu , Xing Xia , Gao Jing , Zhao Shilong , Xing Lihua
Published: March 2021

Background

In December 2019, a new disease named coronavirus disease 2019 (COVID-19) was occurred. Patients who are critically ill with COVID-19 are more likely to die, especially elderly patients. We aimed to describe the effect of age on the clinical and immune characteristics of critically ill patients with COVID-19.

Methods

We retrospectively included 32 patients with COVID-19 who were confirmed to have COVID-19 by the local health authority and who were admitted to the first affiliated hospital of Zhengzhou University in Zhengzhou, China between January 3 and March 20, 2020. Clinical information and experimental test data were retrospectively collected for the patients. The 32 patients in this study were all in a critical condition and were classified as severe, according to the guidelines of 2019-nCoV infection from the National Health Commission of the People’s Republic of China. Data were compared between those <60 years old and ≥60 years old.

Results

Of 32 patients, 13 were under 60 years old, and 19 patients were ≥60 years old. The most common symptom among all patients upon admission was fever (93.8%, 30/32). Compared to younger patients, older patients exhibited increased comorbidities. Among patients who were 60 years and older, platelet count, direct bilirubin (DBIL), indirect bilirubin(IBIL), lactate dehydrogenase (LDH), B-type natriuretic peptide (BNP), C-reactive protein (CRP), procalcitonin (PCT), and interleukin-10 (IL-10) were significantly higher than in younger patients who were less than 60 years old. CD4+ T lymphocytes, CD8+ T lymphocytes, and NKT lymphocytes were decreased, CD4+/CD8+ T lymphocytes were significantly increased in all 32 patients, while there were no evident differences between younger and older patients. The CURB-65 (confusion, urea, respiratory, rate, blood pressure plus age ≥65 years), Acute Physiology and Chronic Health Evaluation (APACHE) II and pH value were significantly higher in older patients than in patients who were under 60 years old. However, the PaO2 and PaO2:FiO2 were lower in older patients than the younger. Compared to patients under 60 years old, patients who were 60 years and older tended to develop ARDS (15 [78.9%] vs 5 [38.5%]), septic shock (7 [36.8%] vs 0 [0.0%]) and were more likely to receive mechanical ventilation (13 [68.4%] vs 3[23.1%]). Dynamic trajectories of seven laboratory parameters were tracked on days 1, 3, 5 and 7, and significant differences in lymphocyte count (P= 0.026), D-dimer (P= 0.010), lactate dehydrogenase (P= 0.000) and C-reactive protein (P= 0.000) were observed between the two age groups.

Conclusions

A high proportion of critically ill patients were 60 or older. Furthermore, rapid disease progression was noted in elderly patients. Therefore, close monitoring and timely treatment should be performed in elderly COVID-19 patients.
Lost to follow-up and associated factors among patients with drug resistant tuberculosis in Ethiopia: A systematic review and meta-analysis
Authors: Andargie Assefa , Molla Asressie , Tadese Fentaw , Zewdie Segenet
Published: March 2021

Background

One third of global antmicrobial resistance deaths are attributed to drug resistant tuberculosis. Lost to follow-up is one of the causes of the development of acquired drug resistant tuberculosis. There is a gap in nationally representative reliable information on lost to follow-up among patients with drug-resistant tuberculosis in Ethiopia.

Objective

To estimate the pooled prevalence and associated factors of lost to follow-up among patients with drug resistant tuberculosis in Ethiopia.

Methods

Observational studies searched from PubMed, HINARI and CINAHL were screened for eligibility. After assessing the quality of studies, data were extracted using a checklist. Heterogeneity was assessed using forest plot, Q and I2. The random effects meta-analysis model was employed to pull the prevalence of lost to follow-up. Sub-group analysis and meta regression were performed to identify the sources of heterogeneity. Publication bias was assessed using funnel plots with Egger’s and Begg’s tests. Sensitivity analysis was performed to assess the influence of individual studies on the overall estimate. The odds ratios were used to measure associations.

Results

The review was performed among 11 studies of which 9 were cohort studies. The sample sizes ranged from 90 to 612 and comprised a total of 3,510 participants. The pooled prevalence of lost to follow-up was 8.66% (95% CI, 5.01–13.14) with a high heterogeneity (I2 = 93.49%, p<0.001). Pulmonary multi-drug resistant tuberculosis patients were 50% less likely to loss from follow-up compared to extra pulmonary tuberculosis patients.

Conclusion

There was a high prevalence of lost to follow-up among multi-drug resistant tuberculosis patients in Ethiopia. Anatomical site of tuberculosis was a significant factor affecting lost to follow-up. Strengthening the health care system and patient education should be given a due emphasis.

Registration number

CRD42020153326; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=153326.
Comparison of clinical and radiographic signs of hip osteoarthritis in contralateral hip joints of fifty working dogs
Authors: Alves J. C. , Santos Ana , Jorge Patrícia , Lavrador Catarina , Carreira L. Miguel
Published: March 2021

Objective

This study aimed to compare the symmetry of clinical and radiographic signs of right and left pelvic limbs of dogs with bilateral hip osteoarthritis (OA) and evaluate the association of physical findings and radiographic abnormalities.

Patients and methods

One hundred pelvic limbs of police working dogs with bilateral hip OA were evaluated, following a screening program. Weight distribution, joint range of motion at flexion and extension, thigh girth, and radiographic signs were recorded and compared with the results of the contralateral limb and by breed, age, and sex with the Paired Samples T-Test and Pearson correlation coefficient, with p<0.05.

Results

The sample mean age was 6.5±2.2 years, and the bodyweight of 26.7±5.3kg. No significant differences were observed when comparing weight distribution, joint range of motion, and thigh girth of left and right limbs. Weight distribution and age showed a statistically significant correlation with joint extension. The right limbs showed a significantly higher frequency of circumferential femoral head osteophyte (CFHO) regarding radiographic signs. Limbs with CFHO or caudolateral curvilinear osteophyte had significantly larger joint flexion angle (p = 0.02) and smaller extension angle (p<0.01), respectively, compared to those that did not. Age showed a significant correlation with the presence of several radiographic findings, as did different breeds.

Conclusion

Clinical and radiographic signs occur symmetrically in naturally occurring hip OA in police working dogs. Several correlations were observed between the evaluations performed and differences between breeds, which can be useful in assessing and early diagnosis of hip OA.
Low-dose hydralazine during gestation reduces renal fibrosis in rodent offspring exposed to maternal high fat diet
Authors: Larkin Benjamin P. , Saad Sonia , Glastras Sarah J. , Nguyen Long T. , Hou Miao , Chen Hui , Wang Rosy , Pollock Carol A.
Published: March 2021

Background

Maternal high fat diet (HFD) promotes chronic kidney disease (CKD) in offspring. This is in accordance with the theory of fetal programming, which suggests adverse conditions occurring in utero predispose offspring to chronic conditions later in life. DNA methylation has been proposed as a key mechanism by which fetal programming occurs and is implicated in CKD progression. DNA demethylating drugs may interrupt the fetal programming of CKD by maternal obesity. Hydralazine, an antihypertensive agent, demethylates DNA at low doses which do not reduce blood pressure. We used a mouse model of maternal obesity to determine whether gestational administration of low-dose hydralazine to mothers can prevent CKD in offspring.

Methods

C57BL/6 dams received HFD or chow from 6 weeks prior to mating and were administered subcutaneous hydralazine (5mg/kg) or saline thrice weekly during gestation. Male offspring were weaned to chow and were sacrificed at either postnatal week 9 or week 32. Biometric and metabolic parameters, renal global DNA methylation, renal structural and functional changes and markers of fibrosis, oxidative stress and inflammation were measured in offspring at weeks 9 and 32.

Results

In week 9 offspring, maternal HFD consumption did not significantly alter anthropometric or metabolic parameters, or renal global DNA methylation. Week 32 offspring had increased renal global DNA methylation, together with albuminuria, glomerulosclerosis, renal fibrosis and oxidative stress. Administration of low-dose hydralazine to obese mothers during gestation reduced renal global DNA methylation and renal fibrotic markers in week 32 offspring.

Conclusion

Gestational hydralazine reduced renal global DNA methylation in offspring of obese mothers and attenuated maternal obesity-induced renal fibrosis. These data support the use of low-dose hydralazine as a demethylating agent to prevent CKD arising in offspring due to maternal HFD consumption.
Copepods and ostracods associated with bromeliads in the Yucatán Peninsula, Mexico
Authors: Mercado-Salas Nancy F. , Khodami Sahar , Martínez Arbizu Pedro
Published: March 2021

A substantial fraction of the freshwater available in the Neotropical forests is enclosed within the rosettes of bromeliads that form small aquatic islands within a terrestrial landscape. These aquatic oases provide shelter, water, nutrients and resting of aggregation sites for several aquatic organisms, among them crustaceans. However, in comparison with the multitude of studies on open aquatic systems, our knowledge on crustaceans inhabiting semi-terrestrial habitats and phytotelmata is limited and their presence in such environments is poorly understood. The present study was carried out in two natural protected areas of the Yucatán Peninsula aiming to understand the diversity and dispersal strategies of crustaceans living in bromeliads. Sediment and water contained in four species of bromeliads have been collected in order to understand the diversity and dispersal strategies of crustaceans living in such habitats. From a total of 238 bromeliads surveyed, 55% were colonized by crustaceans. Sixteen copepod, three ostracod and one branchiopod species were recorded during this study, however only seven species are considered as true bromeliad inhabitants. Different degrees of association between crustaceans and bromeliad species were assessed with an indicator species analysis, where significant associations were found for all crustaceans. We found significant differences between bromeliad species and reserves and their associated fauna. In order to analyze the genetic diversity of this fauna, we sequenced several individuals of each species with two genetic markers (18S rRNA and COI mtDNA). Bayesian analyses and the Generalized Mixed Yule Coalescent method (GMYC), delimited 7 well supported species. A comparison of the dispersal strategies used by different species, including passive dispersal, phoretic behavior and active dispersal, is included. This study stresses the need of studying meiofauna of phytotelms, which could be used as an indicator of local diversity in Neotropical forests.
Odour of domestic dogs infected with Leishmania infantum is attractive to female but not male sand flies: Evidence for parasite manipulation
Authors: Staniek Monica E. , Hamilton James G. C.
Published: March 2021

Globally visceral leishmaniasis (VL) causes thousands of human deaths every year. In South America, the etiologic agent, Leishmania infantum, is transmitted from an infected canine reservoir to human hosts by the bite of the sand fly vector; predominantly Lutzomyia longipalpis. Previous evidence from model rodent systems have suggested that the odour of infected hosts is altered by the parasite making them more attractive to the vector leading to an increased biting rate and improved transmission prospects for the pathogen. However, there has been no assessment of the effect of Le infantum infection on the attractiveness of dogs, which are the natural reservoirs for human infection. Hair collected from infected and uninfected dogs residing in a VL endemic city in Brazil was entrained to collect the volatile chemical odours present in the headspace. Female and male Lu. longipalpis sand flies were offered a choice of odour entrained from infected and uninfected dogs in a series of behavioural experiments. Odour of uninfected dogs was equally attractive to male or female Lu. longipalpis when compared to a solvent control. Female Lu. longipalpis were significantly more attracted to infected dog odour than uninfected dog odour in all 15 experimental replicates (average 45.7±0.87 females attracted to infected odour; 23.9±0.82 to uninfected odour; paired T-test, P = 0.000). Male Lu. longipalpis did not significantly prefer either infected or uninfected odour (average 36.1±0.4 males to infected odour; 35.7±0.6 to uninfected odour; paired T-test, P = 0.722). A significantly greater proportion of females chose the infected dog odour compared to the males (paired T-test, P = 0.000). The results showed that the odour of dogs infected with Le. infantum was significantly more attractive to blood-seeking female sand flies than it was to male sand flies. This is strong evidence for parasite manipulation of the host odour in a natural transmission system and indicates that infected dogs may have a disproportionate significance in maintaining infection in the canine and human population.
‘The evil of our collective soul’: Zombies, medical capitalism and environmental apocalypse
Authors: Hughes William
Published: March 2021

Though frequently comprehended as a vehicle for social satire or post-cultural speculation, zombie fictions also demonstrably mobilize the climatic unease of the current Anthropocene. Focusing in particular upon Max Brooks’s 2006 novel World War Z: An Oral History of the Zombie War, this article considers the complex politics which have frequently underwritten a mythical origin for pandemics in the Othered East, and their contemporary reproduction in western concerns regarding unregulated surgery and the capitalism of human tissue. The article then proposes that the deterioration of human culture consequent upon the fictional zombie pandemic interrogates the contemporary understanding of integrated nationhood and problematizes the dichotomy structured between geographically stable and refugee populations. The sudden eclipse of the competitive Anthropocene by a mindless Zombicene brings not renewal for a planet no longer supporting agriculture and industry but rather a hastening of perceived environmental collapse, where unregulated hunting and the uncontrolled burning of natural resources accelerate climatic deterioration, imperilling further the survival of residual humanity. As a type of apocalyptic fiction, the zombie narrative thus poses questions with regard to the persistence of conventional human behaviours, even in a post-capitalist environment, where the political concepts structuring nationhood have come to function as little more than a memory.
The zombie in the grey flannel suit: Romero’s classic Dead trilogy and metaphors of mass subjectivity
Authors: Rambukkana Nathan
Published: March 2021

This article explores the relationship between zombies and ‘mass subjectivity’ through examining the motifs, as well as the critical and scholarly reception, of Romero’s classic Dead movies and their successors. Contrasting the ‘fast zombies’ of later films, Romero’s zombies are withered and decayed versions of everyday people: tattered and frayed at the edges, their colours muted, their skin and clothing rendered in greyed-out tones. They are the mundane dead, animated. Romero’s filmic horror taps an uncanny rendering of the everyday. Gardens, streets and malls are made strange by the homogeneous mob progressing in endless lines, murmuring incoherencies and striving to just be. We can locate the visual character of the zombie within a genealogy of metaphors of mass subjectivity such as the man of the crowd, the badaud figure, constantly searching for a place, but symbolically disarticulated. By considering the sometimes comic, sometimes tragic and often horrific Romero zombie in a lineage of visual and literary figures linked to mass subjectivities – the man in the suit, the monstrous man, the man of the crowd, the badaud – this article answers the question: What does thinking about the relationship between the Romero zombie and mass subjectivity enable us to do, think or observe?
Independent dreams, American nightmares: Industrial transgression and critical organization in the work of George A. Romero
Authors: Fallows Tom
Published: March 2021

Film critic Robin Wood categorized George A. Romero as a transgressive genre filmmaker, a director who with films such as Dawn of the Dead offered a consistent, and consistently bloody, attack on the normative social constructs that dominate US culture. Within such advocacy, Wood helped define Romero as a specific cultural type – as a horror film auteur. This article considers Wood’s framing within a wider critical, commercial and industrial context, asking how this ideological analysis became, paradoxically, part of a more conservative organization of Romero. By drawing upon business theory and a media industries methodology, I shed new light on Romero’s efforts to cultivate a boundaryless independent cinema unbeholden to institutional norms, demonstrating challenges to leadership roles, market orientation, financing and genre. While Romero’s typecasting as a horror auteur was ultimately delimiting, I also consider the filmmaker’s complicity in this codification, scrutinizing his knowing attempts to parlay brand-name recognition into a lasting platform for non-Hollywood production. This article offers a unique insight into the industrial and business contexts of horror cinema, revealing a rare intersection between critical reception and industrial navigation while complicating our understanding of both Wood’s seminal writings and one of the genre’s totemic ‘masters’.