Highlights of the BMC Series – July 2021

Deconstructing COVID-19 false dichotomies - identifying tomatoes varieties ready for global warming - using wearable devices to avoid solitary deaths - effect of growing old in areas with lower sunlight exposure on the incidence of colorectal cancer - safety and feasibility of oral-fecal microbiota transplantation for the treatment of ulcerative colitis.

BMC Infectious Diseases – COVID-19 false dichotomies and a comprehensive review of the evidence regarding public health, COVID-19 symptomatology, SARS-CoV-2 transmission, mask wearing, and reinfection

The coronavirus disease 2019 (COVID-19) represents an unparalleled challenge not only to our health systems, but also to our lives as a community. During the COVID-19 pandemic we have seen a lot of misinformation and polarization around topics related to the virus and its spread. In a commendable effort to shed some light on this issue, Escandón from Universidad del Valle, Cali, Colombia, and colleagues present a comprehensive, engaging and well documented review that deconstructs six common COVID-19 false dichotomies: 1) Health and lives vs. economy and livelihoods, 2) Indefinite lockdown vs. unlimited reopening, 3) Symptomatic vs. asymptomatic SARS-CoV-2 infection, 4) Droplet vs. aerosol transmission of SARS-CoV-2, 5) Masks for all vs. no masking, and 6) SARS-CoV-2 reinfection vs. no reinfection. As a take-home message, the authors highlight the critical need for meaningful public health communication and science-informed policies that recognize shades of gray, uncertainties, local context, and social determinants of health.


BMC Plant Biology – Identification of tomato accessions as source of new genes for improving heat tolerance: from controlled experiments to field

The last report from the United Nations assessing climate change estimates a global average increase of 1.5 degrees Celsius in the next 20 years. Urgent climate actions are needed and governments should prepare to secure food sources with the ability to thrive under high temperature environments. In their study, Gonzalo and colleagues from Universitat Politècnica de València, Valencia, Spain focus on one of the most important horticultural crops worldwide, the tomato. The researchers exposed 219 tomato varieties to high temperature stress in controlled greenhouse experiments and measured reproductive traits such as flower and fruit number production to evaluate their heat tolerance. Although extreme high temperatures strongly decrease these traits in most varieties, 15 of them showed significant heat tolerance as well as good agronomic performance in open field cultivation under moderate temperature stress. The study also includes a transcriptomic analysis that offers a wide look into the genetic control of the heat tolerance mechanisms, making it a valuable source for future breeding programs.


BMC Medical Ethics – Solitary death and new lifestyles during and after COVID-19: wearable devices and public health ethics

Even before COVID-19 severely impaired our social connections, solitary home deaths from preventable causes have been on the rise in recent years, especially in the elderly population. In this article, Dr. Nakazawa and colleagues from University of Tokyo, Japan, present a balanced discussion about how wearable devices offer a promising platform for reducing solitary deaths in socially isolated individuals by swiftly connecting them to a broader range of health and social services.

The affordability, availability and functionality of these devices make them invaluable tools, but the authors point out that a successful social implementation will require closing the digital divide and tailoring devices to user preferences. In addition, the use of wearable devices must respect the autonomy and personhood of users and there is a need for proper governance of the information produced by the devices, such as policies to limit access to data from wearables and the purposes for which that data can be used.


BMC Public Health – Could age increase the strength of inverse association between ultraviolet B exposure and colorectal cancer?

As the second cause of death due to cancer worldwide, colorectal cancer (CRC) is still in need of advanced prevention and treatment strategies. Here, Purushothaman and colleagues from University of California, San Diego, USA, assess the accumulative carcinogenic effect from vitamin D deficiency related to inadequate UVB exposure from sunlight.

By using UVB estimates data for 186 different countries obtained from NASA EOS Aura Spacecraft, authors modelled Vitamin D deficiency’s effects as a function of time where long-term chronic deficiencies correlate with increased incidence of colorectal cancer. Increasing age and environmental factors such as lower exposure to UVB radiation (e.g. living at higher latitudes) directly translated into a higher incidence of colorectal cancer. This association was more prominent in age groups over 45 years, even after taking into account factors such as life expectancy, smoking, skin pigmentation or stratospheric ozone.

The study highlights the need for adequate public health programs to avoid vitamin D inadequacy at national and global levels, especially in regions with lower UVB exposure.


BMC Gastroenterology – Daily, oral FMT for long-term maintenance therapy in ulcerative colitis: results of a single-center, prospective, randomized pilot study

The global incidence of Inflammatory Bowel Diseases like Ulcerative colitis and Crohn’s disease has been steadily increasing, prompting a great deal of research into treatment regimens.

Ulcerative colitis (UC) is a complex chronic inflammatory disease of the gastrointestinal tract characterized by immune dysregulation and alterations in the gut microbiota.

In recent years, fecal microbiota transplantation (FMT) has been used increasingly to treat intestinal disorders such as UC but previous studies only use invasive endoscopic or enema-based approaches. In this prospective pilot study, Crothers from University of Vermont Medical Center, USA and colleagues set out to test the feasibility, safety and efficacy of frozen, encapsulated oral FTM as treatment for UC. After 2 weeks of ambulatory oral FTM treatment, researchers observed sustained donor-induced shifts in fecal microbial composition. These changes persisted up to for 4 weeks longer than the intervals reported in previous studies using only colonoscopy FTM treatments. Longitudinal phenotyping analysis of peripheral T-cell populations also showed a correlation between decreased IL-17A and IFNγ mucosal-associated invariant T cell positivity and clinical scores improvement in patients after oral FTM.

Although this is a pilot study conducted on a small number of study subjects, it provides early evidence that warrants further studies on oral FTM treatments for UC.

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