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There has been a general consensus that greenhouse gas emission is closely related with energy consumption. A systematic and complete investigation of the state and evolution of the energy consumption structure (ECS) of global countries is of great importance to figure out the different positions, responsibilities and missions of each country in the global climate change cooperation. Furthermore, such task is of great policy implications to generate a global reference system for different countries, guiding each one to improve, update and optimize its ECS. However, most existing studies regarding the world ECS neglects the evolutionary trends of ECS and their distributional positions in the global picture. Noting the paucity of studies of convergence in ECS across the world countries, this paper aims to explore the evolution of ECS at the national level and the global level to sharpen understandings on the state of global energy transition by employing the distribution dynamics approach. Three major energy sources were investigated, including coal, oil, and natural gas. The dataset was collected from the Global Trade Analysis Project database whose latest version covers the period from 2004 to 2014. In the second part of the analysis, the dataset is further divided into different income groups so as to evaluate the impacts of income on the distribution dynamics. A distribution dynamics approach is used to analyze the data of almost all the countries and regions in the world. The visualization of global ECS provides an insightful and novel understanding on the underlying trends. This study fills an important gap in the literature by providing several important findings which are not available from traditional econometric techniques. First, many countries would reduce their relative coal and oil consumption in the future but oil would remain to be the most common form of energy source. However, great variability can be observed for the distribution of gas consumption. Second, from the ergodic distribution of the gas market, it can be observed convergence clubs may emerge in the long run as the countries would congregate in certain clusters with similar levels of gas consumption. These findings call for further research and policy planning for the development of gas industry. Third, the distribution dynamics is very different for the four income groups (according to the World Bank), and so it is necessary to take a country's income level into consideration in formulating energy policies. Fourth, our findings reflect the issue of global inequality amongst the countries as the energy consumption of the poor countries are much lower than the other countries. Fifth, oil is deemed to be the most popular form of energy sources for the upper-middle-income and high-income countries, while coal is not a preferred energy source for the affluent countries, thereby suggesting the need to provide aid to the poor countries for mitigating the use of coal. Finally, gas consumption seems to have a very high variability and the countries can have very different consumption patterns of gas even if they belong to the same income category, implying that country-specific policies should be formulated for the development of the gas industry. Furthermore, it is observed that for the lower-middle-income and upper-middle-income countries, the big consumers of gas tend to increase their gas consumption further. The findings derived from this study may prove valuable for the policy makers in formulating energy policies for adapting to market changes, and may assist the design of international aid program on mitigating carbon emissions for the poor countries.

Adipocyte fatty acid-binding protein (AFABP: FABP4) is a member of the intracellular lipid-binding protein family that is thought to target long-chain fatty acids to nuclear receptors such as peroxisome proliferator-activated receptor gamma (PPARγ), which in turn plays roles in insulin resistance and obesity. A molecular understanding of AFABP function requires robust isolation of the protein in liganded and free forms as well as characterization of its oligomerization state(s) under physiological conditions. We report development of a protocol to optimize the production of members of this protein family in pure form, including removal of their bound lipids by mixing with hydrophobically functionalized hydroxypropyl dextran beads and validation by two-dimensional NMR spectroscopy. The formation of self-associated or covalently bonded protein dimers was evaluated critically using gel filtration chromatography, revealing conditions that promote or prevent formation of disulfide-linked homodimers. The resulting scheme provides a solid foundation for future investigations of AFABP interactions with key ligand and protein partners involved in lipid metabolism.

Summary: Immune cells express an incredible variety of proteins; by measuring combinations of these, cell types influencing disease can be precisely identified. We developed terraFlow, a platform that defines cell subsets exhaustively by combinatorial protein expression. Using high-parameter checkpoint-focused and function-focused panels, we studied classical Hodgkin’s lymphoma (cHL), where systemic T cells have not been investigated in detail. terraFlow revealed immune perturbations in patients, including elevated activated, exhausted, and interleukin (IL)-17+ phenotypes, along with diminished early, interferon (IFN)γ+, and tumor necrosis factor (TNF)+ T cells before treatment; many perturbations remained after treatment. terraFlow identified more disease-associated differences than other tools, often with better predictive power, and included a non-gating approach, eliminating time-consuming and subjective manual thresholds. It also reports a method to identify the smallest set of markers distinguishing study groups. Our results provide mechanistic support for past reports of immune deficiency in cHL and demonstrate the value of terraFlow in immunotherapy and biomarker studies.

Objectives Identifying key barriers to accessing quality-assured and affordable antimicrobials among forcibly displaced persons in Uganda, Yemen and Colombia and investigating their (1) utilisation patterns of antibiotics, (2) knowledge about antimicrobial resistance (AMR) and (3) perception of the quality of antimicrobials received.Design Pilot cross-sectional survey.Setting Data were collected from five health facilities in the Kiryandongo refugee settlement (Bweyale, Uganda), three camps for internally displaced persons (IDPs) in the Dar Sad district (Aden, Yemen) and a district with a high population of Venezuelan migrants (Kennedy district, Bogotá, Colombia). Data collection took place between February and May 2021. The three countries were selected due to their high number of displaced people in their respective continents.Participants South Sudanese refugees in Uganda, IDPs in Yemen and Venezuelan migrants in Colombia.Outcome measure The most common barriers to access to quality-assured and affordable antimicrobials.Results A total of 136 participants were enrolled in this study. Obtaining antimicrobials through informal pathways, either without a doctor’s prescription or through family and friends, was common in Yemen (27/50, 54.0%) and Colombia (34/50, 68.0%). In Yemen and Uganda, respondents used antibiotics to treat (58/86, 67.4%) and prevent (39/86, 45.3%) a cold. Knowledge of AMR was generally low (24/136, 17.6%). Barriers to access included financial constraints in Colombia and Uganda, prescription requirements in Yemen and Colombia, and non-availability of drugs in Uganda and Yemen.Conclusion Our multicentred research identified common barriers to accessing quality antimicrobials among refugees/IDPs/migrants and common use of informal pathways. The results suggest that knowledge gaps about AMR may lead to potential misuse of antimicrobials. Due to the study’s small sample size and use of non-probability sampling, the results should be interpreted with caution, and larger-scale assessments on this topic are needed. Future interventions designed for similar humanitarian settings should consider the interlinked barriers identified.

Abstract Cement producers and their investors are navigating evolving risks and opportunities as the sector’s climate and sustainability implications become more prominent. While many companies now disclose greenhouse gas emissions, the majority from carbon-intensive industries appear to delegate emissions to less efficient suppliers. Recognizing this, we underscore the necessity for a globally consolidated asset-level dataset, which acknowledges production inputs provenance. Our approach not only consolidates data from established sources like development banks and governments but innovatively integrates the age of plants and the sourcing patterns of raw materials as two foundational variables of the asset-level data. These variables are instrumental in modeling cement production utilization rates, which in turn, critically influence a company’s greenhouse emissions. Our method successfully combines geospatial computer vision and Large Language Modelling techniques to ensure a comprehensive and holistic understanding of global cement production dynamics.

In the open proportional legislative election system, the relationship between the legislative candidates and their constituents is the primary factor that determines their electability in parliamentary seats. Especially in areas with a high population, it causes hard efforts for a legislative candidate to spread his influence in society, even though in unconstitutional ways. As a result, the pathology of democracy will slowly emerge and undermine the existing political system. Therefore, the model of the legislative candidate's approach to constituents is considered to be an important thing to study. Not limited to AAM, who is the legislative candidate with the highest electability who succeeded in defeating 107 competitors from 13 different political parties in the 2019 Tulungagung District legislative election in the electoral district of Tulungagung II, which is the electoral district with the largest population in Tulungagung Regency, so this is a question mark about what kind of approach he applied to achieve this victory. Fundamentally, this research is a qualitative research, using in-depth interviews and document studies as data collection techniques, which are then validated using source triangulation techniques based on the Political Linkage Theory by Herbert Kistchelt as the analytical tool. As for the research, the results showed that there was a tendency for AAM to use clientelist linkage as a model for his political linkage with three forms of exchange, first, direct gifts in the form of money, clothing, food and other goods; second, special access in the form of benefits in public affairs through public institutions; and third, preferential access to jobs in the public/private sector regulated by public officials. In addition, this study found two "contradictory" facts between theoretical assumptions and the reality that occurred in the field, namely first, there was no specific targeting of parties receiving goods/services in political exchanges, so that the goods/services were still given even to constituents whose side is politically unpredictable; second, the occurrence of opportunistic defection by constituents to AAM even though he has carried out an iterative exchange control.

Abstract Genetically modified mouse models provide a versatile and efficient platform to extend our understanding of the underlying disease processes and evaluate potential treatments for congenital heart valve diseases. However, applications have been limited to the gene and molecular levels due to the small size of murine heart valves, which prohibits the use of standard mechanical evaluation and in vivo imaging methods. We have developed an integrated imaging/computational mechanics approach to evaluate, for the first time, the functional mechanical behavior of the murine pulmonary heart valve (mPV). We utilized extant mPV high resolution µCT images of 1-year-old healthy C57BL/6J mice, with mPVs loaded to 0, 10, 20 or 30 mmHg then chemically fixed to preserve their shape. Individual mPV leaflets and annular boundaries were segmented and key geometric quantities of interest defined and quantified. The resulting observed inter-valve variations were small and consistent at each TVP level. This allowed us to develop a high fidelity NURBS-based geometric model. From the resultant individual mPV geometries, we developed a mPV shape-evolving geometric model (SEGM) that accurately represented mPV shape changes as a continuous function of transvalvular pressure. The SEGM was then integrated into an isogeometric finite element based inverse model that estimated the individual leaflet and regional mPV mechanical behaviors. We demonstrated that the mPV leaflet mechanical behaviors were highly anisotropic and nonlinear, with substantial leaflet and regional variations. We also observed the presence of strong axial mechanical coupling, suggesting the important role of the underlying collagen fiber architecture in the mPV. When compared to larger mammalian species, the mPV exhibited substantially different mechanical behaviors. Thus, while qualitatively similar, the mPV exhibited important functional differences that will need to accounted for in murine heart valve studies. The results of this novel study will allow detailed murine tissue and organ level investigations of semi-lunar heart valve diseases.

Sorghum grain is a vital staple cereal crop for food and nutritional security for rural households in Burkina Faso. However, its yields are regularly affected by environmental and socio-economic constraints. Here, we aim to assess the performance and grain yield stability of local sorghum genotypes, as well as their acceptability by smallholder farmers. Nine genotypes were assessed across five environments in the North-Sudanian zone (700–900 mm) in Burkina Faso during the 2019, 2020, and 2021 rainy seasons. A randomized complete block with three replications was used to establish the experiments, from which data were collected on five quantitative traits as well as five participatory assessment criteria chosen by sorghum farmers and users. Grain yield analysis for each environment revealed significant differences between genotypes. The combined analysis showed highly significant differences between genotypes, environments and years, as well as their interactions. Most of the variation in grain yield was hexplained by the environment effect (29.0%), followed by the environment-by-year interaction (20.3%). The GGE biplot analysis identified two mega-environments (ME) with ME1 consisting of one environment (E1) and ME2, represented by four environments (E2, E3, E4, and E5). The E1 is a non-discriminating and poor environment with the lowest grain yield (1506 kg ha−1). The E5 and E2 were respectively, the most discriminating and representative environments, with also the highest grain yields (2406 and 2102 kg ha−1). In terms of stability, genotypes G6, G3, G5, and G9 exhibited the highest stability but lower performance, while G4 was the most unstable. G2 and G8, which produced respectively 2240 and 2072 kg ha−1, were better adapted to ME2. G2 was identified as the closest to the ''ideal genotype''. The principal component analysis showed that genotypes G2, G8, G7, G4, and G9 were the most selected in both individual and group assessments, owing to the panicle productivity, the good grain quality for storability, the grain attractiveness, and grain heaviness. This study highlighted the potential of genotypes G2 and G8 as promising varieties that could broaden the range of improved varieties and offer income opportunities for sorghum smallholder farmers in Burkina Faso.

Introduction There is an urgent need to investigate the capabilities of active surveillance in strengthening the development of pharmacovigilance (PV) systems in low-resource settings. Here, we assess the capability and feasibility of prospectively collected data to document maternal immunisation and adverse birth outcomes across delivery centres in Kinshasa, Democratic Republic of the Congo (DRC) according to the Global Alignment of Immunisation Safety Assessment in pregnancy (GAIA) definitions.Methods We conducted a facility-based prospective cohort study that enrolled mothers via convenience sampling either during their antenatal care visit or following their delivery. Demographic and clinical information as well as postpartum details related to the index pregnancy were collected after delivery; all mothers were also contacted via telephone 30 days postdelivery to determine if certain outcomes occurred after health facility discharge. Adverse birth outcomes of interest and maternal tetanus immunisation were categorised according to the GAIA criteria, and the level and impact of loss to follow-up (LTFU) was also evaluated.Results The study population consisted of 2675 mothers. The proportion of adverse birth outcomes ranged from 1.6% (for neonatal death) to 15.8% (for small for gestational age). Evidence of maternal tetanus immunisation during the index pregnancy was found for 637 mothers of newborns with any adverse birth outcome. GAIA diagnostic certainty was high for low birth weight and preterm birth, but much lower for stillbirth and neonatal bloodstream infections. Additionally, LTFU was high: only 47.9% of all mothers were successfully followed up via phone call.Conclusion Our investigation highlighted some of the challenges associated with the utilisation of the GAIA criteria in (prospective) observational studies within health facilities in Kinshasa, DRC (eg, data quality, LTFU and selection bias). Nevertheless, active surveillance remains a promising tool for future PV activities in DRC and beyond.

ABSTRACTThis paper provides firstly an overview of the literature on hardware start-ups, which are also related to manufacturing innovation. It continues with a framework, based on an interview series with hardware start-ups and their respective stakeholders. It includes a discussion about the relevant challenges and success factors, along with a potential set of metrics that can be of help for the evaluation of start-ups.

Abstract Background Little research has been conducted on the impact of the coronavirus disease 2019 (COVID-19) pandemic on either birth outcomes or the ability of archival medical records to accurately capture these outcomes. Our study objective is thus to compare the prevalence of preterm birth, stillbirth, low birth weight (LBW), small for gestational age (SGA), congenital microcephaly, and neonatal bloodstream infection (NBSI) before and during the first wave of the COVID-19 pandemic in Kinshasa, Democratic Republic of Congo (DRC). Methods We conducted a facility-based retrospective cohort study in which identified cases of birth outcomes were tabulated at initial screening and subcategorized according to level of diagnostic certainty using Global Alignment of Immunization Safety Assessment in pregnancy (GAIA) definitions. Documentation of any birth complications, delivery type, and maternal vaccination history were also evaluated. The prevalence of each birth outcome was compared in the pre-COVID-19 (i.e., July 2019 to February 2020) and intra-COVID-19 (i.e., March to August 2020) periods via two-sample z-test for equality of proportions. Results In total, 14,300 birth records were abstracted. Adverse birth outcomes were identified among 22.0% and 14.3% of pregnancies in the pre-COVID-19 and intra-COVID-19 periods, respectively. For stillbirth, LBW, SGA, microcephaly, and NBSI, prevalence estimates were similar across study periods. However, the prevalence of preterm birth in the intra-COVID-19 period was significantly lower than that reported during the pre-COVID-19 period (8.6% vs. 11.5%, p

BackgroundAutologous breast reconstruction is highly regarded in reconstructive surgery after mastectomy. DIEP flap reconstruction represents the gold standard for autologous breast reconstruction. The major advantages of DIEP flap reconstruction are its adequate volume, large vascular caliber and pedicle length. Despite reliable anatomy, there are procedures where the plastic surgeon's creativity is required, not only to shape the new breast, but also to overcome microsurgical challenges. An important tool in these cases is the superficial epigastric vein (SIEV).Methods150 DIEP flap procedures performed between 2018 and 2021 were retrospectively evaluated for SIEV use. Intraoperative and postoperative data were analyzed. Rate of anastomosis revision, total and partial flap loss, fat necrosis and donor site complications were evaluated.ResultsIn a total of 150 breast reconstructions with a DIEP flap performed in our clinic, the SIEV was used in 5 cases. The indication for using the SIEV was to improve the venous drainage of the flap or as a graft to reconstruct the main artery perforator. Among the 5 cases, no flap loss occurred.ConclusionsUse of the SIEV is an excellent method to expand the microsurgical options in breast reconstruction with DIEP flap surgery. It provides a safe and reliable procedure to improve venous outflow in cases of inadequate outflow from the deep venous system. The SIEV could also provide a very good option for fast and reliable application as an interposition device in case of arterial complications.

Abstract Deciphering genomic architecture is key to identifying novel disease drivers and understanding the mechanisms underlying myeloma initiation and progression. In this work, using the CoMMpass dataset, we show that structural variants (SV) occur in a nonrandom fashion throughout the genome with an increased frequency in the t(4;14), RB1, or TP53 mutated cases and reduced frequency in t(11;14) cases. By mapping sites of chromosomal rearrangements to topologically associated domains and identifying significantly upregulated genes by RNAseq we identify both predicted and novel putative driver genes. These data highlight the heterogeneity of transcriptional dysregulation occurring as a consequence of both the canonical and novel structural variants. Further, it shows that the complex rearrangements chromoplexy, chromothripsis and templated insertions are common in MM with each variant having its own distinct frequency and impact on clinical outcome. Chromothripsis is associated with a significant independent negative impact on clinical outcome in newly diagnosed cases consistent with its use alongside other clinical and genetic risk factors to identify prognosis.

Kenya has registered over 300,000 cases of COVID-19 and is a high-burden tuberculosis country. Tuberculosis diagnosis was significantly disrupted by the pandemic. Access to timely diagnosis, which is key to effective management of tuberculosis and COVID-19, can be expanded and made more efficient through integrated screening. Decentralized testing at community level further increases access, especially for underserved populations, and requires robust systems for data and process management. This study delivered integrated COVID-19 and tuberculosis testing to commercial motorbike (Bodaboda) riders, a population at increased risk of both diseases with limited access to services, in four counties: Nairobi, Kiambu, Machakos and Kajiado. Testing sheds were established where riders congregate, with demand creation carried out by the Bodaboda association. Integrated symptom screening for tuberculosis and COVID-19 was conducted through a digital questionnaire which automatically flagged participants who should be tested for either, or both, diseases. Rapid antigen-detecting tests (Ag-RDTs) for COVID-19 were conducted onsite, while sputum samples were collected and transported to laboratories for tuberculosis diagnosis. End-to-end patient data were captured using digital tools. 5663 participants enrolled in the study, 4946 of whom were tested for COVID-19. Ag-RDT positivity rate was 1% but fluctuated widely across counties in line with broader regional trends. Among a subset tested by PCR, positivity was greater in individuals flagged as high risk by the digital tool (8% compared with 4% overall). Of 355 participants tested for tuberculosis, 7 were positive, with the resulting prevalence rate higher than the national average. Over 40% of riders had elevated blood pressure or abnormal sugar levels. The digital tool successfully captured complete end-to-end data for 95% of all participants. This study revealed high rates of undetected disease among Bodaboda riders and demonstrated that integrated diagnosis can be delivered effectively in communities, with the support of digital tools, to maximize access.

Abstract Background In Sierra Leone (SL), a low-income country in West Africa, dental care is very limited, largely private, and with services focused in the capital Freetown. There is no formal dental education. Ten dentists supported by a similar number of dental care professionals (DCPs) serve a population of over 7.5 million people. The objective of this research was to estimate needs-led requirements for dental care and human resources for oral health to inform capacity building, based on a national survey of oral health in SL. Methods A dedicated operational research (OR) decision tool was constructed in Microsoft Excel to support this project. First, total treatment needs were estimated from our national epidemiological survey data for three key ages (6, 12 and 15 years), collected using the ‘International Caries Classification and Management System (ICCMS)’ tool. Second, oral health needs were extrapolated to whole population levels for each year-group, based on census demographic data. Third, full time equivalent (FTE) workforce capacity needs were estimated for mid-level providers in the form of Dental Therapists (DTs) and non-dental personnel based on current oral disease management approaches and clinical timings for treatment procedures. Fourth, informed by an expert panel, three oral disease management scenarios were explored for the national population: (1) Conventional care (CC): comprising oral health promotion (including prevention), restorations and tooth extraction; (2) Surgical and Preventive care (S 5&6 P and S 6 P): comprising oral health promotion (inc. prevention) and tooth extraction (D5 and D6 together, & at D6 level only); and (3) Prevention only (P): consisting of oral health promotion (inc. prevention). Fifth, the findings were extrapolated to the whole population based on demography, assuming similar levels of treatment need. Results To meet the needs of a single year-group of childrens’ needs, an average of 163 DTs (range: 133–188) would be required to deliver Conventional care (CC); 39 DTs (range: 30–45) to deliver basic Surgical and Preventive care (S 6 P); 54 DTs for more extended Surgical and Preventive care (S 5&6 P) (range 38–68); and 27 DTs (range: 25–32) to deliver Prevention only (P). When scaled up to the total population, an estimated 6,147 DTs (range: 5,565–6,870) would be required to deliver Conventional care (CC); 1,413 DTs (range: 1255–1438 DTs) to deliver basic Surgical and Preventive care (S 6 P); 2,000 DTs (range 1590–2236) for more extended Surgical and Preventive care (S 5&6 P) (range 1590–2236); and 1,028 DTs to deliver Prevention only (P) (range: 1016–1046). Furthermore, if oral health promotion activities, including individualised prevention, could be delivered by non-dental personnel, then the remaining surgical care could be delivered by 385 DTs (range: 251–488) for the S 6 P scenario which was deemed as the minimum basic baseline service involving extracting all teeth with extensive caries into dentine. More realistically, 972 DTs (range: 586–1179) would be needed for the S 5&6 P scenario in which all teeth with distinctive and extensive caries into dentine are extracted. Conclusion The study demonstrates the huge dental workforce needs required to deliver even minimal oral health care to the Sierra Leone population. The gap between the current workforce and the oral health needs of the population is stark and requires urgent action. The study also demonstrates the potential for contemporary epidemiological tools to predict dental treatment needs and inform workforce capacity building in a low-income country, exploring a range of solutions involving mid-level providers and non-dental personnel.

Abstract Background Selinexor is an oral, selective nuclear export inhibitor. STORM was a phase 2b, single-arm, open-label, multicenter trial of selinexor with low dose dexamethasone in patients with penta-exposed relapsed/refractory multiple myeloma (RRMM) that met its primary endpoint, with overall response of 26% (95% confidence interval [CI], 19 to 35%). Health-related quality of life (HRQoL) was a secondary endpoint measured using the Functional Assessment of Cancer Therapy – Multiple Myeloma (FACT-MM). This study examines impact of selinexor treatment on HRQoL of patients treated in STORM and reports two approaches to calculate minimal clinically important differences for the FACT-MM. Methods FACT-MM data were collected at baseline, on day 1 of each 4-week treatment cycle, and at end of treatment (EOT). Changes from baseline were analyzed for the FACT-MM total score, FACT-trial outcome index (TOI), FACT-General (FACT-G), and the MM-specific domain using mixed-effects regression models. Two approaches for evaluating minimal clinically important differences were explored: the first defined as 10% of the instrument range, and the second based on estimated mean baseline differences between Eastern Cooperative Oncology Group performance status (ECOG PS) scores. Post-hoc difference analysis compared change in scores from baseline to EOT for treatment responders and non-responders. Results Eighty patients were included in the analysis; the mean number of prior therapies was 7.9 (standard deviation [SD] 3.1), and mean duration of myeloma was 7.6 years (SD 3.4). Each exploratory minimal clinically important difference threshold yielded consistent results whereby most patients did not experience HRQoL decline during the first six cycles of treatment (range: 53.9 to 75.7% for the first approach; range: 52.6 to 72.9% for the second). Treatment responders experienced less decline in HRQoL from baseline to EOT than non-responders, which was significant for the FACT-G, but not for other scores. Conclusion The majority of patients did not experience decline in HRQoL based on minimal clinically important differences during early cycles of treatment with selinexor and dexamethasone in the STORM trial. An anchor-based approach utilizing patient-level data (ECOG PS score) to define minimal clinically important differences for the FACT-MM gave consistent results with a distribution-based approach. Trial registration This trial was registered on ClinicalTrials.gov under the trial-ID NCT02336815 on January 8, 2015.

Abstract Exponential rise of metagenomics sequencing is delivering massive functional environmental genomics data. However, this also generates a procedural bottleneck for on-going re-analysis as reference databases grow and methods improve, and analyses need be updated for consistency, which require acceess to increasingly demanding bioinformatic and computational resources. Here, we present the KAUST Metagenomic Analysis Platform (KMAP), a new integrated open web-based tool for the comprehensive exploration of shotgun metagenomic data. We illustrate the capacities KMAP provides through the re-assembly of ~ 27,000 public metagenomic samples captured in ~ 450 studies sampled across ~ 77 diverse habitats. A small subset of these metagenomic assemblies is used in this pilot study grouped into 36 new habitat-specific gene catalogs, all based on full-length (complete) genes. Extensive taxonomic and gene annotations are stored in Gene Information Tables (GITs), a simple tractable data integration format useful for analysis through command line or for database management. KMAP pilot study provides the exploration and comparison of microbial GITs across different habitats with over 275 million genes. KMAP access to data and analyses is available at https://www.cbrc.kaust.edu.sa/aamg/kmap.start .

Objectives To describe face mask use among pregnant women seeking antenatal care (ANC) in Kinshasa, Democratic Republic of Congo and to identify factors associated with masking adherence in this population.Design Facility-based cross-sectional study nested within a prospective cohort study.Setting Random sample of 10 health facilities, including 5 primary health centers and 5 secondary facilities or hospitals.Participants A total of 934 pregnant women aged 18 years or above with a gestational age of at least 32 weeks were consecutively surveyed from 17 August 2020 to 31 January 2021.Primary and secondary outcome measures We estimated the proportions of pregnant women wearing a face mask and masking correctly (ie, over the mouth and nose), and assessed their knowledge regarding the COVID-19 pandemic. Multivariable logistic regression was employed to identify factors associated with overall and correct face mask use.Results Overall, 309 (33.1%) women wore a mask during the interview after their antenatal appointments, but only 33 (10.7%) wore a mask correctly. The odds of masking and correct mask use were significantly higher among women who had their ANC visit in a facility that provided COVID-19 care. Additionally, women who experienced COVID-19-like symptoms in the past 6 months had higher odds of wearing a mask correctly compared with those reporting no recent symptoms. Although 908 (97.2%) women were aware of the COVID-19 pandemic, only 611 (67.3%) thought that COVID-19 was circulating locally in Kinshasa.Conclusion Overall and correct face mask adherence levels were low among pregnant women attending ANC in Kinshasa. Our study highlights the need for improving adherence to correct face mask use in order to help control the spread of COVID-19 within Kinshasa alongside other control measures, like vaccination.

Autotrophic and heterotrophic bacterioplankton are essential to the biogeochemistry of tropical ecosystems. However, the processes that govern their dynamics are not well known. We provide here a high-frequency assessment of bacterial community dynamics and concurrent environmental factors in Red Sea coastal waters. Weekly sampling of surface samples during a full annual cycle at an enclosed station revealed high variability in ecological conditions, which reflected in changes of major bacterioplankton communities. Temperature varied between 23 and 34°C during the sampling period. Autotrophic (Synechococcus, 1.7–16.2 × 104 cells mL−1) and heterotrophic bacteria (1.6–4.3 × 105 cells mL−1) showed two maxima in abundance in spring and summer, while minima were found in winter and autumn. Heterotrophic cells with high nucleic acid content (HNA) peaked in July, but their contribution to the total cell counts (35–60%) did not show a clear seasonal pattern. Actively respiring cells (CTC+) contributed between 4 and 51% of the total number of heterotrophic bacteria, while live cells (with intact membrane) consistently accounted for over 90%. Sequenced 16S rRNA amplicons revealed a predominance of Proteobacteria in summer and autumn (>40%) and a smaller contribution in winter (21–24%), with members of the Alphaproteobacteria class dominating throughout the year. The contribution of the Flavobacteriaceae family was highest in winter (21%), while the Rhodobacteraceae contribution was lowest (6%). Temperature, chlorophyll-a, and dissolved organic carbon concentration were the environmental variables with the greatest effects on bacterial abundance and diversity patterns.

Recent whole-genome sequencing studies identified two novel recurrent mutations in the enhancer region of GPR126 in urothelial bladder cancer (UBC) tumor samples. This mutational hotspot is the second most common after the TERT promoter in UBC. The aim of the study was to develop a digital droplet PCR screening assay for the simultaneous detection of GPR126 mutations in a single tube. Its performance combined with TERT promoter mutation analysis was evaluated in urine of healthy volunteers (n = 50) and patients with cystitis (n = 22) and UBC (n = 70). The developed assay was validated using DNA constructs carrying the studied variants. None of the mutations were detected in control and cystitis group samples. GPR126 mutations were observed in the urine of 25/70 UBC patients (area under the ROC curve (AUC) of 0.679; mutant allele fraction (MAF) of 21.61 [8.30–44.52] %); TERT mutations–in 40/70 (AUC of 0.786; MAF = 28.29 [19.03–38.08] %); ≥1 mutation–in 47/70 (AUC of 0.836)). The simultaneous presence of GPR126 and TERT mutations was observed in 18/70 cases, with no difference in MAFs for the paired samples (31.96 [14.78–47.49] % vs. 27.13 [17.00–37.62] %, p = 0.349, respectively). The combined analysis of these common non-coding mutations in urine allows the sensitive and non-invasive detection of UBC.

Background: Hypertension is a stronger predictor of hemorrhagic than ischemic strokes in the general population. We aimed to identify whether hypertension or other risk factors, including HIV-related factors, differ in their associations with stroke subtypes in people living with HIV (PLWHIV). Methods: HIV-1-positive individuals from the Data collection on Adverse events of anti-HIV Drugs (D:A:D) study were followed from the time of first blood pressure (BP) measurement after 1/1/1999 or study entry until the first of a validated stroke, 6 months after last follow-up or 1/2/2014. Stroke events were centrally validated using standardized criteria. Hypertension was defined as one systolic BP ≥140 mm Hg and/or diastolic BP ≥90 mm Hg. Poisson and Cox proportional hazards regression models determined associations of established cerebro/cardiovascular disease and HIV-related risk factors with stroke and tested whether these differed by stroke subtype. Findings: 590 strokes (83 hemorrhagic, 296 ischemic, 211 unknown) occurred over 339,979 person-years (PYRS) (incidence rate/1000 PYRS 1.74 [95% confidence interval (CI) 1.60–1.88]). Common predictors of both hemorrhagic and ischemic strokes were hypertension (relative hazard 3.55 [95% CI 2.29–5.50] and 2.24 [1.77–2.84] respectively) and older age (1.28 [1.17–1.39] and 1.19 [1.12–1.25]). Male gender (1.62 [1.14–2.31] and 0.60 [0.35–0.91]), previous cardiovascular events (4.03 [2.91–5.57] and 1.44 [0.66–3.16]) and smoking (1.90 [1.41–2.56] and 1.08 [0.68–1.71]) were stronger predictors of ischemic then hemorrhagic strokes, whereas hypertension, hepatitis C (1.32 [0.72–2.40] and 0.46 [0.30–0.70]) and estimated glomerular filtration rate

Abstract Background/Aim Migraine-related intracerebral white matter lesions (WMLs) are likely to be microvascular in nature and can be found in all hemispheric lobes. The aim of this study was to investigate migraine patients with or without WMLs to see the effects of these tissue damages on cortical thickness and volume. The role of migraine characteristics (duration of headache, attack frequency, estimated lifetime attack number, aura) was also tested. Methods As study participants, 161 female migraine patients (63 with aura; 52 with WMLs) and 40 age-matched healthy female subjects were enrolled in the study. None of the included migraine patients’ headache or aura (where present) was unilaterally side-locked. Patients and controls were all right handed. Except for migraine, patients were free of any medical comorbidity. Cortical reconstruction and segmentation were performed on the 3D T1-weighted images using Freesurfer 5.3 image analysis suite. The automatic cortical parcellation was based on Freesurfer’s Desikan–Killiany–Tourville atlas, which has 31 cortical regions per hemisphere. The segmented regions were divided into five lobes (frontal, parietal, temporal, occipital, insula). Since the left and right differences in lobar and insular volumes/thicknesses were not different among our groups, volume and cortical thickness were calculated for corresponding bilateral lobes. Results There was no significant difference in age between the whole migraine and the control groups. Migraineurs with WMLs (L+ patients) were significantly older than lesion-free (L-) patients (P = 0.0003) and controls (P = 0.018). Disease duration (P = 0.003), the total number of migraine attacks (P = 0.022) and the rate of aura (P = 0.0003) were significantly higher in L+ patients than in L- patients. Cortical thickness and volume measurements of lobes were not statistically different between the three groups (L+, L-, control). Age showed a significant negative association with both thickness and volume in each examined lobe (P