bluuebunny/crossref_metadata_2025 huggingface dataset:
Capability, opportunity, and motivation: an across contexts empirical examination of the COM-B model
Authors: Willmott Taylor Jade , Pang Bo , Rundle-Thiele Sharyn
Published: May 2021

Background

There is limited evidence for successful weight gain prevention interventions targeting young adults. Developing effective interventions necessitates a theoretical model that can identify barriers and enablers for healthy eating and physical activity among young adults to support weight management. This study empirically examines the utility of the COM-B model as a framework for intervention planning across two behavioural contexts: eating and physical activity.

Methods

A cross-sectional survey research design was employed to empirically test the COM-B model in the contexts of young adult’s eating and physical activity behaviours. Informed by the Theoretical Domains Framework, pre-validated measures appropriate for capturing the latency of the COM (Capability, Opportunity, and Motivation) constructs were sourced. Both surveys (eating and physical activity) were administered online to two independent samples of young adults aged 18–35 years. Models were specified and tested using structural equation modelling.

Results

A total of 582 (mean age = 22.8 years; 80.3% female) and 455 (mean age = 24.9 years; 80.8% female) participants were included in the physical activity and eating analyses, respectively. The COM-B model explained 31% of variance in physical activity behaviour and 23% of variance in eating behaviour. In the physical activity model (N = 582), capability and opportunity were found to be associated with behaviour through the mediating effect of motivation. In the eating model (N = 455), capability was found to be associated with behaviour through the mediating effect of motivation. Capability was also found to mediate the association between opportunity and motivation. Consistencies and variations were observed across both models in terms of COM indicators.

Conclusions

Findings support the COM-B model’s explanatory potential in the context of young adult’s physical activity and eating behaviours. Barriers and enablers underlying young adult’s physical activity and eating behaviours were identified that represent potential targets for future intervention design. Further research is needed to validate present study findings across different populations and settings.
A qualitative analysis of the perceived socio-cultural contexts and health concerns of sugar-sweetened beverages among adults studying or working at a post-secondary institution in Dharwad, India
Authors: Riediger Natalie , Dhalla Anika , Cooper Maureen , Bombak Andrea , Sreeramaiah Hemalatha
Published: May 2021

Background

We sought to explore the perceptions of the socio-cultural contexts and health concerns of consuming sugar-sweetened beverages (SSB) among Indian adults working or studying at a post-secondary institution in Karnataka, India.

Methods

We completed a qualitative study, including 24 semi-structured interviews between 2017 and 2018 at the University of Agricultural Sciences, Dharwad, Karnataka, India. Data were analyzed using thematic content analysis.

Results

One over-arching theme emerged,westernization and changing perceptions of food, sugar, and health. Participants discussed SSB and associated health concerns in the broad context of westernization and overall economic development in India. Three sub-themes regarding the health perceptions of consuming SSB were:healthy drinks are clean and natural;hydration and energy;andmoderation and body weight. Hygienically-prepared beverages were a consistent concern among participants. Juices and beverages, such as tea or coffee, sweetened with jaggery were viewed positively due to their naturalness and lack of processed sugar. Participants perceived SSB as providing hydration and energy, particularly in hot weather. Lastly, if consumed in moderation, SSB were thought to have no direct adverse health consequences. Though some participants noted excessive, ‘addictive’ consumption would contribute to weight gain and diabetes.

Conclusion

Perceived health concerns of SSB reflect dominant health issues in India, namely, food insecurity, food safety, and increasingly, diabetes. Policymakers tend to prioritize acute challenges over long-term concerns. As such, the capacity of any policy to address chronic nutritional concerns related to SSB are likely to be muted in the absence of improvements to food safety and security.
Delineating patterns of sexualized substance use and its association with sexual and mental health outcomes among young gay, bisexual and other men who have sex with men in Singapore: a latent class analysis
Authors: Tan Rayner Kay Jin , O’Hara Caitlin Alsandria , Koh Wee Ling , Le Daniel , Tan Avin , Tyler Adrian , Tan Calvin , Kwok Chronos , Banerjee Sumita , Wong Mee Lian
Published: May 2021

Background

Young gay, bisexual, and other men who have sex with men (YMSM) are vulnerable to the risks associated with sexualized substance use. This is a novel study in Singapore that aims to classify patterns of sexualized substance use among YMSM, and investigate its association with sexual and mental health outcomes.

Methods

In this cross-sectional study among 570 YMSM aged 18 to 25 years old, latent class analysis (LCA) conducted to identify classes with similar patterns of sexualized substance use, across which measures of inconsistent condom use, recent STI diagnoses, past suicide ideation and depression severity were compared.

Results

LCA revealed three classes of YMSM based on types of substances ever used in sexualized contexts, which we labelled as ‘substance-naive’, ‘substance-novice’, and ‘chemsex’. Substance-naive participants (n = 404) had only ever used alcohol, while substance-novice participants (n = 143) were primarily amyl nitrite users with a small proportion who reported using chemsex-related drugs. Chemsex participants (n = 23) comprised individuals who had mostly used such drugs. Those in the chemsex group were more likely to report recent unprotected anal sex with casual partners (aPR = 3.28, 95%CI [1.85, 5.79]), depression severity (aβ = 3.69, 95%CI [0.87, 6.51]) and a history of suicide ideation (aPR = 1.64, 95%CI [1.33, 2.03]).

Conclusions

Findings of this study highlight how the use of varying substances in sexualized contexts may be classified and characterized by different sexual and mental health outcomes. Health promotion efforts should be differentiated accordingly to address the risks associated with sexualized substance use among YMSM.
Individual, family, and community factors related to loneliness in mothers raising children less than 3 years of age: a cross-sectional study
Authors: Arimoto Azusa , Tadaka Etsuko
Published: May 2021

Background

Loneliness in mothers raising children under 3 years of age is a major challenge. The purpose of this study was to identify the individual, family, and community factors associated with loneliness among mothers raising children under 3 years of age with social isolation as a mediator.

Methods

A cross-sectional survey was conducted using anonymous self-administered questionnaires. The target population was all 649 mothers of children under 3 years of age visiting a public health center in Yokohama City and eligible for child health examinations between November 2019 and February 2020. The study measures included loneliness (10-item version of the UCLA Loneliness Scale), social isolation (Lubben Social Network Scale [LSNS-6]), demographic data, individual factors, family factors, and community factors from an ecological systems model. Social isolation was classified based on the LSNS-6 cutoff points. Multiple regression analysis was conducted to examine the association between loneliness and individual, family, and community factors with social isolation as a mediator.

Results

A total of 531 participants (81.8% response rate) responded, and 492 (75.8% valid response rate) were included in the analysis. Loneliness was significantly higher in the isolated group (n = 171, 34.8%) than in the non-isolated group (n = 321, 65.2%) (mean = 22.3,SD = 5.6 and mean = 17.6,SD = 4.6, respectively). Factors associated with high loneliness included individual and family factors (a high number of parenting and life concerns [β = 0.211,p < 0.01], not eating breakfast every day [β = 0.087,p < 0.05], and fewer partners’ supportive behaviors for household duties and childcare [β =  − 0.240,p < 0.001]) and community factors (fewer people to consult about parenting [β =  − 0.104,p < 0.01] and low community commitment [β =  − 0.122,p < 0.05]) with social isolation as a mediator.

Conclusion

Referral to a counseling organization to alleviate worries about parenting and the creation of a child-rearing environment to enhance the recognition of the community may be considered. These findings could help develop intervention programs for the prevention or alleviation of loneliness experienced by mothers and prevent the associated health risks among mothers and child outcomes.
Development and validation of a Nurse Station Ergonomics Assessment (NSEA) tool
Authors: Mokarami Hamidreza , Eskandari Sahar , Cousins Rosanna , Salesi Mahmood , Kazemi Reza , Razeghi Mohsen , Choobineh Alireza
Published: May 2021

Background

Nurse stations are one of the primary units for supporting effective functioning of any hospital. They are important working environments that demand adherence to known ergonomic principles for the well-being of both staff and patients. The aim of this study was to develop a psychometrically tested tool for the assessment of the ergonomic conditions of nurse workstations in hospitals.

Methods

Ten hospitals, with a total of 133 nurse stations participated in this mixed-methods research. The domains and items of the tool were developed based on a literature review, an experts’ panel, and interviews with nurses.

Results

The final nurse station ergonomic assessment (NSEA) tool has good psychometric properties. Validity was assessed by face validity and content validity. Reliability was evaluated using inter-rater agreement and test-retest reliability analyses with a four-week interval between assessments. The NSEA is comprised of 64 items across eight domains: layout and location (7 items), workspace (11 items), security-safety (5 items), environmental conditions (8 items), counter (8 items), chair (13 items), desk (9 items), and monitor (3 items).

Conclusions

The NSEA adds to the literature a tool for managers to ensure they comply with legal requirements and support best practice for those working on hospital wards. The NSEA can be used to identify challenges for healthcare professionals who use nurse stations and support the execution of targeted interventions to improve human-environment interactions.
Examining the average scores of nursing teamwork subscales in an acute private medical ward
Authors: Costello Martina , Rusell Kylie , Coventry Tracey
Published: May 2021

Background

Healthcare is delivered by multidisciplinary healthcare teams who rely on communication and effective teamwork to ensure safe patient care. Teamwork builds on employee cohesion and reduces medical and nursing errors, resulting in greater patient satisfaction and improved healthcare. Effective teamwork not only improves efficiency and patient safety but leads to a healthier and happier workplace, reducing burnout among healthcare professionals. The purpose of this paper is to describe the findings of a pilot project on an acute medical ward in Western Australia. The aim was to understand the participants perceived level of teamwork to support future work practices and ultimately patient care.

Methods

This study used a descriptive survey research method to measure nursing teamwork in a clinical environment. The Nursing Teamwork Survey(NTS)measures the levels of nursing teamwork in acute healthcare facilities. Items for the NTS were generated on theoretical grounds, based on teamwork behaviours, offering a practical explanation of teamwork dynamics.

Results

The survey incorporated five subscales. The response rate to the survey was 90 % (n = 45) with an overall average result on the survey being (m = 2.97) on a 0–4 Likert scale. The validated NTS has provided participants the opportunity to consider nursing teamwork with regards to their position and perceived responsibilities towards patients and team members.

Conclusion

The findings highlight areas for consolidation and improvement in teamwork. Introducing teambuilding strategies and acting on results of this survey may support enhanced communication and teamwork influencing nursing care and patient outcomes. Findings recommend that activities to improve teamwork and ensuring teambuilding strategies are implemented to improve effective communication in an acute medical care setting would have significant impacts on staff satisfaction.
The impact of work-place social capital in hospitals on patient-reported quality of care: a cohort study of 5205 employees and 23,872 patients in Denmark
Authors: Clark Alice , Prætorius Thim , Török Eszter , Hvidtfeldt Ulla Arthur , Hasle Peter , Rod Naja Hulvej
Published: May 2021

Background

Decision-makers increasingly consider patient-reported outcomes as important measures of care quality. Studies on the importance of work-place social capital–a collective work-place resource–for the experience of care quality are lacking. We determined the association between the level of work-place social capital and patient-reported quality of care in 148 hospital sections in the Capital Region of Denmark.

Methods

This cross-sectional study combined section-level social capital from 5205 health care professionals and 23,872 patient responses about care quality. Work-place social capital encompassed three dimensions: trust, justice and collaboration. Patient-reported quality of care was measured as: overall satisfaction, patient involvement, and medical errors. Linear regression analysis and generalized linear models assessed the mean differences in patient reported experience outcomes and the risk of belonging to the lowest tertile of care quality.

Results

A higher level of work-place social capital (corresponding to the interquartile range) was associated with higher patient-reported satisfaction and inpatient and acute care patient involvement. The risk of a section belonging to the lowest tertile of patient involvement was lower in sections with higher social capital providing inpatient (RR = 0.39, 0.19–0.81 per IQR increase) and acute care (RR = 0.53, 0.31–0.89). Patient-reported errors were fewer in acute care sections with higher social capital (RR = 0.65, 0.43 to 0.99). The risk of being in the lowest tertile of patient-reported satisfaction was supported for acute care sections (RR = 0.47, 0.28–0.79).

Conclusions

Although we found small absolute differences in the association between patient-reported experience measures and social capital, even a small upward shift in the distribution of social capital in the hospital sector would, at the population level, have a large positive impact on patients’ care experience.
Trends and determinants of catastrophic health expenditure in China 2010–2018: a national panel data analysis
Authors: Liu Cai , Liu Zhao-min , Nicholas Stephen , Wang Jian
Published: May 2021

Background

Catastrophic health expenditures (CHE) are out-of-pocket payments (OOP) that exceed a predefined percentage or threshold of a household’s resources, usually 40 %, that can push households into poverty in China. We analyzed the trends in the incidence and intensity, and explored the determinants, of CHE, and proposed policy recommendation to address CHE.

Methods

A unique 5-year national urban-rural panel database was constructed from the China Family Panel Studies (CFPS) surveys. CHE incidence was measured by calculating headcount (percentage of households incurring CHE to the total household sample) and intensity was measured by overshoot (degree by which an average out of pocket health expenditure exceeds the threshold of the total sample). A linear probability model was employed to assess the trend in the net effect of the determinants of CHE incidence and a random effect logit model was used to analyse the role of the characteristics of the household head, the household and household health utilization on CHE incidence.

Results

CHE determinants vary across time and geographical location. From 2010 to 2018, the total, urban and rural CHE incidence all showed a decreasing tend, falling from 14.7 to 8.7 % for total households, 12.5–6.6 % in urban and 16.8–10.9 % in rural areas. CHE intensity decreased in rural (24.50–20.51 %) and urban (22.31–19.57 %) areas and for all households (23.61–20.15 %). Inpatient services were the most important determinant of the incidence of CHE. For urban households, the random effect logit model identified household head (age, education, self-rated health); household characteristics (members 65 + years, chronic diseases, family size and income status); and healthcare utilization (inpatient and outpatient usage) as determinants of CHE. For rural areas, the same variables were significant with the addition of household head’s sex and health insurance.

Conclusions

The incidence and intensity of CHE in China displayed a downward trend, but was higher in rural than urban areas. Costs of inpatient service usage should be a key intervention strategy to address CHE. The policy implications include improving the economic level of poor households, reforming health insurance and reinforcing pre-payment hospital insurance methods.
The association between opening a short stay paediatric assessment unit and trends in short stay hospital admissions
Authors: Turner Steve , Raja Edwin-Amalraj
Published: May 2021

Background

Many inpatient facilities in Scotland have opened short stay paediatric assessment units (SSPAU) which are clinical areas separate from the usual inpatient ward area and these are where most short stay (also called zero day) admissions are accommodated. Here we describe the effect of opening short stay paediatric assessment units (SSPAU) on the proportion of zero day admissions relative to all emergency admissions.

Methods

Details of all emergency medical paediatric admissions to Scottish hospitals between 2000 and 2013 were obtained, including the number of zero day admissions per month and health board (i.e. geographic region). The month and year that an SSPAU opened in each health board was provided by local clinicians.

Results

SSPAUs opened in 7 health boards, between 2004 and 2012. Health boards with an SSPAU had a slower rise in zero day admissions compared to those without SSPAU (0.6% per month [95% CI 0.04, 0.09]. Across all 7 health boards, opening an SSPAU was associated with a 13% [95% CI 10, 15] increase in the proportion of zero day admissions. When considered individually, zero day admissions rose in four health boards after their SSPAU opened, were unchanged in one and fell in two health boards. Independent of SSPAUs opening, there was an increase in the proportion of all admissions which were zero day admissions (0.1% per month), and this accelerated after SSPAUs opened.

Conclusion

Opening an SSPAU has heterogeneous outcomes on the proportion of zero day admissions in different settings. Zero day admissions could be reduced in some health boards by understanding differences in clinical referral pathways between health boards with contrasting trends in zero day admissions after their SSPAU opens.
Elastosonographic features of the metacarpophalangeal joint capsule in horses
Authors: Straticò Paola , Guerri Giulia , Palozzo Adriana , Di Francesco Paola , Vignoli Massimo , Varasano Vincenzo , Petrizzi Lucio
Published: May 2021

Background

Capsulitis leads to the release of inflammatory mediators in the joint, causing capsular fibrosis and osteoarthritis (OA). Strain elastosonography (SE) measures the elasticity of tissue by evaluating its strain in operator-dependent deformation. The aims of the study were to assess the feasibility, repeatability, and reproducibility of SE for imaging the distal attachment of the joint capsule (DJC) of metacarpophalangeal joints in sound horses (Group S) and in horses with metacarpophalangeal OA (Group P) and to evaluate differences in the elastosonographic patterns of these horses. After a whole lameness examination, fore fetlock DJCs were assigned to Group S and Group P and were thereafter examined by two operators using SE. Qualitative (i.e., colour grading score) and semi-quantitative (i.e., elasticity index (EI) and strain ratio (SR)) methods were used to evaluate the elastograms. The inter-rater reliability (IRR), intraclass correlation coefficient (intra-CC) and interclass correlation coefficient (inter-CC) were used to compare colour grading scores and the repeatability and reproducibility of EI and SR outcomes. The same parameters were compared between groups. P < 0.05 indicated a significant finding.

Results

Forty-one horses were included: 11 were in Group S and 30 were in Group P (16 with bilateral OA, 8 with left OA and 6 with right OA). IRR outcomes ranged from good to excellent. For transverse and longitudinal ultrasound scans, the colour grading score of Group S was significantly higher than the metacarpophalangeal DJCs of Group P. Both Inter-CC and intra-CC were higher in Group S than in Group P, with values always > 0.8. Significative differences in EI and SR were detected between groups and between Group S and the affected limb of Group P; values were lower in Group S than in Group P.

Conclusions

SE can be a useful technique for evaluating DJCs, with good repeatability and reproducibility. DJCs appear softer in sound horses.
Exonic variants undergoing allele-specific selection in cancers
Authors: Li Qiyuan , Zeng Yuanyuan , Wang Janet , Fang Hongkun , Guo Jintao , Yu Liying , Zhong Taoling , Xu Chaoqun , Freedman Matthew , LaFramboise Thomas
Published: May 2021

Background

Allelic imbalance (AI) in tumors is caused by chromosomal and sub-chromosomal gains and losses.

Results

We evaluated AI at 109,086 germline exonic SNP loci in four cancer types, and identified a set of SNPs that demonstrate strong tumor allele specificity in AI events. Further analyses demonstrated that these alleles show consistently different frequencies in the cancer population compared to the healthy population and are significantly enriched for predicted protein-damaging variants. Moreover, genes harboring SNPs that demonstrate allele specificity are enriched for cancer-related biological processes and are more likely to be essential in cancer cells.

Conclusions

In summary, our study provides a unique and complementary method to identify genes and variants that are relevant to carcinogenesis.
Correction to: The association between variants in PLA2R and HLA-DQA1 and renal outcomes in patients with primary membranous nephropathy in Western China
Authors: Fan Shulei , Wang Qiuxia , Wang Amanda Y. , Zhang Ping , Zhong Xiang , Chen Shasha , Li Guisen , Wang Li , Wang Wei
Published: May 2021

An amendment to this paper has been published and can be accessed via the original article.
The TRIB3 R84 variant is associated with increased left ventricular mass in a sample of 2426 White individuals
Authors: Mannino Gaia Chiara , Averta Carolina , Fiorentino Teresa Vanessa , Succurro Elena , Spiga Rosangela , Mancuso Elettra , Miceli Sofia , Perticone Maria , Sciacqua Angela , Andreozzi Francesco , Sesti Giorgio
Published: May 2021

Background

Prior studies in animal models showed that increased cardiac expression of TRIB3 has a pathogenic role in inducing left ventricular mass (LVM). Whether alterations in TRIB3 expression or function have a pathogenic role in inducing LVM increase also in humans is still unsettled. In order to address this issue, we took advantage of a nonsynonymous TRIB3 Q84R polymorphism (rs2295490), a gain-of-function amino acid substitution impairing insulin signalling, and action in primary human endothelial cells which has been associated with insulin resistance, and early vascular atherosclerosis.

Methods

SNP rs2295490 was genotyped in 2426 White adults in whom LVM index (LVMI) was assessed by validated echocardiography-derived measures.

Results

After adjusting for age and sex, LVMI progressively and significantly increased from 108 to 113, to 125 g/m2 in Q84Q, Q84R, and R84R individuals, respectively (Q84R vs. Q84Q, P = 0.03; R84R vs. Q84Q, P < 0.0001). The association between LVMI and the Q84R and R84R genotype remained significant after adjusting for blood pressure, smoking habit, fasting glucose levels, glucose tolerance status, anti-hypertensive treatments, and lipid-lowering therapy (Q84R vs. Q84Q, P = 0.01; R84R vs. Q84Q, P < 0.0001).

Conclusions

We found that the gain-of-function TRIB3 Q84R variant is significantly associated with left ventricular mass in a large sample of White nondiabetic individual of European ancestry.
Determinants of the varied profiles of Plasmodium falciparum infections among infants living in Kintampo, Ghana
Authors: Botwe Akua Kyerewaa , Oppong Felix Boakye , Gyaase Stephaney , Owusu-Agyei Seth , Asghar Muhammad , Asante Kwaku Poku , Färnert Anna , Osier Faith
Published: May 2021

Background

Understanding why some infants tolerate infections, remaining asymptomatic while others succumb to repeated symptomatic malaria is beneficial for studies of naturally acquired immunity and can guide control interventions. This study compared demographic, host and maternal factors associated with being either parasite negative or having asymptomatic infections versus developing symptomatic malaria in the first year of life.

Methods

A birth cohort (n = 1264) was monitored longitudinally over two years for malaria infections in Kintampo, Ghana. Symptomatic and asymptomatic infections were detected actively through monthly home visits, complemented by passive case detection. Light microscopy was used to detect parasitaemia. Based on data from a minimum of eight monthly visits within the first year of life, infants were classified into one of four groups: “parasite negative”, “only-asymptomatic”, “only-symptomatic” or “alternating” i.e., sometimes symptomatic and other times asymptomatic. The host and maternal characteristics and demographic factors in relation to these four groups were compared.

Results

The parasite negative group formed 36% of the cohort, whilst the only-symptomatic were 35%. The alternating group were 22% and the only-asymptomatic were 7% of the cohort. There were significant associations between residence, socio-economic status (SES), parity, IPTp doses, delivery place of infant and having or not having malaria parasites. Maternal factors such as early commencement and frequency of ante-natal care (ANC) were significantly higher in the parasite negative group compared to all others. ITN use in pregnancy increased the odds of infant having only asymptomatic infections (“protected against disease”). Placental malaria was more common in the groups of infants with symptomatic malaria. Urban residence was significantly higher in the parasite negative group, while birth in the malaria transmission season were significantly more common in the alternating and parasite negative groups. Risk factors for infants with symptomatic malaria included low SES, birth in private maternity homes, sickle cell normal variant, lower MUAC, reported intake of anti-malarials and increased morbidity before the first microscopic infection was detected.

Conclusion

Strengthening ANC by encouraging early and regular attendance, the use of IPTp, maternal bed nets and improving the nourishment of infants help reduce the frequency of symptomatic malaria over the first year of life.
Genetic diversity and genetic relatedness in Plasmodium falciparum parasite population in individuals with uncomplicated malaria based on microsatellite typing in Eastern and Western regions of Uganda, 2019–2020
Authors: Agaba Bosco B. , Anderson Karen , Gresty Karryn , Prosser Christiane , Smith David , Nankabirwa Joaniter I. , Nsobya Sam , Yeka Adoke , Namubiru Rhoda , Arinaitwe Emmanuel , Mbaka Paul , Kissa John , Lim Chae Seung , Karamagi Charles , Nakayaga Joan K. , Kamya Moses R. , Cheng Qin
Published: May 2021

Background

Genetic diversity and parasite relatedness are essential parameters for assessing impact of interventions and understanding transmission dynamics of malaria parasites, however data on its status in Plasmodium falciparum populations in Uganda is limited. Microsatellite markers and DNA sequencing were used to determine diversity and molecular characterization of P. falciparum parasite populations in Uganda.

Methods

A total of 147 P. falciparum genomic DNA samples collected from cross-sectional surveys in symptomatic individuals of 2–10 years were characterized by genotyping of seven highly polymorphic neutral microsatellite markers (n = 85) and genetic sequencing of the Histidine Rich Protein 2 (pfhrp2) gene (n = 62). ArcGIS was used to map the geographical distribution of isolates while statistical testing was done using Student's t-test or Wilcoxon's rank-sum test and Fisher’s exact test as appropriate at P ≤ 0.05.

Results

Overall, 75.5% (95% CI 61.1–85.8) and 24.5% (95% CI14.2–38.9) of parasites examined were of multiclonal (mixed genotype) and single clone infections, respectively. Multiclonal infections occurred more frequently in the Eastern region 73.7% (95% CI 48.8–89.1), P < 0.05. Overall, multiplicity of infection (MOI) was 1.9 (95% CI 1.7–2.1), P = 0.01 that was similar between age groups (1.8 vs 1.9), P = 0.60 and regions (1.9 vs 1.8), P = 0.43 for the < 5 and ≥ 5 years and Eastern and Western regions, respectively. Genomic sequencing of the pfhrp2 exon2 revealed a high level of genetic diversity reflected in 96.8% (60/62) unique sequence types. Repeat type AHHAAAHHATD and HRP2 sequence Type C were more frequent in RDT−/PCR + samples (1.9% vs 1.5%) and (13% vs 8%), P < 0.05 respectively. Genetic relatedness analysis revealed small clusters of gene deleted parasites in Uganda, but no clustering with Eritrean parasites.

Conclusion

High level of genetic diversity of P. falciparum parasites reflected in the frequency of multiclonal infections, multiplicity of infection and variability of the pfhrp2 gene observed in this study is consistent with the high malaria transmission intensity in these settings. Parasite genetic analysis suggested spontaneous emergence and clonal expansion of pfhrp2 deleted parasites that require close monitoring to inform national malaria diagnosis and case management policies.
Luteolin transforms the polarity of bone marrow-derived macrophages to regulate the cytokine storm
Authors: Wang Shuxia , Xu Shuhang , Zhou Jing , Zhang Li , Mao Xiaodong , Yao Xiaoming , Liu Chao
Published: May 2021

Background

Macrophages are indispensable regulators of inflammatory responses. Macrophage polarisation and their secreted inflammatory factors have an association with the outcome of inflammation. Luteolin, a flavonoid abundant in plants, has anti-inflammatory activity, but whether luteolin can manipulate M1/M2 polarisation of bone marrow-derived macrophages (BMDMs) to suppress inflammation is still unclear. This study aimed to observe the effects of luteolin on the polarity of BMDMs derived from C57BL/6 mice and the expression of inflammatory factors, to explore the mechanism by which luteolin regulates the BMDM polarity.

Methods

M1-polarised BMDMs were induced by lipopolysaccharide (LPS) + interferon (IFN)-γ and M2-polarisation were stimulated with interleukin (IL)-4. BMDM morphology and phagocytosis were observed by laser confocal microscopy; levels of BMDM differentiation and cluster of differentiation (CD)11c or CD206 on the membrane surface were assessed by flow cytometry (FCM); mRNA and protein levels of M1/M2-type inflammatory factors were performed by qPCR and ELISA, respectively; and the expression of p-STAT1 and p-STAT6 protein pathways was detected by Western-blotting.

Results

The isolated mouse bone marrow cells were successfully differentiated into BMDMs, LPS + IFN-γ induced BMDM M1-phenotype polarisation, and IL-4 induced M2-phenotype polarisation. After M1-polarised BMDMs were treated with luteolin, the phagocytosis of M1-polarized BMDMs was reduced, and the M1-type pro-inflammatory factors including IL-6, tumour necrosis factor (TNF)-α, inducible nitric oxide synthase (iNOS), and CD86 were downregulated while the M2-type anti-inflammatory factors including IL-10, IL-13, found in inflammatory zone (FIZZ)1, Arginase (Arg)1 and CD206 were upregulated. Additionally, the expression of M1-type surface marker CD11c decreased. Nevertheless, the M2-type marker CD206 increased; and the levels of inflammatory signalling proteins phosphorylated signal transducer and activator of transcription (p-STAT)1 and p-STAT6 were attenuated and enhanced, respectively.

Conclusions

Our study suggests that luteolin may transform BMDM polarity through p-STAT1/6 to regulate the expression of inflammatory mediators, thereby inhibiting inflammation. Naturally occurring luteolin holds promise as an anti-inflammatory and immunomodulatory agent.
Reactive oxygen species scavenging and inflammation mitigation enabled by biomimetic prussian blue analogues boycott atherosclerosis
Authors: Zhang Yan , Yin Yifei , Zhang Wei , Li Hongyan , Wang Taixia , Yin Haohao , Sun Liping , Su Chunxia , Zhang Kun , Xu Huixiong
Published: May 2021

Background

As one typical cardiovascular disease, atherosclerosis severely endanger people’ life and cause burden to people health and mentality. It has been extensively accepted that oxidative stress and inflammation closely correlate with the evolution of atherosclerotic plaques, and they directly participate in all stages of atherosclerosis. Regarding this, anti-oxidation or anti-inflammation drugs were developed to enable anti-oxidative therapy and anti-inflammation therapy against atherosclerosis. However, current drugs failed to meet clinical demands.

Methods

Nanomedicine and nanotechnology hold great potential in addressing the issue. In this report, we engineered a simvastatin (Sim)-loaded theranostic agent based on porous manganese-substituted prussian blue (PMPB) analogues. The biomimetic PMPB carrier could scavenge ROS and mitigate inflammation in vitro and in vivo. Especially after combining with Sim, the composite Sim@PMPB NC was expected to regulate the processes of atherosclerosis. As well, Mn2+release from PMPB was expected to enhance MRI.

Results

The composite Sim@PMPB NC performed the best in regulating the hallmarks of atherosclerosis with above twofold decreases, typically such as oxidative stress, macrophage infiltration, plaque density, LDL internalization, fibrous cap thickness and foam cell birth, etc.Moreover, H2O2-induced Mn2+release from PMPB NC in atherosclerotic inflammation could enhance MRI for visualizing plaques. Moreover, Sim@PMPB exhibited high biocompatibility according to references and experimental results.

Conclusions

The biomimetic Sim@PMPB theranostic agent successfully stabilized atherosclerotic plaques and alleviated atherosclerosis, and also localized and magnified atherosclerosis, which enabled the monitoring of H2O2-associated atherosclerosis evolution after treatment. As well, Sim@PMPB was biocompatible, thus holding great potential in clinical translation for treating atherosclerosis.

Graphic abstract
Development and validation of a guideline on sexual and reproductive health of breast cancer survivors in Iran: a mixed methods study protocol
Authors: Roshandel Solmaz , Lamyian Minoor , Azin Seyed Ali , Haghighat Shahpar , Mohammadi Eesa
Published: May 2021

Background

Sexual and reproductive health problems significantly decrease quality of life in survivors of breast cancer. The best approach is to provide services according to evidence-based guidelines developed based on their practical context. Here, we aim to develop and validate a guideline on the sexual and reproductive health of breast cancer survivors in Iran.

Methods

The guideline will be developed and validated using an exploratory sequential mixed methods approach in three phases: (1) describing sexual and reproductive health needs of survivors of breast cancer in Iran and the health services they receive in this regard, (2) performing a systematic review of existing guidelines, resources, and documents on the sexual and reproductive health of breast cancer survivors worldwide, and (3) developing and validating a guideline on the sexual and reproductive health of women who survived breast cancer in Iran based on the results of phases 1 and 2 through multiple steps.

Discussion

A comprehensive and practical guideline on the sexual and reproductive health of breast cancer survivors in Iran will be developed which will be compatible with their specific needs and culture, considering the limited resources available. This guideline can significantly improve the quality of life in breast cancer survivors in Iran. In addition, the approach we will use here can be utilized to develop guidelines on sexual and reproductive health of female cancer survivors in general.
Comparative analysis of spatial-temporal patterns of human metapneumovirus and respiratory syncytial virus in Africa using genetic data, 2011–2014
Authors: Oketch John W. , Kamau Everlyn , Otieno James R. , Mwema Anthony , Lewa Clement , Isoe Everlyne , Nokes D. James , Agoti Charles N.
Published: May 2021

Background

Human metapneumovirus (HMPV) and respiratory syncytial virus (RSV) are leading causes of viral severe acute respiratory illnesses in childhood. Both the two viruses belong to the Pneumoviridae family and show overlapping clinical, epidemiological and transmission features. However, it is unknown whether these two viruses have similar geographic spread patterns which may inform designing and evaluating their epidemic control measures.

Methods

We conducted comparative phylogenetic and phylogeographic analyses to explore the spatial-temporal patterns of HMPV and RSV across Africa using 232 HMPV and 842 RSV attachment (G) glycoprotein gene sequences obtained from 5 countries (The Gambia, Zambia, Mali, South Africa, and Kenya) between August 2011 and January 2014.

Results

Phylogeographic analyses found frequently similar patterns of spread of RSV and HMPV. Viral sequences commonly clustered by region, i.e., West Africa (Mali, Gambia), East Africa (Kenya) and Southern Africa (Zambia, South Africa), and similar genotype dominance patterns were observed between neighbouring countries. Both HMPV and RSV country epidemics were characterized by co-circulation of multiple genotypes. Sequences from different African sub-regions (East, West and Southern Africa) fell into separate clusters interspersed with sequences from other countries globally.

Conclusion

The spatial clustering patterns of viral sequences and genotype dominance patterns observed in our analysis suggests strong regional links and predominant local transmission. The geographical clustering further suggests independent introduction of HMPV and RSV variants in Africa from the global pool, and local regional diversification.
miR-520c-3p regulates IL-1β-stimulated human chondrocyte apoptosis and cartilage degradation by targeting GAS2
Authors: Peng Le , Deng Ming , Ma Yonggang , Hu Wei , Liang Fan
Published: May 2021

Background

MicroRNAs (miRNAs) have been shown to be associated with osteoarthritis (OA) progression. This study aimed to explore the role of miR-520c-3p in OA progression.

Methods

Expression levels of miR-520c-3p and Growth arrest-specific 2 (GAS2) were detected using quantitative real-time PCR. The proliferation and apoptosis of cells were measured using cell counting kit 8 (CCK8) assay and flow cytometry. Furthermore, the protein levels of apoptosis-related markers, extracellular degradation markers, inflammatory response markers, and GAS2 were tested using quantitative real-time polymerase chain reaction (RT-PCR) and western blot (WB) analysis. In addition, the interaction between miR-520c-3p and GAS2 was examined using dual luciferase reporter assay.

Results

GAS2 was highly expressed, and miR-520c-3p was lowly expressed in OA cartilage tissues. miR-520c-3p could promote the proliferation and inhibit the apoptosis and inflammation of OA chondrocytes. miR-520c-3p could be sponged by GAS2, and its inhibitor could reverse the regulation of GAS2 on the biological functions of OA chondrocytes. GAS2 was a target of miR-520c-3p, which was identified by bioinformatic analysis and dual-luciferase reporter assay. Overexpression of GAS2 could inhibit the proliferation and promoted the apoptosis and inflammation of OA chondrocytes.

Conclusion

Our data showed that miR-520c-3p might regulate the GAS2 to inhibit the progression of OA.
Potential predictors of severe cardiovascular involvement in Marfan syndrome: the emphasized role of genotype–phenotype correlations in improving risk stratification—a literature review
Authors: Stengl Roland , Ágg Bence , Pólos Miklós , Mátyás Gábor , Szabó Gábor , Merkely Béla , Radovits Tamás , Szabolcs Zoltán , Benke Kálmán
Published: May 2021

Background

Marfan syndrome (MFS) is a genetically determined systemic connective tissue disorder, caused by a mutation in the FBN1 gene. In MFS mainly the cardiovascular, musculoskeletal and ocular systems are affected. The most dangerous manifestation of MFS is aortic dissection, which needs to be prevented by a prophylactic aortic root replacement.

Main body

The indication criteria for the prophylactic procedure is currently based on aortic diameter, however aortic dissections below the threshold defined in the guidelines have been reported, highlighting the need for a more accurate risk stratification system to predict the occurrence of aortic complications. The aim of this review is to present the current knowledge on the possible predictors of severe cardiovascular manifestations in MFS patients, demonstrating the wide range of molecular and radiological differences between people with MFS and healthy individuals, and more importantly between MFS patients with and without advanced aortic manifestations. These differences originating from the underlying common molecular pathological processes can be assessed by laboratory (e.g. genetic testing) and imaging techniques to serve as biomarkers of severe aortic involvement. In this review we paid special attention to the rapidly expanding field of genotype–phenotype correlations for aortic features as by collecting and presenting the ever growing number of correlations, future perspectives for risk stratification can be outlined.

Conclusions

Data on promising biomarkers of severe aortic complications of MFS have been accumulating steadily. However, more unifying studies are required to further evaluate the applicability of the discussed predictors with the aim of improving the risk stratification and therefore the life expectancy and quality of life of MFS patients.
Legacies of humanitarian neglect: long term experiences of children who returned from the Lord’s Resistance Army in Uganda
Authors: Parker Melissa , Fergus Cristin A. , Brown Charlotte , Atim Dorothy , Ocitti James , Atingo Jackline , Allen Tim
Published: May 2021

Background

Much has been written about the short-term challenges facing children returning ‘home’ from rebel fighting groups, but little is known about the longer term day to day realities of return. This article presents findings from the first long-term assessment of the social and economic challenges facing an officially registered group of children who passed through an internationally-financed reception centre after a period of time with the Lord’s Resistance Army (LRA).

Methods

Records from a reception centre were used to trace a random sample of individuals to their current location. Two hundred and thirty in-depth semi-structured interviews were carried out and 40 follow-up interviews between 2013 and 2016.Interviews were informed by long-term ethnographic research in the region. These interviews were subsequently coded and analysed to describe the long-term day to day realities of return.

Results

At the time of interview, 90% of formerly abducted people returned ‘home’ six or more years ago, and 75% returned nine or more years ago. The majority have managed to access family land for farming, but concerns about what they may have done to survive whilst living with the LRA adversely affects their day-to-day lives. However, some important differences were noted: those men and women who spent less time with the LRA are more likely to live on ancestral land with close relatives; and they are more likely to report experiencing stigma and a spiritual affliction called ‘cen’. In contrast, those who spent the longest time with the LRA are less likely to report these problems, they are mainly living in urban locations and tend to manage slightly better. Children born of war are vulnerable to abuse, irrespective of current residence.

Conclusions

Research findings question the merits of post-conflict reintegration programmes emphasising immediate family reunifications, without follow-up monitoring, social protection, education and skills training. By overlooking the diverse experiences of those who lived and fought with the LRA, and failing to anticipate or respond to the long term socio-political and economic challenges facing children on their return, reception centre processes not only failed to foster social reintegration, but they also inadvertently exacerbated the vulnerability of returning children.
Oleaginous yeasts respond differently to carbon sources present in lignocellulose hydrolysate
Authors: Brandenburg Jule , Blomqvist Johanna , Shapaval Volha , Kohler Achim , Sampels Sabine , Sandgren Mats , Passoth Volkmar
Published: May 2021

Background

Microbial oils, generated from lignocellulosic material, have great potential as renewable and sustainable alternatives to fossil-based fuels and chemicals. By unravelling the diversity of lipid accumulation physiology in different oleaginous yeasts grown on the various carbon sources present in lignocellulose hydrolysate (LH), new targets for optimisation of lipid accumulation can be identified. Monitoring lipid formation over time is essential for understanding lipid accumulation physiology. This study investigated lipid accumulation in a variety of oleaginous ascomycetous and basidiomycetous strains grown in glucose and xylose and followed lipid formation kinetics of selected strains in wheat straw hydrolysate (WSH).

Results

Twenty-nine oleaginous yeast strains were tested for their ability to utilise glucose and xylose, the main sugars present in WSH. Evaluation of sugar consumption and lipid accumulation revealed marked differences in xylose utilisation capacity between the yeast strains, even between those belonging to the same species. Five different promising strains, belonging to the species Lipomyces starkeyi, Rhodotorula glutinis, Rhodotorula babjevae and Rhodotorula toruloides, were grown on undiluted wheat straw hydrolysate and lipid accumulation was followed over time, using Fourier transform-infrared (FTIR) spectroscopy. All five strains were able to grow on undiluted WSH and to accumulate lipids, but to different extents and with different productivities. R. babjevae DVBPG 8058 was the best-performing strain, accumulating 64.8% of cell dry weight (CDW) as lipids. It reached a culture density of 28 g/L CDW in batch cultivation, resulting in a lipid content of 18.1 g/L and yield of 0.24 g lipids per g carbon source. This strain formed lipids from the major carbon sources in hydrolysate, glucose, acetate and xylose. R. glutinis CBS 2367 also consumed these carbon sources, but when assimilating xylose it consumed intracellular lipids simultaneously. Rhodotorula strains contained a higher proportion of polyunsaturated fatty acids than the two tested Lipomyces starkeyi strains.

Conclusions

There is considerable metabolic diversity among oleaginous yeasts, even between closely related species and strains, especially when converting xylose to biomass and lipids. Monitoring the kinetics of lipid accumulation and identifying the molecular basis of this diversity are keys to selecting suitable strains for high lipid production from lignocellulose.