Corrigendum: Maternal serum iron status, hepcidin and interleukin-6 levels in women with preeclampsia.

[This corrects the article DOI: 10.3389/fphys.2023.1049994.].

Iron deficiency and thyroid dysfunction among sudanese women in first trimester of pregnancy: a cross-sectional study.

BACKGROUND: Pregnant women are more susceptible to iron deficiency (ID), and it can lead to several maternal and perinatal adverse effects. There are some published data on the effect of ID on thyroid function, but none of the studies were conducted in sub-Saharan African countries including Sudan. This study was conducted to investigate association between ID (ferritin < 15 µg/L) and thyroid functions [thyroid-stimulating hormone (TSH), free triiodothyronine (FT3), and free thyroxine (FT4)] among Sudanese women in the first trimester of pregnancy. METHOD: A cross-sectional study was conducted in Saad Abuelela Maternity Hospital, Sudan. Obstetric/sociodemographic characteristics were gathered through questionnaires. Hemoglobin, serum ferritin, TSH, FT3, and FT4 were measured in all pregnant women. Continuous variables were compared with either independent sample t-test if they were normally distributed, or with Mann-Whitney U- test if they were not-normally distributed. Spearman correlations were performed between the continuous variables. RESULTS: In total, 127 pregnant women with mean [standard deviation (SD)] age of 27.0 (5.5) years and gestational age of 10.5 (3.0) weeks, respectively, were enrolled in this study. Forty-seven (37.0%) of these 127 women had ID. While the median [interquartile range (IQR)] of the parity, TSH, and FT3 were not different between women with ID and women without ID, the median (IQR) of FT4 was significantly lower in women with ID compared with women without ID [1.020 (0.910‒1.120) vs. 1.095 (0.990‒1.217) pmol, P = 0.014]. Serum ferritin was inversely correlated with FT3, (r = -0.225, P = 0.011). There was no significant correlation between serum ferritin, TSH, and FT4. CONCLUSIONS: Iron deficiency was common during the first trimester of pregnancy and was associated with thyroid dysfunctions. Therefore, ID should be evaluated to avoid thyroid dysfunction.

Spatio-temporal variation of the microbial community of the coast of Lebanon in response to petroleum hydrocarbon pollution.

In this study, the coast of Lebanon was analyzed for the dynamic changes in sediment microbial communities in response to a major petroleum oil spill and tar contamination that occurred in the summer of 2021. Spatio-temporal variations in the microbial structure along the shores of Lebanon were assessed in comparison to baseline microbial structure determined in 2017. Microbial community structure and diversity were determined using Illumina MiSeq technology and DADA2 pipeline. The results show a significant diversity of microbial populations along the Lebanese shore, and a significant change in the sediment microbial structure within four years. Namely, Woeseia, Blastopirellula, and Muriicola were identified in sediment samples collected in year 2017, while a higher microbial diversity was observed in 2021 with Woeseia, Halogranum, Bacillus, and Vibrio prevailing in beach sediments. In addition, the results demonstrate a significant correlation between certain hydrocarbon degraders, such as Marinobacter and Vibrio, and measured hydrocarbon concentrations.

Maternal serum iron status, hepcidin and interleukin-6 levels in women with preeclampsia.

Introduction: Preeclampsia can lead to a number of adverse maternal and perinatal effects. The association between iron status [serum iron, ferritin and total iron-binding capacity (TIBC)], unsaturated iron-binding capacity, hepcidin, interleukin-6 (IL-6) levels and preeclampsia is not fully understood. Objective: To assess the levels of iron status, hepcidin and interleukin-6 in women with preeclampsia compared with healthy pregnant women. Method: A case-control study (60 women were recruited in each group) was conducted at Saad Abuelela Maternity Hospital in Khartoum, Sudan. Sociodemographic and clinical data were gathered through a questionnaire. The levels of iron status, hepcidin and IL-6 were measured using applicable methods. Results: There was no significant difference in the median [interquartile range (IQR)] of age, parity or body mass index between the two groups. Moreover, the median (IQR) of the iron status, hepcidin and interleukin-6 did not differ between women with preeclampsia and healthy controls. There were no significant correlations between haemoglobin, hepcidin and IL-6. There were also no significant correlations between serum iron, serum ferritin, hepcidin and IL-6. However, there was a significant positive correlation between hepcidin and IL-6 (r = 0.393, p = 0.002). Conclusion: In this study, women with preeclampsia had levels of iron status, hepcidin and IL-6 similar to those observed in healthy pregnant women. There was no significant correlation between iron status, hepcidin and IL-6.

Association of Maternal Anemia and Cesarean Delivery: A Systematic Review and Meta-Analysis.

Anaemia during pregnancy is associated with an increased incidence of caesarean delivery (CD). This study was conducted to explore the association between CD and maternal anaemia. The PubMed/MEDLINE, Cochrane, Google, Google Scholar and ScienceDirect databases were searched for relevant studies on this topic. The assessment and review were conducted with the Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument. The studies were assessed using the modified Newcastle−Ottawa quality assessment scale. Data were collected in an Excel sheet, and the 'meta' package of the R 4.0.3 software was used for statistical analysis. Fourteen studies that enrolled 336,128 pregnant women were included in the meta-analysis. Women with anaemia were found to be at a higher risk for CD (OR = 1.63, 95% CI = 1.23−2.17). As heterogeneity was detected in the studies, the random-effects model was used for the pooled meta-analysis (Q = 96.7, p < 0.001). In the subgroup analysis, anaemic women were found to be at higher risk for CD in studies from both low-middle-income (7) and high-income countries (7). In meta-regression analysis, none of the investigated covariates were associated with the pooled OR of CD. This evidence demonstrates with a moderate level of certainty that anaemic pregnant women are more likely to have CD than non-anaemic pregnant women.

Association of Selenium Levels with Preeclampsia: A Systematic Review and Meta-analysis.

Several observational studies have shown inconclusive findings on the association between selenium levels and preeclampsia. This systematic review and meta-analysis was conducted to clarify the association between selenium levels and preeclampsia. The databases PubMed, Google Scholar, ScienceDirect, and the Cochrane Library were searched for studies which investigated selenium levels with preeclampsia and which were published up to April 2022. The overall standardized mean differences (SMD) of selenium levels between cases and controls were measured. Sensitivity analysis, reporting bias, subgroup analysis, and meta-regression were performed for the estimate. The meta-analysis was calculated using the "meta" package in the open-source software R. A total of 26 studies with 1855 preeclampsia cases compared with 3728 healthy pregnant controls were included. The level of selenium was significantly lower in cases of preeclampsia compared with the controls [SMD = - 0.85; 95% confidence interval (CI): (- 1.46, - 0.25); P = < 0.01). As there was significant heterogeneity [I2 = 96%, Cochran's Q = 620.47; P = < 0.01], the random effects model was used. A stratified meta-analysis revealed that selenium levels were significantly lower in the cases compared with the controls among pregnant women from the African continent [SMD = - 1.15 (- 1.65, - 0.65); P = < 0.01]. Likewise, the same pattern was observed among women from middle- and low-income countries [SMD = - 1.32 (- 2.22, - 0.42); P = < 0.01]. None of the investigated factors (Modified Newcastle-Ottawa Scale quality score, year of publication, and sample size) showed significant association with the selenium SMD. The level of certainty of this evidence is "low certainty," as calculated by the GRADEpro GDT online tool. This meta-analysis with low level of evidence certainty revealed that low selenium level is associated significantly with preeclampsia. This pattern is also observed in women from the African continent and women from low- or middle-income countries. Further studies with different prospective designs and detailed patient characteristics are needed to consolidate this evidence.

Association between Retinol-Binding Protein 4 Levels and Preeclampsia: A Systematic Review and Meta-Analysis.

Retinol-binding protein 4 (RBP4) is claimed to be associated with the development of preeclampsia, yet the reports are inconclusive. This systematic review and meta-analysis aimed to assess the association between RBP4 levels and preeclampsia. The PubMed, Google Scholar and ScienceDirect databases were searched for studies that investigated RBP4 levels in preeclampsia patients and compared them with normal controls. The meta-analysis was conducted by calculating the standardized mean difference (SMD) of RBP4 between cases and controls. The meta package with the R software was used to perform all statistical analysis. A total of 13 studies, comprising 569 cases and 1411 controls, met the inclusion criteria and were thus included in the meta-analysis. According to the random effect model, the SMD of RBP4 was significantly higher in women with preeclampsia compared with normal controls [SMD of RBP4: 0.55 ng/mL; 95% CI (0.06; 1.05); p = 0.028; I2 = 89%]. Likewise, the stratified meta-analysis showed the same pattern in the studies which measured RBP4 levels in the third trimester, as well as in the studies that investigated severe preeclampsia. Meta-regression did not identify any factor that significantly affected the overall estimate. There was no evidence of reporting bias (Egger's test; t = 0.43; p = 0.587). This meta-analysis with high heterogeneity showed that higher levels of RBP4 were associated with preeclampsia risk. More longitudinal studies spanning the three trimester periods are needed to clarify the association of RBP4 and its dynamics in preeclampsia cases throughout pregnancy.

Gene polymorphisms of cyclin-dependent kinase inhibitor and matrix metalloproteinase-9 in Sudanese patients with esophageal squamous cell carcinoma.

BACKGROUND: The polymorphisms of the cyclin-dependent kinase inhibitor (CDKN1A) gene and matrix metalloproteinase-9 (MMP9) gene may increase one's susceptibility to malignancies. In this study, the association of the single nucleotide polymorphisms (SNPs) CDKN1A rs1059234 c.70C>T at the 3' untranslated region and MMP9 rs17576 (c.836A>G, p.Gln279Arg) with esophageal squamous cell carcinoma (ESCC) in Sudanese individuals were investigated. MATERIALS AND METHODS: A case-control study involving age- and gender-matched groups were conducted in a cancer center in eastern Sudan (Gadarif) between April and October 2020. The case group consisted of ESCC patients, whereas the control group comprised healthy subjects. Polymerase chain reaction-restriction fragment length polymorphism was performed for the genotyping of the CDKN1A rs1059234 and MMP9 rs17576 SNPs. The genotyping results were confirmed by Sanger sequencing. RESULTS: The genotype distributions for CDKN1A rs1059234 and MMP9 rs17576 were in agreement with the Hardy-Weinberg equilibrium. The variant allele T in CDKN1 rs1059234 c.70C>T was significantly more prevalent in the ESCC patients than in the healthy controls [51.3% vs. 19.2%; OR = 4.4; 95% CI (2.6-7.4); p < 0.001]. Moreover, in CDKN1A rs1059234, the genotype TC + TT [76.9% vs. 38.4%; OR = 5.3; 95% CI (2.6-10.7); p < 0.001] was more frequent in the cases than in the controls, and it was significantly associated with ESCC risk. In MMP9 rs17576, the variant allele G was also significantly prevalent in the cases relative to the controls, and it was significantly associated with increased ESCC risk in the cases compared with the controls [27.5% vs. 1.9%; OR = 19.4; 95%CI (5.8-64.1); p < 0.001]. Both genotypes containing the allele G (AG + GG) were the most common genotypes in the cases [48.7% vs. 3.8%; OR = 23.7; 95%CI (6.8-81.7); p < 0.001], and they significantly increased the risk of ESCC. CONCLUSION: A significant increase in ESCC risk is associated with the SNPs CDKN1A rs1059234 and MMP9 rs17576.

Association of Selenium Levels with Gestational Diabetes Mellitus: An Updated Systematic Review and Meta-Analysis.

Several studies have investigated the association between selenium levels and gestational diabetes mellitus (GDM); however, their results are not conclusive. This systematic review and meta-analysis aimed to update and draw conclusions regarding the evidence from published studies that investigated selenium levels in relation to GDM. PubMed, Google Scholar, Cochrane Library and ScienceDirect were searched for studies related to selenium and GDM, published from the inception of each database through to July 2022. The meta-analysis was conducted by measuring the standardized mean difference (SMD) between the selenium levels of women with GDM and those pregnant without GDM (control group). Stratified meta-analysis, meta-regression analysis and reporting bias were applied. The "meta" package in the open-access software R was used to analyze all of the data. A total of 12 studies, including 940 pregnant women with GDM and 1749 controls met this study's inclusion criteria. The selenium levels were significantly lower in women with GDM compared with the control group (SMD = -0.66; 95% confidence interval (CI): (-1.04, -0.28); p ≤ 0.001). Due to significant heterogeneity (I2 = 94%, Cochrane Q = 186.7; p ≤ 0.0001), the random-effects model was followed. The stratified meta-analysis showed that the selenium levels were lower in the cases compared with the normal controls in the third trimester (SMD = -1.85 (-3.03, -0.66); p ≤ 0.01). The same trend was observed in the studies published before the year 2014 (SMD = -0.99 (-1.70, -0.28); p ≤0.01) and those published in or after 2014 (SMD = -0.45 (-0.90, 0.00); p = 0.05). None of the investigated covariates in the meta-regression analysis (each study's geographic location, trimester of selenium quantification, World Bank economic classification, method of selenium determination, study design, study quality score, publication year and study's sample size) were significantly associated with the selenium SMD. The current evidence indicates that selenium levels are lower among women with GDM in comparison to those without GDM; however, after the correction of the reporting bias, the result was no longer significant. Further studies with more prospective designs are needed to confirm this evidence and explain the function of selenium in GDM throughout pregnancy.

Clinical profile and aetiologies of delayed puberty: a 15 years' experience from a tertiary centre in Sudan.

OBJECTIVES: Delayed puberty is a common presentation to endocrine clinics, with adult height, sexual capability and fertility being the main concerns for the child and his/her family. Presentation is variable including short stature and/or absence of secondary sexual characteristics. The aetiology can either be constitutional, functional or permanent hypogonadotropic hypogonadism, permanent hypergonadotropic hypogonadism or unclassified. Despite the importance of this subject, there are no publications from Sudan. METHODS: A retrospective hospital-based study. Records of all patients who were seen in the endocrinology unit at Gaffar Ibn Auf Children's Hospital and were diagnosed as having delayed puberty were reviewed and demographic, clinical, and investigations data were obtained. RESULTS: A total of 136 patients were included in this study. Presentation includes short stature in 52.2%, both short stature and delayed puberty in 27.2%, and delayed puberty in 20.6%. The most common aetiologies were permanent hypogonadotropic hypogonadism and functional hypogonadotropic hypogonadism presented in 37.5% and 36% respectively, while constitutional delay of growth and puberty was found in only 14.7%. Type 1 diabetes mellitus (T1DM) was the most frequent chronic illness followed by coeliac disease. Hypergonadotropic hypogonadism was diagnosed in 11.7%, the majority of which were females. CONCLUSIONS: The aetiological pattern reported in this series highlights the role of nutrition and general well-being in pubertal development, as well as the major impact of genetics and consanguinity on disease patterns. Data from African countries are limited and this is the first reported cohort on delayed puberty from Sudan.

CO2 sequestration by propagation of the fast-growing Azolla spp.

Azolla is a group of aquatic floating plants that can achieve very high growth rates compared to other aquatic macrophytes, with a doubling time of 2-5 days under optimal growing conditions. The ability of Azolla to grow at such rapid rates allows for the opportunity of utilizing it as a method to sequester a significant amount of atmospheric CO2 in the form of biomass, which can be locked away to completely remove the carbon from the active carbon cycle, or which can be used in various applications such as animal feeds, biofertilizers, and biofuel production, which in turn will contribute to reduction in the fossil CO2 emissions. In this desktop study, the potential use of Azolla for mitigating the annual increase in the atmospheric CO2 levels was addressed, which were estimated at 18.9 billion tons of CO2 per year. A theoretical setup of 1-ha ponds was assessed to estimate the total Azolla growing area required for counterbalancing the annual atmospheric CO2 increase. Each 1-ha pond was found capable of capturing 21,266 kg of CO2 (C) per year. The calculated required total area to mitigate the total annual increase was estimated to be 1,018,023 km2 (equivalent to around a fifth of the Amazon forest area). Sensitivity analysis, which was based on the variations in the productivity of Azolla due to growing conditions, indicated that the required area would range between 763,518 and 1,527,036 km2. This study provides a novel natural method for CO2 sequestration that has lower environmental impacts compared to conventional sequestration technologies as an alternative green approach for mitigating the effects of fossil fuels.

Handwashing knowledge, attitudes, and practices during the COVID-19 pandemic in Saudi Arabia: A non-representative cross-sectional study.

Handwashing (HW) with water and soap is one of the cheapest and most effective ways of protecting oneself and others against the coronavirus. Here, the HW knowledge, attitudes, and practices of Saudi adults were assessed during the COVID-19 pandemic using a cross-sectional study conducted between May 8 and June 8, 2020, during a partial lockdown period. A web-based validated questionnaire was distributed through different social media platforms, and the sociodemographic characteristics of the participants, seven items related to knowledge, four items related to attitudes, and thirteen items related to the practice of HW were assessed. A total of 1323 (51% male and 49% female) adults from all regions of Saudi Arabia responded to the questionnaire. The overall mean (± SD) was 5.13 (± 1.18) for knowledge of HW and COVID-19, 2.79 (± 0.77) for attitude toward HW, and 7.8 (± 2.56) for HW practice. A multiple linear regression analysis revealed factors associated with knowledge to be age and family income. Sex, educational level, family income, and HW knowledge were associated with negative and neutral attitude, whereas age, sex, family income, and HW knowledge were associated with practice. These results suggest that HW knowledge was strongly associated with positive attitudes toward HW and correct HW practice in Saudi adults during the COVID-19 lockdown.

Ferric iron stimulation in marine SMFCs: Impact on the microbial structure evolution in contaminated sediments with low and high molecular weight PAHs.

The impact of ferric iron stimulation on the evolution of microbial structure in marine sediment microbial fuel cells (SMFCs), operated for the bioremediation of a complex mixture of low and high molecular weight PAHs (naphthalene, fluorene, pyrene and benzo(a)pyrene), was assessed. Microbial evolution profiles showed high relative abundances of exoelectrogenic iron-reducing bacteria throughout the biodegradation, namely Geoalkalibacter, under ferric iron stimulation and anode reducing conditions, irrespective of sulfate reducing bacteria (SRB) inhibition. Highest PAHs removal was measured in the absence of anode reduction, under Fe stimulation and SRB inhibition, reaching 40.85% for benzo(a)pyrene, the most persistent PAH used in this study. Results suggest that amendment of contaminated sediment with ferric iron could constitute a better bioremediation strategy than using SMFCs. This becomes significant when considering the well-established and dominant indigenous SRB population in marine sediments that usually limits the performance of the anode as a terminal electron acceptor in marine SMFCs.

The association of the prothrombin G20210A single-nucleotide polymorphism and the risk of preeclampsia: Systematic review and meta-analysis.

OBJECTIVE: We conducted this systematic review and meta-analysis to assess the association between the risk of preeclampsia and the prothrombin G20210A single-nucleotide polymorphism. STUDY DESIGN: We followed the "Preferred Reporting Items for Systematic Reviews and Meta-Analyses" guidelines. Relevant published studies were searched in the data base. The retrieved studies were assessed for quality by using the Modified Newcastle-Ottawa Scale for quality assessment. OpenMeta Analyst software was used for the statistics. RESULTS: Twenty-eight case-control studies enrolling 3821 cases and 4808 controls were included in this systematic review and meta-analysis. We found a significantly increased preeclampsia risk associated with the G20210A polymorphism in three models: allele contrast (A vs. G), OR 2.183, 95 % CI 1.665-2.862; heterozygote (AG vs. GG), OR 2.233, 95 % CI 1.690-2.95; and the dominant model (AA + AG vs. GG) OR 2.240, 95 % CI 1.700-2.950. However, the association was not observed in the homozygote (AA vs. GG) OR 1.310, 95 % CI = 0.632-2.713 r recessive model (AA vs. AG + GG), OR 1.315, 95 % CI = 0.642-2.695. CONCLUSIONS: In this meta-analysis, the prothrombin G20210A single-nucleotide polymorphism was associated with an increased risk of preeclampsia.

Leptin receptor gene polymorphisms c.668A>G and c.1968G>C in Sudanese women with preeclampsia: a case-control study.

BACKGROUND: Leptin receptor gene (LEPR) variants may affect the leptin levels and act as a risk factor for preeclampsia. Two LEPR gene missense variants rs1137101 (c.668A>G) and rs1805094 (c.1968G>C) were investigated in Sudanese women with preeclampsia. METHODS: A matched case-control study (122 women in each arm) was conducted in Saad Abualila Maternity Hospital in Khartoum, Sudan from May to December 2018. The cases were women with preeclampsia and the controls were healthy pregnant women. Genotyping for LEPR gene variants c.668A>G and c.1968G>C was performed using polymerase chain reaction-restriction fragment length polymorphism. Logistic regression models (adjusted for age, parity, body mass index and hemoglobin level) were conducted. RESULTS: Genotype frequency of LEPR gene variants c.668A>G and c.1968G>C was in accordance with Hardy-Weinberg equilibrium (P > 0.05) in the controls. Allele G in LEPRc.668A>G variant was significantly more frequent in the cases compared with the controls [43.4% vs. 10.2%; OR = 6.44; 95%CI (3.98-10.40); P < 0.001]. In variant LEPRc.668A>G, genotype AG was the prevalent genotype in the cases compared with the controls, and it was significantly associated with preeclampsia risk [37.7% vs. 15.5%; AOR = 3.48; 95%CI (1.15-10.54); P = 0.027]. Likewise, the GG genotype was the second most common genotype in the cases compared with the controls, and was associated with preeclampsia risk [24.6% vs. 2.5%; AOR = 14.19; 95%CI (1.77-113.76); P = 0.012]. None of the LEPRc.1968G>C variant genotypes were associated with preeclampsia. The CC genotype was not detected in neither the cases nor the controls. The haplotype A-G 70.1% was the prevalent haplotype in this population, and it significantly protected against preeclampsia [OR = 0.14; 95%CI (0.09-0.23); P < 0.001]. However, the haplotype G-G 26.8% was significantly associated with preeclampsia risk [OR = 6.70; 95%CI (4.16-11.05); P < 0.001]. Both variants c.668A>G and c.1968G>C were in strong linkage disequilibrium (D' = 1, r2 = 0.012). CONCLUSIONS: Our data indicate that the rs1137101 (c.668A>G) variant and G-G haplotype may independently associate with the development of preeclampsia.

Microbial community evolution during the aerobic biodegradation of petroleum hydrocarbons in marine sediment microcosms: Effect of biostimulation and seasonal variations.

Evolution of the microbial community structure in crude oil contaminated marine sediments was assessed under aerobic biodegradation during wet (18 °C) and dry (28 °C) seasons experiments, to account for seasonal variations in nutrients and temperature, under biostimulation and natural attenuation conditions. NMDS showed significant variation in the microbial communities between the wet and the dry season experiments, and between the biostimulation and the natural attenuation treatments in the dry season microcosms. No significant variation in the microbial community and oil biodegradation was observed during the wet season experiments due to high background nitrogen levels eliminating the effect of biostimulation. Larger variations were observed in the dry season experiments and were correlated to enhanced alkanes removal in the biostimulated microcosms, where Alphaproteobacteria dominated the total microbial community by the end of biodegradation (54%). Many hydrocarbonoclastic bacterial genera showed successive dominance during the operation affecting the ultimate performance of the microcosms.

Association of VEGFA and IL1ß gene polymorphisms with preeclampsia in Sudanese women.

BACKGROUND: Preeclampsia can lead to adverse maternal and perinatal outcomes. There are few studies on the genetic factors associated with preeclampsia in Africa in general and in Sudan in specific. METHODS: A case-control study (60 women in each arm) was conducted at Saad Abualila Hospital in Khartoum, Sudan, from March to September 2018. The participants were genotyped for vascular endothelial growth factor A (VEGFA) rs3025039, interleukin 1 beta (IL1ß) rs16944, and IL1ß rs1143634 by performing polymerase chain reaction-restriction fragment length polymorphism analysis, and the results were confirmed by DNA sequencing. RESULTS: There was no significant difference in the age, parity, body mass index, or other characteristics tested between the preeclampsia group and the control group (60 women in each arm). The rs3025039, rs16944, and rs1143634 genotypes were distributed in accordance with Hardy-Weinberg equilibrium (p > .05). For rs3025039, CT, CT+TT, and the T allele were risk factors for preeclampsia (odds ratio [OR] = 2.4; 95% CI [1.12-5.32]; p = .02; OR = 2.49 [1.17-25.27]; p = .01; OR = 2.05; 95% CI [1.10-3.83]; p = .02, respectively). Regarding rs16944, only the heterozygous genotype CT was associated with preeclampsia (OR = 2.55; 95% CI [1.15-5.56]; p = .01). Regarding rs1143634, CT, CT+TT, and the T allele were risk factors for preeclampsia (OR = 5.28; 95% CI [2.26-12.33]; p < .001; OR = 4.50; 95% CI [2.06-9.81]; p < .001; OR = 2.75; 95% CI [1.48-5.12]; p = .001, respectively). CONCLUSION: Polymorphisms in IL1ß and VEGFA were associated with preeclampsia in this setting. Significant associations were observed between preeclampsia and rs3025039, rs16944, and rs1143634.

Response of sediment microbial communities to crude oil contamination in marine sediment microbial fuel cells under ferric iron stimulation.

In this study, response of the microbial communities associated with the bioremediation of crude oil contaminated marine sediments was addressed using sediment microbial fuel cells (SMFCs). Crude oil was spiked into marine sediments at 1 g/kg of dry sediment to simulate a heavily contaminated marine environment. Conventional SMFCs were used with carbon fiber brushes as the electrode components and were enhanced with ferric iron to stimulate electrochemically active bacteria. Controls were operated under open circuit with and without ferric iron stimulation, with the latter condition simulating natural attenuation. Crude oil removal in the Fe enhanced SMFCs reached 22.0 ± 5.5% and was comparable to the measured removal in the control treatments (19.2 ± 7.4% in natural attenuation SMFCs and 15.2 ± 2.7% in Fe stimulated open circuit SMFCs), indicating no major enhancement to biodegradation under the applied experimental conditions. The low removal efficiency could be due to limitations in the mass transfer of the electron donor to the microbes and the anodes. The microbial community structure showed similarity between the iron stimulated SMFCs operated under the open and closed circuit. Natural attenuation SMFCs showed a unique profile. All SMFCs showed high relative abundances of hydrocarbon degrading bacteria rather than anode reducers, such as Marinobacter and Arthrobacter in the case of the natural attenuation SMFCs, and Gordonia in the case of iron stimulated SMFCs. This indicated that the microbial structure during the bioremediation process was mainly determined by the presence of petroleum contamination and to a lesser extent the presence of the ferric iron, with no major involvement of the anode as a terminal electron acceptor. Under the adopted experimental conditions, the absence of electrochemically active microbes throughout the biodegradation process indicates that the use of SMFCs in crude oil bioremediation is not a successful approach. Further studies are required to optimize SMFCs systems for this aim.

Cytotoxic T-lymphocyte antigen-4 +49A/G polymorphisms in Sudanese adults with type 1 diabetes and latent autoimmune diabetes.

OBJECTIVES: This study was conducted to assess the association of T-lymphocyte-associated protein 4 (CTLA-4 +49A/G) variant with Latent autoimmune diabetes in adults (LADA) in Eastern Sudan. The study included 24 LADA, 240 patients with type 1 diabetes mellitus (T1DM), and 240 healthy controls. Genotyping for CTLA-4 +49A/G was done by polymerase chain reaction restriction fragment length polymorphism (PCR-RFLP). RESULTS: Genotypes distribution of CTLA-4 in controls was in accordance with the HWE (P > 0.05). The frequency of mutation (both homozygous and heterozygous) of CTLA-4 +49A/G (AG + GG) was significantly higher in LADA compared with T1DM and the controls [19 (79.1%) vs. 100 (41.7%) vs. 78 (32.5%), P < 0.001]. It was significantly higher when LADA was compared with T1DM [19 (79.1%) vs. 100 (41.7%), P = 0.018, OR = 3.21, 95% CI 1.16-8.89] and when LADA was compared with the controls [19 (79.1%) vs. 78 (32.5%), P = 0.001, OR = 4.49, 95% CI 1.62-12.42]. The rate of heterozygous mutation of the CTLA-4 +49A/G (AG) was significantly higher in LADA compared with T1DM and the controls [16 (66.7%) vs. 85 (35.4%) vs. 70 (29.2%), P < 0.001]. It was significantly higher when LADA was compared with T1DM [16 (66.7%) vs. 85 (35.4%), P = 0.002, OR = 3.64, 95% CI 1.49-8.87] and when LADA was compared with the controls [16 (66.6%) vs. 85 (35.4%), P = 0.001, OR = 4.85, 95% CI 1.98-11.86].

Total quality management in the health-care context: integrating the literature and directing future research.

BACKGROUND: Synergistic integration of predictors and elements that determine the success of total quality management (TQM) implementations in hospitals has been the bane of theoretical development in the TQM research area. Thus, this paper aims to offer a systematic literature review to provide a foundation on which research on TQM can be built and to identify the predictors of successful TQM in the health-care context. MATERIALS AND METHODS: A systematic literature survey was adopted in this paper, involving the review of 25 relevant researched articles found in the databases Science Direct, EBSCO, MEDLINE, CINAHL and PubMed. RESULT: The systematic literature survey reveals five variables to be core predictors of TQM, signifying how important these variables are in the successful implementation of TQM in the health-care context. Also, it is revealed that the identified core predictors have positive effects on an improved health-care system. However, the systematic survey of the literature reveals a dearth of studies on TQM in the health-care context. CONCLUSION: As TQM has become an important management approach for advancing effectiveness in the health-care sector, this kind of research is of value to researchers and managers. Stakeholders in the health sectors should introduce and implement TQM in hospitals and clinics. Nevertheless, this study has limitations, including that the databases and search engines adopted for the literature search are not exhaustive.