bluuebunny/crossref_metadata_2025 huggingface dataset:
Longer-Term Impact of the Flavored Tobacco Restriction in Two Massachusetts Communities: A Mixed-Methods Study
Authors: Kingsley Melody , Setodji Claude M , Pane Joseph D , Shadel William G , Song Glory , Robertson Jennifer , Kephart Lindsay , Zepeda Samantha , Henley Patricia , Ursprung W W Sanouri
Published: May 2021

Introduction

In response to high rates of youth tobacco use, many states and localities are considering regulations on flavored tobacco products. The purpose of this study was to assess whether flavored tobacco restrictions (FTRs) in Massachusetts curb youth tobacco use over time and whether a dose–response effect of length of policy implementation on tobacco-related outcomes exists.

Aims and Methods

Using a quasiexperimental design, two municipalities with a FTR (adopting municipalities) were matched to a comparison municipality without a FTR. Surveys were administered before (December 2015) and after (January and February 2018) policy implementation to high school students in these municipalities (more than 2000 surveys completed at both timepoints). At follow-up, adopting municipalities had a policy in place for 1 and 2 years, respectively. In 2019, focus groups were conducted with high school students in each municipality.

Results

Increases seen in current tobacco use from baseline to follow-up were significantly smaller in adopting municipalities compared to the comparison (−9.4% [−14.2%, −4.6%] and −6.3% [−10.8%, −1.8%], respectively). However, policy impact was greater in one adopting municipality despite shorter length of implementation. Focus groups indicated reasons for differential impact, including proximity to localities without FTRs.

Conclusions

Restrictions implemented in adopting municipalities had positive impacts on youth tobacco awareness and use 1–2 years postimplementation. Policy impact varies depending on remaining points of access to flavored tobacco, as such policy effectiveness may increase as more localities restrict these products.

Implications

In response to high rates of youth flavored tobacco use (including flavored vape products), federal, state, and localities have passed FTRs that reduce availability of flavored tobacco in youth-accessible stores. Previous research has found that FTRs may curb youth tobacco use in the short-term; however, the long-term effectiveness remains unknown.

This is the first study to show FTRs can curb youth tobacco use and reduce youth awareness of tobacco prices and brands even 2 years after policy passage. Municipality-specific factors, including proximity to localities without FTRs, may attenuate policy impact, highlighting the importance of widespread policy adoption.
How Do Smoking Status and Smoking Cessation Efforts Affect TB Recurrence After Successful Completion of Anti-TB Treatment? A Multicenter, Prospective Cohort Study With a 7-Year Follow-up in China
Authors: Lin Haoxiang , Lin Yan , Xiao Lixin , Chen Yongming , Zeng Xianglin , Chang Chun
Published: May 2021

Introduction

Many important risk factors are associated with tuberculosis (TB) recurrence; among them, smoking is the most common and modifiable behavioral factor. We aimed to assess the association of smoking status and cessation support during anti-TB treatment with subsequent TB recurrence.

Aims and Methods

A 7-year prospective cohort study was performed on 634 TB patients in China. The participants were grouped by smoking status at baseline. Cox proportional hazards models were applied to analyze the association between baseline characteristics and TB recurrence. The cumulative incidence of TB recurrence was estimated by Kaplan–Meier curves.

Results

Multivariable analysis showed that patients who continued smoking during anti-TB treatment were at higher risk for TB recurrence (hazard ratio = 3.45; 95% confidence interval: 1.54–7.73) than nonsmokers. Moreover, this risk remained significant even in those who stopped smoking during anti-TB treatment (hazard ratio = 2.75; 95% confidence interval: 1.47–5.14) than nonsmokers. The association between smoking and TB recurrence was stronger for smear-positive TB patients than for smear-negative TB patients. Among all the subgroups, patients who continued smoking had a higher TB recurrence rate over the 7-year follow-up than those who successfully quit during their anti-TB treatment (log-rank statistic, p < .01). With the increase in the number of cigarettes smoked daily, the TB recurrence risk also increased accordingly (log-rank statistic, p = .02).

Conclusions

Our findings highlight the importance of incorporating effective smoking cessation intervention measures into TB services and call for continuous monitoring of TB recurrence. Among patients who continue smoking or have a history of smoking, special attention should be given to smear-positive patients and heavy smokers when monitoring recurrence.

Implications

This study provides a comprehensive picture of the association of smoking behavior and cessation efforts with TB recurrence. It shows that patients who are nonsmokers have the lowest risk of recurrence and that ex-smokers have a lower risk of recurrence than current smokers. Moreover, patients who successfully quit smoking during TB treatment have a lower risk of recurrence than those who continue smoking. Health workers should provide cessation intervention, focus on TB patients with a history of smoking, and continuously monitor TB recurrence after the completion of anti-TB treatment, particularly for smear-positive TB patients.
Mathematical and Computational Models for Pain: A Systematic Review
Authors: Lang Victoria Ashley , Lundh Torbjörn , Ortiz-Catalan Max
Published: May 2021

Objective

There is no single prevailing theory of pain that explains its origin, qualities, and alleviation. Although many studies have investigated various molecular targets for pain management, few have attempted to examine the etiology or working mechanisms of pain through mathematical or computational model development. In this systematic review, we identified and classified mathematical and computational models for characterizing pain.

Methods

The databases queried were Science Direct and PubMed, yielding 560 articles published prior to January 1st, 2020. After screening for inclusion of mathematical or computational models of pain, 31 articles were deemed relevant.

Results

Most of the reviewed articles utilized classification algorithms to categorize pain and no-pain conditions. We found the literature heavily focused on the application of existing models or machine learning algorithms to identify the presence or absence of pain, rather than to explore features of pain that may be used for diagnostics and treatment.

Conclusions

Although understudied, the development of mathematical models may augment the current understanding of pain by providing directions for testable hypotheses of its underlying mechanisms. Additional focus is needed on developing models that seek to understand the underlying mechanisms of pain, as this could potentially lead to major breakthroughs in its treatment.
Ultrasound Versus Fluoroscopy for Stellate Ganglion Block: A Cadaveric Study
Authors: Hughey Scott , Schafer Jeffrey , Cole Jacob , Booth Gregory , Tuttle Ralph , Stedje-Larsen Eric
Published: May 2021

Objective

Post-Traumatic Stress Disorder (PTSD) is a common psychiatric disorder. Recent investigations have demonstrated effectiveness of Stellate Ganglion Blocks (SGB) for reducing symptoms associated with PTSD. Both fluoroscopic guided and ultrasound guided SGB have been described and are regularly used in clinical practice. This study sought to evaluate differences in block performance when comparing fluoroscopic versus ultrasound guided SGB.

Design

Cadaveric Pilot Study.

Setting

Academic Research Laboratory.

Subjects

Ten Soft-Cured Human Cadavers.

Methods

Ten soft-cured human cadavers were used after being at room temperature for 3 hours. Fluoroscopic and ultrasound guided injections were both performed on each cadaver, randomized to left or right sidedness. In total, 7 mL of omnipaque and methylene blue (5:1) was injected in each side. Injectate spread was assessed by measuring vertebral body spread under fluoroscopy. Successful staining of the sympathetic trunk was assessed under cadaveric dissection, with visualization of the sympathetic trunk stained with methylene blue.

Results

Ultrasound guided injections resulted in successful staining in 9 of 10 injections, while 6 of 10 for fluoroscopic guidance (P = .3034). The average spread in the ultrasound group was 4.0 compared with 5.2 for the fluoroscopic group (P =.088). In the four fluoroscopic guided injections which failed to stain, the injection occurred posterior to the prevertebral fascia. In the single ultrasound guided block that failed to stain, the injection was in the carotid sheath.

Conclusions

While there appeared to be a trend favoring ultrasound guidance, no statistical significance was achieved. This was likely due to this being a limited pilot study. Numerous limitations exist in cadaveric studies, and future investigations should be completed to further study this comparison. That said, the use of the SGB may provide significant relief for patients suffering with PTSD.
The Female Penalty for Novelty and the Offsetting Effect of Alternate Status Characteristics
Authors: Trapido Denis
Published: May 2021

Research has shown that audiences penalize novelty in women’s work but also that such penalty may vary. This study builds on theories of uncertainty and status signaling to identify contingencies that may account for the variation in the female penalty for novelty, particularly in the production of technological and scientific knowledge. Drawing on theories of expectation states and gender status beliefs, I posit that peer audiences have a baseline bias against novelty in women’s work and penalize novelty in female authors’ contributions. However, when authors possess status characteristics that are more task-relevant than gender, this penalty erodes. I identify two academic status characteristics, prestigious graduate degrees and prestigious mentors, which offset the female penalty for novelty. Longitudinal multi-source data on the productivity of academic engineers show that female engineers who have these characteristics face no significant citation penalty for the novelty of their work. Implications of these findings for gender inequality and for policies that aim to reduce it are discussed.
Single-Cell RNA Sequencing Reveals a Unique Monocyte Population in Bronchoalveolar Lavage Cells of Mice Challenged With Afghanistan Particulate Matter and Allergen
Authors: Berman Reena , Min Elysia , Huang Jie , Kopf Katrina , Downey Gregory P , Riemondy Kent , Smith Harry A , Rose Cecile S , Seibold Max A , Chu Hong Wei , Day Brian J
Published: May 2021

Upon returning from deployment to Afghanistan, a substantial number of U.S. military personnel report deployment-related lung disease (DRLD) symptoms, including those consistent with an asthma-like airways disease. DRLD is thought to be caused by prolonged inhalation of toxic desert particulate matter, which can persist in the postdeployment setting such as exposure to common household allergens. The goal of this study was to define the transcriptomic responses of lung leukocytes of mice exposed to Afghanistan desert particulate matter (APM) and house dust mite (HDM). C57BL/6 mice (n = 15/group) were exposed to filtered air or aerosolized APM for 12 days, followed by intranasal PBS or HDM allergen challenges for 24 h. Bronchoalveolar lavage (BAL) cells were collected for single-cell RNA sequencing (scRNAseq), and assessment of inflammation and airway hyper-responsiveness. Unsupervised clustering of BAL cell scRNAseq data revealed a unique monocyte population induced only by both APM and allergen treatments. This population of monocytes is characterized by the expression of genes involved in allergic asthma, including Alox15. We validated Alox15 expression in monocytes via immunostaining of lung tissue. APM pre-exposure, followed by the HDM challenge, led to significantly increased total respiratory system resistance compared with filtered air controls. Using this mouse model to mimic DRLD, we demonstrated that inhalation of airborne PM during deployment may prime airways to be more responsive to allergen exposure after returning home, which may be linked to dysregulated immune responses such as induction of a unique lung monocyte population.
Warming and elevated CO2 alter tamarack C fluxes, growth and mortality: evidence for heat stress-related C starvation in the absence of water stress
Authors: Murphy Bridget K , Way Danielle A
Published: May 2021

Climate warming is increasing the frequency of climate-induced tree mortality events. While drought combined with heat is considered the primary cause of this mortality, little is known about whether moderately high temperatures alone can induce mortality, or whether rising CO2 would prevent mortality at high growth temperatures. We grew tamarack (Larix laricina) under ambient (400 p.p.m.) and elevated (750 p.p.m.) CO2 concentrations combined with ambient, ambient +4 °C and ambient +8 °C growth temperatures to investigate whether high growth temperatures lead to carbon (C) limitations and mortality. Growth at +8 °C led to 40% mortality in the ambient CO2 (8TAC) treatment, but no mortality in the elevated CO2 treatment. Thermal acclimation of respiration led to similar leaf C balances across the warming treatments, despite a lack of photosynthetic acclimation. Photosynthesis was stimulated under elevated CO2, increasing seedling growth, but not leaf C concentrations. However, growth and foliar C concentrations were lowest in the +8 °C treatments, even with elevated CO2. Dying 8TAC seedlings had lower needle C concentrations and lower ratios of photosynthesis to respiration than healthy 8TAC seedlings, indicating that C limitations were likely the cause of seedling mortality under high growth temperatures.
Postoperative opioid-free ureteroscopy discharge: A quality initiative pilot protocol
Authors: Kasman Alex M. , Schmidt Bogdana , Spradling Kyle , Chow Charlene , Hunt Rebecca , Wu Mechele , Sockol Alexa , Liao Joseph , Leppert John T. , Shah Jay , Conti Simon L.
Published: May 2021

Background:

Opioids are commonly prescribed after ureteroscopy. With an increasing adoption of ureteroscopy for management of urolithiasis, this subset of patients is at high risk for opioid dependence. We sought to pilot an opioid-free discharge protocol for patients undergoing ureteroscopy for urolithiasis.

Materials and methods:

A prospective cohort study was performed of all patients undergoing ureteroscopy for urolithiasis and compared them to a historical control group. An opioid-free discharge protocol was initiated targeting all areas of surgical care from June 20th, 2019 to September 20th, 2019 as part of an institutional quality improvement initiative. Demographic and surgical data were collected as were morphine equivalent doses (MEDs) prescribed at discharge, postoperative measures including phone calls, clinic visits, and emergency room visits for pain.

Results:

Between October 1st, 2017 and February 1st, 2018, a total of 54 patients who underwent ureteroscopy were identified and comprised the historical control cohort while 54 prospective patients met the inclusion criteria since institution of the quality improvement initiative. There were no statistically significant differences in baseline patient demographics or surgical characteristics between the 2 patient groups. Total 37% of the intervention group had a preexisting opioid prescription versus 42.6% of the control group with no difference in preoperative MED (p = 0.55). The intervention group had a mean MED of 12.03 at discharge versus 110.5 in the control cohort (p ≤ 0.001). At discharge 3.7% of the intervention group received an opioid prescription versus 88.9% of the control group (p < 0.001). Overall, there was no difference in postoperative pain related phone calls (p = 1.0) or emergency room visits (p = 1.0).

Conclusions:

An opioid-free discharge protocol can dramatically reduce opioid prescription at discharge following ureteroscopy for urinary calculi without affecting postoperative measures such as phone calls, clinic visits, or subsequent prescriptions.
On a Quantitative Approach to Clinical Neuroscience in Psychiatry: Lessons from the Kuramoto Model
Authors: Anyaeji Chinedu I. , Cabral Joana , Silbersweig David
Published: May 2021

The human brain is a complex system comprising subregions that dynamically exchange information between its various parts through synchronization. These dynamic, complex interactions ultimately play a role in perception, emotion, cognition, and behavior, as well as in various maladaptive neurologic and psychiatric processes. It is therefore important to understand how brain dynamics might be implicated in these processes. Over the past few years, network neuroscience and computational neuroscience have highlighted the importance of measures such as metastability (a property whereby members of an oscillating system tend to linger at the edge of synchronicity without permanently becoming synchronized) in quantifying brain dynamics. Altered metastability has been implicated in various psychiatric illnesses, such as traumatic brain injury and Alzheimer’s disease. Computational models, which range in complexity, have been used to assess how various parameters affect metastability, synchronization, and functional connectivity. These models, though limited, can act as heuristics in understanding brain dynamics. This article (aimed at the clinical psychiatrist who might not possess an extensive mathematical background) is intended to provide a brief and qualitative summary of studies that have used a specific, highly simplified computational model of coupled oscillators (Kuramoto model) for understanding brain dynamics—which might bear some relevance to clinical psychiatry.
Outcomes of Primary Trabeculectomy From Two Same-centre Cohorts 10 Years Apart
Authors: Shiwani Haaris A. , Naqvi Salman , Cristian Cristina , Au Leon , Spencer Anne F. , Fenerty Cecilia H. , Mercieca Karl J.
Published: May 2021

Precis:

Trabeculectomy can effectively lower intraocular pressure (IOP). A more junior surgeon profile is emerging. Mitomycin C (MMC) has replaced 5-fluorouracil (5-FU) intraoperatively with comparable success rates and a decrease in postoperative antimetabolite administration.

Purpose:

We compare 2-year outcomes for primary trabeculectomy in 2 cohorts, 10 years apart, performed at a large UK teaching hospital.

Methods:

Consecutive case series of trabeculectomies at Manchester Royal Eye Hospital between 2004-2005 (Cohort 1/C1) and 2014-2015 (Cohort 2/C2). Preoperative and postoperative data was collected for IOP outcomes and complications. Success was defined as IOP ≥6 and ≤21, ≤18, ≤16, ≤14, or ≤12 mm Hg with/without a ≥20% decrease from preoperative IOP. The need for and absence of postoperative antihypertensive medication defined qualified and complete success, respectively.

Results:

A total of 186 cases were analyzed [52 (C1), 134 (C2)]. Mean preoperative IOP was 24±10 mm Hg (C1) and 21±7 mm Hg (C2) (P=0.01). Overall, 34 (79%), 33 (77%), 33 (77%), 29 (67%), and 25 (58%) patients in C1 and 88 (70%), 82 (65%), 73 (58%), 64 (51%), and 40 (32%) patients in C2 achieved complete success for IOP ≤21 mm Hg (P=0.33), ≤18 mm Hg (P=0.22), ≤16 mm Hg (P=0.04), ≤14 mm Hg (P=0.09), or ≤12 mm Hg (P=0.004). Similarly, 43 (93%), 40 (87%), 40 (87%), 35 (76%), and 27 (59%) in C1 and 123 (98%), 116 (92%), 106 (84%), 87 (69%), and 58 (49%) in C2 achieved qualified success (P=0.34, 0.37, 0.83, 0.48, and 0.19). In all, 32 (74%), 31 (72%),31 (72%), 28 (65%), and 24 (56%) in C1 and 64 (51%), 63 (50%), 61 (48%), 54 (43%), and 39 (31%) in C2 achieved complete success with ≥20% reduction from preoperative IOP and IOP of ≤21 mm Hg (P=0.01), ≤18 mm Hg (P=0.02), ≤16 mm Hg (P=0.01), ≤1 mm Hg (P=0.02), or ≤12 mm Hg (P=0.006). By same definition, 37 (80%), 36 (78%), 36 (78%), 33 (72%), and 26 (57%) in C1 and 94 (75%), 93 (74%), 90 (71%), 75 (60%), and 58 (46%) in C2 achieved qualified success (P=0.55, 0.69, 0.48, 0.20, and 0.30). Mean IOP at 2 years was 13±5 mm Hg (C1) and 13±4 mm Hg (C2) (P=0.35). Overall, 62% had intraoperative 5-FU in C1; only MMC was used in C2 (P<0.0001). Postoperative 5-FU was administered in 54% versus 22% in C1 and C2, respectively (P<0.0001). Needling rates were not statistically different [42% (C1), 54% (C2)] (P=0.22).

Conclusions:

Trabeculectomy is effective in lowering IOP with success comparable across various definitions. MMC replaced 5-FU as intraoperative antimetabolite resulting in reduced need for postoperative antimetabolite but not increased complications.
Clinical PET/CT utilization during the COVID-19 pandemic: initial experience at Yale University
Authors: Adin Mehmet Emin , Uezono Haruka , Isufi Edvin , Pang Yulei , Zucconi William , Saperstein Lawrence , Pucar Darko
Published: May 2021

Objective

To determine temporal changes in PET/CT utilization during the COVID-19 pandemic and examine the impact of epidemiologic, demographic and oncologic factors on PET/CT utilization.

Methods

Clinical PET-CT utilization between 1 January 2020 and 15 June 2020 at a tertiary academic center was assessed using change-point-detection (CPD) analysis. COVID-19 epidemiologic trend was obtained from Connecticut Department of Public Health records. Demographic and oncologic data were gathered from electronic medical records and PET-CT scans by four reviewers in consensus.

Results

A total of 1685 cases were reviewed. CPD analysis identified five distinct phases of PET-CT utilization during COVID-19, with a sharp decline and a gradual recovery. There was a 62.5% decline in case volumes at the nadir. These changes correlated with COVID-19 epidemiologic changes in the state of Connecticut, with a negative correlation between COVID-19 cases and PET-CT utilization (τ = −0.54; P value < 0.001). Statistically significant differences in age, race, cancer type and current and prior scan positivity were observed in these five phases. A greater percentage of young patients and minorities were scanned during the pandemic relative to baseline. PET/CT scanning was less impacted for hematologic malignancies than for solid cancers, with less profound decline and better recovery.

Discussion

PET-CT cancer imaging was vulnerable to the COVID-19 pandemic at our institution. Epidemiologic, demographic and oncologic factors affected PET-CT utilization.
How Positive Are Conversion Disorder Diagnoses?
Authors: Nikrad Ehsan , Kanaan Richard A.
Published: May 2021

The Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) diagnostic criteria for conversion disorder have replaced the criterion of evidence of a “psychogenic” etiology with a criterion that patients must be “positively” diagnosed on the basis of their neurological assessment. We retrospectively studied referrals to a specialist functional neurology clinic to see how commonly the new criteria were met since DSM-5's introduction. Positive signs were reported in a quarter of referrals (26.5%), which was associated with diagnosticians' confidence (p = 0.001) and with the clinic confirming the diagnosis (p = 0.01). Our clinic found positive signs in 28.6% of the referrals. In 13 (13.3%) patients, the new criterion was not met. In conclusion, positive signs are diagnostically helpful but are only reported in a minority of assessments. A significant group of those currently believed to have conversion disorder would not meet the revised diagnostic criteria based on this.
Kinetics of emergence of liver complications in hepatitis C virus infected patients and advanced fibrosis, with and without HIV-coinfection, after sustained virological response
Authors: Corma-Gómez Anaïs , Macías Juan , Téllez Francisco , Morano Luis , Rivero Antonio , Serrano Miriam , Ríos María José , Vera-Méndez Francisco Jesús , Santos Marta , Real Luis Miguel , Palacios Rosario , Santos Ignacio de Los , Geijo Paloma , Imaz Arkaitz , Merino Dolores , Galindo Maria José , Reus-Bañuls Sergio , López-Ruz Miguel Ángel , Galera Carlos , Pineda Juan A.
Published: May 2021

Objective:

There is scarce available evidence on the distribution over time of liver complications emergence in hepatitis C virus (HCV)-infected patients who achieve sustained virological response (SVR) with direct-acting antiviral (DAA)-based therapy. Therefore, we aimed at describing the kinetics of liver-related events appearance in this setting.

Design:

A multicentric prospective cohort study.

Methods:

HCV-monoinfected and HIV/HCV-coinfected patients from GEHEP-011 cohort, whose inclusion criteria were had achieved SVR with DAA-based therapy; liver stiffness prior to starting treatment at least 9.5 kPa; and available liver stiffness measurement at SVR. SVR was considered as the baseline time-point.

Results:

One thousand and thirty-five patients were included, 664 (64%) coinfected with HIV. Before DAA-based therapy, 63 (6.1%) individuals showed decompensated cirrhosis. After SVR, 51 (4.9%) patients developed liver complications. Median (Q1-Q3) time to the emergence of hepatic events was hepatic encephalopathy 11 (7–24) months, ascites 14 (6–29) months, hepatocellular carcinoma (HCC) 17 (11–42) months and portal hypertension gastrointestinal bleeding (PHGB) 28 (22–38) months (P = 0.152). We define two profiles of liver complications: those emerging earlier (encephalopathy and ascites) and, those occurring continuously during the follow-up (HCC, PHGB) [median (Q1-Q3) time to emergence 12.7 (6.6–28.2) months vs. 25.4 (12.5–41.53) months, respectively (P = 0.026)].

Conclusion:

The vast majority of HCV-infected patients who develop liver complications after reaching SVR with DAA do it within 3 years after SVR time-point. Specifically, hepatic encephalopathy and ascites do not usually emerge after this period. Conversely, HCC and PHGB may occur in longer term. It is critical to identify patients at risk of developing hepatic events to continue performing surveillance for them.
Cervical cancer incidence stratified by age in women with HIV compared with the general population in the United States, 2002–2016
Authors: Stier Elizabeth A. , Engels Eric , Horner Marie-Josèphe , Robinson William T. , Qiao Baozhen , Hayes Jennifer , Bayakly Rana , Anderson Bridget J. , Gonsalves Lou , Pawlish Karen S. , Zavala Diego , Monterosso Analise , Shiels Meredith S.
Published: May 2021

Objective:

Recommendations for the age of initiating screening for cervical cancer in women with HIV (WWH) in the United States have not changed since 1995 when all women (regardless of immune status) were screened for cervical cancer from the age of onset of sexual activity, which often occurs in adolescence. By 2009, recognizing the lack of benefit as well as harms in screening young women, guidelines were revised to initiate cervical cancer screening for the general population at age 21 years. By comparing cervical cancer incidence in young WWH to that of the general population, we assessed the potential for increasing the recommended age of initiating cervical cancer screening in WWH.

Design:

We compared age-specific invasive cervical cancer (ICC) rates among WWH to the general population in the United States HIV/AIDS Cancer Match Study.

Methods:

We estimated standardized incidence ratios as the observed number of cervical cancer cases among WWH divided by the expected number, standardized to the general population by age, race/ethnicity, registry, and calendar year.

Results:

ICC rates among WWH were elevated across all age groups between ages 25 and 54 years (SIR = 3.80; 95% CI 3.48--4.15) but there were zero cases among ages less than 25 years.

Conclusion:

The absence of ICC among WWH less than 25 years supports initiating cervical cancer screening at age 21 years, rather than adolescence, to prevent cancers in WWH at ages with higher risk of ICC.
Hospital Adoption of Electronic Decision Support Tools for Preeclampsia Management
Authors: Bui Linh N. , Marshall Cassondra , Miller-Rosales Chris , Rodriguez Hector P.
Published: May 2021

Background:

Electronic health record (EHR)–based clinical decision support tools can improve the use of evidence-based clinical guidelines for preeclampsia management that can reduce maternal mortality and morbidity. No study has investigated the organizational capabilities that enable hospitals to use EHR-based decision support tools to manage preeclampsia.

Objective:

To examine the association of organizational capabilities and hospital adoption of EHR-based decision support tools for preeclampsia management.

Methods:

Cross-sectional analyses of hospitals providing obstetric care in 2017. In total, 739 hospitals responded to the 2017-2018 National Survey of Healthcare Organizations and Systems (NSHOS) and were linked to the 2017 American Hospital Association (AHA) Annual Survey Database and the Area Health Resources File (AHRF). A total of 425 hospitals providing obstetric care across 49 states were included in the analysis. The main outcome was whether a hospital adopted EHR-based clinical decision support tools for preeclampsia management. Hospital organizational capabilities assessed as predictors include EHR functions, adoption of evidence-based clinical treatments, use of quality improvement methods, and dissemination processes to share best patient care practices. Logistic regression estimated the association of hospital organizational capabilities and hospital adoption of EHR-based decision support tools to manage preeclampsia, controlling for hospital structural and patient sociodemographic characteristics.

Results:

Two-thirds of the hospitals (68%) adopted EHR-based decision support tools for preeclampsia, and slightly more than half (56%) of hospitals had a single EHR system. Multivariable regression results indicate that hospitals with a single EHR system were more likely to adopt EHR-based decision support tools for preeclampsia (17.4 percentage points; 95% CI, 1.9 to 33.0; P < .05) than hospitals with a mixture of EHR and paper-based systems. Compared with hospitals having multiple EHRs, on average, hospitals having a single EHR were also more likely to adopt the tools by 9.3 percentage points, but the difference was not statistically significant (95% CI, −1.3 to 19.9). Hospitals with more processes to aid dissemination of best patient care practices were also more likely to adopt EHR-based decision-support tools for preeclampsia (0.4 percentage points; 95% CI, 0.1 to 0.6, for every 1-unit increase in dissemination processes; P < .01).

Conclusion:

Standardized EHRs and policies to disseminate evidence are foundational hospital capabilities that can help advance the use of EHR-based decision support tools for preeclampsia management in the approximately one-third of US hospitals that still do not use them.
New human-associated species of the family Atopobiaceae and proposal to reclassify members of the genus Olsenella
Authors: Zgheib Rita , Anani Hussein , Meng Marine Makoa , Mailhe Morgane , Ricaboni Davide , Morand Aurélie , Caputo Aurelia , Traore Sory Ibrahima , Fontanini Anthony , Armstrong Nicholas , Raoult Didier , Fournier Pierre Edouard
Published: May 2021

Five novel bacterial strains, Marseille-P1476T (=CSURP1476T=DSM 100642T), Marseille-P3256T (=CSURP3256T=CECT 9977T), Marseille-P2936T (=CSURP2936T=DSM 103159T), Marseille-P2912T (=CSURP2912T=DSM 103345T) and Marseille-P3197T (=CSURP3197T=CCUG 71847T), were isolated from various human specimens. These five strains were not identified at the species level by matrix-assisted laser desorption/ionization time of flight mass spectrometry. Following 16S rRNA gene sequence comparisons with the GenBank database, the highest nucleotide sequence similarities of all studied strains were obtained to members of the paraphyletic genus

Olsenella

. A polyphasic taxono-genomic strategy (16S rRNA gene-based and core genome-based phylogeny, genomic comparison, phenotypic and biochemical characteristics) enabled us to better classify these strains and reclassify

Olsenella

species. Among the studied strains, Marseille-P1476T, Marseille-P2936T and Marseille-P3197T belonged to new species of the genus

Olsenella

for which we propose the names Olsenella massiliensis sp. nov., Olsenella phocaeensis sp. nov. and Olsenella urininfantis sp. nov., respectively. Strains Marseille-P2912T and Marseille-P3256T belonged to a new genus for which the names Thermophilibacter provencensis gen. nov., sp. nov. and Thermophilibacter mediterraneus gen. nov., sp. nov. are proposed, respectively. We also propose the creation of the genera Parafannyhessea gen. nov., Tractidigestivibacter gen. nov. and Paratractidigestivibacter gen. nov. and the reclassification of

Olsenella umbonata

as Parafannyhessea umbonata comb. nov.,

Olsenella scatoligenes

as Tractidigestivibacter scatoligenes comb. nov., and

Olsenella faecalis

as Paratractidigestivibacter faecalis comb. nov.
Sphingobacterium lumbrici sp. nov., a novel bacterium isolated from wormcast of Eisenia foetida
Authors: Zhang Xiao-Fei , Shi Rui , Chen Min , Zhou Xing-Kui , Wei Yu-Qian , Cha Qi-Yan , Li Ni , Su Yuan-Xiao , Ma Li , Mo Ming-He , Cao Yi
Published: May 2021

A novel Gram-stain-negative, rod-shaped, non-motile, yellowish bacterium, designated strain 1.3611T, was isolated from the wormcast of Eisenia foetida. The strain grew optimally at 30–37 ℃, at pH 7.0 and with 0–1.0 % (w/v) NaCl. Based on the results of 16S rRNA gene sequence and phylogenetic analyses, strain 1.3611T showed the highest degree of 16S rRNA gene sequence similarity to

Sphingobacterium olei

HAL-9T (97.0 %), followed by

Sphingobacterium alkalisoli

Y3L14T (95.8 %). The respiratory quinone of strain 1.3611T was menaquinone-7 (MK-7) and its major cellular fatty acids were iso-C15 : 0 (41.3 %), summed feature 3 (C16 : 1
 ω7c and/or C16 : 1
 ω6c, 22.1 %) and iso-C17 : 0 3-OH (16.2 %). The major polar lipids were sphingophospholipid, phosphatidylethanolamine, four unidentified glycolipids, two unidentified phospholipids and five unidentified polar lipids. The genomic DNA G+C content was 39.0 mol%. The digital DNA–DNA hybridization and average nucleotide identity values between the genomes of strain 1.3611T and

S. olei

HAL-9T were 37.9 and 88.9 %, respectively. According to the phenotypic and chemotaxonomic phylogenetic results, strain 1.3611T should represent a novel species of the genus

Sphingobacterium

, for which the name Sphingobacterium lumbrici sp. nov. is proposed, with strain 1.3611T (=KCTC 62980T=CCTCC AB 2018349T) as the type strain.
Portable and label-free quantitative Loop-mediated Isothermal Amplification (qLAMP) for reliable COVID-19 diagnostics in 3 minutes: An Arduino-based detection system assisted by a pH microelectrode
Authors: Moisés Alvarez Mario , Bravo-González Sergio , González-González Everardo , Santiago Grissel Trujillo-de
Published: May 2021

Loop-mediated isothermal amplification (LAMP) has been recently studied as an alternative method for cost-effective diagnostics in the context of the current COVID-19 pandemic. Recent reports document that LAMP-based diagnostic methods have a comparable sensitivity and specificity to that of RT-qPCR. We report the use of a portable Arduino-based LAMP-based amplification system assisted by pH microelectrodes for the accurate and reliable diagnosis of SARS-CoV-2 during the first 3 minutes of the amplification reaction. We show that this simple system enables a straightforward discrimination between samples containing or not containing artificial SARS-CoV-2 genetic material in the range of 10 to 10,000 copies per 50 µL of reaction mix. We also spiked saliva samples with SARS-CoV-2 synthetic material and corroborated that the LAMP reaction can be successfully monitored in real time using microelectrodes in saliva samples as well. These results may have profound implications for the design of real-time and portable quantitative systems for the reliable detection of viral pathogens including SARS-CoV-2.
Chromosome X-wide analysis of positive selection in human populations: from common and private signals to selection impact on inactivated genes and enhancers-like signatures
Authors: Villegas-Mirón Pablo , Acosta Sandra , Nye Jessica , Bertranpetit Jaume , Laayouni Hafid
Published: May 2021

The ability of detecting adaptive (positive) selection in the genome has opened the possibility of understanding the genetic bases of population-specific adaptations genome-wide. Here we present the analysis of recent selective sweeps specifically in the X chromosome in different human populations from the third phase of the 1000 Genomes Project using three different haplotype-based statistics. We describe numerous instances of genes under recent positive selection that fit the regimes of hard and soft sweeps, showing a higher amount of detectable sweeps in sub-Saharan Africans than in non-Africans (Europe and East Asia). A global enrichment is seen in neural-related processes while numerous genes related to fertility appear among the top candidates, reflecting the importance of reproduction in human evolution. Commonalities with previously reported genes under positive selection are found, while particularly strong new signals are reported in specific populations or shared across different continental groups. We report an enrichment of signals in genes that escape X chromosome inactivation, which may contribute to the differentiation between sexes. We also provide evidence of a widespread presence of soft-sweep-like signatures across the chromosome and a global enrichment of highly scoring regions that overlap potential regulatory elements. Among these, enhancers-like signatures seem to present putative signals of positive selection that might be in concordance with selection in their target genes. Also, particularly strong signals appear in regulatory regions that show differential activities, which might point to population-specific regulatory adaptations.
SELP Asp603Asn and severe thrombosis in COVID-19 males: implication for anti P-selectin monoclonal antibodies treatment
Authors: Fallerini Chiara , Daga Sergio , Benetti Elisa , Picchiotti Nicola , Zguro Kristina , Catapano Francesca , Baroni Virginia , Lanini Simone , Bucalossi Alessandro , Marotta Giuseppe , Baldassarri Margherita , Fava Francesca , Beligni Giada , Di Sarno Laura , Alaverdian Diana , Palmieri Maria , Croci Susanna , Isidori Andrea M. , Furini Simone , Frullanti Elisa ,   GEN-COVID Multicenter Study, Renieri Alessandra , Mari Francesca
Published: May 2021

Thromboembolism is a frequent cause of severity and mortality in COVID-19. However, the etiology of this phenomenon is not well understood. A cohort of 1,186 subjects, from the GEN-COVID consortium, infected by SARS-CoV-2 with different severity were stratified by sex and adjusted by age. Then, common coding variants from whole exome sequencing were mined by LASSO logistic regression. The homozygosity of the cell adhesion molecule P-selectin gene (SELP) rs6127 (c.1807G>A; p.Asp603Asn) which increases platelet activation is found to be associated with severity in the male subcohort of 513 subjects (Odds Ratio= 2.27, 95% Confidence Interval 1.54-3.36). As the SELP gene is downregulated by testosterone, the odd ratio is increased in males older than 50 (OR 2.42, 95% CI 1.53-3.82). Asn/Asn homozygotes have increased D-dimers values especially when associated with poly Q≥23 in the androgen receptor (AR) gene (OR 3.26, 95% CI 1.41-7.52). These results provide a rationale for the repurposing of antibodies against P-selectin as adjuvant therapy in rs6127 male homozygotes especially if older than 50 or with impaired AR gene.

Key points

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The functional polymorphism rs6127 (p.Asp603Asn) in the testosterone-regulated SELP gene associates with COVID-19 severity and thrombosis.

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Conditions with decreased testosterone (old males), or decreased testosterone efficacy (AR gene polyQ ≥ 23) strengthen the association.
Estimating the wave 1 and wave 2 infection fatality rates from SARS-CoV-2 in India
Authors: Purkayastha Soumik , Kundu Ritoban , Bhaduri Ritwik , Barker Daniel , Kleinsasser Michael , Ray Debashree , Mukherjee Bhramar
Published: May 2021

Objective

There has been much discussion and debate around the underreporting of COVID-19 infections and deaths in India. In this short report we first estimate the underreporting factor for infections from publicly available data released by the Indian Council of Medical Research on reported number of cases and national seroprevalence surveys. We then use a compartmental epidemiologic model to estimate the undetected number of infections and deaths, yielding estimates of the corresponding underreporting factors. We compare the serosurvey based ad hoc estimate of the infection fatality rate (IFR) with the model-based estimate. Since the first and second waves in India are intrinsically different in nature, we carry out this exercise in two periods: the first wave (April 1, 2020 - January 31, 2021) and part of the second wave (February 1, 2021 – May 15, 2021). The latest national seroprevalence estimate is from January 2021, and thus only relevant to our wave 1 calculations.

Results

Both wave 1 and wave 2 estimates qualitatively show that there is a large degree of “covert infections” in India, with model-based estimated underreporting factor for infections as 11.11 (95% credible interval (CrI) 10.71-11.47) and for deaths as 3.56 (95% CrI 3.48 - 3.64) for wave 1. For wave 2, underreporting factor for infections escalate to 26.77 (95% CrI 24.26 – 28.81) and to 5.77 (95% CrI 5.34 – 6.15) for deaths. If we rely on only reported deaths, the IFR estimate is 0.13% for wave 1 and 0.03% for part of wave 2. Taking underreporting of deaths into account, the IFR estimate is 0.46% for wave 1 and 0.18% for wave 2 (till May 15). Combining waves 1 and 2, as of May 15, while India reported a total of nearly 25 million cases and 270 thousand deaths, the estimated number of infections and deaths stand at 491 million (36% of the population) and 1.21 million respectively, yielding an estimated (combined) infection fatality rate of 0.25%. There is considerable variation in these estimates across Indian states. Up to date seroprevalence studies and mortality data are needed to validate these model-based estimates.
Correlation of the commercial anti-SARS-CoV-2 receptor binding domain antibody test with the chemiluminescent reduction neutralizing test and possible detection of antibodies to emerging variants
Authors: Morinaga Yoshitomo , Tani Hideki , Terasaki Yasushi , Nomura Satoshi , Kawasuji Hitoshi , Shimada Takahisa , Igarashi Emiko , Saga Yumiko , Yoshida Yoshihiro , Yasukochi Rei , Kaneda Makito , Murai Yushi , Ueno Akitoshi , Miyajima Yuki , Fukui Yasutaka , Nagaoka Kentaro , Ono Chikako , Matsuura Yoshiharu , Fujimura Takashi , Ishida Yoichi , Oishi Kazunori , Yamamoto Yoshihiro
Published: May 2021

Background

Serological tests are beneficial for recognizing the immune response against SARS-CoV-2. To identify protective immunity, optimization of the chemiluminescent reduction neutralizing test (CRNT), using pseudotyped SARS-CoV-2, is critical. Whether commercial antibody tests are comparably accurate is unknown.

Methods

Serum samples collected before variants were locally found were obtained from confirmed COVID-19 patients (n = 74), confirmed non-COVID-19 individuals (n = 179), and unscreened individuals (suspected healthy individuals, n = 229). The convalescent phase was defined as the period after day 10 from disease onset. The CRNT against pseudotyped viruses displaying the wild-type spike protein and a commercially available anti-receptor binding domain (RBD) antibody test were assayed. The CRNT was also assayed, using South African (SA) and United Kingdom (UK)-derived variants.

Results

The CRNT (cut off value, 50% inhibition) and the anti-RBD antibody test (cut off value, 0.8 U/mL) concurred regarding symptomatic COVID-19 patients in the convalescent phase and clearly differentiated between patients and suspected healthy individuals (sensitivity; 95.8% and 100%, specificity; 99.1% and 100%, respectively). Anti-RBD antibody test results correlated with neutralizing titer (r = 0.47, 95% CI 0.20-0.68). Compared with the wild-type, CRNT reduction was observed for the SA and UK-derived variants. Of the samples with ≥100 U/mL by the anti-RBD antibody test, 77.8% and 88.9% showed ≥50% neutralization against the UK and the SA variants, respectively.

Conclusion

The CRNT and commercial anti-RBD antibody test effectively classified convalescent COVID-19 patients. The strong positive results using the commercial antibody test can reflect neutralizing activity against emerging variants.
Translational control of fungal gene expression during the wheat-Fusarium graminearum interaction
Authors: Kage Udaykumar , Gardiner Donald M , Stiller Jiri , Kazan Kemal
Published: May 2021

To date, translational regulation of key genes controlling infection-related processes in fungal pathogens during their interactions with plants has not been studied. Here, we employed ribosome profiling (ribo-seq) to study translational responses and how such responses are coordinated with transcriptional changes in the fungal pathogen Fusarium graminearum (Fg), which causes Fusarium head blight (FHB), a destructive disease of cereal crops worldwide.

Transcription and translation were not always coordinated with approximately 22% of Fg genes showing a discordant relationship during wheat infection. Nitrite reductase, which we show here as an important component of fungal virulence, is only regulated at the translational level in Fg. In addition, more than 1000 new open reading frames (ORFs), many of which are short and highly conserved, were identified in the Fg genome.

Like in higher eukaryotes, translation is controlled by upstream ORFs (uORFs) in Fg during infection. Similarly, miRNAs control both transcription and translation in Fg during wheat infection. However, Fgdicer2-dependent miRNAs do not have a significant effect on transcriptional gene expression at the global outset.

The ribo-seq study undertaken here for the first time in any fungal pathogen discovered novel insights about the biology of an important plant pathogen.
Single-Molecule Dynamics of SARS-CoV-2 5’ Cap Recognition by Human eIF4F
Authors: Hong Hea Jin , Guevara Matthew G. , Lin Eric , O’Leary Seán E.
Published: May 2021

Coronaviruses initiate translation through recognition of the viral RNA 5’ m7GpppAmcap by translation factor eIF4F. eIF4F is a heterotrimeric protein complex with cap-binding, RNA-binding, and RNA helicase activities. Modulating eIF4F function through cellular regulation or small-molecule inhibition impacts coronavirus replication, including for SARS-CoV-2. Translation initiation involves highly coordinated dynamics of translation factors with messenger or viral RNA. However, how the eIF4F subunits coordinate on the initiation timescale to define cap-binding efficiency remains incompletely understood. Here we report that translation supported by the SARS-CoV-2 5’-UTR is highly sensitive to eIF4A inhibition by rocaglamide. Through a single-molecule fluorescence approach that reports on eIF4E–cap interaction, we dissect how eIF4F subunits contribute to cap-recognition efficiency on the SARS-CoV-2 5’ UTR. We find that free eIF4A enhances cap accessibility for eIF4E binding, but eIF4G alone does not change the kinetics of eIF4E–RNA interaction. Conversely, formation of the full eIF4F complex significantly alters eIF4E–cap interaction, suggesting that coordinated eIF4E and eIF4A activities establish the net eIF4F–cap recognition efficiency. Moreover, the eIF4F complex formed with phosphomimetic eIF4E(S209D) binds the viral UTR more efficiently than with wild-type eIF4E. These results highlight a dynamic interplay of eIF4F subunits and mRNA that determines cap-recognition efficiency.