bluuebunny/crossref_metadata_2025 huggingface dataset:
Rheumatoid arthritis and dietary interventions: systematic review of clinical trials
Authors: Philippou Elena , Petersson Sara Danuta , Rodomar Carrie , Nikiphorou Elena
Published: May 2020

Context

The impact of various dietary interventions on rheumatoid arthritis (RA), characterized by immune-inflammatory response, has been subject to increased attention.

Objective

A systematic review was conducted to update the current knowledge on the effects of nutritional, dietary supplement, and fasting interventions on RA outcomes.

Data Sources

Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, with prespecification of all methods, Medline and Embase were systematically searched for relevant articles.

Data Extraction

Data were extracted by 2 independent reviewers.

Results

A total of 70 human studies were identified. Administration of omega-3 polyunsaturated fatty acids at high doses resulted in a reduction in RA disease activity and a lower failure rate of pharmacotherapy. Vitamin D supplementation and dietary sodium restriction were beneficial on some RA outcomes. Fasting resulted in significant but transient subjective improvements. While the Mediterranean diet demonstrated improvements in some RA disease activity measures, outcomes from vegetarian, elimination, peptide, or elemental diets suggested that responses are very individualized.

Conclusion

Some dietary approaches may improve RA symptoms and thus it is recommended that nutrition should be routinely addressed.
Prevalence and Characteristics of Neuroinfectious Disease Inquiries Within the Emerging Infections Network: A 22-Year Retrospective Study
Authors: Matthews Elizabeth , Diaz-Arias Luisa A , Beekmann Susan E , Polgreen Philip , Waldrop Greer , Yang Vivian , Rimmer Kathryn , Venkatesan Arun , Thakur Kiran T
Published: May 2020

Background

To monitor emerging infectious diseases, the Centers for Disease Control and Prevention and the Infectious Disease Society of America established the Emerging Infections Network (EIN), allowing infectious disease specialists to post inquiries about clinical cases. We describe the frequency and characteristics of neuroinfectious disease-related inquiries.

Methods

The EIN listserv was retrospectively reviewed from February 1997 to December 2019 using search terms associated with neurologic diseases. We recorded case summaries, disease type (ie, meningitis, encephalitis), inquiry type (diagnostic approach, result interpretation, management decisions), unique patient populations, exposures, pathogens, ultimate diagnosis, and change in clinical care based on responses.

Results

Of 2348 total inquiries, 285 (12.1%) related to neuroinfectious diseases. The majority involved meningitis (99, 34.7%) or encephalitis (56, 19.6%). One hundred fifteen inquiries (40%) related to management, 34 (12%) related to diagnostic workup, and 22 (8%) related to result interpretation. Eight (2.8%) specifically involved results of cerebrospinal fluid polymerase chain reaction testing. Sixty-three (22.1%) involved immunosuppressed patients (29 human immunodeficiency virus-positive cases [46%]). The most common pathogens were Treponema pallidum (19, 6.7%) and Cryptococcus neoformans (18, 6.3%). In 74 (25%) inquiries, patients had neurologic symptoms without a clear infection, 38 (51.3%) of which included noninfectious neurologic etiologies in the differential diagnosis.

Conclusions

This study demonstrates the significant challenges of diagnosis and management of neuroinfectious diseases within the field of infectious diseases. It also highlights the importance of curated forums to guide the approach of difficult cases, in particular instances that mimic infectious diseases. Finally, the EIN listserv may assist in identifying areas for research and training to address these complexities.
Long-term Outcomes of Patients With Fungal Infections Associated With Contaminated Methylprednisolone Injections
Authors: Malani Anurag N , Kauffman Carol A , Latham Robert , Peglow Sheree , Ledtke Christopher S , Kerkering Thomas M , Kaufman David H , Triplett Patricia F , Wright Patty W , Bloch Karen C , McCotter Orion , Toda Mitsuru , Jackson Brendan R , Pappas Peter G , Chiller Tom M
Published: May 2020

Background

The largest health care–associated infection outbreak in the United States occurred during 2012–2013. Following injection of contaminated methylprednisolone, 753 patients developed infection with a dematiaceous mold, Exserohilum rostratum. The long-term outcomes of these infections have not been described.

Methods

This retrospective cohort study of 440 of a total of 753 patients with proven or probable Exserohilum infection evaluated clinical and radiographic findings, antifungal therapy and associated adverse effects, and outcomes at 6 weeks, 3, 6, 9, and 12 months after diagnosis. Patients were grouped into 4 disease categories: meningitis with/without stroke, spinal or paraspinal infections, meningitis/stroke plus spinal/paraspinal infections, and osteoarticular infections.

Results

Among the 440 patients, 223 (51%) had spinal/paraspinal infection, 82 (19%) meningitis/stroke, 123 (28%) both, and 12 (3%) osteoarticular infection. Of 82 patients with meningitis/stroke, 18 (22%) died; among those surviving, 87% were cured at 12 months. Only 7 (3%) of 223 patients with spinal/paraspinal infection died, but at 12 months, 68% had persistent or worsening pain and only 47% were cured. For the 123 patients with both meningitis/stroke and spinal/paraspinal infection, 10 (8%) died, pain persisted in 72%, and 52% were cured at 12 months. Only 37% of those with osteoarticular infection were cured at 12 months. Adverse events from antifungal therapy were noted at 6 weeks in 71% of patients on voriconazole and 81% on amphotericin B.

Conclusions

Fungal infections related to contaminated methylprednisolone injections culminated in death in 8% of patients. Persistent pain and disability were seen at 12 months in most patients with spinal/paraspinal infections.
Implementation of Intraoperative Cone-Beam Computed Tomography (O-arm) for Stereotactic Imaging During Deep Brain Stimulation Procedures
Authors: Holewijn Rozemarije A , Bot Maarten , van den Munckhof Pepijn , Schuurman P Richard
Published: May 2020

BACKGROUND

Intraoperative cone-beam computed tomography (iCBCT) allows for rapid 3-dimensional imaging. However, it is currently unknown whether this imaging technique offers sufficient accuracy for stereotactic registration during deep brain stimulation (DBS) procedures.

OBJECTIVE

To determine the accuracy of iCBCT, with the O-arm O2 (Medtronic), for stereotactic registration by comparing this modality to stereotactic magnetic resonance imaging (MRI).

METHODS

All DBS patients underwent a preoperative non-stereotactic 3 Tesla MRI, stereotactic 1.5 Tesla MRI, stereotactic O-arm iCBCT, postimplantation O-arm iCBCT, and postoperative conventional multidetector computed tomography (CT) scan. We compared stereotactic (X, Y, and Z) coordinates of the anterior commissure (AC), the posterior commissure (PC), and midline reference (MR) between stereotactic MRI and iCBCT. For localisation comparison of electrode contacts, stereotactic coordinates of electrode tips were compared between the postoperative multidetector CT and iCBCT.

RESULTS

A total of 20 patients were evaluated. The average absolute difference in stereotactic coordinates of AC, PC, and MR was 0.4 ± 0.4 mm for X, 0.4 ± 0.4 mm for Y, and 0.7 ± 0.5 mm for Z. The average absolute difference in X-, Y-, and Z-coordinates for electrode localisation (N = 34) was 0.3 ± 0.3 mm, 0.6 ± 0.3 mm, and 0.6 ± 0.6 mm. These differences were small enough not to be considered clinically relevant.

CONCLUSION

Stereotactic MRI and O-arm iCBCT yield comparable coordinates in pre- and postoperative imaging. Differences found are below the threshold of clinical relevance. Intraoperative O-arm CBCT offers rapid stereotactic registration and evaluation of electrode placement. This increases patient comfort and neurosurgical workflow efficiency.
Early gestational diabetes mellitus (GDM) is associated with worse pregnancy outcomes compared with GDM diagnosed at 24–28 weeks gestation despite early treatment
Authors: Mustafa M , Bogdanet D , Khattak A , Carmody L A , Kirwan B , Gaffney G , O’Shea P M , Dunne F
Published: May 2020

Background

Gestational diabetes mellitus (GDM) is associated+ with adverse pregnancy outcomes compared with women with normal glucose tolerance in pregnancy. The WHO recommends screening at 24–28 weeks gestation for GDM. Women who are diagnosed before 24–28 weeks gestation have a longer intervention period which may impact positively on pregnancy outcomes.

Aim

This study aimed to examine pregnancy outcomes of women with GDM diagnosed <24 weeks gestation compared with those diagnosed at 24–28 weeks in a large Irish cohort.

Methods

A retrospective cohort study of 1471 pregnancies in women with GDM diagnosed using IADPSG criteria between September 2012 and April 2016 was conducted. At GDM diagnosis, women were classified as early GDM <24 weeks or standard GDM 24–28 weeks gestation.

Results

Women with early GDM had a significantly greater risk of pregnancy-induced hypertension (12.4% vs. 5.3%; P < 0.05), post-partum haemorrhage (8.7% vs. 2.4%; P < 0.05) and post-partum glucose abnormalities (32% vs. 15.6%; P < 0.05). Their offspring had a greater risk of pre-maturity (10.9% vs. 6.6%; P < 0.05), stillbirth (1.4% vs. 0.5%; P < 0.05), large for gestational age (19.1% vs. 13.4% P < 0.05) and need neonatal intensive care (30.7% vs. 22.1%; P < 0.05) compared with offspring of women with standard GDM. Rates of C-section and pre-maturity were still higher in the early GDM group when the two groups where compared based on their post-natal OGTT.

Conclusion

Early GDM women and their offspring are at greater risk of an adverse pregnancy outcome compared with those diagnosed at 24–28 weeks. In view of the abnormal post-natal glucose findings, early GDM may reflect a more advanced state in diabetes pathogenesis.
Optimization and mechanism of postponing aging of polysaccharides from Chinese herbal medicine formula
Authors: Pu Xiuying , Luo Amiao , Su Hui , Zhang Kaili , Tian Changyi , Chen Bo , Chai Pengdi , Xia Xiaoyu
Published: May 2020

To study the extraction technology of polysaccharides (AAP) from Chinese herbal medicine formula and its mechanism of delaying aging. First, L9(3)4 orthogonal test was used to optimize the optimal enzyme-assisted extraction parameters of polysaccharides. And the anti-aging effects was evaluated by detecting mitochondrial function, protein, DNA, adhesion molecules and cell cycle in aging rats. The optimal extraction process parameters were the cellulase concentration of 1.5%, the pH at 5, the enzyme temperature at 50°C and the extraction time of 180 min. The anti-aging results showed that AAP can effectively increase the activities of malate dehydrogenase, succinate dehydrogenase and superoxide dismutase. It also can decrease the activity of monoamine oxidase and methane dicarboxylic aldehyde levels in the brain tissue. Meanwhile, the polysaccharides enhanced telomerase activity while reduced p16 protein expression of the brain mitochondria. In addition, the polysaccharides continued to improve heart damage and significantly lessen mitochondrial DNA concentrations. For a certain period of time, it also enhanced the activity of superoxide dismutase, reduced glutathione, glutathione peroxidase and decreased protein carbonyl and methane dicarboxylic aldehyde content of kidney in D-galactose-induced aging rats. Furthermore, the polysaccharides restored the number of cells in the peripheral blood lines and BMNC through inhibiting the drop of the number of red blood cells, white blood cells, platelets in the peripheral blood and bone marrow mononuclear cell of the aging rats. At the same time, AAP accelerated G1 phase cell to enter S phase in cell cycle in aging rats. Our research suggests that the polysaccharides may be a potential anti-aging agent and can be further developed as a functional food or new drug to delay aging or treat aging-related diseases.
Carpogenic Germinability of Diverse Sclerotinia sclerotiorum Populations Within the Southwestern Australian Grain Belt
Authors: Michael Pippa J. , Lui King Yin , Thomson Linda L. , Stefanova Katia , Bennett Sarita J.
Published: May 2020

Sclerotinia stem rot, caused by the necrotrophic plant pathogen Sclerotinia sclerotiorum (Lib.) de Bary, is a major disease of canola and pulses in Australia. Current disease management relies greatly on cultural and chemical means of control. Timing of fungicide applications remains a challenge, because efficacy is dependent on accurate prediction of ascospore release and presence on the plant. The aims of this study were to determine the optimal temperature for carpogenic germination of S. sclerotiorum populations sampled from canola and lupin fields in southwestern Australia and characterize diversity using mycelial compatibility groupings (MCGs). Sclerotia were collected from four diseased canola and one diseased lupin field from across southwestern Australia. Forty sclerotia from each population were incubated at four alternating temperatures of 30/15, 20/15, 20/4, and 15/4°C (12-h/12-h light/dark cycle) and assessed every 2 to 3 days for a 180-day period. MCG groupings for populations were characterized using 12 reference isolates. Results indicated the time to initial carpogenic germination decreased as diurnal temperature fluctuations decreased, with a fluctuation of 5°C (20/15°C) having the most rapid initial germination followed by 11°C (15/4°C) followed by 16°C (20/4°C). Optimal germination temperature for all five populations was 20/15°C; however, population responses to other diurnal temperature regimes varied considerably. No germination was observed at 30/15°C. MCG results indicate extensive diversity within and between populations, with at least 40% of sclerotia within each population unable to be characterized. We suggest that this diversity has enabled S. sclerotiorum populations to adapt to varying environmental conditions within southwestern Australia.
Inhibition of MyD88 by LM8 Attenuates Obesity-Induced Cardiac Injury
Authors: Liu Hui , Jia Wenjing , Tang Yelin , Zhang Wentao , Qi Jiayu , Yan Jueqian , Ding Wenting , Cao Huixin , Liang Guang , Zhu Zaisheng , Zheng Hao , Zhang Yali
Published: May 2020

Obesity-induced cardiomyopathy involves chronic and sustained inflammation. The toll-like receptor 4 (TLR4) signaling pathway can associate innate immunity with obesity. Myeloid differentiation primary response 88 (MyD88), an indispensable downstream adaptor molecule of TLR4, has been reported to mediate obesity complications. However, whether inhibition of MyD88 can mitigate obesity-induced heart injury remains unclear. LM8, a new MyD88 inhibitor, exhibits prominent anti-inflammatory activity in lipopolysaccharide-treated macrophages. In this study, the protective effects of LM8 on a high-fat diet (HFD)-induced heart injury were assessed in a mouse model of obesity. As suggested from the achieved results, LM8 treatment alleviated HFD-induced pathological and functional damages of the heart in mice. Meantime, the treatment of mice with LM8 could significantly inhibit myocardial hypertrophy, fibrosis, inflammatory cytokines expression, and inflammatory cell infiltration induced by HFD. Besides, LM8 administration inhibited the formation of MyD88/TLR4 complex, phosphorylation of ERK, and activation of nuclear factor–κB induced by HFD. According to the achieved results, MyD88 inhibitor LM8 ameliorated obesity-induced heart injury by inhibiting MyD88-ERK/nuclear factor–κB dependent cardiac inflammatory pathways. Furthermore, targeting MyD88 might be a candidate of a therapeutic method to treat obesity-induced heart injury.
Clinical, Demographic, and Tomographic Aspects Related to Iris Mammillations Among Patients With Keratoconus: A Cross-Sectional Study
Authors: Antunes-Foschini Rosalia , Costa Roberta Martins S. , Menezes‐Filho Celso Ribeiro Ângelo , Bellissimo-Rodrigues Fernando , de Faria-e-Sousa Sidney Julio , Rocha Eduardo Melani
Published: May 2020

Purpose:

Iris mammillations (IM) were previously described in patients with keratoconus, but the clinical implications of this finding have never been studied. Our aim was to investigate demographic, tomographic, and clinical characteristics potentially associated with the presence of IM among patients with keratoconus.

Methods:

This was a cross-sectional study performed among patients with keratoconus in a public-affiliated university hospital. All patients under follow-up were considered eligible to participate in the study. Participants were evaluated by 2 trained ophthalmologists and submitted to corneal tomography (Pentacam). Selected demographic, clinical, and tomographic characteristics were assessed and compared among participants with IM (IM group) and without IM (No-IM group) using the Wilcoxon test or 2-tailed Fisher exact test, as appropriate.

Results:

The study population consisted of 106 subjects and 19 (17.9%) presented with IM. The median age and interquartile range were 18 years old (14–24) in the IM group and 20 years old (17–24) in the No-IM group (P = 0.135). The female proportion was 47.3% in the IM group and 52.8% in the No-IM group (P = 0.801). Median (interquartile ranges) pachymetric values of the right eyes were 498 (466–525) for the IM group and 459 (421–482) for the No-IM group (P = 0.005). For the left eyes, the values were 490 (456–523) in the IM group and 450 (418–485) in the No-IM group (P = 0.024).

Conclusions:

Subjects with keratoconus presenting with IM have thicker corneas than those without IM. Follow-up studies should be performed to evaluate the clinical implications of this finding.
The Use of Anatomical Side Markers in General Radiology: A Systematic Review of the Current Literature
Authors: Chung Lilian , Kumar Saravana , Oldfield Joanne , Phillips Maureen , Stratfold Megan
Published: May 2020

Objectives

The use of an anatomical side marker (ASM) on x-rays, be it digital or radiopaque, is an important quality and safety concept within general radiology. Using radiopaque ASMs is best practice, and lack of any ASMs may have dire consequences in terms of patient safety. To date, there have been no systematic reviews investigating the use of ASMs in clinical practice.

Methods

A systematic search of electronic databases (CINAHL, the Cochrane Library, Medline, EMBASE, ERIC, and JBI) from inception to March 1, 2018, was undertaken. Gray literature searching (through Google) and pearling was conducted. Methodological quality was assessed using a modified version of the McMaster Critical Appraisal tool for quantitative studies. A customized data extraction tool was developed, which included characteristics of the studies.

Results

Of 624 studies, 7 studies met the eligibility criteria. Despite diverse study designs, collectively, the studies demonstrated that only a small number of x-rays did not include an ASM. On x-rays that did use a radiopaque ASM, most of them were positioned in the primary radiation field. A noticeable shift in practice from the use of radiopaque ASMs to digital ASM was also identified. Multifaceted barriers were reported for the use of ASM in routine clinical practice.

Conclusions

Although missing ASMs on x-rays were a small feature, findings from this review highlight opportunities for improvement and a need to ameliorate barriers for ASM use.
Implementation of a Patient-Provider Agreement to Improve Healthcare Delivery for Patients With Substance Use Disorder in the Inpatient Setting
Authors: Wurcel Alysse G. , Yu Sun , Burke Deirdre , Lund Amy , Schelling Kim , Weingart Saul N. , Freund Karen M.
Published: May 2020

Objectives

Inpatient healthcare delivery to people who use drugs is an opportunity to provide acute medical stabilization and offer treatment for underlying substance use disorder (SUD). The process of delivering quality healthcare to people with SUD can present challenges.

Methods

We convened a group of stakeholders to discuss challenges and opportunities for improving healthcare safety and employee satisfaction when providing inpatient care to people with SUD.

Results

We developed, implemented, and evaluated a “Pain and Addiction Agreement” tool, a document to guide discussions between providers and patients about expectations and policies for inpatient care.

Conclusions

In this article, we share our experience of working closely with stakeholders. We hope that our project can serve as a blueprint motivating other centers to pursue quality improvement initiatives to improve healthcare for people with SUD and support the people who take care of them in the hospital.
Laparoscopic Radical Antegrade Modular Pancreatosplenectomy (RAMPS) Technique: Toward the Standardization of the Technique (With Video)
Authors: Ielpo Benedetto , Pietrasz Daniel , Torrent Laia , Tortajada Pauline , Ciacio Oriana , Pittau Gabriella , Adam Rene , Sa Cunha Antonio
Published: May 2020

Laparoscopic left pancreatectomy for pancreatic cancer has increased worldwide over the last decade. However, this procedure is technically challenging compared with traditional laparoscopic left pancreatectomy and still needs to be better standardized. On this video, we describe the standardization of the technique at our center, highlighting some technical tips and tricks.
Virulence-mediated infectiousness and activity trade-offs and their impact on transmission potential of influenza patients
Authors: McKay Brian , Ebell Mark , Dale Ariella Perry , Shen Ye , Handel Andreas
Published: May 2020

Communicable diseases are often virulent, i.e. they cause morbidity symptoms in those infected. While some symptoms may be transmission-enhancing, other symptoms are likely to reduce transmission potential. For human diseases, the reduction in transmission opportunities is commonly caused by reduced activity. There is limited data regarding the potential impact of virulence on transmission potential. We performed an exploratory data analysis of 324 influenza patients at a university health centre during the 2016/2017 influenza season. We classified symptoms as infectiousness-related or morbidity-related and calculated two scores. The scores were used to explore the relationship between infectiousness, morbidity (virulence), and activity level. We found a decrease in the activity level with increasing morbidity scores. There was no consistent pattern between an activity level and an infectiousness score. We also found a positive correlation between morbidity and infectiousness scores. Overall, we find that increasing virulence leads to increased infectiousness and reduced activity, suggesting a trade-off that can impact overall transmission potential. Our findings indicate that a reduction of systemic symptoms may increase host activity without reducing infectiousness. Therefore, interventions should target both systemic- and infectiousness-related symptoms to reduce overall transmission potential. Our findings can also inform simulation models that investigate the impact of different interventions on transmission.
Evaluating lipid-lowering drug targets for Parkinson disease prevention with Mendelian randomization
Authors: Williams Dylan M. , Bandres-Ciga Sara , Heilbron Karl ,   the 23andMe Research Team,   the International Parkinson’s Disease Genomics Consortium, Hinds David , Noyce Alastair J
Published: May 2020

Objective

To examine whether long-term exposure to statins and other lipid-lowering drugs may affect PD risk – either beneficially or adversely – using Mendelian randomization (MR).

Methods

MR analyses were based on variants in genes encoding the targets of several approved or emerging drug classes that reduce circulating low-density lipoprotein cholesterol (LDL-C) or triglycerides. Variants were weighted by their associations with differences in circulating LDL-C, triglycerides or apolipoprotein B (ApoB) using data from genome-wide association studies of lipids (N = 14,004 to 295,826). MR models indexing the effects of modulating each drug target on PD risk were then estimated from genetic associations with PD case-control status (N = 37,688 cases and 981,372 controls).

Results

Estimates for statin exposure were incompatible with drug use increasing PD risk, but were not precise enough to confirm a protective effect: odds ratio for PD per standard deviation (SD) reduction in low-density lipoprotein cholesterol = 0.83; 95% confidence interval (CI): 0.65, 1.07. Findings for other LDL-lowering targets were also close to the null. Among triglyceride-lowering targets, variants indexing Apolipoprotein-A5 / Apolipoprotein-C3 modulation suggested a protective effect (OR per SD lower triglycerides = 0.84; 95% CI = 0.80, 0.89), whereas others were null.

Interpretation

This genetic evidence does not support findings from large observational studies which suggest that statin exposure could alter risk of PD. Our overall pattern of results suggest peripheral lipid transport may not influence PD etiology, but this does not necessarily exclude effects of statins or the modulation of apolipoproteins A5/C3 via other mechanisms.
Massive Multiplexing Can Deliver a $1 Test for COVID-19
Authors: Hebert Paul DN , Prosser Sean WJ , Ivanova Natalia V , Zakharov Evgeny V , Ratnasingham Sujeevan
Published: May 2020

The severe acute respiratory syndrome virus, SARS-CoV-2 (hereafter COVID-19), rapidly achieved global pandemic status, provoking large-scale screening programs in many nations. Their activation makes it imperative to identify methods that can deliver a diagnostic result at low cost. This paper describes an approach which employs sequence variation in the gene coding for its envelope protein as the basis for a scalable, inexpensive test for COVID-19. It achieves this by coupling a simple RNA extraction protocol with low-volume RT-PCR, followed by E-Gel screening and sequencing on high-throughput platforms to analyze 10,000 samples in a run. Slight modifications to the protocol could support screening programs for other known viruses and for viral discovery. Just as the $1,000 genome is transforming medicine, a $1 diagnostic test for viral and bacterial pathogens would represent a major advance for public health.
COVID-19 Induced Anxiety and Protective Behaviors During COVID-19 Outbreak: Scale Development and Validation
Authors: Riad Abanoub , Huang Yi , Zheng Liping , Elavsky Steriani
Published: May 2020

Background

The outbreak of communicable diseases increases community anxiety levels; however, it demands protective behavioral changes with adjacent awareness of the emerging epidemic. This work aims to develop valid instruments to evaluate COVID-19 induced anxiety, protective behaviors, and knowledge towards COVID-19, and to explore the relationship between the three constructs.

Methods

A total sample of 215 university students were recruited to participate in an online self-administered questionnaire. The e-survey consisted of three instruments: COVID-19 Induced Anxiety Scale (CIAS) with 10 items, Protective Behaviors towards COVID-19 Scale (PBCS) with 14 items, and COVID-19 Related Knowledge Scale (CRKS) with 12 items.

Results

Item-total analysis and CFA models indicated that CIAS items no. 1, 2, 5, and 8 should be removed to achieve adequate internal consistency (Cronbach’s alpha=0.78) and structural validity. The protective behaviors towards COVID-19 can be estimated from 3 dimensions: Routine Protective Behaviors (RPB), Post-exposure Protective Behaviors (PPB), and Post-exposure Risky Behaviors (PRB). Meanwhile, PBCS showed good internal consistency (Cronbach’s alpha=0.85). Although the sample was unbalanced on gender, gender explained 5% of the variance in protective behaviors with females being more inclined to engage in protective behaviors. Structural Equation Model (SEM) implied that an individual’s COVID-19 related knowledge was associated with the three dimensions of protective behaviors (RPB, PPB and PRB) positively. However, the level of COVID-19 induced anxiety was linked to RPB and PPB positively but negatively to PRB.

Conclusion

The 6-item version of CIAS and the 14-item version of PBCS are promising tools for measuring COVID-19 induced anxiety and protective behaviors and can be adopted for future use during early phases of communicable diseases outbreaks. Knowledge is a key indicator for protective behavior; therefore, awareness strategies need to suppress infodemic impact. Severe stress must be monitored during early phases of outbreaks as it significantly increases the probability of risk behavior engagement.
Diagnostic serial interval as a novel indicator for contact tracing effectiveness exemplified with the SARS-CoV-2/COVID-19 outbreak in South Korea
Authors: Mettler Sofia K. , Kim Jihoo , Maathuis Marloes H.
Published: May 2020

BACKGROUND

The clinical onset serial interval is often used as a proxy for the transmission serial interval of an infectious disease. For SARS-CoV-2/COVID-19, data on clinical onset serial intervals is limited, since symptom onset dates are not routinely recorded and do not exist in asymptomatic carriers.

METHODS

We define the diagnostic serial interval as the time between the diagnosis dates of the infector and infectee. Based on the DS4C project data on SARS-CoV-2/COVID-19 in South Korea, we estimate the means of the diagnostic serial interval, the clinical onset serial interval and the difference between the two. We use the balanced cluster bootstrap method to construct 95

RESULTS

The mean of the diagnostic serial interval was estimated to be 3.63 days (95

CONCLUSIONS

The relatively short diagnostic serial intervals of SARS-CoV-2/COVID-19 in South Korea are likely due to the country’s extensive efforts towards contact tracing. We suggest the mean diagnostic serial interval as a new indicator for the effectiveness of a country’s contact tracing as part of the epidemic surveillance.
Predicting Disease Progression in COVID19: A Score Based On Lab Tests At Time Of Diagnosis
Authors: Jamal Mohammad H. , Doi Suhail A. , AlYouha Sarah , Almazeedi Sulaiman , Al-Haddad Mohannad , Al-Muhaini Ali , Al-Ghimlas Fahad , Al-Sabah Salman
Published: May 2020

Background

COVID19 is worldwide pandemic that is mild in the majority of patients but can result in a pneumonia like illness with progression to acute respiratory distress syndrome and death. Predicting the disease severity at time of diagnosis can be helpful in prioritizing hospital admission and resources.

Methods

We prospectively recruited 1096 consecutive patients with COVID19 from the Jaber Hospital, a COVID19 facility in Kuwait, between 24 February and 20 April 2020. The primary endpoint of interest was disease severity defined algorithmically. Predefined risk variables were collected at the time of PCR based diagnosis of the infection. Prognostic model development used 5-fold cross-validated regularized logit regression. The cohort was divided into a training and validation cohort and all model development proceeded on the training cohort.

Results

There were 643 patients with clinical course data of whom 94 developed severe COVID19. In the final model, age, CRP, procalcitonin, lymphocyte and monocyte percentages and serum albumin were independent predictors of a more severe illness course. The final prognostic model demonstrated good discrimination, calibration and internal validity.

Conclusion

We developed and validated a simple score calculated at time of diagnosis that can predict patients with severe COVID19 disease.
Anxiety and Depression in Health Workers and General Population During COVID-19 Epidemic in IRAN: A Web-Based Cross-Sectional Study
Authors: Hassannia Leila , Taghizadeh Fatemeh , Moosazadeh Mahmood , Zarghami Mehran , Taghizadeh Hassan , Dooki Azadeh Fathi , Fathi Mohammad , Navaei Reza Alizadeh , Hedayatizadeh-Omran Akbar
Published: May 2020

Background

The COVID-19 outbreak has exerted a great deal of psychological pressure on Iranian health workers and the general population. In the present study, the prevalence of anxiety and depression symptoms along with the related variables in this epidemic were investigated.

Method

An online cross-sectional study was conducted for the general public and healthcare workers in IRAN using a questionnaire comprised of demographic questions and Hospital Anxiety and Depression Scale. Chi square test was used to compare categorical variables, and univariate and multivariate logistic regression models were conducted.

Results

Of the 2045 participants,1136 (65.6%) were considered to have moderate and severe anxiety symptoms, and 865(42.3%) had moderate and severe depression symptoms. Based on the logistic regression models, the prevalence of anxiety was higher in the females than in the males (OR=1.4, 95% CI: 1.123-1.643, P=.002); the prevalence of anxiety was significantly higher in those aged 30-39 years than in other age groups (OR=1.6, 95% CI: 1.123-2.320, P=0.001); furthermore, the prevalence of anxiety and depression was significantly higher in doctors and nurses compared with other occupations (OR=1.9, 95% CI: 1.367-2.491, P< 0.001) and(OR=1.5, 95% CI: 1.154-2.021, P=0.003). In addition, the prevalence of anxiety symptoms in the likely-infected COVID-19 group was higher than in the noninfected COVID-19 group (OR=1.35, 95% CI: 1.093-1.654, P=0.005).

Conclusions

Regarding the high prevalence of anxiety and depression symptoms, especially among health care workers, appropriate psychological/psychiatric intervention necessitates.
Application-oriented mathematical algorithms for group testing
Authors: Csóka Endre
Published: May 2020

Group testing is a widely used protocol which aims to test a small group of people to identify whether at least one of them is infected. It is particularly efficient if the infection rate is low, because it only requires a single test if everybody in the group is negative. The most efficient use of group testing is a complex mathematical question. However, the answer highly depends on practical parameters and restrictions, which are partially ignored by the mathematical literature. This paper aims to offer practically efficient group testing algorithms, focusing on the current COVID-19 epidemic.
Lack of association between angiotensin converting enzyme inhibitors and angiotensin receptor blockers and pain improvement in patients with oral cancer
Authors: Du K.N. , Shepherd A.J. , Ma I.V. , Roldan C.J. , Amit M. , Feng L. , Desai S. , Cata Juan P.
Published: May 2020

Background

There is a growing body of literature implicating angiotensin II in the modulation of tumor associated inflammation and pain. However, the impact of angiotensin converting enzyme inhibitors (ACEis) and angiotensin II receptor blockers (ARBs) on this pathway has not yet been studied in oral cancers. Our objective is to investigate the role of ACEi and ARB pharmacotherapy on preoperative pain and inflammatory biomarkers, neutrophil to lymphocyte ratio (NLR) and monocyte to lymphocyte ratio (MLR), in patients with oral cancer.

Methods

We performed a retrospective study on patients who underwent oral cancer surgery. Wilcoxon rank sum test or Kruskal-Wallis analysis were used to evaluate differences in demographic, tumor-related, and preoperative characteristics and among patients using ARBs, ACEis, and no treatment. Multivariable analysis was fitted to estimate the effects of important covariates on severe preoperative pain.

Results

162 patients with oral malignancies were included in the study. After adjusting for significant covariates, patients with perineural invasion were found to have higher levels of pain (p = 0.0278). Likewise, patients taking ARBs were found to have lower levels of perineural invasion (p = 0.035). Our analysis did not demonstrate a significant difference in pain levels when comparing ARBs or ACEis to the no treatment group (p= 0.250). Furthermore, ARB or ACEi use did not significantly alter preoperative NLR (p = 0.701) or MLR (p = 0.869).

Conclusions

When compared to no treatment, ARBs and ACEis are not associated with significant analgesic effect or decreased inflammatory scores (NLR, MLR).
Mental Health Impact of COVID-19: A global study of risk and resilience factors
Authors: Płomecka Martyna Beata , Gobbi Susanna , Neckels Rachael , Radziński Piotr , Skórko Beata , Lazzeri Samuel , Almazidou Kristina , Dedić Alisa , Bakalović Asja , Hrustić Lejla , Ashraf Zainab , Es haghi Sarvin , Rodríguez-Pino Luis , Waller Verena , Jabeen Hafsa , Alp A. Beyza , Behnam Mehdi A , Shibli Dana , Barańczuk-Turska Zofia , Haq Zeeshan , Qureshi Salah U , Strutt Adriana M. , Jawaid Ali
Published: May 2020

This study anonymously screened 13,332 individuals worldwide for psychological symptoms related to Corona virus disease 2019 (COVID-19) pandemic from March 29th to April 14th, 2020. A total of n=12,817 responses were considered valid with responses from 12 featured countries and five WHO regions. Female gender, pre-existing psychiatric condition, and prior exposure to trauma were identified as notable risk factors, whereas optimism, ability to share concerns with family and friends like usual, positive prediction about COVID-19, and daily exercise predicted fewer psychological symptoms. These results could aid in dynamic optimization of mental health services during and following COVID-19 pandemic.
Indian community’s Knowledge, Attitude & Practice towards COVID-19
Authors: Tomar Balvir Singh , Singh Pratima , Suman Supriya , Raj Preeti , Nathiya Deepak , Tripathi Sandeep , Chauhan Dushyant Singh
Published: May 2020

As COVID-19 pandemic has caused unprecedented human health consequences. Knowledge, attitude, perception of general population of India towards the transmission and prevention plays vital role for effective control measures. The study was conducted to assess the knowledge, attitude and practice of the general public of India on COVID-19. In this study, a web-based cross-sectional survey was conducted between 10th March to 18th April 2020. A 19-item questionnaire was generated, Cronbach’s alpha was used to measure the internal consistency of the questionnaire & randomly distributed among the public using Google forms through social media networks. The chi-square test or Fischer exact test was used to compare categorical data and multiple linear regression was used to identify factor influencing KAP. Among 7978 participants, the overall knowledge, attitude and practice score was 80.64%, 97.33% and 93.8% consecutively. Majority of Indian population demonstrated preceded good knowledge, positive attitude and good practice regarding COVID-19 pandemic.
Mindfulness-Based Stress Reduction for Breast Cancer Survivors (MBSR (BC)): Evaluating Mediators of Psychological and Physical Outcomes in a Large Randomized Controlled Trial
Authors: Lengacher Cecile A. , Gruss L. Forest , Kip Kevin E. , Reich Richard R. , Moscoso Manolete S. , Chauca Katterine G. , Joshi Anisha , Shani Pinky Budhrani , Cousin Lakeshia , Khan Carly Paterson , Goodman Matthew , Park Jong Y.
Published: May 2020

MBSR(BC) is known to have a positive impact on psychological and physical symptoms among breast cancer survivors (BCS). However, the cognitive mechanisms of “how” MBSR(BC) works are unknown. The purpose of this study, as part of a larger R01 trial, was to test whether positive effects achieved from the MBSR(BC) program were mediated through changes in increased mindfulness, decreased fear of breast cancer recurrence, and perceived stress. Female BCS >21 years diagnosed with Stage 0-III breast cancer were randomly assigned to a 6-week MBSR(BC) or a Usual Care(UC) regimen. Potential outcome mediators were identified by use of an analysis of covariance (ANCOVA), comparing mean values of outcome variables and potential mediating variables followed by mediational and bootstrap analyses. Among 322 BCS (167 MBSR(BC) and 155 UC), fear of recurrence and perceived stress, but not mindfulness, mediated reductions in anxiety and fatigue at weeks 6 and 12, partially supporting our hypothesis of cognitive mechanisms of MBSR(BC).

Support:This study was supported by the National Cancer Institute (Award Number 1R01 CA131080-01A2). This work also has been supported in part by the Biostatistics and Bioinformatics Shared Resource at the H. Lee Moffitt Cancer Center & Research Institute, an NCI designated Comprehensive Cancer Center (P30-CA076292). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Cancer Institute or the National Institutes of Health. This study protocol was approved by the Institutional Review Board at the University of South Florida to ensure the ethical treatment of participants.

Conflict of Interest:The authors have no conflicts to report.

Trial Registration:www.ClinicalTrials.govRegistration Number:NCT01177124
County-level factors influence the trajectory of Covid-19 incidence
Authors: Kranjac Ashley Wendell , Kranjac Dinko
Published: May 2020

With new cases of Covid-19 surging in the United States, we need to better understand how the spread of novel coronavirus varies across all segments of the population. We use hierarchical exponential growth curve modeling techniques to examine whether community social and economic characteristics uniquely influence the incidence of Covid-19 cases in the urban built environment. We show that, as of May 3, 2020, confirmed coronavirus infections are concentrated along demographic and socioeconomic lines in New York City and surrounding areas, the epicenter of the Covid-19 pandemic in the United States. Furthermore, we see evidence that, after the onset of the pandemic, timely enactment of physical distancing measures such as school closures is imperative in order to limit the extent of the coronavirus spread in the population. Public health authorities must impose nonpharmaceutical measures early on in the pandemic and consider community-level factors that associate with a greater risk of viral transmission.
Are Vapers More Susceptible to COVID-19 Infection?
Authors: Li Dongmei , Croft Daniel P. , Ossip Deborah J. , Xie Zidian
Published: May 2020

Background

COVID-19, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was declared a global pandemic in March 2020. Electronic cigarette use (vaping) rapidly gained popularity in the US in recent years. Whether electronic cigarette users (vapers) are more susceptible to COVID-19 infection is unknown.

Methods

Using integrated data in each US state from the 2018 Behavioral Risk Factor Surveillance System (BRFSS), United States Census Bureau and the 1Point3Acres.com website, generalized estimating equation (GEE) models with negative binomial distribution assumption and log link functions were used to examine the association of weighted proportions of vapers with number of COVID-19 infections and deaths in the US.

Results

The weighted proportion of vapers who used e-cigarettes every day or some days ranged from 2.86% to 6.42% for US states. Statistically significant associations were observed between the weighted proportion of vapers and number of COVID-19 infected cases as well as COVID-19 deaths in the US after adjusting for the weighted proportion of smokers and other significant covariates in the GEE models. With every one percent increase in weighted proportion of vapers in each state, the number of COVID-19 infected cases increase by 0.3139 (95% CI: 0.0554 –0.5723) and the number of COVID-19 deaths increase by 0.3705 (95% CI: 0.0623 – 0.6786) in log scale in each US state.

Conclusions

The positive associations between the proportion of vapers and the number of COVID-19 infected cases and deaths in each US state suggest an increased susceptibility of vapers to COVID-19 infections and deaths.
Studies of Novel Coronavirus Disease 19 (COVID-19) Pandemic: A Global Analysis of Literature
Authors: Tran Bach Xuan , Ha Giang Hai , Nguyen Long Hoang , Vu Giang Thu , Phan Hai Thanh , Le Huong Thi , Latkin Carl A. , Ho Cyrus S.H. , Ho Roger C.M.
Published: May 2020

An exponential growth of literature about novel coronavirus disease 19 (COVID-19) has been observed in the last few months. This textual analysis of 5,780 publications extracted from the Web of Science, Medline, and Scopus databases was performed to explore the current research focuses and propose further research agenda. The Latent Dirichlet allocation was used for topic modeling. Regression analysis was conducted to examine country variations in the research focuses. Results indicated that publications were mainly contributed by the United States, China, and European countries. Guidelines for emergency care and surgical, viral pathogenesis, and global responses in the COVID-19 pandemic were the most common topics. There was variation in the research approaches to mitigate COVID-19 problems in countries with different income and transmission levels. Findings highlighted the need for global research collaboration among high- and low/middle-income countries in the different stages of prevention and control the pandemic.
SARS-CoV-2 proteins exploit host’s genetic and epigenetic mediators for the annexation of key host signaling pathways that confers its immune evasion and disease pathophysiology
Authors: Khan Md. Abdullah-Al-Kamran , Islam Abul Bashar Mir Md. Khademul
Published: May 2020

The constant rise of the death toll and cases of COVID-19 has made this pandemic a serious threat to human civilization. Understanding of host-SARS-CoV-2 interaction in viral pathogenesis is still in its infancy. In this study we aimed to correlate how SARS-CoV-2 utilizes its proteins for tackling the host immune response; parallelly, how host epigenetic factors might play a role in this pathogenesis was also investigated. We have utilized a blend of computational and knowledgebase approach to elucidate the interplay between host and SARS-CoV-2. Integrating the experimentally validated host interactome proteins and differentially expressed host genes due to SARS-CoV-2 infection, we have taken a blend of computational and knowledgebase approach to delineate the interplay between host and SARS-CoV-2 in various signaling pathways. Also, we have shown how host epigenetic factors are involved in the deregulation of gene expression. Strikingly, we have found that several transcription factors and other epigenetic factors can modulate some immune signaling pathways, helping both host and virus. We have identified miRNA hsa-miR-429 whose transcription factor was also upregulated and targets were downregulated and this miRNA can have pivotal role in suppression of host immune responses. While searching for the pathways in which viral proteins interact with host proteins, we have found pathways like-HIF-1 signaling, autophagy, RIG-I signaling, Toll-like receptor signaling, Fatty acid oxidation/degradation, Il-17 signaling etc significantly associated. We observed that these pathways can be either hijacked or suppressed by the viral proteins, leading to the improved viral survival and life-cycle. Moreover, pathways like-Relaxin signaling in lungs suggests aberration by the viral proteins might lead to the lung pathophysiology found in COVID-19. Also, enrichment analyses suggest that deregulated genes in SARS-CoV-2 infection are involved in heart development, kidney development, AGE-RAGE signaling pathway in diabetic complications etc. might suggest why patients with comorbidities are becoming more prone to SARS-CoV-2 infection. Our results suggest that SARS-CoV-2 integrates its proteins in different immune signaling pathway and other cellular signaling pathways for developing efficient immune evasion mechanisms, while leading the host to more complicated disease condition. Our findings would help in designing more targeted therapeutic interventions against SARS-CoV-2.