A Lesson from COVID-19 in the Importance of Sex Disaggregated Data: Sex Differences in SARS-CoV-2 Infection and Mortality Rates

Background: Emerging surveillance data from the COVID 19 pandemic suggest better outcomes in women. Objective: This analysis aims to determine the magnitude of sex differences in SARS-CoV-2 infection rates and survival at a country level. Methods: Data was sourced from the Global Health 50/50 (GH 50/50) website https://globalhealth5050.org/covid19, housed at University College of London, which collects government reported national surveillance data on confirmed cases of COVID 19 and confirmed deaths. This analysis used data completely disaggregated by sex, cutoff date 5/8/2020. Results: Of 78 countries, with 3,044,513 confirmed cases of COVID 19 and 181,742 deaths, data were completely disaggregated by sex in 36 countries, partially disaggregated in 26, and not disaggregated in 16. In countries, with completely disaggregated data, 1,240, 803 cases of COVID-19 were reported on May 3, 4, 5 or 6, 2020 in 31 countries, and between Feb 28 and April 28 in 5 countries. The average proportion of cases in women was 50.3%: range 22% (Pakistan) to 63% (Netherlands). Deaths were reported in 83,388 individuals. The mean proportion of deaths in women was 39.2% (range 20% to 53%). The mean ratio of deaths (men to women) was 1.62 (range 0.9 to 3.2). Discussion: This analysis of surveillance data from 36 countries shows a sex difference in mortality from COVID-19, with men more likely to die than women. Possible explanations include sex differences in the immune system, gender differences in environmental exposures or access to healthcare, and differences in comorbidities. Additional research to assess potential causes, and collect and analyze data by age, race, and ethnicity as well as sex and gender would be of value. These observations highlight the importance of disaggregating data by sex and gender in order to understand disease susceptibility, prevalence, and outcomes.https://jdc.jefferson.edu/sexandgenderhealth/1017/thumbnail.jp

Metal-insulator transition in vanadium dioxide nanobeams: probing sub-domain properties of strongly correlated materials

Many strongly correlated electronic materials, including high-temperature superconductors, colossal magnetoresistance and metal-insulator-transition (MIT) materials, are inhomogeneous on a microscopic scale as a result of domain structure or compositional variations. An important potential advantage of nanoscale samples is that they exhibit the homogeneous properties, which can differ greatly from those of the bulk. We demonstrate this principle using vanadium dioxide, which has domain structure associated with its dramatic MIT at 68 degrees C. Our studies of single-domain vanadium dioxide nanobeams reveal new aspects of this famous MIT, including supercooling of the metallic phase by 50 degrees C; an activation energy in the insulating phase consistent with the optical gap; and a connection between the transition and the equilibrium carrier density in the insulating phase. Our devices also provide a nanomechanical method of determining the transition temperature, enable measurements on individual metal-insulator interphase walls, and allow general investigations of a phase transition in quasi-one-dimensional geometry.Comment: 9 pages, 3 figures, original submitted in June 200

The Australian national binge drinking campaign: campaign recognition among young people at a music festival who report risky drinking

<p>Abstract</p> <p>Background</p> <p>The Australian Government launched a mass media campaign in 2009 to raise awareness of the harms and costs associated risky drinking among young Australians. The aim of this study was to assess if young people attending a music festival who report frequent risky single occasions of drinking (RSOD) recognise the key message of the campaign, "<it>Binge drinking can lead to injuries and regrets</it>", compared to young people who report less frequent RSOD.</p> <p>Methods</p> <p>A cross-sectional behavioural survey of young people (aged 16-29 years) attending a music festival in Melbourne, Australia, was conducted in January 2009. We collected basic demographics, information on alcohol and other drug use and sexual health and behaviour during the previous 12 months, and measured recognition of the Australian National Binge Drinking Campaign key message. We calculated the odds of recognition of the key slogan of the Australian National Binge Drinking Campaign among participants who reported frequent RSOD (defined as reported weekly or more frequent RSOD during the previous 12 months) compared to participants who reported less frequent RSOD.</p> <p>Results</p> <p>Overall, three-quarters (74.7%) of 1072 participants included in this analysis recognised the campaign message. In the adjusted analysis, those reporting frequent RSOD had significantly lower odds of recognising the campaign message compared to those not reporting frequent RSOD (OR 0.7, 95% CI 0.5-0.9), whilst females had significantly greater odds of recognising the campaign message compared to males (OR 1.8, 95% CI 1.4-2.1).</p> <p>Conclusions</p> <p>Whilst a high proportion of the target group recognised the campaign, our analysis suggests that participants that reported frequent RSOD - and thus the most important group to target - had statistically significantly lower odds of recognising the campaign message.</p

Instantons and Killing spinors

We investigate instantons on manifolds with Killing spinors and their cones. Examples of manifolds with Killing spinors include nearly Kaehler 6-manifolds, nearly parallel G_2-manifolds in dimension 7, Sasaki-Einstein manifolds, and 3-Sasakian manifolds. We construct a connection on the tangent bundle over these manifolds which solves the instanton equation, and also show that the instanton equation implies the Yang-Mills equation, despite the presence of torsion. We then construct instantons on the cones over these manifolds, and lift them to solutions of heterotic supergravity. Amongst our solutions are new instantons on even-dimensional Euclidean spaces, as well as the well-known BPST, quaternionic and octonionic instantons.Comment: 40 pages, 2 figures v2: author email addresses and affiliations adde

Consumer perceptions of co-branding alliances: Organizational dissimilarity signals and brand fit

This study explores how consumers evaluate co-branding alliances between dissimilar partner firms. Customers are well aware that different firms are behind a co-branded product and observe the partner firms’ characteristics. Drawing on signaling theory, we assert that consumers use organizational characteristics as signals in their assessment of brand fit and for their purchasing decisions. Some organizational signals are beyond the control of the co-branding partners or at least they cannot alter them on short notice. We use a quasi-experimental design and test how co-branding partner dissimilarity affects brand fit perception. The results show that co-branding partner dissimilarity in terms of firm size, industry scope, and country-of-origin image negatively affects brand fit perception. Firm age dissimilarity does not exert significant influence. Because brand fit generally fosters a benevolent consumer attitude towards a co-branding alliance, the findings suggest that high partner dissimilarity may reduce overall co-branding alliance performance

Multiple micronutrient supplementation improves vitamin B12 and folate concentrations of HIV infected children in Uganda: a randomized controlled trial

<p>Abstract</p> <p>Background</p> <p>The effect of multiple micronutrient supplementation on vitamin B₁₂and folate has hither to not been reported in African HIV infected children. This paper describes vitamin B₁₂and folate status of Ugandan HIV infected children aged 1-5 years and reports the effect of multiple micronutrient supplementation on serum vitamin B₁₂and folate concentrations.</p> <p>Methods</p> <p>Of 847 children who participated in a multiple micronutrient supplementation trial, 214 were assessed for vitamin B₁₂and folate concentrations pre and post supplementation. One hundred and four children were randomised to two times the recommended dietary allowance (RDA) of a 14 multiple micronutrient supplement (MMS) and 114 to a 'standard of care' supplement of 6 multivitamins (MV). Serum vitamin B₁₂was measured by an electrochemiluminescence immunoassay and folate by a competitive protein-binding assay using Modular E (Roche) automatic analyzer. Vitamin B₁₂concentrations were considered low if less than 221picomoles per litre (pmol/L) and folate if < 13.4 nanomoles per litre (nmol/L). The Wilcoxon Signed Ranks test was used to measure the difference between pre and post supplementation concentrations.</p> <p>Results</p> <p>Vitamin B₁₂was low in 60/214 (28%) and folate in 62/214 (29.0%) children. In the MMS group, the median concentration (IQR) of vitamin B₁₂at 6 months was 401.5 (264.3 - 518.8) pmol/L compared to the baseline of 285.5 (216.5 - 371.8) pmol/L, p < 0.001. The median (IQR) folate concentrations increased from 17.3 (13.5 - 26.6) nmol/L to 27.7 (21.1 - 33.4) nmol/L, p < 0.001. In the 'standard of care' MV supplemented group, the median concentration (IQR) of vitamin B₁₂at 6 months was 288.5 (198.8 - 391.0) pmol/L compared to the baseline of 280.0 (211.5 - 386.3) pmol/L while the median (IQR) folate concentrations at 6 months were 16.5 (11.7 - 22.1) nmol/L compared to 15.7 (11.9 - 22.1) nmol/L at baseline. There was a significant difference in the MMS group in both vitamin B₁₂and folate concentrations but no difference in the MV group.</p> <p>Conclusions</p> <p>Almost a third of the HIV infected Ugandan children aged 1-5 years had low serum concentrations of vitamin B₁₂and folate. Multiple micronutrient supplementation compared to the 'standard of care' supplement of 6 multivitamins improved the vitamin B₁₂and folate status of HIV infected children in Uganda.</p> <p>Trial registration</p> <p><url>http://ClinicalTrials.gov</url><a href="http://www.clinicaltrials.gov/ct2/show/NCT00122941">NCT00122941</a>)</p

Response of Coastal Fishes to the Gulf of Mexico Oil Disaster

The ecosystem-level impacts of the Deepwater Horizon disaster have been largely unpredictable due to the unique setting and magnitude of this spill. We used a five-year (2006–2010) data set within the oil-affected region to explore acute consequences for early-stage survival of fish species inhabiting seagrass nursery habitat. Although many of these species spawned during spring-summer, and produced larvae vulnerable to oil-polluted water, overall and species-by-species catch rates were high in 2010 after the spill (1,989±220 fishes km-towed−1 [μ ± 1SE]) relative to the previous four years (1,080±43 fishes km-towed−1). Also, several exploited species were characterized by notably higher juvenile catch rates during 2010 following large-scale fisheries closures in the northern Gulf, although overall statistical results for the effects of fishery closures on assemblage-wide CPUE data were ambiguous. We conclude that immediate, catastrophic losses of 2010 cohorts were largely avoided, and that no shifts in species composition occurred following the spill. The potential long-term impacts facing fishes as a result of chronic exposure and delayed, indirect effects now require attention

How does study quality affect the results of a diagnostic meta-analysis?

Background: The use of systematic literature review to inform evidence based practice in diagnostics is rapidly expanding. Although the primary diagnostic literature is extensive, studies are often of low methodological quality or poorly reported. There has been no rigorously evaluated, evidence based tool to assess the methodological quality of diagnostic studies. The primary objective of this study was to determine the extent to which variations in the quality of primary studies impact the results of a diagnostic meta-analysis and whether this differs with diagnostic test type. A secondary objective was to contribute to the evaluation of QUADAS, an evidence-based tool for the assessment of quality in diagnostic accuracy studies. Methods: This study was conducted as part of large systematic review of tests used in the diagnosis and further investigation of urinary tract infection (UTI) in children. All studies included in this review were assessed using QUADAS, an evidence-based tool for the assessment of quality in systematic reviews of diagnostic accuracy studies. The impact of individual components of QUADAS on a summary measure of diagnostic accuracy was investigated using regression analysis. The review divided the diagnosis and further investigation of UTI into the following three clinical stages: diagnosis of UTI, localisation of infection, and further investigation of the UTI. Each stage used different types of diagnostic test, which were considered to involve different quality concerns. Results: Many of the studies included in our review were poorly reported. The proportion of QUADAS items fulfilled was similar for studies in different sections of the review. However, as might be expected, the individual items fulfilled differed between the three clinical stages. Regression analysis found that different items showed a strong association with test performance for the different tests evaluated. These differences were observed both within and between the three clinical stages assessed by the review. The results of regression analyses were also affected by whether or not a weighting (by sample size) was applied. Our analysis was severely limited by the completeness of reporting and the differences between the index tests evaluated and the reference standards used to confirm diagnoses in the primary studies. Few tests were evaluated by sufficient studies to allow meaningful use of meta-analytic pooling and investigation of heterogeneity. This meant that further analysis to investigate heterogeneity could only be undertaken using a subset of studies, and that the findings are open to various interpretations. Conclusion: Further work is needed to investigate the influence of methodological quality on the results of diagnostic meta-analyses. Large data sets of well-reported primary studies are needed to address this question. Without significant improvements in the completeness of reporting of primary studies, progress in this area will be limited

An EGF-like Protein Forms a Complex with PfRh5 and Is Required for Invasion of Human Erythrocytes by Plasmodium falciparum

Invasion of erythrocytes by Plasmodium falciparum involves a complex cascade of protein-protein interactions between parasite ligands and host receptors. The reticulocyte binding-like homologue (PfRh) protein family is involved in binding to and initiating entry of the invasive merozoite into erythrocytes. An important member of this family is PfRh5. Using ion-exchange chromatography, immunoprecipitation and mass spectroscopy, we have identified a novel cysteine-rich protein we have called P. falciparum Rh5 interacting protein (PfRipr) (PFC1045c), which forms a complex with PfRh5 in merozoites. Mature PfRipr has a molecular weight of 123 kDa with 10 epidermal growth factor-like domains and 87 cysteine residues distributed along the protein. In mature schizont stages this protein is processed into two polypeptides that associate and form a complex with PfRh5. The PfRipr protein localises to the apical end of the merozoites in micronemes whilst PfRh5 is contained within rhoptries and both are released during invasion when they form a complex that is shed into the culture supernatant. Antibodies to PfRipr1 potently inhibit merozoite attachment and invasion into human red blood cells consistent with this complex playing an essential role in this process