bluuebunny/crossref_metadata_2025 huggingface dataset:
Adherence to National Guidelines on Cervical Screening: A Population-Based Evaluation From a Statewide Registry
Authors: Castle Philip E , Kinney Walter K , Chen Lu , Kim Jane J , Jenison Steven , Rossi Giovanna , Kang Huining , Cuzick Jack , Wheeler Cosette M ,   the New Mexico HPV Pap Registry Steering Committee,   New Mexico HPV Pap Registry Steering Committee Collaborators, Joste Nancy E Walter , Kinney Cosette M , Wheeler Charles L , Wiggins Michael , Robertson Ruth M , McDonald Alan , Waxman Steven , Jenison Jean , Howe Debbie , Saslow Jane J , Kim Mark H , Stoler Jack , Cuzick Philip E , Castle Rebecca B , Perkins Janice L , Gonzales Salina , Torres Giovanna , Rossi Kevin , English
Published: August 2021

In 2012, national recommendations for cervical cancer screening of women aged 30-64 years were quinquennial human papillomavirus and cytology cotesting or triennial cytology. Data from a statewide surveillance program in New Mexico demonstrated 65.2% (95% confidence interval [95% CI] = 64.6% to 65.7%) of women screened in 2019 had a negative cotest within the last 3 years. Percentages of women screened in 2013, 2016, and 2019 with a prior negative cotest more than 5 years and up to 7 years ago were 2.6% (95% CI = 2.2% to 2.9%), 2.1% (95% CI = 1.9% to 2.2%), and 6.5% (95% CI = 6.2% to 6.8%), respectively (2-sided Ptrend < .001). Percentages of women screened in 2013, 2016, and 2019 with a prior negative cytology more than 5 years and up to 7 years ago were 3.8% (95% CI = 3.7% to 3.9%), 9.0% (95% CI = 8.7% to 9.3%), and 14.9% (95% CI = 14.4% to 15.4%), respectively (2-sided Ptrend < .001). Thus, in 2019, only 12.7% (95% CI = 12.4% to 13.1%) of the 30 215 women aged 30-64 years underwent cotesting and 27.7% (95% CI = 27.1% to 28.3%) of the 18 733 underwent cytology at the recommended interval. The observed under- and overscreening could result in increases in cervical cancer incidence and harms and costs, respectively.
Convergent Phenotypic Evolution of Rhodopsin for Dim-Light Sensing across Deep-Diving Vertebrates
Authors: Xia Yu , Cui Yimeng , Wang Aishan , Liu Fangnan , Chi Hai , Potter Joshua H T , Williamson Joseph , Chen Xiaolan , Rossiter Stephen J , Liu Yang
Published: August 2021

Rhodopsin comprises an opsin attached to a retinal chromophore and is the only visual pigment conferring dim-light vision in vertebrates. On activation by photons, the retinal group becomes detached from the opsin, which is then inactive until it is recharged. Of all vertebrate species, those that dive face unique visual challenges, experiencing rapid decreases in light level and hunting in near darkness. Here, we combine sequence analyses with functional assays to show that the rhodopsin pigments of four divergent lineages of deep-diving vertebrates have undergone convergent increases in their retinal release rate. We compare gene sequences and detect parallel amino acids between penguins and diving mammals and perform mutagenesis to show that a single critical residue fully explains the observed increases in retinal release rate in both the emperor penguin and beaked whale. At the same time, we find that other shared sites have no significant effect on retinal release, implying that convergence does not always signify adaptive significance. We propose that accelerated retinal release confers rapid rhodopsin recharging, enabling the visual systems of diving species to adjust quickly to changing light levels as they descend through the water column. This contrasts with nocturnal species, where adaptation to darkness has been attributed to slower retinal release rates.
What matters for people with brain cancer? Selecting clinical quality indicators for an Australian Brain Cancer Registry
Authors: Matsuyama Misa , Sachchithananthan Mythily , Leonard Robyn , Besser Michael , Nowak Anna K , Truran Donna , Vajdic Claire M , Zalcberg John R , Gan Hui K , Gedye Craig , Varikatt Winny , Koh Eng-Siew , Kichenadasse Ganessan , Sim Hao-Wen , Gottardo Nicholas G , Spyridopoulos Desma , Jeffree Rosalind L
Published: August 2021

Background

The goal of a clinical quality registry is to deliver immediate gains in survival and quality of life by delivering timely feedback to practitioners, thereby ensuring every patient receives the best existing treatment. We are developing an Australian Brain Cancer Registry (ABCR) to identify, describe, and measure the impact of the variation and gaps in brain cancer care from the time of diagnosis to the end of life.

Methods

To determine a set of clinical quality indicators (CQIs) for the ABCR, a database and internet search were used to identify relevant guidelines, which were then assessed for quality using the AGREE II Global Rating Scale. Potential indicators were extracted from 21 clinical guidelines, ranked using a modified Delphi process completed in 2 rounds by a panel of experts and other stakeholders, and refined by a multidisciplinary Working Group.

Results

Nineteen key quality reporting domains were chosen, specified by 57 CQIs detailing the specific inclusion and outcome characteristics to be reported.

Conclusion

The selected CQIs will form the basis for the ABCR, provide a framework for achievable data collection, and specify best practices for patients and health care providers, with a view to improving care for brain cancer patients. To our knowledge, the systematic and comprehensive approach we have taken is a world first in selecting the reporting specifications for a brain cancer clinical registry.
Sex and Gender Differences in Testing, Hospital Admission, Clinical Presentation, and Drivers of Severe Outcomes From COVID-19
Authors: Scully Eileen P , Schumock Grant , Fu Martina , Massaccesi Guido , Muschelli John , Betz Joshua , Klein Eili Y , West Natalie E , Robinson Matthew , Garibaldi Brian T , Bandeen-Roche Karen , Zeger Scott , Klein Sabra L , Gupta Amita
Published: August 2021

Background

Males experience increased severity of illness and mortality from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) compared with females, but the mechanisms of male susceptibility are unclear.

Methods

We performed a retrospective cohort analysis of SARS-CoV-2 testing and admission data at 5 hospitals in the Maryland/Washington DC area. Using age-stratified logistic regression models, we quantified the impact of male sex on the risk of the composite outcome of severe disease or death (World Health Organization score 5–8) and tested the impact of demographics, comorbidities, health behaviors, and laboratory inflammatory markers on the sex effect.

Results

Among 213 175 SARS-CoV-2 tests, despite similar positivity rates, males in age strata between 18 and 74 years were more frequently hospitalized. For the 2626 hospitalized individuals, clinical inflammatory markers (interleukin-6, C-reactive protein, ferritin, absolute lymphocyte count, and neutrophil:lymphocyte ratio) were more favorable for females than males (P < .001). Among 18–49-year-olds, male sex carried a higher risk of severe outcomes, both early (odds ratio [OR], 3.01; 95% CI, 1.75 to 5.18) and at peak illness during hospitalization (OR, 2.58; 95% CI, 1.78 to 3.74). Despite multiple differences in demographics, presentation features, comorbidities, and health behaviors, these variables did not change the association of male sex with severe disease. Only clinical inflammatory marker values modified the sex effect, reducing the OR for severe outcomes in males aged 18–49 years to 1.81 (95% CI, 1.00 to 3.26) early and 1.39 (95% CI, 0.93 to 2.08) at peak illness.

Conclusions

Higher inflammatory laboratory test values were associated with increased risk of severe coronavirus disease 2019 for males. A sex-specific inflammatory response to SARS-CoV-2 infection may underlie the sex differences in outcomes.
Light-Response Bric-A-Brack/Tramtrack/Broad proteins mediate cryptochrome 2 degradation in response to low ambient temperature
Authors: Ma Libang , Li Xu , Zhao Zhiwei , Hao Yuhao , Shang Ruixin , Zeng Desheng , Liu Hongtao
Published: August 2021

Cryptochromes (crys) are photolyase-like blue-light receptors first discovered in Arabidopsis thaliana and later identified in all major evolutionary lineages. Crys are involved in not only blue light responses but also in temperature responses; however, whether and how cry protein stability is regulated by temperature remains unknown. Here, we show that cry2 protein abundance is modulated by ambient temperature and cry2 protein is degraded under low ambient temperature via the 26S proteasome. Consistent with this, cry2 shows high levels of ubiquitination under low ambient temperatures. Interestingly, cry2 degradation at low ambient temperatures occurs only under blue light and not under red light or dark conditions, indicating blue-light-dependent degradation of cry2 at low ambient temperature. Furthermore, low ambient temperature promotes physical interaction of Light-Response Bric-a-Brack/Tramtrack/Broad (LRB) proteins with cry2 to modulate its ubiquitination and protein stability in response to ambient temperature. LRBs promote high-temperature-induced hypocotyl elongation by modulating the protein stability of cry2 protein. These results indicate that cry2 accumulation is regulated by not only blue light but also ambient temperature, and LRBs are responsible for cry2 degradation at low ambient temperature. The stabilization of cry2 by high temperature makes cry2 a better negative regulator of temperature responses.
A Systematic Review and Meta-analysis of Clinical Trials of Neuraxial, Intravenous, and Inhalational Anesthesia for External Cephalic Version
Authors: Hao Q. , Hu Y. , Zhang L. , Ross J. , Robishaw S. , Noble C. , Wu X. , Zhang X.
Published: August 2021

(Anesth Analg. 2020;131:1800–1811)

External cephalic version (ECV) is a procedure used on parturient women at term during vaginal delivery of noncephalic fetal presentation. Data suggests that successful ECV at term decreases the rate of cesarean delivery and overall financial cost without increasing neonatal complications. While several interventions have been shown to increase the efficacy of ECV, there is no consensus regarding anesthetic care in association to ECV. This study aims to analyze data to compare maternal and fetal outcomes of ECV techniques (with and without inhalational, neuraxial, and intravenous anesthesia) and the association with cesarean delivery rates.
Carbetocin Compared With Oxytocin in Nonelective Cesarean Delivery: A Systematic Review, Meta-analysis, and Trial Sequential Analysis of Randomized-controlled Trials
Authors: Onwochei D.N. , Owolabi A. , Singh P.M. , Monks D.T.
Published: August 2021

(Can J Anesth. 2020;67:1524–1534)

Uterotonic agents, such as oxytocin and carbetocin, are used in the management of uterine atony, a major cause of postpartum hemorrhage (PPH). While oxytocin and carbetocin both have fast onset of action, oxytocin has a short duration of action, requiring immediate intravenous (IV) infusion during the perioperative period. In contrast, carbetocin has a longer duration with effects lasting for 60 minutes after onset. Previous literature suggests that carbetocin may be as effective as oxytocin, and a recent study showed that the need for additional uterotonics was reduced by 53% with carbetocin versus oxytocin for elective cesarean delivery (CD). However, it remains unclear how these 2 uterotonics compare in pregnant women undergoing nonelective CD. The aim of this study was to compare the efficacy of carbetocin with oxytocin in women undergoing nonelective CD.
Epidemiological Analysis of Peripartum Hysterectomy Across 9 European Countries
Authors: Kallianidis A.F. , Maraschini A. , Danis J. , Colmorn L.B. , Deneux-Tharaux C. , Donati S. , Gissler M. , Jakobsson M. , Knight M. , Kristufkova A. , Lindqvist P.G. , Vandenberghe G. , Van Den Akker T.
Published: August 2021

(Acta Obstet Gynecol Scand. 2020;99:1364–1373)

Peripartum hysterectomy is typically performed in cases of severe obstetric complications such as massive obstetric hemorrhage, sepsis, uterine rupture, or abnormally invasive placenta. It is an outcome of interest in obstetric surveillance due to its classification by the World Health Organization as a near-miss criteria. The primary aim of this study was to compare rates of and indications for peripartum hysterectomy within high-income countries. Secondarily, authors aimed to describe hysterectomy indications and prevalence of peripartum hysterectomy based on country and other categories of birth including previous cesarean delivery (CD).
Obstetric Hemorrhage and Risk of Cardiovascular Disease After Three Decades: A Population-based Cohort Study
Authors: Ukah U.V. , Platt R.W. , Potter B.J. , Paradis G. , Dayan N. , He S. , Augera N.
Published: August 2021

(BJOG. 2020;127:1489–1497)

The association between pregnancy complications and future risk of cardiovascular disease has been well studied. But most studies have focused on the hypertensive disorders of pregnancy and gestational diabetes. Less examined is the effect of other common disorders of pregnancy, such as obstetric hemorrhage, on the risk of cardiovascular disease later in life. The aim of this study was to examine whether there is an increased risk of cardiovascular disease up to 3 decades after pregnancy with obstetric hemorrhage.
Clinical Validation of Bioreactance for the Measurement of Cardiac Output in Pregnancy
Authors: Ling H.Z. , Gallardo-Arozena M. , Company-Calabuig A.M. , Nicolaides K.H. , Kametas N.A.
Published: August 2021

(Anaesthesia. 2020;75:1307–1313)

This study aimed to use 2-dimensional transthoracic echocardiography (TTE) and the Non-Invasive Cardiac Output Monitor (NICOM) to investigate distinct hemodynamic patterns found in pregnancy to determine whether those measurements could be used to predict and prevent preeclampsia and fetal growth restriction. The primary outcome was validation of cardiac output assessment via bioreactance compared against TTE with simultaneously paired recordings.
Association of SARS-CoV-2 Test Status and Pregnancy Outcomes
Authors: Ahlberg M. , Neovius M. , Saltvedt S. , Söderling J. , Pettersson K. , Brandkvist C. , Stephansson O.
Published: August 2021

(JAMA. 2020;324:1782–1785)

Case reports and case series make up most of the studies on coronavirus disease 2019 (COVID-19) and pregnancy outcomes. Lacking are studies with a comparison group. The aim of this study was to compare women in labor infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) with those who were not infected.
Clinical Outcomes of Pregnant and Postpartum Extracorporeal Membrane Oxygenation Patients
Authors: Lankford A.S. , Chow J.H. , Jackson A.M. , Wallis M. , Galvagno S.M. , Malinow A.M. , Turan O.M. , Menaker J.A. , Crimmins S.D. , Rector R. , Kaczorowski D. , Griffith B. , Kon Z. , Herr D. , Mazzeffi M.A.
Published: August 2021

(Anesth Analg. 2021;132:777–787)

Cardiovascular issues account for more than one third of pregnancy-related deaths in the United States. Extracorporeal membrane oxygenation (ECMO) is used to treat patients in shock, with hypoxemic and hypercapnic acute respiratory failure, acute respiratory distress syndrome (ARDS), and massive pulmonary embolism (PE), among others. Pregnancy involves unique etiologies of cardiopulmonary failure like amniotic fluid embolism, preeclampsia, and postpartum hemorrhage. There is little data on ECMO in pregnancy, and even a lack of data on the mortality benefit of venoarterial (VA) or venovenous (VV) ECMO in nonpregnant patients with cardiopulmonary arrest, ARDS, and massive PE. This study explored long-term cardiopulmonary outcomes in patients who received peripartum ECMO treatment.
Examining Adverse Fetal/Neonatal Outcomes Associated With Severe Maternal Morbidity
Authors: Lawton B. , Filoche S. , MacDonald E.J. , Stanley J. , Meeks M. , Stone P. , Storey F. , Geller S.E.
Published: August 2021

(Aust N Z J Obstet Gynaecol. 2020;60:865–870)

Severe maternal morbidity (SMM) affects up to 2% of pregnancies worldwide. Up to 40% of SMM may be preventable, and racial and ethnic disparities exist within SMM. Less is known about the effect of SMM on fetal and neonatal outcomes. The aim of this study was to review fetal and neonatal outcomes associated with SMM in pregnancy in New Zealand.
Relationship Between Postpartum Mood Disorder and Birth Experience: A Prospective Observational Study
Authors: Kountanis J.A. , Muzik M. , Chang T. , Langen E. , Cassidy R. , Mashour G.A. , Bauer M.E.
Published: August 2021

(Int J Obstet Anesth. 2020;44:90–99)

Postpartum depression (PPD) affects 1 in 5 mothers and posttraumatic stress disorder (PTSD) may affect up to 15.7% postpartum women. Traumatic birth experience has been identified as a risk factor associated with PPD, but what qualifies an event as traumatic is at times unclear and varies across studies. A patient’s expectations, when differing from the realized experience, can also contribute to risk for PPD or PTSD. This study aimed to identify birth events associated with increased risk of PPD and postpartum PTSD.
Risk of Complicated Birth at Term in Nulliparous and Multiparous Women Using Routinely Collected Maternity Data in England: Cohort Study
Authors: Jardine J. , Blotkamp A. , Gurol-Urganci I. , Knight H. , Harris T. , Hawdon J. , van der Meulen J. , Walker K. , Pasupathy D.
Published: August 2021

(BMJ. 2020;371:1–10)

Risk assessment during antenatal and intrapartum care allows health care providers to identify patients who might have complications during childbirth. In the UK, risk factors such as woman’s age, body mass index (BMI), and the presence of specific clinical and obstetric conditions are used to identify in which location a woman should deliver. The National Institute for Health and Care Excellence (NICE) guidelines state while low-risk women could deliver at home or in a midwife setting, women with increased risk are recommended to deliver in an obstetric unit. The primary aim of this study was to assess the NICE guidelines to determine the rate of complicated at-term birth in low-risk women and to assess if risk classification can be improved by expanding the list of considered risk factors including parity.
Antenatal Glucocorticoids in Low-Resource Settings—Who, When, and Where?
Authors: Rouse D.J. , Stringer J.S.A.
Published: August 2021

(N Engl J Med. 2020;383:2584–2585)

Glucocorticoid therapy has been long known to improve neonatal outcomes in preterm birth. The data supporting the use of antenatal glucocorticoids largely comes from high-resource countries. The Antenatal Corticosteroids Trial (ACT) published in 2015 investigated the use of antenatal dexamethasone in settings with limited access to obstetricians and neonatal intensive care. ACT found antenatal dexamethasone did not lower mortality among neonates with a birth weight below the fifth percentile (a proxy for preterm birth), but instead increased overall neonatal mortality compared with placebo (27.4 vs. 23.9 deaths/1000 live births) and increased the incidence of suspected maternal infection (3% to 2%).
A Risk Score for Postoperative Nausea and/or Vomiting in Women Undergoing Cesarean Delivery With Intrathecal Morphine
Authors: Tan H.S. , Cooter M. , George R.B. , Habib A.S.
Published: August 2021

(Int J Obstet Anesth. 2020;44:126–130)

Up to 4 of 5 cesarean delivery (CD) patients receiving intrathecal morphine are affected by postoperative nausea and/or vomiting (PONV). Existing PONV risk assessment scores including the Apfel score were developed based on the general surgical population, while none have been designed specifically for obstetric patients. This post hoc analysis aimed to develop a PONV prediction model (the Duke score) specifically for the obstetric population and compare it to the Apfel score.
Intraoperative Ketorolac 15 mg Versus 30 mg for Analgesia Following Cesarean Delivery: A Retrospective Study
Authors: Yurashevich M. , Pedro C. , Fuller M. , Habib A.S.
Published: August 2021

(Int J Obstet Anesth. 2020;44:116–121)

Ketorolac is commonly used to manage postcesarean delivery pain. While the manufacturer recommends an intravenous (IV) dose of 30 mg for adults under age 65, a dose of 15 mg is sometimes used. There is a lack of data on the efficacy, outcomes, or side effects associated with a higher or lower dose. This study was conducted in a center that uses both doses for postcesarean analgesia and aimed to compare analgesic efficacy for each dose. The hypothesis was that the 30 mg dose would be associated with lower opioid use.
Evidence-based practice knowledge, attitudes, practices, and barriers
Authors: Crable Jane , Highfield Martha E. Farrar , Patmon Frances
Published: August 2021

This study assessed nurses' knowledge, attitudes, practices, and perceived barriers related to evidence-based practice (EBP). Nurses reported highly positive attitudes toward EBP, and relatively strong EBP knowledge and practices, but they also identified several barriers. Removing barriers and building on strengths may close this knowledge-practice gap.
Renal cell carcinoma, part 3
Authors: Pullen Richard L.
Published: August 2021

Renal cell carcinoma (RCC) accounts for most renal malignancies. This article, the last in a three-part series, presents treatment options for RCC using the American Joint Committee on Cancer Tumor, Node, and Metastasis staging system as a framework, as well as nursing-care options for patients undergoing partial or radical nephrectomy.
Improving mental health education in nursing school
Authors: Bennett Courtney
Published: August 2021

Nurses are at the forefront of providing care to individuals with mental illness in various healthcare settings, yet the World Health Organization and others have found that many nurses are inadequately prepared to provide mental health care. This article discusses the nurse's role in providing care to individuals with mental illness and the importance of integrating more mental health education into undergraduate nursing curricula.
Increasing Hepatitis C Screening in a Federally Qualified Health Center: A Quality Improvement Initiative
Authors: Klein Melissa D. , Harrington Bryna J. , East Joan , Cunningham Jennifer , Ifill Nicole , Santos Jan Lee
Published: August 2021

Hepatitis C virus (HCV) is a chronic infection that can lead to severe liver damage if left untreated. With increased availability and affordability of curative treatments, screening for HCV has become an important first step in reducing morbidity and mortality. At a rural federally qualified health center in North Carolina, two quality improvement initiatives—an electronic health record (EHR) prompt and educational flyers—were implemented to improve HCV screening rates. We compared the proportion of eligible patients born from 1945 to 1965 who received HCV screening before, during, and after the initiatives. HCV screening rates were highest during the two initiatives (30% and 39%, respectively). Screening rates fell in the 6-month period after the initiatives' conclusion (12%) but remained higher than at baseline (6%). Although HCV screening can increase with simple interventions, more durable solutions are needed to maintain screening coverage.
Why Competency Standardization Matters for Improvement: An Assessment of the Healthcare Quality Workforce
Authors: Miltner Rebecca , Pesch Lucie , Mercado Stephanie , Dammrich Thomas , Stafford Terry , Hunter Jaclyn , Stewart Glenda
Published: August 2021

Healthcare transformation requires a healthcare quality workforce with the requisite expertise to lead, oversee, and implement positive change within healthcare organizations. The National Association for Healthcare Quality (NAHQ) Competency Framework, which spans 29 competencies across 8 domains of healthcare quality, outlines the specific knowledge and skills needed to advance personal and organizational quality goals. This study describes 1,671 responses to the NAHQ Professional Assessment survey from a diverse group of healthcare quality professionals representative of NAHQ's professional community. Results show that two-thirds of respondents indicated they are working in 4 or more competency domains, with 85% reporting working in Performance and Process Improvement. Results also indicate that individuals who hold the Certified Professional in Healthcare Quality (CPHQ) certification perform work at more advanced levels across all eight domains of the competency framework. This was statistically significant for 13 of the 29 competencies including all three competency statements within the Performance and Process Improvement domain. Healthcare organizations need a workforce with specialized quality and safety expertise to advance quality goals, and this study suggests that those who invest in continued professional development by attaining the CPHQ certification may be better positioned to contribute meaningfully to advance these goals and improve organizational outcomes.
Methylene Blue
Authors: Pushparajah Mak Renita S. , Liebelt Erica L.
Published: August 2021

Methylene blue has been in medicinal use for centuries and is best known as an antidotal treatment for acquired methemoglobinemia (MetHB). More recently, methylene blue has gained recognition for its efficacious use in the treatment of ifosfamide neurotoxicity and refractory vasoplegic shock in both the pediatric and adult critical care literature, extending its use beyond MetHB. Methylene blue’s mechanism of action is somewhat complex and based partly on its oxidizing capabilities, ironically the same mechanism that causes MetHB. This review will examine methylene blue’s use in the treatment of acquired MetHB and ifosfamide neurotoxicity and review the current literature regarding its role in critically ill pediatric and adult patients with refractory vasoplegic shock. Methylene blue’s pharmacologic actions, dosing, and adverse effects will also be discussed.
Interviewing for an Aesthetic Provider Position? Questions You Should Be Asking!
Authors: Hagen Mary Beth
Published: August 2021

Interviewing for aesthetic provider positions is vastly different from the interview process for many jobs. The field of aesthetics, especially providing injectable treatments, requires strong competencies in medical and nursing knowledge, artistic skill, and marketing prowess. Competition for hiring and retaining the best injectors can be fierce among employers. In a world where skilled injectors may have their pick of positions, candidates should be cognizant of the types of questions they should be asking their potential employers during the interview process to determine if a job is the best fit for them. Similarly, employers should be cognizant of the questions they should be asking potential employees to ensure that the candidate has the knowledge, skills, and abilities to meet the demands of the position.
Pioneering polyploids: the impact of whole-genome duplication on biome shifting in New Zealand
Coprosma
(Rubiaceae) and
Veronica
(Plantaginaceae)
Authors: Liddell Luke G. , Lee William G. , Dale Esther E. , Meudt Heidi M. , Matzke Nicholas J.
Published: August 2021

The role of whole-genome duplication (WGD) in facilitating shifts into novel biomes remains unknown. Focusing on two diverse woody plant groups in New Zealand,
Coprosma
(Rubiaceae) and
Veronica
(Plantaginaceae), we investigate how biome occupancy varies with ploidy level, and test the hypothesis that WGD increases the rate of biome shifting. Ploidy levels and biome occupancy (forest, open and alpine) were determined for indigenous species in both clades. The distribution of low-ploidy (
Coprosma
: 2
x
,
Veronica
: 6
x
) versus high-ploidy (
Coprosma
: 4–10
x
,
Veronica
: 12–18
x
) species across biomes was tested statistically. Estimation of the phylogenetic history of biome occupancy and WGD was performed using time-calibrated phylogenies and the R package BioGeoBEARS. Trait-dependent dispersal models were implemented to determine support for an increased rate of biome shifting among high-ploidy lineages. We find support for a greater than random portion of high-ploidy species occupying multiple biomes. We also find strong support for high-ploidy lineages showing a three- to eightfold increase in the rate of biome shifts. These results suggest that WGD promotes ecological expansion into new biomes.
The ontogeny of human laughter
Authors: Kret Mariska E. , Venneker Dianne , Evans Bronwen , Samara Iliana , Sauter Disa
Published: August 2021

Human adult laughter is characterized by vocal bursts produced predominantly during exhalation, yet apes laugh while exhalingandinhaling. The current study investigated our hypothesis that laughter of human infants changes from laughter similar to that of apes to increasingly resemble that of human adults over early development. We further hypothesized that the more laughter is produced on the exhale, the more positively it is perceived. To test these predictions, novice (n= 102) and expert (phonetician,n= 15) listeners judged the extent to which human infant laughter (n= 44) was produced during inhalation or exhalation, and the extent to which they found the laughs pleasant and contagious. Support was found for both hypotheses, which were further confirmed in two pre-registered replication studies. Likely through social learning and the anatomical development of the vocal production system, infants' initial ape-like laughter transforms into laughter similar to that of adult humans over the course of ontogeny.
An update on ampicillin resistance and β-lactamase genes of Bacteroides spp.
Authors: Sóki József , Keszőcze Anikó , Nagy István , Burián Katalin , Nagy Elisabeth
Published: August 2021

Introduction. There are several β-lactamase genes described for

Bacteroide

s strains, of which cepA and cfiA are specific for

Bacteroides fragilis

and define two genetic divisions. The expression and phenotypic effects of these genes are usually regulated by insertional activation.

Hypotheses/Gap Statement. Information is lacking about how cepA is regulated for most of the

B. fragilis

strains and whether there could be a genetic element for it.

Aim. We aimed to investigate the molecular background of ampicillin (and other β-lactam) resistance among

Bacteroides

strains as mediated mainly by cepA and also to find a genetic element for it as known for cfiA.

Methodology. Various PCR methods were used for β-lactamase-resistance gene and insertion sequence (IS) element detection in 42

Bacteroides

strains. β-Lactamase activity measurements and antimicrobial-susceptibility testing using agar dilution were also applied. Further molecular experiments involved sequencing, gene targeting, Southern blotting and bioinformatic analyses.

Results. We found that high antibiotic resistance and β-lactamase levels are brought about by insertional activation of the cepA gene or by similar or dissimilar activation of cfxA or cfiA, or by the newly described pbbA genes. Non-activated cepA genes produced low levels of specific β-lactamase activities that did not correlate with ampicillin resistance. We found a genetic element for cepA and another region close to it that are characteristic for division I

B. fragilis

strains, which are replaced by other sequences in division II

B. fragilis

strains.

Conclusion.
cepA usually is not activated by IS elements and usually produces low β-lactamase activities that do not correlate with the ampicillin MICs; therefore, it probably involves some non-β-lactamase-mediated resistance mechanism(s). pbpA is a newly described, effective β-lactamase gene that is located on a plasmid, and cepA resides on a well-defined chromosomal segment that is mutually replaced in division II

B. fragilis

strains. This latter finding demonstrates the genetic dichotomy of cepA–cfiA in

B. fragilis

and requires further investigation.
Inferring Transmission Fitness Advantage of SARS-CoV-2 Variants of Concern in Wastewater Using Digital PCR
Authors: Caduff Lea , Dreifuss David , Schindler Tobias , Devaux Alexander J. , Ganesanandamoorthy Pravin , Kull Anina , Stachler Elyse , Fernandez-Cassi Xavier , Beerenwinkel Niko , Kohn Tamar , Ort Christoph , Julian Timothy R.
Published: August 2021

Throughout the global COVID-19 pandemic, SARS-CoV-2 genetic variants of concern (VOCs) have repeatedly and independently arisen. VOCs are characterized by increased transmissibility, increased virulence, or reduced neutralization by antibodies obtained from prior infection or vaccination. Tracking the introduction and transmission of VOCs relies on sequencing, typically whole-genome sequencing of clinical samples. Wastewater surveillance is increasingly used to track the introduction and spread of SARS-CoV-2 variants through sequencing approaches. Here, we adapt and apply a rapid, high-throughput method for detection and quantification of the frequency of two deletions characteristic of the B.1.1.7, B.1.351, and P.1 VOCs in wastewater. We further develop a statistical approach to analyze temporal dynamics in drop-off RT-dPCR assay data to quantify transmission fitness advantage, providing data similar to that obtained from clinical samples. Digital PCR assays targeting signature mutations in wastewater offer near real-time monitoring of SARS-CoV-2 VOCs and potentially earlier detection and inference on transmission fitness advantage than clinical sequencing.
Symptomatology associated with the diffusion of the SARS-CoV-2 Lambda variant in Peru: An infodemiologic analysis
Authors: Henry Brandon Michael , de Oliveira Maria Helena Santos , de Oliveira Thaís Barbosa , Notarte Kin Israel , Lippi Giuseppe
Published: August 2021

The SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2) Lambda variant rapidly diffused across Peru following its identification in December 2020, and had now spread worldwide. In this study, we investigated infodemiologic trends in symptomatology associated with the Coronavirus Disease 2019 (COVID-19) following the spread of SARS-CoV-2 Lambda variant in Peru, enabling infodemiologic surveillance of SARS-CoV-2 in regions with high circulation of this new variant. Weekly Google Trends scores were obtained for key symptom keywords between March 1st, 2020 and July 4th, 2021, whilst case count data were obtained from Peruvian Ministry of Health. Multiple time series linear regression was used to assess trends in each score series, using the week of December 27th as cutoff for emergence of the Lambda variant. The significance of such trends was tested for each time period, before and after the cutoff date. A total 2,075,484 confirmed SARS-CoV-2 infections in Peru in relation to Google Trends data were analyzed. After Lambda variant emergence, searches for “diarrhea” demonstrated a change from a negative to positive correlation with weekly case counts and anticipated dynamic changes in case counts by 1-5 weeks. Searches for “shortness of breath” and “headache” remained consistently positively correlated to weekly case counts before and after Lambda emergence. No changes in searches for other common cold symptoms were observed, while no specific trends were observed for “taste loss” or “smell loss”. Diarrhea, headache, and shortness of breath appear to be the most important symptoms for infodemiologic tracking the current outbreak in Peru and other regions with high circulation of SARS-CoV-2 Lambda variant.
Identifying Online Advice-Seekers for Recovering from Opioid Use Disorder
Authors: Garcia Gian-Gabriel P. , Dehghanpoor Ramin , Stringfellow Erin J. , Gupta Marichi , Rochelle Jillian , Mason Elizabeth , Pujol Toyya A. , Jalali Mohammad S.
Published: August 2021

Background

Online communities can provide social support for those recovering from opioid use disorder. However, advice-seekers on these platforms risk exposure to uncurated medical advice, potentially harming their health or recovery efforts. The objective of this analysis is to combine text annotation, social network analysis, and statistical modeling to identify advice-seekers on online social media for buprenorphine-naloxone use and study their characteristics.

Methods

We collected 5,258 posts and their comments from Reddit between 2014 and 2019. Among 202 posts which met our inclusion criteria, we annotated each post to determine which were advice-seeking (n=137) and not advice-seeking (n=65). We also annotated each posting user’s medication use stage and quantified their connectedness using social network analysis. In order to analyze the relationship between advice-seeking with a user’s social connectivity and medication use stage, we constructed four models which varied in explanatory variables.

Results

The stepwise model (containing “total degree” (P=0.002), “using: inducting/tapering” (P<0.001), and “using: other” (P=0.01) as significant explanatory variables) outperformed all other models. We found that users with fewer connections and who are currently using buprenorphine-naloxone are more likely to seek advice than users who are well-connected and no longer using the medication, respectively. Importantly, advice-seeking behavior is most accurately predicted using a combination of network characteristics and medication use status, rather than either factor alone.

Conclusions

Our findings provide insights for the clinical care of people recovering from opioid use disorder and the nature of online medical advice-seeking overall. Clinicians should be especially attentive (e.g., through frequent follow-up) to patients who are inducting or tapering buprenorphine-naloxone or signal limited social support.
Prediction of vaccine efficacy of the Delta variant
Authors: Chen Xinhua , Azman Andrew S. , Lu Wanying , Sun Ruijia , Zheng Nan , Ge Shijia , Deng Xiaowei , Yang Juan , Leung Daniel T. , Yu Hongjie
Published: August 2021

The emergence of SARS-CoV-2 variants have raised concerns over the protective efficacy of the current generation of vaccines, and it remains unclear to what extent, if any, different variants impact the efficacy and effectiveness of various SARS-CoV-2 vaccines. We systematically searched for studies of SARS-CoV-2 vaccine efficacy and effectiveness, as well as neutralization data for variants, and used a previously published statistical model to predict vaccine efficacy against variants. Overall, we estimate the efficacy of mRNA-1273 and ChAdOx1 nCoV-19 against infection caused by the Delta variant to be 25-50% lower than that of prototype strains. The predicted efficacy against symptomatic illness of the mRNA vaccines BNT162b2 and mRNA-1273 are 95.1% (UI: 88.4-98.1%) and 80.8% (60.7-92.3%), respectively, which are higher than that of adenovirus-vector vaccines Ad26.COV2.S (44.8%, UI: 29.8-60.1%) and ChAdOx1 nCoV-19 (41.1%, 19.8-62.8%). Taken together, these results suggest that the development of more effective vaccine strategies against the Delta variant may be needed. Finally, the use of neutralizing antibody titers to predict efficacy against variants provides an additional tool for public health decision making, as new variants continue to emerge.
A thalamo-centric neural signature for restructuring negative self-beliefs
Authors: Steward Trevor , Kung Po-Han , Davey Christopher G. , Moffat Bradford A. , Glarin Rebecca K. , Jamieson Alec J. , Felmingham Kim L. , Harrison Ben J.
Published: August 2021

Negative self-beliefs are a core feature of psychopathology. Despite this, we have a limited understanding of the brain mechanisms by which negative self-beliefs are cognitively restructured. Using a novel paradigm, we had participants use Socratic questioning techniques to restructure self-beliefs during ultra-high resolution 7-Tesla functional magnetic resonance imaging (UHF fMRI) scanning. Cognitive restructuring elicited prominent activation in a fronto-striato-thalamic circuit, including the mediodorsal thalamus (MD), a group of deep subcortical nuclei believed to synchronize and integrate prefrontal cortex activity, but which has seldom been directly examined with fMRI due to its small size. Increased activity was also identified in the medial prefrontal cortex (MPFC), a region consistently activated by internally focused mental processing, as well as in lateral prefrontal regions associated with regulating emotional reactivity. Using Dynamic Causal Modelling (DCM), evidence was found to support the MD as having a strong excitatory effect on the activity of regions within the broader network mediating cognitive restructuring. Moreover, the degree to which participants modulated MPFC-to-MD effective connectivity during cognitive restructuring predicted their individual tendency to engage in repetitive negative thinking. Our findings represent a major shift from a cortico-centric framework of cognition and provide important mechanistic insights into how the MD facilitates key processes in cognitive interventions for common psychiatric disorders. In addition to relaying integrative information across basal ganglia and the cortex, we propose a multifaceted role for the MD whose broad excitatory pathways act to increase synchrony between cortical regions to sustain complex mental representations, including the self.
BNT162b2 vaccine booster dose protection: A nationwide study from Israel
Authors: Bar-On Yinon M. , Goldberg Yair , Mandel Micha , Bodenheimer Omri , Freedman Laurence , Kalkstein Nir , Mizrahi Barak , Alroy-Preis Sharon , Ash Nachman , Milo Ron , Huppert Amit
Published: August 2021

Background

On July 30, 2021, a third (booster) dose of the Pfizer BNT162b2 vaccine was approved in Israel for individuals 60 years or older who had been fully vaccinated (i.e., received two doses) at least five months previously. Here, we estimate the reduction in relative risk for confirmed infection and severe COVID-19 provided by the booster dose.

Methods

1,144,690 individuals aged 60y and older who were eligible for a booster dose were followed between July 30 and August 22, 2021. We defined dynamic cohorts where individuals initially belong to the ‘non-booster’ cohort, leave it when receiving the booster dose and join the ‘booster’ cohort 12 days later. Rates of infection and severe COVID-19 outcomes per person-days at risk were compared between the cohorts using Poisson regression, adjusting for possible confounding factors.

Results

Twelve days or more after the booster dose we found an 11.4-fold (95% CI: [10.0, 12.9]) decrease in the relative risk of confirmed infection, and a >10-fold decrease in the relative risk of severe illness. Under a conservative sensitivity analysis, we find ≈5-fold protection against confirmed infection.

Conclusions

In conjunction with safety reports, this study demonstrates the effectiveness of a third vaccine dose in both reducing transmission and severe disease and indicates the great potential of curtailing the Delta variant resurgence by administering booster shots.
Short-Term Immune Response After Inactivated SARS-CoV-2 (CoronaVac®, Sinovac) And ChAdOx1 nCoV-19 (Vaxzevria®, Oxford-AstraZeneca) Vaccinations in Thai Health Care Workers
Authors: Jantarabenjakul Watsamon , Chantasrisawad Napaporn , Puthanakit Thanyawee , Wacharapluesadee Supaporn , Hirankarn Nattiya , Ruenjaiman Vichaya , Paitoonpong Leilani , Suwanpimolkul Gompol , Torvorapanit Pattama , Pradit Rakchanok , Sophonphan Jiratchaya , Putcharoen Opass
Published: August 2021

Background

Inactivated SARS-CoV-2 (CoronaVac®,Sinovac, or SV) and ChAdOx1 nCoV-19 (Vaxzevria®,Oxford-Astra Zeneca, or AZ) vaccines have been administered to the health care workers (HCWs) in Thailand.

Objective

To determine the short-term immune response after the SV and AZ vaccinations in HCWs.

Methods

In this prospective cohort study, HCWs who completed a 2-dose regimen of the SV or AZ were included. Immune response was evaluated by surrogate viral neutralization test (sVNT) and anti-SARS-CoV-2 total antibody. Blood samples were analyzed at 4 and 12 weeks after the complete SV vaccination and at 4 weeks after each dose of the AZ vaccination. The primary outcome was the seroconversion rate at 4-weeks after complete immunization.

Results

Overall, 185 HCWs with a median (IQR) age of 40.5(30.3-55.8) years (94 HCWs in the SV group and 91 in the AZ group) were included. At 4 weeks after completing the SV vaccination, 60.6% (95%CI:50.0-70.6%) had seroconversion evaluated by sVNT(≥68%inhibition), comparable to the patients recovered from mild COVID-19 infection(69.0%), with a rapid reduction to 12.2%(95%CI:6.3-20.8) at 12 weeks. In contrast, 85.7%(95%CI:76.8-92.2%) HCWs who completed the second dose of the AZ for 4 weeks had seroconversion, comparable to the COVID-19 pneumonia patients(92.5%). When using the anti-SAR-CoV-2 total antibody level(≥132 U/ml) criteria, only 71.3% HCWs in the SV group had seroconversion, compared to 100% in the AZ group.

Conclusion

A rapid decline of short-term immune response in the HCWs after the SV vaccination indicates the need for a vaccine booster, particularly during the ongoing spreading of the SAR-CoV-2 variants of concern.
Longitudinal tau PET using [18F]flortaucipir: Comparison of (semi)quantitative parameters
Authors: Visser Denise , Tuncel Hayel , Ossenkoppele Rik , Yaqub Maqsood , Wolters Emma E , Timmers Tessa , Weltings Emma , Coomans Emma M , Hollander Marijke den , van der Flier Wiesje M , van Berckel Bart NM , Golla Sandeep SV
Published: August 2021

Purpose

Semi-quantitative PET measures can be affected by changes in blood flow, whereas quantitative measures are not. The aim of the study was to compare semi-quantitative(SUVr) and quantitative(R1, BPND) parameters of longitudinal tau PET scans with [18F]flortaucipir, with respect to changes in blood flow.

Methods

Subjects with subjective cognitive decline(SCD; n=38) and Alzheimer’s disease(AD) patients(n=24) underwent baseline(BL) and 2-year follow-up(FU) dynamic [18F]flortaucipir PET scans. BPND and R1 were estimated using RPM and SUVr(80-100min) was calculated (cerebellar gray as reference). For each region-of-interest ((trans)entorhinal, limbic and neocortical) and parameter, %change was calculated. Regional SUVrs were compared to corresponding DVR (= BPND+1) using paired T-tests. Additionally, simulations were performed to model effects of flow changes on BPND and SUVr in different binding categories. Thereafter, %bias for SUVr with respect to underlying binding and flow were evaluated.

Results

In SCD, there was a difference between %change in the (trans)entorhinal ROI (DVR 2.56% vs SUVr 1.85%) only. In AD, a difference was found in the limbic ROI (DVR 6.61% vs SUVr 7.52%) only. R1 changes were small(+0.7% in SCD and -1.6% in AD). Simulations illustrated with increasing flow a decreased %bias for SUVr in low binding conditions, whereas a slightly increased bias was observed in high binding conditions.

Conclusion

SUVr provided an accurate estimate of specific binding for [18F]flortaucipir over a two-year follow-up. However, simulations showed that flow changes can affect [18F]flortaucipir SUVr, hence DVR/BPND should be preferred in more advanced disease stages and/or conditions that could induce significant flow changes like pharmacotherapeutic interventions.