bluuebunny/crossref_metadata_2025 huggingface dataset:
Immunochemical evidence for multiple serotypes of Bacteroides fragilis
Authors: Cherniak R , Lombard G L , Dowell V R
Published: June 2021

An immunochemical comparison of outer membrane antigens obtained from five select and biochemically defined strains indicated that there are several serotypes of Bacteroides fragilis. Each strain was serologically defined by individual or by combinations of determinant groups composed of carbohydrates in the form of polysaccharides or glycoproteins. The carbohydrate constituents were tentatively identified as glucose, galactose, fucose, rhamnose, glucosamine, galactosamine, and traces of mannose. Strains were observed to have minor qualitative and major quantitative variations in carbohydrate composition.
Cytotoxic antibody to cells infected with measles virus in serum and cerebrospinal fluid of multiple sclerosis and control patients
Authors: Cremer N E , Johnson K P , Fein G , Likosky W H
Published: June 2021

Sera and cerebrospinal fluids (CSFs) from 66 patients selected from a larger sample of multiple sclerosis (MS) and control patients were studied for presence of complement-dependent cytotoxic (CT) antibody against baby hamster kidney cells infected with measles virus, strain Lec. The MS group contained 26 patients with clinically definite disease and 7 with probable MS. Seventeen of the 33 patients selected from the MS group had hemagglutination-inhibiting (HI) antibody to measles virus in their CSFs. Specimens from 33 control patients with other identifiable neurological disorders were matched according to the time of specimen sampling and with the age of the donors. Seven of the controls had HI CSF antibody. The serum CT geometric mean antibody titer of the MS group was approximately twofold higher than that of the control group. Forty-two percent of the MS group and 18% of the control group had CT antibody in the CSF. With the exception of the ratio of one control patient, the serum/CSF ratios of CT antibody from all patients were 128 or less. Nine CSFs (six MS and three control specimens) had CT antibody but no detectable HI antibody. Conversely, 12 CSFs (eight MS and four control specimens) had HI antibody but no detectable CT antibody. Five patients in the MS group with both kinds of CSF antibodies had reduced CT ratios but normal HI ratios. The results suggest that the two tests detect CSF antibodies reactive with different antigens. In this study, where less than half of the MS patients displayed CSF CT antibody, it is unlikely that such antibodies play an active role in the pathogenetic mechanism operative in the disease.
Comparison of two media for isolation of haemophilus vaginalis
Authors: Smith R F
Published: June 2021

Starch agar and V agar were comparable in the isolation of Haemophilus vaginalis from vaginal discharge specimens. Each medium had certain advantages over the other, which are described.
Long-term outcome of neovascular age-related macular degeneration: association between treatment outcome and major risk alleles
Authors: Vofo Brice Nguedia , Beykin Gala , Levy Jaime , Chowers Itay
Published: June 2021

Aims

To evaluate the long-term functional and anatomical outcomes of neovascular age-related macular degeneration (nvAMD) treated with intravitreal anti-vascular endothelial growth factor (anti-VEGF) for up to 10 years, and to identify associated risk factors.

Methods

Clinical and optical coherence tomography findings were retrieved for nvAMD cases treated with intravitreal anti-VEGF compounds using a treat-and-extend protocol. In addition, the major risk alleles for AMD in theCFH(rs1061170),HTRA1(rs1200638) andC3(rs2230199) genes were genotyped.

Results

From 276 eligible eyes in 206 patients, 80 eyes (29%) in 66 patients (32.0%) had a follow-up period of ≥8 years and were included in this study. Over a 10-year period, 73.3±28.0 (mean±SD) anti-VEGF injections were administered. Best-corrected visual acuity (BCVA; LogMAR) deteriorated from 0.55±0.53 at baseline to 1.00±0.73 at 10 years (p<0.0005). Central subfield thickness (CST) decreased from 415.8±162.1 µm at baseline to 323±113.6 µm (p<0.0005) after three monthly injections and remained lower than baseline throughout the follow-up period. Visual outcome was associated with BCVA and intraretinal fluid (IRF) at baseline, macular atrophy, and macular thinning at follow-up. The decrease in CST was inversely correlated with the number ofCFHand/orC3risk alleles carried by the patient (Pearson’s r: −0.608; p=0.003).

Conclusions

Patients with nvAMD who received anti-VEGF therapy for 10 years developed substantial vision loss associated with the presence of IRF at baseline and macular atrophy. Major risk alleles for AMD in two complement genes were associated with a reduced long-term reduction in macular thickness.
Social determinants of health are associated with physical therapy use: a systematic review
Authors: Braaten Amanda Day , Hanebuth Cannon , McPherson Holt , Smallwood Dashae , Kaplan Samantha , Basirico David , Clewley Derek , Rethorn Zachary
Published: June 2021

Objective

The purpose of this systematic review is to identify and summarise the social determinants of health (SDH) cited in the literature and evaluate their association with individuals using physical therapy services.

Design

A systematic review using qualitatively synthesised information to describe the association between SDH and physical therapy use.

Data sources

The electronic databases Medline, Embase and Scopus were searched from inception to February 2021, identifying observational and qualitative studies.

Eligibility criteria

Published studies included all adults, aged 18 or older, who independently sought to use physical therapy, in all practice settings from all geographical locations.

Results

Of the 9248 studies screened, 36 met the inclusion criteria for the review. The participants represented 8 countries and totaled 2 699 437. The majority of the papers reported moderate strength of association for each SDH. Female gender, non-Hispanic white race/ethnicity, increased education attainment, urban environment, access to transportation, employment, high socioeconomic status and private insurance were associated with higher likelihood of physical therapy use.

Conclusion

This systematic review identifies predisposing and enabling factors impacting physical therapy usage among adults in different countries and across physical therapy settings. The results of this study have implications for policy and future research regarding populations that have been shown to be using physical therapy services less, such as those with lower levels of education, those in a rural area, or those in a low socioeconomic class.
Short and long-term psychosocial consequences of participating in a colorectal cancer screening programme: a matched longitudinal study
Authors: Malmqvist Jessica , Siersma Volkert Dirk , Hestbech Mie Sara , Bang Christine Winther , Nicolaisdóttir Dagný Rós , Brodersen John
Published: June 2021

Objectives

To investigate the psychosocial consequences of receiving a false-positive (no abnormalities) result or being diagnosed with polyps compared with receiving a negative result in a colorectal cancer (CRC) screening programme.

Design and setting

This was a longitudinal study nested in the roll-out of the Danish CRC screening programme that targets all individuals aged 50–74 years.

Participants

In the inclusion period (April–September 2017), all positive screenees (n=1854) were consecutively enrolled and matched 2:1:1 on sex, age (±2 years), municipality and screening date with negative screenees (n=933) and individuals not yet invited to screening (n=933).

Questionnaires were sent by mail to all eligible participants in Region Zealand, Denmark, after the screening result, 2 months and 12 months after the final result.

Positive screenees who did not receive the follow-up procedure were excluded.

Main outcome measures

The primary outcomes were psychosocial consequences. Outcomes were measured with the CRC screening-specific questionnaire Consequences of screening in CRC with 11 outcomes after the screening result and with 21 outcomes at the two later assessments.

Results

After receiving the screening result, individuals with no abnormalities, low-risk and medium-risk and high-risk polyps scored significantly worse on 8 of 11 outcomes compared with the negative screenee group. At the 12-month follow-up, the differences were still significant in 8 of 21 outcomes (no abnormalities), 4 of 21 outcomes (low-risk polyps) and 10 of 21 outcomes (medium-risk and high-risk polyps). The negative screenee group and the group not yet invited to screening differed psychosocially on 5 of 11 outcomes after the screening result, but on none of the 21 outcomes at the 2 months and 12 months follow-up.

Conclusions

The study showed that there are both short-term and long-term psychosocial consequences associated with receiving a no abnormalities result or being diagnosed with polyps. The consequences were worst for individuals diagnosed with medium-risk and high-risk polyps.
Unravelling ‘low-resource settings’: a systematic scoping review with qualitative content analysis
Authors: van Zyl Chanel , Badenhorst Marelise , Hanekom Susan , Heine Martin
Published: June 2021

Introduction

The effects of healthcare-related inequalities are most evident in low-resource settings. Such settings are often not explicitly defined, and umbrella terms which are easier to operationalise, such as ‘low-to-middle-income countries’ or ‘developing countries’, are often used. Without a deeper understanding of context, such proxies are pregnant with assumptions, insinuate homogeneity that is unsupported and hamper knowledge translation between settings.

Methods

A systematic scoping review was undertaken to start unravelling the term ‘low-resource setting’. PubMed, Africa-Wide, Web of Science and Scopus were searched (24 June 2019), dating back ≤5 years, using terms related to ‘low-resource setting’ and ‘rehabilitation’. Rehabilitation was chosen as a methodological vehicle due to its holistic nature (eg, multidisciplinary, relevance across burden of disease, and throughout continuum of care) and expertise within the research team. Qualitative content analysis through an inductive approach was used.

Results

A total of 410 codes were derived from 48 unique articles within the field of rehabilitation, grouped into 63 content categories, and identified nine major themes relating to the term ‘low-resource setting’. Themes that emerged relate to (1) financial pressure, (2) suboptimal healthcare service delivery, (3) underdeveloped infrastructure, (4) paucity of knowledge, (5) research challenges and considerations, (6) restricted social resources, (7) geographical and environmental factors, (8) human resource limitations and (9) the influence of beliefs and practices.

Conclusion

The emerging themes may assist with (1) the groundwork needed to unravel ‘low-resource settings’ in health-related research, (2) moving away from assumptive umbrella terms like ‘low-to-middle-income countries’ or ‘low/middle-income countries’ and (3) promoting effective knowledge transfer between settings.
Accuracy of verbal autopsy, clinical data and minimally invasive autopsy in the evaluation of malaria-specific mortality: an observational study
Authors: Rakislova Natalia , Jordao Dercio , Ismail Mamudo R , Mayor Alfredo , Cisteró Pau , Marimon Lorena , Ferrando Melania , Hurtado Juan Carlos , Lovane Lucilia , Carrilho Carla , Lorenzoni Cesaltina , Fernandes Fabiola , Nhampossa Tacilta , Cossa Anelsio , Mandomando Inacio , Navarro Mireia , Casas Isaac , Munguambe Khatia , Maixenchs Maria , Quintó Llorenç , Macete Eusebio , Martinez Mikel , Snow Robert W , Bassat Quique , Menéndez Clara , Ordi Jaume
Published: June 2021

Background

Global malaria mortality estimates are hindered by the low reliability of the verbal autopsy (VA) and the clinical records, the most common sources of information used to estimate malaria-specific mortality. We aimed to determine the accuracy of these tools, as well as of the minimally invasive autopsy (MIA), a needle-based postmortem sampling method, to identify malaria-specific mortality in a large series of deceased patients from Mozambique, using complete autopsy as the gold standard.

Methods

Observational study that included 264 deaths, occurring at a tertiary level hospital in Mozambique, from 1 November 2013 to 31 March 2015 (17 months-long period). Clinical data were abstracted, a computer coded VA was completed using the clinical data as source of information, and an MIA followed by a complete autopsy were performed. Screening for malaria infection was conducted postmortem to all participants using molecular and histological techniques (PCR and immunohistochemistry).

Findings

Malaria infection was considered the cause of death in 6/264 (2.3%) cases: 2/54 children (3.7%, both less than 5 years old) and 4/57 (7.0%) maternal deaths. The sensitivity and specificity of the VA, the clinical data and the MIA to identify malaria-specific deaths were 33.3% and 96.1%, 66.7% and 96.1%, and 100% and 100%, respectively. In addition, malaria was identified as a possible contributor in 14 additional patients who died of other diseases. These cases were also accurately identified by the MIA (sensitivity 82.4%, specificity 100%).

Interpretation

The high sensitivity and specificity of the MIA in identifying malaria may help to improve current estimates of malaria-specific mortality in endemic areas.
Defining global health: findings from a systematic review and thematic analysis of the literature
Authors: Salm Melissa , Ali Mahima , Minihane Mairead , Conrad Patricia
Published: June 2021

Introduction

Debate around a common definition of global health has seen extensive scholarly interest within the last two decades; however, consensus around a precise definition remains elusive. The objective of this study was to systematically review definitions of global health in the literature and offer grounded theoretical insights into what might be seen as relevant for establishing a common definition of global health.

Method

A systematic review was conducted with qualitative synthesis of findings using peer-reviewed literature from key databases. Publications were identified by the keywords of ‘global health’ and ‘define’ or ‘definition’ or ‘defining’. Coding methods were used for qualitative analysis to identify recurring themes in definitions of global health published between 2009 and 2019.

Results

The search resulted in 1363 publications, of which 78 were included. Qualitative analysis of the data generated four theoretical categories and associated subthemes delineating key aspects of global health. These included: (1) global health is a multiplex approach to worldwide health improvement taught and pursued at research institutions; (2) global health is an ethically oriented initiative that is guided by justice principles; (3) global health is a mode of governance that yields influence through problem identification, political decision-making, as well as the allocation and exchange of resources across borders and (4) global health is a vague yet versatile concept with multiple meanings, historical antecedents and an emergent future.

Conclusion

Extant definitions of global health can be categorised thematically to designate areas of importance for stakeholders and to organise future debates on its definition. Future contributions to this debate may consider shifting from questioning the abstract ‘what’ of global health towards more pragmatic and reflexive questions about ‘who’ defines global health and towards what ends.
Quantifying audio visual alcohol imagery in popular Indian films: a content analysis
Authors: Bhagawath Rohith , Kulkarni Muralidhar M , Britton John , Cranwell Jo , Arora Monika , Nazar Gaurang P , Mullapudi Somya , Kamath Veena G
Published: June 2021

Objectives

Though exposure to alcohol imagery in films is a significant determinant of uptake and severity of alcohol consumption among young people, there is poor evidence regarding the content of alcohol imagery in films in low-income and middle-income countries. We have measured alcohol imagery content and branding in popular Indian films, in total and in relation to language and age rating.

Design

In this observational study we measured alcohol imagery semiquantitatively using 5-minute interval coding. We coded each interval according to whether it contained alcohol imagery or brand appearances.

Setting

India.

Participants

None. Content analysis of a total of 30 national box office hit films over a period of 3 years from 2015 to 2017.

Primary and secondary outcome measures

To assess alcohol imagery in Indian films and its distribution in relation to age and language rating has been determined.

Results

The 30 films included 22 (73%) Hindi films and 8 (27%) in regional languages. Seven (23%) were rated suitable for viewing by all ages (U), and 23 (77%) rated as suitable for viewing by children subject to parental guidance for those aged under 12 (UA). Any alcohol imagery was seen in 97% of the films, with 195 of a total of 923 5-minute intervals, and actual alcohol use in 25 (83%) films, in 90 (10%) intervals. The occurrence of these and other categories of alcohol imagery was similar in U-rated and UA-rated films, and in Hindi and local language films. Episodes of alcohol branding occurred in 10 intervals in five films.

Conclusion

Almost all films popular in India contain alcohol imagery, irrespective of age rating and language. Measures need to be undertaken to limit alcohol imagery in Indian films to protect the health of young people, and to monitor alcohol imagery in other social media platforms in future.
Excretion of SARS-CoV-2 in breast milk: a single-centre observational study
Authors: Prasad Arun , N Yankappa , Kumar Pradeep , Chaudhary Bhavesh Kant , Pati Binod Kumar , Anant Monika , Tiwari Lokesh Kumar
Published: June 2021

Background

Breast feeding by SARS-CoV-2-infected mothers has been a concern because of the possibility of excretion of virus in breast milk.

Objective

To detect SARS-CoV-2 in expressed breast milk (EBM) of mothers infected with SARS-CoV-2 and clinical outcome of neonates delivered and breast fed by them.

Design

A single-centre, prospective observational study involving 50 SARS-CoV-2-infected mothers and their 51 neonates.

Setting

A tertiary care hospital in Eastern India.

Participants

SARS-CoV-2-infected mothers and neonates delivered by them.

Main outcome measures

We investigated the presence of SARS-CoV-2 in the breast milk of mothers, who tested positive for this virus in their nasopharyngeal swab (NPS). Clinical outcome was assessed in neonates breast fed by these mothers after 1 month of the postnatal period.

Results

50 SARS-CoV-2-positive expectant mothers were enrolled for the study. One out of 51 neonates, who delivered through lower segment caesarean section at term gestation and tested SARS-CoV-2 negative, died due to severe birth asphyxia. One sample of EBM was collected from each of the 49 mothers within 4 days of delivery. All EBM samples tested negative for SARS-CoV-2 through real-time reverse transcriptase-PCR (RT-PCR). All the newborns were screened twice for presence of SARS-CoV-2 RNA in their NPS, by RT-PCR. 2 of 51 neonates had COVID-19 infection after 24 hours of life. Caregivers of 37 of 50 alive neonates responded to follow-up via telephone. Except for minor feed intolerance in one (1 of 37) neonate, all neonates were reported well after 1 month of their age.

Conclusion

All the samples of breast milk were negative for SARS-CoV-2. Most of the neonates remained asymptomatic on breast feeding, whose mothers had SARS-CoV-2 infection before delivery.
Concussion in European professional football: a view of team physicians
Authors: Gouttebarge Vincent , Ahmad Imtiaz , Iqbal Zafar , Orhant Emmanuel , Rosenbloom Craig , Sas Kristof , Kerkhoffs Gino M M J
Published: June 2021

Objectives

The objective was to explore the view and thoughts of physicians working in professional football about several aspects (eg, education and use of video footages) likely to enhance concussions’ recognition and on-field management.

Methods

An observational study based on a cross-sectional design by means of an electronic survey was conducted among physicians working for a professional football club in Belgium, England or France.

Results

A total of 96 physicians (95% male; mean age: 44 years) completed the survey. Nearly all participants (95%) were in favour of informational sessions about concussion for players or technical staff. Only 5%–10% of the participants mentioned that they had felt pressured by the technical staff or players not to substitute a player with a (potential) concussion. Most participants were in favour of an additional permanent concussion substitution and a temporary concussion substitution. Four out of five participants reported that the availability of instant video footages (side-line) would ease the recognition of concussion.

Conclusion

A better recognition and on-field management of concussions in professional football can only be achieved with a holistic approach, including adequate laws of the football game and protocols. Especially, regular education of players and technical staff should be made mandatory while the medical teams should be provided side-line with instant video footages.
Prognostic accuracy of emergency department triage tools for adults with suspected COVID-19: the PRIEST observational cohort study
Authors: Thomas Ben , Goodacre Steve , Lee Ellen , Sutton Laura , Bursnall Matthew , Loban Amanda , Waterhouse Simon , Simmonds Richard , Biggs Katie , Marincowitz Carl , Schutter José , Connelly Sarah , Sheldon Elena , Hall Jamie , Young Emma , Bentley Andrew , Challen Kirsty , Fitzsimmons Chris , Harris Tim , Lecky Fiona , Lee Andrew , Maconochie Ian , Walter Darren
Published: June 2021

Background

The WHO and National Institute for Health and Care Excellence recommend various triage tools to assist decision-making for patients with suspected COVID-19. We aimed to compare the accuracy of triage tools for predicting severe illness in adults presenting to the ED with suspected COVID-19.

Methods

We undertook a mixed prospective and retrospective observational cohort study in 70 EDs across the UK. We collected data from people attending with suspected COVID-19 and used presenting data to determine the results of assessment with the WHO algorithm, National Early Warning Score version 2 (NEWS2), CURB-65, CRB-65, Pandemic Modified Early Warning Score (PMEWS) and the swine flu adult hospital pathway (SFAHP). We used 30-day outcome data (death or receipt of respiratory, cardiovascular or renal support) to determine prognostic accuracy for adverse outcome.

Results

We analysed data from 20 891 adults, of whom 4611 (22.1%) died or received organ support (primary outcome), with 2058 (9.9%) receiving organ support and 2553 (12.2%) dying without organ support (secondary outcomes). C-statistics for the primary outcome were: CURB-65 0.75; CRB-65 0.70; PMEWS 0.77; NEWS2 (score) 0.77; NEWS2 (rule) 0.69; SFAHP (6-point rule) 0.70; SFAHP (7-point rule) 0.68; WHO algorithm 0.61. All triage tools showed worse prediction for receipt of organ support and better prediction for death without organ support. At the recommended threshold, PMEWS and the WHO criteria showed good sensitivity (0.97 and 0.95, respectively) at the expense of specificity (0.30 and 0.27, respectively). The NEWS2 score showed similar sensitivity (0.96) and specificity (0.28) when a lower threshold than recommended was used.

Conclusion

CURB-65, PMEWS and the NEWS2 score provide good but not excellent prediction for adverse outcome in suspected COVID-19, and predicted death without organ support better than receipt of organ support. PMEWS, the WHO criteria and NEWS2 (using a lower threshold than usually recommended) provide good sensitivity at the expense of specificity.

Trial registration number

ISRCTN56149622.
Neoadjuvant immunotherapy for non-small cell lung cancer: right drugs, right patient, right time?
Authors: Ahern Elizabeth , Solomon Ben J , Hui Rina , Pavlakis Nick , O'Byrne Ken , Hughes Brett G M
Published: June 2021

Standard curative treatment of early-stage non-small cell lung cancer (NSCLC) involves surgery in combination with postoperative (adjuvant) platinum-based chemotherapy where indicated. Preoperative (neoadjuvant) therapies offer certain theoretical benefits compared with adjuvant approaches, including the ability to assess on-treatment response, reduce the tumor bulk prior to surgery, and enhance tolerability in the preoperative setting. Indeed, the use of neoadjuvant therapies are well established in other cancers such as breast and rectal cancers to debulk the tumor and guide ongoing therapy, and neoadjuvant chemotherapy has similar efficacy but less toxicity in NSCLC. More recently, immune checkpoint inhibitors (ICI) targeting programmed death-1 (PD1)/PD1-ligand 1 (PD-L1) have transformed the treatment of advanced NSCLC; the unique mechanisms of action of ICI offer additional rationale for assessment in the neoadjuvant setting. Preclinical studies in mouse cancer models support the proof of concept of neoadjuvant ICI (NAICI) through improvement of T-cell effector function and long-term memory induction. Preliminary early-phase human trial data support the proposition that NAICI in NSCLC may provide an feasible and potentially efficacious future treatment strategy and large, randomized phase III trials are currently recruiting to assess this approach. However, outstanding issues include defining optimal treatment combinations which balance high efficacy with acceptable toxicity, validating biomarkers to aid in patient selection, and avoiding potential pitfalls such as missing a window for successful surgery, that is, choosing the right drugs, for the right patient, at the right time. Predictive biomarkers to direct selection of therapy are required, and the validation of major pathological response (MPR) as a surrogate for survival will be important in the uptake of the neoadjuvant approach.
Type 17 immunity promotes the exhaustion of CD8+ T cells in cancer
Authors: Kim Byung-Seok , Kuen Da-Sol , Koh Choong-Hyun , Kim Hyung-Don , Chang Seon Hee , Kim Sehui , Jeon Yoon Kyung , Park Young-Jun , Choi Garam , Kim Jiyeon , Kang Keon Wook , Kim Hye Young , Kang Suk-Jo , Hwang Shin , Shin Eui-Cheol , Kang Chang-Yuil , Dong Chen , Chung Yeonseok
Published: June 2021

Background

Multiple types of immune cells producing IL-17 are found in the tumor microenvironment. However, their roles in tumor progression and exhaustion of CD8+ tumor-infiltrating lymphocytes (TILs) remain unclear.

Methods

To determine the role of type 17 immunity in tumor, we investigated the growth of B16F10 melanoma and the exhaustion of CD8+ TILs in Il17a−/− mice, Il17aCreR26DTA mice, RORγt inhibitor-treated mice, or their respective control mice. Adoptive transfer of tumor-specific IL-17-producing T cells was performed in B16F10-bearing congenic mice. Anti-CD4 or anti-Ly6G antibodies were used to deplete CD4+ T cells or CD11b+Gr-1hi myeloid cells in vivo, respectively. Correlation between type 17 immunity and T cell exhaustion in human cancer was evaluated by interrogating TCGA dataset.

Results

Depletion of CD4+ T cells promotes the exhaustion of CD8+ T cells with a concomitant increase in IL-17-producing CD8+ T (Tc17) cells in the tumor. Unlike IFN-γ-producing CD8+ T (Tc1) cells, tumor-infiltrating Tc17 cells exhibit CD103+KLRG1−IL-7Rαhi tissue resident memory-like phenotypes and are poorly cytolytic. Adoptive transfer of IL-17-producing tumor-specific T cells increases, while depletion of IL-17-producing cells decreases, the frequency of PD-1hiTim3+TOX+ terminally exhausted CD8+ T cells in the tumor. Blockade of IL-17 or RORγt pathway inhibits exhaustion of CD8+ T cells and also delays tumor growth in vivo. Consistent with these results, human TCGA analyses reveal a strong positive correlation between type 17 and CD8+ T cell exhaustion signature gene sets in multiple cancers.

Conclusion

IL-17-producing cells promote terminal exhaustion of CD8+ T cells and tumor progression in vivo, which can be reversed by blockade of IL-17 or RORγt pathway. These findings unveil a novel role for IL-17-producing cells as tumor-promoting cells facilitating CD8+ T cell exhaustion, and propose type 17 immunity as a promising target for cancer immunotherapy.
Picturing sanity, in black and white
Authors: Mukandi Bryan
Published: June 2021

This speculative work grapples with a riddle: if white supremacy is noxious, and if it is inescapable, is apparent black health, black sanity, in fact healthy? In order to help the reader appropriately appreciate the feat that is black sanity, I begin with a treatment of Fyodor Dostoevsky’s literary character, Mr Golyadkin. I go on to extend my claim that Golyadkin’s ill health or lack of sanity can be understood in terms of the violation of the norms of sociality, onto Antonin Artaud. Dostoevsky and Artaud therefore provide case studies with which it is possible to begin to develop an outline of the bounds and mechanics of white sanity. I juxtapose this outline to readings from a selection of works by African writers—Bessie Head, Véronique Tadjo and Dambudzo Marechera. This culminates in an interrogation of Franz Fanon’s metaphorisation of disability. I grapple especially with the ethical and existential implications of his understanding of black amputation. The conclusion that I eventually reach is another riddle, which may or may not amount to a restatement of the riddle with which I begin.
Association between IL-6 and severe disease and mortality in COVID-19 disease: a systematic review and meta-analysis
Authors: Liu Xiaohui , Wang Hongwei , Shi Si , Xiao Jinling
Published: June 2021

Background

So far, SARS-CoV-2 is the seventh coronavirus found to infect humans and cause disease with quite a strong infectivity. Patients diagnosed as severe or critical cases are prone to multiple organ dysfunction syndrome, acute respiratory distress syndrome and even death. Proinflammatory cytokine IL-6 has been reported to be associated with the severity of disease and mortality in patients with COVID-19.

Objective

This systematic review and meta-analysis were carried out to evaluate the association between IL-6 and severe disease and mortality in COVID-19 disease.

Methods

A systematic literature search using China National Knowledge Infrastructure, Wanfang databases, China Science and Technology Journal Database, Chinese Biomedical Literature, Embase, PubMed and Cochrane Central Register of Controlled Trials was performed from inception until 16 January 2021.

Results

12 studies reported the value of IL-6 for predicting the severe disease in patients with COVID-19. The pooled area under the curve (AUC) was 0.85 (95% CI 0.821 to 0.931). 5 studies elaborated the predictive value of IL-6 on mortality. The pooled sensitivity, specificity and AUC were 0.15 (95% CI 0.13 to 0.17, I2=98.9%), 0.73 (95% CI 0.65 to 0.79, I2=91.8%) and 0.531 (95% CI 0.451 to 0.612), respectively. Meta-regression analysis showed that country, technique used, cut-off, sample, study design and detection time did not contribute to the heterogeneity of mortality.

Conclusion

IL-6 is an adequate predictor of severe disease in patients infected with the COVID-19. The finding of current study may guide clinicians and healthcare providers in identifying potentially severe or critical patients with COVID-19 at the initial stage of the disease. Moreover, we found that only monitoring IL-6 levels does not seem to predict mortality and was not associated with COVID-19’s mortality.

PROSPERO registration number

CRD42021233649.
Evaluation of a survey for acute care programme directors on the utilisation of point-of-care ultrasound
Authors: Wang Annie , McCabe Melissa , Gow-Lee Esther , James Stephanie , Austin Briahnna , Wailes Dustin , Dinh Vi , Ramsingh Davinder
Published: June 2021

Purpose

Point-of-care ultrasound (POCUS) is ultrasound brought to the patient's bedside and performed in ‘real time’ by the healthcare provider. The utility of POCUS to facilitate management of the acutely ill patient has been demonstrated for multiple pathologies. However, the integration of ultrasonography and echocardiography training into residency curriculum varies across the acute care specialties.

Study design

After an institutional review board approval, anaesthesiology, emergency medicine, family medicine, internal medicine, paediatrics and general surgery programme directors (PDs) were surveyed. The survey consisted of 11 questions evaluating the primary bedside assessment tool for common acute care situations, POCUS topics that the PDs were comfortable practising and topics that the PDs felt were useful for their specialty. Barriers to POCUS use, certification and documentation were also surveyed.

Results

Overall, 270 PD surveys were completed. The preferred primary assessment tool for common acute care situations varied with specialty; emergency medicine PDs consistently responded that POCUS was the diagnostic modality of choice (p<0.0001). The majority of the PDs reported lack of educational opportunities as the primary barrier to learning POCUS (64%). Most PDs indicated that POCUS examinations should be documented (95.7%), and 39% reported that departmental certification would be sufficient.

Conclusions

This study is the first to evaluate differences in the preferred initial bedside assessment tool between the acute care specialties. Although POCUS is a superior tool for evaluating acute pathologies, disconnect between education and utilisation remains. This study highlights the need to incorporate POCUS into the acute care specialty curriculum.
Eye lenses reveal ontogenetic trophic and habitat shifts in an imperiled fish, Clear Lake hitch (Lavinia exilicauda chi)
Authors: Young Matthew J. , Larwood Veronica , Clause Justin K. , Bell-Tilcock Miranda , Whitman George , Johnson Rachel , Feyrer Frederick
Published: June 2021

Stable isotopes recorded in fish eye lenses are an emerging tool to track dietary shifts coincident with use of diverse habitats over the lifetime of individuals. Eye lenses are metabolically inert, sequentially deposited, archival tissues that can open avenues to chronicle contaminant exposures, diet histories, trophic dynamics and migratory histories of individual fishes. In this study, we demonstrated that trophic histories reconstructed using eye lenses can resolve key uncertainties regarding diet and trophic habitat shifts. Clear Lake hitch (Lavinia exilicauda chi), a threatened cyprinid, inhabits a single lake (Clear Lake, Lake County, California) and utilizes tributary streams for reproduction. Bayesian mixing models applied to δ13C and δ15N recorded in eye lenses uncovered ontogenetic diet shifts that corresponded with shifts in occupation of habitats providing spawning (tributary streams), rearing (littoral lake), and growth (pelagic lake) functions. The reconstruction of size-structured trophic and habitat information can provide vital information needed to manage and conserve imperiled species such as the Clear Lake hitch.
Competition-driven modeling of temporal networks
Authors: Zhu Kaijie , Fletcher George , Yakovets Nikolay
Published: June 2021

We study the problem of modeling temporal networks constrained by the size of a concurrent set, a characteristic of temporal networks shown to be important in many application areas, e.g., in transportation, social, process, and other networks. We propose a competition-driven model for the generation of such constrained networks. Our method carries out turns of competitions along the timeline where each node in a network is labeled with a probability to gain outgoing edges in competitions. We present a thorough theoretical analysis to investigate the cardinality and degree distributions of the generated networks. Our experimental results demonstrate that our model simulates real-world networks well and generates networks efficiently and at scale.
A Multi-Threshold Ant Colony System-based Sanitization Model in Shared Medical Environments
Authors: Wu Jimmy Ming-Tai , Srivastava Gautam , Lin Jerry Chun-Wei , Teng Qian
Published: June 2021

During the past several years, revealing some useful knowledge or protecting individual’s private information in an identifiable health dataset (i.e., within an Electronic Health Record) has become a tradeoff issue. Especially in this era of a global pandemic, security and privacy are often overlooked in lieu of usability. Privacy preserving data mining (PPDM) is definitely going to be have an important role to resolve this problem. Nevertheless, the scenario of mining information in an identifiable health dataset holds high complexity compared to traditional PPDM problems. Leaking individual private information in an identifiable health dataset has becomes a serious legal issue. In this article, the proposed Ant Colony System to Data Mining algorithm takes the multi-threshold constraint to secure and sanitize patents’ records in different lengths, which is applicable in a real medical situation. The experimental results show the proposed algorithm not only has the ability to hide all sensitive information but also to keep useful knowledge for mining usage in the sanitized database.
Improved Fake Reviews Detection Model Based on Vertical Ensemble Tri-Training and Active Learning
Authors: Yin Chunyong , Cuan Haoqi , Zhu Yuhang , Yin Zhichao
Published: June 2021

People’s increasingly frequent online activity has generated a large number of reviews, whereas fake reviews can mislead users and harm their personal interests. In addition, it is not feasible to label reviews on a large scale because of the high cost of manual labeling. Therefore, to improve the detection performance by utilizing the unlabeled reviews, this article proposes a fake reviews detection model based on vertical ensemble tri-training and active learning (VETT-AL). The model combines the features of review text with the user behavior features as feature extraction. In the VETT-AL algorithm, the iterative process is divided into two parts: vertical integration within the group and horizontal integration among the groups. The intra-group integration is to integrate three original classifiers by using the previous iterative models of the classifiers. The inter-group integration is to adopt the active learning based on entropy to select the data with the highest confidence and label it, and as the result of that, the second generation classifiers are trained by the traditional process to improve the accuracy of the label. Experimental results show that the proposed model has a good classification performance.
PP-PG: Combining Parameter Perturbation with Policy Gradient Methods for Effective and Efficient Explorations in Deep Reinforcement Learning
Authors: Li Shilei , Li Meng , Su Jiongming , Chen Shaofei , Yuan Zhimin , Ye Qing
Published: June 2021

Efficient and stable exploration remains a key challenge for deep reinforcement learning (DRL) operating in high-dimensional action and state spaces. Recently, a more promising approach by combining the exploration in the action space with the exploration in the parameters space has been proposed to get the best of both methods. In this article, we propose a new iterative and close-loop framework by combining the evolutionary algorithm (EA), which does explorations in a gradient-free manner directly in the parameters space with an actor-critic, and the deep deterministic policy gradient (DDPG) reinforcement learning algorithm, which does explorations in a gradient-based manner in the action space to make these two methods cooperate in a more balanced and efficient way. In our framework, the policies represented by the EA population (the parametric perturbation part) can evolve in a guided manner by utilizing the gradient information provided by the DDPG and the policy gradient part (DDPG) is used only as a fine-tuning tool for the best individual in the EA population to improve the sample efficiency. In particular, we propose a criterion to determine the training steps required for the DDPG to ensure that useful gradient information can be generated from the EA generated samples and the DDPG and EA part can work together in a more balanced way during each generation. Furthermore, within the DDPG part, our algorithm can flexibly switch between fine-tuning the same previous RL-Actor and fine-tuning a new one generated by the EA according to different situations to further improve the efficiency. Experiments on a range of challenging continuous control benchmarks demonstrate that our algorithm outperforms related works and offers a satisfactory trade-off between stability and sample efficiency.
Who Has the Last Word? Understanding How to Sample Online Discussions
Authors: Boschi Gioia , Young Anthony P. , Joglekar Sagar , Cammarota Chiara , Sastry Nishanth
Published: June 2021

In online debates, as in offline ones, individual utterances or arguments support or attack each other, leading to some subset of arguments (potentially from different sides of the debate) being considered more relevant than others. However, online conversations are much larger in scale than offline ones, with often hundreds of thousands of users weighing in, collaboratively forming large trees of comments by starting from an original post and replying to each other. In large discussions, readers are often forced to sample a subset of the arguments being put forth. Since such sampling is rarely done in a principled manner, users may not read all the relevant arguments to get a full picture of the debate from a sample. This article is interested in answering the question of how users should sample online conversations to selectively favour the currently justified or accepted positions in the debate. We apply techniques from argumentation theory and complex networks to build a model that predicts the probabilities of the normatively justified arguments given their location in idealised online discussions of comments and replies, which we represent as trees. Our model shows that the proportion of replies that are supportive, the distribution of the number of replies that comments receive, and the locations of comments that do not receive replies (i.e., the “leaves” of the reply tree) all determine the probability that a comment is a justified argument given its location. We show that when the distribution of the number of replies is homogeneous along the tree length, for acrimonious discussions (with more attacking comments than supportive ones), the distribution of justified arguments depends on the parity of the tree level, which is the distance from the root expressed as number of edges. In supportive discussions, which have more supportive comments than attacks, the probability of having justified comments increases as one moves away from the root. For discussion trees that have a non-homogeneous in-degree distribution, for supportive discussions we observe the same behaviour as before, while for acrimonious discussions we cannot observe the same parity-based distribution. This is verified with data obtained from the online debating platform Kialo. By predicting the locations of the justified arguments in reply trees, we can therefore suggest which arguments readers should sample, to grasp the currently accepted opinions in such discussions. Our models have important implications for the design of future online debating platforms.
An Efficient Deep Learning Paradigm for Deceit Identification Test on EEG Signals
Authors: Edla Damodar Reddy , Dodia Shubham , Bablani Annushree , Kuppili Venkatanareshbabu
Published: June 2021

Brain-Computer Interface is the collaboration of the human brain and a device that controls the actions of a human using brain signals. Applications of brain-computer interface vary from the field of entertainment to medical. In this article, a novel Deceit Identification Test is proposed based on the Electroencephalogram signals to identify and analyze the human behavior. Deceit identification test is based on P300 signals, which have a positive peak from 300 ms to 1,000 ms of the stimulus onset. The aim of the experiment is to identify and classify P300 signals with good classification accuracy. For preprocessing, a band-pass filter is used to eliminate the artifacts. The feature extraction is carried out using “symlet” Wavelet Packet Transform (WPT). Deep Neural Network (DNN) with two autoencoders having 10 hidden layers each is applied as the classifier. A novel experiment is conducted for the collection of EEG data from the subjects. EEG signals of 30 subjects (15 guilty and 15 innocent) are recorded and analyzed during the experiment. BrainVision recorder and analyzer are used for recording and analyzing EEG signals. The model is trained for 90% of the dataset and tested for 10% of the dataset and accuracy of 95% is obtained.
Anonymous Blockchain-based System for Consortium
Authors: Wang Qin , Chen Shiping , Xiang Yang
Published: June 2021

Blockchain records transactions with various protection techniques against tampering. To meet the requirements on cooperation and anonymity of companies and organizations, researchers have developed a few solutions. Ring signature-based schemes allow multiple participants cooperatively to manage while preserving their individuals’ privacy. However, the solutions cannot work properly due to the increased computing complexity along with the expanded group size. In this article, we propose a Multi-center Anonymous Blockchain-based (MAB) system, with joint management for the consortium and privacy protection for the participants. To achieve that, we formalize the syntax used by the MAB system and present a general construction based on a modular design. By applying cryptographic primitives to each module, we instantiate our scheme with anonymity and decentralization. Furthermore, we carry out a comprehensive formal analysis of our exemplified scheme. A proof of concept simulation is provided to show the feasibility. The results demonstrate security and efficiency from both theoretical perspectives and practical perspectives.
In Praise of the Disassembler
Authors: Neville-Neil George V.
Published: June 2021

When you're starting out you want to be able to hold the entire program in your head if at all possible. Once you're conversant with your first, simple assembly language and the machine architecture you're working with, it will be completely possible to look at a page or two of your assembly and know not only what it is supposed to do but also what the machine will do for you step by step. When you look at a high-level language, you should be able to understand what you mean it to do, but often you have no idea just how your intent will be translated into action. Assembly and machine code is where the action is.