bluuebunny/crossref_metadata_2025 huggingface dataset:
Prevalence and temporal trends of anemia in patients with heart failure
Authors: Rahman E U , Chobufo M D , Farah F , Mohamed T , Elhamdani M , Rueda C , Aronow W S , Fonarow G C , Thompson E
Published: July 2021

Background

Anemia is an important comorbidity in heart failure (HF), and it is associated with increased adverse disease experience and mortality. Previous reports have focused mainly on HF presenting in healthcare settings. We, therefore, set out to establish the nationwide prevalence and temporal trends of anemia in community-based patients with HF in the US.

Aim

To establish the nationwide prevalence and temporal trends of anemia in community-based patients with HF in the US.

Design

The NHANES dataset, conducted by the CDC National Center for Health Statistics was used to collect nationally representative data on the health and nutritional status of the non-institutionalized US population.

Methods

We utilized the National Health and Nutrition Examination data collected over five survey cycles (2007–16). Included were participants aged 20–80 years with self-reported diagnosis of HF. Anemia was defined using 2 sex specific cut offs of 13 and 12 g/dl (cutoff 1), and 12 and 11 g/dl (cutoff 2), for men and women, respectively. The Chi square test was used to compare prevalence across different categories and survey cycles. Data analysis was done using STATA 16 with P-values < 0.05 considered statistically significant.

Results

The median hemoglobin in all HF patients was 13.5 g/dl (IQR 12.4–14.5). The prevalence of anemia among community-based patients with HF in the US was 21.34% (cutoff 1) and 9.03% (cutoff 2) and has been stable from 2007 to 2016. The burden of anemia was disproportionately higher in NH Blacks (34.48%, 95% CI 27.12–42.67) and those with BMI < 25 Kg/m2 (17.4%, 95% CI 10.9–26.64).

Conclusion

The prevalence of anemia in patients with HF in the US is at least 9% and has remained stable over the past decade. This high persistent burden with limited proven interventions should spur further efforts aimed at identifying impactful ways of addressing anemia in patients with HF.
Cluster-randomized trial comparing organizationally tailored versus standard approach for integrating an evidence-based cancer control intervention into African American churches
Authors: Knott Cheryl L , Chen Chang , Bowie Janice V , Mullins C Daniel , Slade Jimmie L , Woodard Nathaniel , Robinson-Shaneman Barbara-Jean R , Okwara Leonore , Huq Maisha R , Williams Ralph , He Xin
Published: July 2021

Lay Summary

Researchers have become interested in studying how health promotion activities fit within the organizational setting where they are delivered. Health activities that are integrated into the host setting’s structures and routine operations are more likely to be fully executed, effective, and sustained. Unfortunately, we know little about how to achieve such integration. This is especially true when working outside of a healthcare system, in community organizations like churches. We report findings from a study that compared an approach to tailoring health promotion activities into their host settings, with a standard, non-tailored approach. The study was conducted in 14 African American churches randomly assigned to the tailored or standard group. The health promotion activity involved training lay people to conduct cancer educational workshops for church members. We measured the extent to which the churches integrated health promotion activities into their structures, processes, resources, and communication at the beginning and one year later. We found that while the churches had overall increases in these factors over time, those in the tailored group did not do so to a greater degree than those in the standard group. Even so, this approach to tailoring health promotion activities to the organizational setting merits future study.
Development and pilot testing of a training for bilingual community education professionals about hereditary breast and ovarian cancer among Latinas: ÁRBOLES Familiares
Authors: Vadaparampil Susan T , Moreno Botero Laura , Fuzzell Lindsay , Garcia Jennifer , Jandorf Lina , Hurtado-de-Mendoza Alejandra , Campos-Galvan Claudia , Peshkin Beth N , Schwartz Marc D , Lopez Katherine , Ricker Charité , Fiallos Katie , Quinn Gwendolyn P , Graves Kristi D
Published: July 2021

Lay Summary

Latinas at high risk for hereditary breast and ovarian cancer (HBOC) have low rates of genetic counseling and testing. Latinas may not have ready access to services like genetic counseling and testing, which need special solutions. One solution can involve training community health workers to bridge the gap between Latinas and genetic specialists. We developed an online and in person training program (ÁRBOLES Familiares or Family Trees) for English-Spanish bilingual community health workers that teaches them how to help Latinas get access to genetic services. We tested this program with a small group of community health workers. After the program, their HBOC knowledge, genetic literacy, and confidence to help Latinas get access to genetic services had improved. Trainees also made suggestions to improve the program, which will be used to help future trainees expand their knowledge and skills to work with Latinas at risk of HBOC.
Seroprevalence estimate and risk factors for Coxiella burnetii infections among humans in a highly urbanised Brazilian state
Authors: Meurer Igor Rosa , Silva Marcio Roberto , Silva Marcos Vinícius Ferreira , de Lima Duré Ana Íris , Adelino Talita Émile Ribeiro , da Costa Alana Vitor Barbosa , Vanelli Chislene Pereira , de Paula Souza e Guimarães Ricardo José , Rozental Tatiana , de Lemos Elba Regina Sampaio , Corrêa José Otávio do Amaral
Published: July 2021

Background

Q fever is among the top 13 global priority zoonoses, however, it is still neglected and under-reported in most of the world, including Brazil. Thus, we evaluated the seroprevalence of and the risk factors for Coxiella burnetii infections in humans from Minas Gerais, a highly urbanised Brazilian state.

Methods

Coxiella burnetii was searched for patient samples (n=437), which were suspected of then later confirmed as negative for dengue fever, by the indirect immunofluorescence technique and real-time PCR. Risk factors for infections and spatial clusters for both C. burnetii-seropositive individuals and livestock concentration were evaluated.

Results

We found that 21 samples (4.8%; 95% CI 3.0 to 7.2%) were reactive for at least one class of anti-C. burnetii antibodies (titer of ≥64), with rural residence (p=0.036) being a risk factor. Also, two spatial clusters of seropositivity were found within a significant area by Scan, and a probable relationship between the Scan result and the livestock concentration by area was found.

Conclusions

Seropositive individuals were associated with rural residence, with a likely relationship with the livestock concentration. Thus, this study establishes baseline figures for C. burnetii seroprevalence in humans in a state of Brazil, allowing the monitoring of trends and setting of control targets, as well as more representative longitudinal and risk analysis studies.
New record of the wood-associated sea starCaymanostella, with notes on the phylogenetic position of the family Caymanostellidae (Asteroidea)
Authors: Dilman Anna B , Minin Kirill V , Petrov Nikolay B
Published: July 2021

In 2016, three specimens of Caymanostella were collected from the Kuril-Kamchatka Trench area at depths of 5101–5134 m. Comparative morphological analysis revealed that the new specimens are similar to Caymanostella spinimarginata, the most geographically distant species (Atlantic Ocean). The new specimens were identified as C. cf. spinimarginata. Multilocus genetic data were obtained for the family Caymanostellidae for the first time in this study. Molecular evidence based on the analyses of three mitochondrial and two nuclear markers recovers the family Caymanostellidae as a sister-taxon to Ophidiasteridae (order Valvatida). Phylogenetic data indicate that morphological features, which were previously used to imply asterinid, xyloplacid or korethrasterid affinities for the family Caymanostellidae, emerged independently. It is suggested that the family Caymanostellidae should be placed within the order Valvatida.
Quantitative Trait Loci Mapping of Resistance to Powdery Mildew Race 1 in a Recombinant Inbred Line Population of Melon
Authors: Branham Sandra E. , Kousik Chandrasekar , Mandal Mihir K. , Wechter W. Patrick
Published: July 2021

Powdery mildew, caused by the fungus Podosphaera xanthii, is one of the most important diseases of melon. Although there are several pathogenic races of P. xanthii, race 1 is the predominant race in South Carolina and in other parts of the United States. We used a densely genotyped recombinant inbred line melon population for traditional quantitative trait loci (QTL) mapping, to identify two major (qPx1-5 and qPx1-12) and two minor (qPx1-4 and qPx1-10) QTLs (named according to race – chromosome number) associated with resistance to P. xanthii race 1. QTL mapping of disease severity in multiple tissues (hypocotyl, cotyledons, true leaves, and stems) identified the same genetic basis of resistance in all tissue types. Whole-genome resequencing of the parents was used for marker development across the major QTLs and functional annotation of single nucleotide polymorphisms (SNPs) for candidate gene analysis. Kompetitive allele-specific PCR (KASP) markers were tightly linked to the QTL peaks of qPx1-5 (pm1-5_25329892, pm1-5_25461503 and pm1-5_25625375) and qPx1-12 (pm1-12_22848920 and pm1-12_22904659) in the population and will enable efficient marker-assisted introgression of powdery mildew resistance into improved germplasm. Candidate genes were identified in both major QTL intervals that encode putative R genes with missense mutations between the parents. The candidate genes provide targets for future breeding efforts and a fundamental examination of resistance to powdery mildew in melon.
Rapid Identification of a Stripe Rust Resistance Gene YrXK in Chinese Wheat Line Xike01015 Using Specific Locus Amplified Fragment (SLAF) Sequencing
Authors: Sun Cai , Liu Yike , Li Qiang , Wang Baotong , Chen Shuhui , Deng Jianxin , Ma Dongfang , Yang Yuheng
Published: July 2021

Wheat stripe rust, an airborne fungal disease caused by Puccinia striiformis Westend. f. sp. tritici, is one of the most devastating diseases of wheat. Chinese wheat cultivar Xike01015 displays high levels of all-stage resistance (ASR) to the current predominant P. striiformis f. sp. tritici race CYR33. In this study, a single dominant gene, designated YrXk, was identified in Xike01015 conferring resistance to CYR33 with genetic analysis of F2 and BC1 populations from a cross of Mingxian169 (susceptible) and Xike01015. The specific length amplified fragment sequencing (SLAF-seq) strategy was used to construct a linkage map in the F2 population. Quantitative trait loci (QTL) analysis mapped YrXk to a 12.4-Mb segment on chromosome1 BS, explaining >86.96% of the phenotypic variance. Gene annotation in the QTL region identified three differential expressed candidate genes, TraesCS1B02G168600.1, TraesCS1B02G170200.1, and TraesCS1B02G172400.1. The qRT-PCR results showed that TraesCS1B02G172400.1 and TraesCS1B02G168600.1 are upregulated and that TraesCS1B02G170200.1 is slightly downregulated after inoculation with CYR33 in the seedling stage, which indicates that these genes may function in wheat resistance to stripe rust. The results of this study can be used in wheat breeding for improving resistance to stripe rust.
Potential Threat of Bruchids on Soybean Production in Sub-Saharan Africa
Authors: Pawlowski Michelle L. , Lagos-Kutz Doris M. , da Fonseca Santos Michelle , Lee Nicole , Chigeza Godfree , Nachilima Christabell , Francischini Josy Helena Merola Botan , Hartman Glen L.
Published: July 2021

Soybean production in sub-Saharan Africa (SSA) has been increasing in recent years in part due to the efforts of several national and international research agencies, including the Soybean Innovation Laboratory (SIL). SIL’s mission to increase utilization and production of soybean in SSA has led to several facets of research including cultivar development to increase yield through the Pan-African Soybean Variety Trials (PATs). Several abiotic and biotic stresses can decrease yield, including pathogens and pests that attack seed. While evaluating seed lots from 32 PAT locations, we identified bruchids and/or bruchid-damaged seed in nine locations in four countries (Cameroon, Malawi, Mozambique, and Rwanda). The most severe damage and infestation was recorded in Bwanje, Malawi, with 28 of the 40 seed lots infested. Seed damage ranged from 0.6 to 100% among the 28 infested seed lots. Adult bruchids discovered at the Bwanje location were identified as Callosobruchus chinensis, or the Chinese bruchid. No adults were found in other locations. Bruchids are a destructive storage pest of legumes, and monitoring the different species attacking soybean will help researchers and producers understand the potential threat of bruchids to soybean production in SSA as well as help implement the best management practices.
Recovery Plan for Wheat Blast Caused by Magnaporthe oryzae Pathotype Triticum
Authors: Valent Barbara , Cruppe Giovana , Stack James P. , Cruz C. D. , Farman Mark L. , Paul Pierce A. , Peterson Gary L. , Pedley Kerry F.
Published: July 2021

Wheat blast is an explosive new fungal disease of wheat caused by an Magnaporthe oryzae (synonym of Pyricularia oryzae) host-adapted subpopulation, the M. oryzae Triticum pathotype (MoT). MoT has been found in South America, South Asia, and Africa, but not in the United States. Wheat blast caused by the MoT fungus was first reported in Brazil in 1985 and subsequently spread to Bolivia, Paraguay, and Argentina in the 1990s and 2000s. The disease first appeared in Bangladesh in 2016 and in Zambia in 2017. The MoT fungus is seedborne, and the most likely route for movement across oceans was though grain trade. Wheat head (spike) blast is the predominant form of the disease in the field, although foliar and stem blast also occurs. The disease has proven hard to control when weather conditions are conducive, often resulting in devastating yield and quality losses. The only currently effective resistance, contained in the 2NvS translocation from the wild wheat relative Aegilops ventricosa, confers partial resistance that is variable depending on the genetic background of the specific wheat variety. Fungicides are not fully effective in controlling wheat head blast if warm, humid weather occurs during the heading stage. A major disease management strategy in areas where the disease occurs involves timing the wheat planting date so that heading does not coincide with warm rainy weather. A climate suitability model for the United States indicates that all of U.S. soft red winter wheat and about half of the hard red winter wheat are at risk.
Extracorporeal Membrane Oxygenation Complications in Heparin- and Bivalirudin-Treated Patients
Authors: Giuliano Katherine , Bigelow Benjamin F. , Etchill Eric W. , Velez Ana K. , Ong Chin Siang , Choi Chun W. , Bush Errol , Cho Sung-Min , Whitman Glenn J. R.
Published: July 2021

OBJECTIVES:

Extracorporeal membrane oxygenation is a potentially life-saving intervention in refractory cardiopulmonary failure, but it requires anticoagulation to prevent circuit thromboses, which exposes the patient to hemorrhagic complications. Heparin has traditionally been the anticoagulant of choice, but the direct thrombin inhibitor bivalirudin is routinely used in cases of heparin-induced thrombocytopenia and has been suggested as a superior choice. We sought to examine the timing of hemorrhagic and thrombotic complications after extracorporeal membrane oxygenation cannulation and to compare the rates of such complications between patients anticoagulated with heparin versus bivalirudin.

DESIGN:

Retrospective cohort study.

SETTING:

Johns Hopkins Hospital patients between January 2016 and July 2019.

PATIENTS:

Adult (> 18 yr) extracorporeal membrane oxygenation patients.

INTERVENTIONS:

Patients were anticoagulated either with heparin or bivalirudin.

MEASUREMENTS AND MAIN RESULTS:

We compared rates of hemorrhagic and thrombotic complications by time on heparin versus bivalirudin and characterized the average time to each complication. Of 144 extracorporeal membrane oxygenation patients (mean age 55.3 yr; 58% male), 41% were on central venoarterial extracorporeal membrane oxygenation, 40% on peripheral venoarterial extracorporeal membrane oxygenation, and 19% on venovenous extracorporeal membrane oxygenation. Thirteen patients (9%) received bivalirudin during their extracorporeal membrane oxygenation run, due to concern for (n = 8) or diagnosis of (n = 4) heparin-induced thrombocytopenia or for heparin resistance (n = 1). The rate of hemorrhagic or thrombotic complications did not differ between heparin (0.13/d) and bivalirudin (0.06/d; p = 0.633), but patients on bivalirudin received significantly fewer blood transfusions (1.0 U of RBCs/d vs 2.9/d on heparin; p < 0.001).

CONCLUSIONS:

Our results confirm the safety and efficacy of bivalirudin as an alternative anticoagulant in extracorporeal membrane oxygenation and suggest a potential benefit in less blood product transfusion, although prospective studies are needed to evaluate the true effect of bivalirudin versus the disease processes that prompted its use in our study population.
Lymphatic Endothelial Cell Defects in Congenital Cardiac Patients With Postoperative Chylothorax
Authors: Shakoor Aqsa , Wu June K. , Muley Ajit , Kitajewski Christopher , McCarron Joseph D. , Shapiro-Franklin Noa , Corda Rozelle , Chrisomalis-Dring Sophia , Chai Paul J. , Shawber Carrie J.
Published: July 2021

Objectives:

Chylothorax following cardiac surgery for congenital cardiac anomalies is a complication associated with severe morbidities and mortality. We hypothesize that there are intrinsic defects in the lymphatics of congenital cardiac patients.

Methods:

Postsurgical chylothorax lymphatic endothelial cells (pcLECs) (n = 10) were isolated from the chylous fluid from congenital cardiac defect patients, and characterized by fluorescent-activated cell sorting, immunofluorescent staining, and quantitative RT-PCR. Results were compared to normal human dermal lymphatic endothelial cells (HdLECs). pcLECs (n = 3) and HdLECs were xenografted into immunocompromised mice. Implants and postoperative chylothorax patient’s pulmonary tissues were characterized by immunostaining for lymphatic endothelial proteins.

Results:

pcLECs expressed endothelial markers VECADHERIN, CD31, VEGFR2, lymphatic endothelial markers PROX1, podoplanin, VEGFR3, and progenitor endothelial markers CD90 and CD146. However, pcLECs had key differences relative to HdLECs, including altered expression and mislocalization of junctional proteins (VECADHERIN and CD31), and essential endothelial proteins, VEGFR2, VEGFR3, and PROX1. When xenografted in mice, pcLECs formed dilated lymphatic channels with poor cell–cell association. Similar to congenital lymphatic anomalies, the pulmonary lymphatics were dilated in a patient who developed postoperative chylothorax after cardiac surgery.

Conclusions:

Recent studies have shown that some postoperative chylothoraces in congenital cardiac anomalies are associated with anatomical lymphatic defects. We found that pcLECs have defects in expression and localization of proteins necessary to maintain lymphatic specification and function. This pcLEC phenotype is similar to that observed in lymphatic endothelial cells from congenital lymphatic anomalies. Co-existence of lymphatic anomalies should be considered as a feature of congenital cardiac anomalies.
A cross-sectional study of breast pain in a diverse population of breast cancer patients
Authors: Fukui Jami , Bantum Erin , Meister Madison , Lim Shannon , Marumoto Ashley Davidson , Pagano Ian
Published: July 2021

Background:

Breast cancer is the most common cancer in women, and postoperative breast pain has been reported to be anywhere from 25% to 60%. However, there is sparse data regarding racial/ethnic differences in breast pain among breast cancer patients.

Methods:

We performed a cross-sectional anonymous survey of breast cancer patients from the Hawaii Cancer Consortium over a 6-week period between 2019 and 2020. The 237 breast cancer participants were ages 29 to 98, 74% Asian, and mainly from outpatient oncology clinics. We evaluated the prevalence of breast pain in a diverse group of breast cancer patients and characterized the pain using a modified short-form McGill pain questionnaire (sfMPQ).

Results:

Eighty-four respondents (35.4%) reported breast pain. On univariable analysis, we found significant racial/ethnic differences in the amount of breast pain, where Chinese and Japanese participants reported significantly less pain compared to White participants on a 10-point pain scale. We found differences in breast pain according to age and endocrine therapy use as well as survey location, however, no differences were seen according to chemotherapy, radiation, or breast surgery. Based on the sfMPQ, the most common descriptors of breast pain were sensory (throbbing, shooting, and stabbing) compared to affective (tiring-exhausting, sickening, fearful, and punishing-cruel) characteristics. Although they were described as mild and intermittent, in women with breast pain, 33.4% reported the breast pain affected their sleep, 16.7% their work, and 15.4% their sexual activity.

Conclusions:

Breast pain is a significant problem in our breast cancer community. This survey assessment has informed our understanding of breast pain in our diverse population. In turn, we are developing culturally appropriate pain management strategies to treat this challenging symptom common in breast cancer survivors.
Cost-effectiveness of Multidisciplinary Care in Plastic Surgery
Authors: Raj Sarth , Williams Elizabeth M. , Davis Matthew J. , Abu-Ghname Amjed , Luu Bryan C. , Buchanan Edward P.
Published: July 2021

Background

Multidisciplinary care has been previously shown to improve outcomes for patients and providers alike, fostering interprofessional collaboration and communication. Many studies have demonstrated the beneficial health care outcomes of interdisciplinary care. However, there has been minimal focus on the cost-effectiveness of such care, particularly in the realm of plastic surgery. This is the first systematic review to examine cost savings attributable to plastic surgery involvement in multidisciplinary care.

Methods

A comprehensive literature review of articles published on cost outcomes associated with multidisciplinary teams including a plastic surgeon was performed. Included articles reported on cost outcomes directly or indirectly attributable to a collaborative intervention. Explicitly reported cost savings were totaled on a per-patient basis. Each article was also reviewed to determine whether the authors ultimately recommended the team-based intervention described.

Results

A total of 604 articles were identified in the initial query, of which 8 met the inclusion criteria. Three studies reported explicit cost savings from multidisciplinary care, with cost savings ranging from $707 to $26,098 per patient, and 5 studies reported changes in secondary factors such as complication rates and length of stay. All studies ultimately recommended multidisciplinary care, regardless of whether cost savings were achieved.

Conclusions

This systematic review of the cost-effectiveness of multidisciplinary plastic surgery care examined both primary cost savings and associated quality outcomes, such as length of stay, complication rate, and resource consumption. Our findings indicate that the inclusion of plastic surgery in team-based care provides both direct and indirect cost savings to all involved parties.
Critical care ultrasound in geriatric trauma resuscitation leads to decreased fluid administration and ventilator days
Authors: Cleveland Elaine Marie , Warren Yancy Everett , Shenoy Rathna , Lewis Margaret Ruffin , Cunningham Kyle William , Wang Huaping , Huynh Toan T. , Brintzenhoff Rita Anne
Published: July 2021

BACKGROUND

Geriatric trauma populations respond differently than younger trauma populations. Critical care ultrasound (CCUS) can guide resuscitation, and it has been shown to decrease intravenous fluid (IVF), lower time until operation, and lower mortality in trauma. Critical care ultrasound–guided resuscitation has not yet been studied in geriatric trauma. We hypothesized that incorporation of CCUS would decrease amount of IVF administered, decrease time to initiation of vasopressors, and decrease end organ dysfunction.

METHODS

A PRE-CCUS geriatric trauma group between January 2015 and October 2016 was resuscitated per standard practice. A POST-CCUS group between January 2017 and December 2018 was resuscitated based on CCUS performed by trained intensivist upon admission to the intensive care unit and 6 hours after initial ultrasound. The PRE-CCUS and POST-CCUS groups underwent propensity score matching, yielding 60 enrollees in each arm. Retrospective review was conducted for demographics, clinical outcomes, and primary endpoints, including amount of IVF in the first 48 hours, duration to initiation of vasopressor use, and end organ dysfunction. Wilcoxon two-sample, χ2 tests, and κ statistics were performed to check associations between groups.

RESULTS

There was no statistical difference between PRE-CCUS and POST-CCUS demographics and Injury Severity Scores. Intravenous fluid within 48 hours decreased from median [interquartile range] of 4941 mL [4019 mL] in the PRE-CCUS to 2633 mL [3671 mL] in the POST-CCUS (p = 0.0003). There was no significant difference between the two groups in time to initiation of vasopressors, vasopressor duration, lactate clearance, intensive care unit length of stay, or hospital length of stay. There was a significant decrease in ventilator days, with 26.7% PRE-CCUS with ventilation longer than 2 days, and only 6.7% POST-CCUS requiring ventilation longer than 2 days (p = 0.0033).

CONCLUSION

Critical care ultrasound can be a useful addition to geriatric resuscitation. The POST-CCUS received less IV fluid and had decreased ventilator days. While mortality, lactate clearance, complications, and hospital stay were not statistically different, there was a perception that CCUS was a useful adjunct for assessing volume status and cardiac function.

LEVEL OF EVIDENCE

Therapeutic, level II.
Outcome measures used in clinical research evaluating prehospital blood component transfusion in traumatically injured bleeding patients: A systematic review
Authors: Tucker Harriet , Avery Pascale , Brohi Karim , Davenport Ross , Griggs Joanne , Weaver Anne , Green Laura
Published: July 2021

BACKGROUND

Trial outcomes should be relevant to all stakeholders and allow assessment of interventions’ efficacy and safety at appropriate timeframes. There is no consensus regarding outcome measures in the growing field of prehospital trauma transfusion research. Harmonization of future clinical outcome reporting is key to facilitate interstudy comparisons and generate cohesive, robust evidence to guide practice. The objective of this study was to evaluate outcome measures reported in prehospital trauma transfusion trials.

METHODS

Data Sources, Eligibility Criteria, Participants, and Interventions

We conducted a scoping systematic review to identify the type, number, and definitions of outcomes reported in randomized controlled trials, and prospective and retrospective observational cohort studies investigating prehospital blood component transfusion in adult and pediatric patients with traumatic hemorrhage. Electronic database searching of PubMed, Embase, Web of Science, Cochrane, OVID, clinical trials.gov, and the Transfusion Evidence Library was completed in accordance with Preferred Reporting Items for Meta-analyses guidelines.

Study Appraisal and Synthesis Methods

Two review authors independently extracted outcome data. Unique lists of salutogenic (patient-reported health and wellbeing outcomes) and nonsalutogenic focused outcomes were established.

RESULTS

A total of 3,471 records were identified. Thirty-four studies fulfilled the inclusion criteria: 4 military (n = 1,566 patients) and 30 civilian (n = 14,398 patients), all between 2000 and 2020. Two hundred twelve individual non–patient-reported outcomes were identified, which collapsed into 20 outcome domains with varied definitions and timings. All primary outcomes measured effectiveness, rather than safety or complications. Sixty-nine percent reported mortality, with 11 different definitions. No salutogenic outcomes were reported.

CONCLUSION

There is heterogeneity in outcome reporting and definitions, an absence of patient-reported outcome, and an emphasis on clinical effectiveness rather than safety or adverse events in prehospital trauma transfusion trials. We recommend stakeholder consultation and a Delphi process to develop a clearly defined minimum core outcome set for prehospital trauma transfusion trials.

LEVEL OF EVIDENCE

Scoping systematic review, level III.
‘Obliging and curious’: Taylor White (1701–1772) and his remarkable collections
Authors: Dickenson Victoria
Published: July 2021

Taylor White (1701–1772) was by profession a barrister and judge, active in public life in London. His life as a jurist and as the long-serving treasurer of the Foundling Hospital is documented in the records of his public appointments and in his own official correspondence. This article reveals the other Taylor White, a Fellow of the Royal Society (1725), and an active participant in the practice of science in the mid eighteenth century. White accumulated a significant collection of specimens and drawings of plants, insects, birds and mammals. Over 900 of the zoological drawings are preserved in the Blacker Wood Natural History Collection at McGill University in Montreal. White's passions for natural history and collecting are revealed tangentially through the very few letters in his hand, the notes he made about his own collection, and infrequent references in the books and letters of his friends and fellow naturalists. This article seeks not only to document the sources of White's collection, but also to extract a narrative of acquisition, transport and exchange of specimens that reveals the informal networks of eighteenth-century naturalists, which included not only scientists but also sailors, merchants and curious lawyers. It also explores the work and motivations of the collector engaged in building a reference collection of animal portraits, painted in their true colours and ‘the size of life’. Close study of this collection positions Taylor White within the community of eighteenth-century naturalists and provides a deeply textured exploration of natural history and collecting in the age of Linnaeus.
Electrocharging face masks with corona discharge treatment
Authors: Bandi M. M. , Ishizu N. , Kang H.-B.
Published: July 2021

We detail an experimental method to electrocharge N95 facepiece respirators and face masks (FMs) made from a variety of fabrics (including non-woven polymer and knitted cloth) using corona discharge treatment (CDT). We present practical designs to construct a CDT system from commonly available parts and detail calibrations performed on different fabrics to study their electrocharging characteristics. After confirming the post-CDT structural integrity of fabrics, measurements showed that all non-woven polymer electret and only some knitted cloth fabrics are capable of charge retention. Whereas polymeric fabrics follow the well-known isothermal charging route, ion adsorption causes electrocharging in knitted cloth fabrics. Filtration tests demonstrate improved steady filtration efficiency in non-woven polymer electret filters. On the other hand, knitted cloth fabric filters capable of charge retention start with improved filtration efficiency which decays in time over up to 7 h depending on the fabric type, with filtration efficiency tracking the electric discharge. A rapid recharge for a few seconds ensures FM reuse over multiple cycles without degradation.
Flavobacterium solisilvae sp. nov. and Flavobacterium silvaticum sp. nov., isolated from forest soil
Authors: Jung Hye Su , Chun Byung Hee , Kim Hyung Min , Jeon Che Ok
Published: July 2021

Two Gram-stain-negative, yellow-pigmented and strictly aerobic bacteria, designated strains SE-s27T and SE-s28T, were isolated from forest soil. Both strains were non-motile rods that were catalase-positive and oxidase-negative and grew optimally at 25–30 °C, pH 8.0 and with 0 % (w/v) NaCl. Strain SE-s28T produced flexirubin-type pigments, but strain SE-s27T did not produce them. Both strains contained menaquinone-6 as the sole respiratory quinone and phosphatidylethanolamine as a major polar lipid. As the major cellular fatty acids (>10 %), SE-s27T contained iso-C15 : 1 and iso-C15 : 1G, whereas SE-s28T contained iso-C15 : 0 and summed feature 3 comprising C16 : 1ω7c and/or C16 : 1ω6c and/or iso-C15 : 0 2-OH. The DNA G+C contents of strains SE-s27T and SE-s28T were 33.1 and 44.3 mol%, respectively. The results of phylogenetic analysis based on 16S rRNA gene sequences revealed that SE-s27T and SE-s28T formed respective distinct phylogenetic lineages within the genus

Flavobacterium

. Strains SE-s27T and SE-s28T were most closely related to

Flavobacterium macrobrachii

an-8T and

Flavobacterium piscinae

ICH-30T with 98.0 and 94.5 % 16S rRNA gene sequence similarities, respectively. In conclusion, strains SE-s27T and SE-s28T represent novel species of the genus

Flavobacterium

, for which the names Flavobacterium solisilvae sp. nov. and Flavobacterium silvaticum sp. nov. are proposed. The type strains of F. solisilvae and F. silvaticum are SE-s27T (=KACC 18802T=JCM 31544T) and SE-s28T (=KACC 18803T=JCM 31545T), respectively.
PathML: A unified framework for whole-slide image analysis with deep learning
Authors: Berman Adam G. , Orchard William R. , Gehrung Marcel , Markowetz Florian
Published: July 2021

The inspection of stained tissue slides by pathologists is essential for the early detection, diagnosis and monitoring of disease. Recently, deep learning methods for the analysis of whole-slide images (WSIs) have shown excellent performance on these tasks, and have the potential to substantially reduce the workload of pathologists. However, successful implementation of deep learning for WSI analysis is complex and requires careful consideration of model hyperparameters, slide and image artefacts, and data augmentation. Here we introduce PathML, a Python library for performing preand post-processing of WSIs, which has been designed to interact with the most widely used deep learning libraries, PyTorch and TensorFlow, thus allowing seamless integration into deep learning workflows. We present the current best practices in deep learning for WSI analysis, and give a step-by-step guide using the PathML framework: from annotating and pre-processing of slides, to implementing neural network architectures, to training and post-processing. PathML provides a unified framework in which deep learning methods for WSI analysis can be developed and applied, thus increasing the accessibility of an important new application of deep learning.
Genotoxicity evaluation of levonorgestrel-releasing intrauterine system (LNG-IUS) in exfoliated cervical cells using the micronucleus (MN) test
Authors: Zamani Ayse Gul , Karatayli Rengin , Kazim Gezginc , Acar Aynur , Yildirim Mahmut Selman
Published: July 2021

Purpose

This study aimed to determine whether any relationships exist between the levonorgestrel-releasing intrauterine system (LNG-IUS) and micronuclei or other nuclear anomalies, including condensed chromatin, karyorrhexis, and karyolysis, on the cervical epithelium in young women.

Methods

A prospective observational study was conducted. The study population comprised healthy women aged ≤40 years who were referred for birth control. Cervical smears that were obtained from 18 women before and three months after LNG-IUS insertion were tested for micronuclei and other nuclear anomaliesusing the micronucleus test.

Results

The results revealed no statistically significant difference (P>0.05) in the frequency of micronucleated exfoliated cervical mucosa cells after LNG-IUS exposure. However, LNG-IUS was able to increase other nuclear alterations closely related to cytotoxicity.

Conclusions

Data indicated that exposure to LNG-IUS may not be a factor in inducing chromosomal damage, but it can promote cytotoxicity.
Humoral immune response in inactivated SARS-CoV-2 vaccine: When should a booster dose be administered?
Authors: Kara Ertan , Tanir Ferdi , Demirhindi Hakan , Mete Burak , Kibar Filiz , Cetiner Salih , Candevir Aslihan , Inaltekin Ayşe
Published: July 2021

Background

For a sustained and essential protective antibody response, it is important to understand how long the humoral immune response induced by the SARS-CoV-2 inactivated vaccine persists.

Aims

This study aimed to detect the first and third-month concentrations and seroconversion rates of the antibodies induced by the inactivated vaccine.

Study Design

This is a vaccine efficacy study.

Methods

The study included 272 health workers who were vaccinated at days 0 and 28 by the inactivated SARS-CoV-2 vaccine (3μg/0.5ml). Anti-S-RBD-IgG and total anti-spike/anti- nucleocapsid-IgG antibody concentrations and seroconversion rates were examined in vaccinated health workers at the 1st and 3rd months after the vaccination. The test method used for the qualitative detection and differentiation of IgG antibodies (indirect method) to SARS-CoV-2 is a chemiluminescence reaction (CLIA).

Results

The mean age of the health workers was 38.93±10.59 (min:21-max:64). A total of 45(16.5%) participants declared to have had COVID-19 before the first dose of the inactivated vaccine. The participants were found to be reactive for anti-S-RBD-IgG antibodies by 98.2% and 97.8% at the first and third months, respectively, after the administration of the second dose. The decrease in the mean plasma concentrations of anti-S-RBD IgG was observed as 56.7% in the cohort with only two doses of the vaccine (1st month:42.4AU/ml versus 3rd month: 18.2AU/ml). In the cohort with a history of COVID-19 prior to the vaccination, the decrease was observed as 25.1% (1st month:58.29 versus 3rd month:43.64 AU/ml) and at a mean of 57.4 (0-90) days prior to vaccination, the decrease was of 43.1% (1st month:55.05 AU/ml versus 3rd month:31.28 AU/ml), keeping more stable in participants infected at a mean of 183.1 (91-330) days prior to vaccination (a decrease of 5.2%; with 62.34 AU/ml at 1st and 59.08 AU/ml at 3rd months). Anti-S-RBD concentrations were observed to increase 10-fold (30.44 AU/ml at 1st and 310.64 AU/ml at 3rd months) in participants infected after the vaccination and to decrease among people aged 50 years and older.

Conclusion

Antibody concentrations at the 1st and 3rd months after the vaccination with two doses of the inactivated SARS-CoV-2 vaccine were found to be decreased, but still detectable (except in one participant). As participants who had COVID-19 at a mean of 181 (90-330) days before the vaccination presented with a more stable antibody level, it can be concluded that a booster at months 6-12, resulting in a schedule of 0-1-6 months, is recommended for the inactive SARS-CoV-2 vaccination.
Infection fatality rate of COVID-19 in community-dwelling populations with emphasis on the elderly: An overview
Authors: Axfors Cathrine , Ioannidis John P A
Published: July 2021

Objective

This mixed design synthesis aimed to estimate the infection fatality rate (IFR) of Coronavirus Disease 2019 (COVID-19) in community-dwelling elderly populations and other age groups from seroprevalence studies. Protocol:https://osf.io/47cgb.

Methods and analyses

Eligible were seroprevalence studies done in 2020 and identified by any of four existing systematic reviews; with ≥1000 participants aged ≥70 years that presented seroprevalence in elderly people; that aimed to generate samples reflecting the general population; and whose location had available data on cumulative COVID-19 deaths in elderly (primary cutoff ≥70 years; ≥65 or ≥60 also eligible). We extracted the most fully adjusted (if unavailable, unadjusted) seroprevalence estimates. We also extracted age- and residence-stratified cumulative COVID-19 deaths (until 1 week after the seroprevalence sampling midpoint) from official reports, and population statistics, to calculate IFRs corrected for unmeasured antibody types. Sample size-weighted IFRs were estimated for countries with multiple estimates. Secondary analyses examined data on younger age strata from the same studies.

Results

Twenty-five seroprevalence surveys representing 14 countries were included. Across all countries, the median IFR in community-dwelling elderly and elderly overall was 2.9% (range 0.2%-6.9%) and 4.9% (range 0.2%-16.8%) without accounting for seroreversion (2.4% and 4.0%, respectively, accounting for 5% monthly seroreversion). Multiple sensitivity analyses yielded similar results. IFR was higher with larger proportions of people >85 years. Younger age strata had low IFR values (median 0.0013%, 0.0088%, 0.021%, 0.042%, 0.14%, and 0.65%, at 0-19, 20-29, 30-39, 40-49, 50-59, and 60-69 years even without accounting for seroreversion).

Conclusions

The IFR of COVID-19 in community-dwelling elderly people is lower than previously reported. Very low IFRs were confirmed in the youngest populations.
Utilization of health care services before and after media attention about fatal side effects of the AstraZeneca vaccine: a nation-wide register-based event study
Authors: Larsen Vilde Bergstad , Grøsland Mari , Telle Kjetil , Magnusson Karin
Published: July 2021

Background

Survey studies have found that vaccinated persons tend to report more side effects after being given information about side effects rather than benefits. However, the impact of high media attention about vaccine-related side effects on the utilization of health care is unknown. We aimed to assess whether utilization of health care services for newly vaccinated health care workers changed after media attention about fatal side effects of the AstraZeneca vaccine on March 11th, 2021, and whether changes differed by age, sex, or occupation.

Methods

We utilized individual-level data on health care use, vaccination, employment, and demographics available in the Norwegian emergency preparedness register Beredt C19. In all 99,899 health care workers in Norway who were vaccinated with AstraZeneca between February 11th and March 11th, we used an event-study design with a matched comparison group to compare the change in primary and inpatient specialist care use from 14 days before to 14 days after the information shock on March 11th, 2021.

Results

Primary health care use increased with 8.2 daily consultations per 1,000 health care workers (95% CI 7.51 to 8.89) the week following March 11th for those vaccinated with AstraZeneca (n = 99,899), compared with no increase for the unvaccinated comparison group (n = 186,885). Utilization of inpatient care also increased with 0.8 daily hospitalizations per 1,000 health care workers (95% CI 0.37 to 1.23) in week two after March 11th. The sharpest increase in daily primary health care use in the first week after March 11th was found for women aged 18-44 (10.6 consultations per 1,000, 95% CI 9.52 to 11.68) and for cleaners working in the health care sector (9.8 consultations per 1,000, 95% CI 3.41 to 16.19).

Conclusions

Health care use was higher after the media reports of a few cases of fatal or severe side effects of the AstraZeneca vaccine. Our results suggest that the reports did not only lead vaccinated individuals to contact primary health care more, but also that physicians referred and treated more cases to specialist care after the new information.
The anti-SARS-CoV-2 immunoglobulin G levels and neutralising capacities against alpha and delta virus variants of concern achieved after initial immunisation with vector vaccine followed by mRNA vaccine boost are comparable to those after double immunisation with mRNA vaccines
Authors: Rose Ruben , Neumann Franziska , Grobe Olaf , Lorentz Thomas , Fickenscher Helmut , Krumbholz Andi
Published: July 2021

Background

The humoral immune response after primary immunisation with a SARS-CoV-2 vector vaccine (AstraZeneca AZD1222, ChAdOx1 nCoV-19, Vaxzevria) followed by an mRNA vaccine boost (Pfizer/BioNTech, BNT162b2; Moderna, m-1273) was examined and compared with the antibody response after homologous vaccination schemes (AZD1222/AZD1222 or BNT162b2/BNT162b2).

Methods

Sera from 59 vaccinees were tested for anti-SARS-CoV-2 immunoglobulin G (IgG) and virus-neutralising antibodies (VNA) with four IgG assays, a surrogate neutralisation test (sVNT), and a Vero cell-based neutralisation test (cVNT) using the B.1.1.7 variant of concern (VOC; alpha) as antigen. Investigation was done before and after heterologous (n=31 and 42) or homologous booster vaccination (AZD1222/AZD1222, n=8/9; BNT162b2/BNT162b2, n=8/8). After the second immunisation, 26 age and gender matched sera (AZD1222/mRNA, n=9; AZD1222/AZD1222, n=9; BNT162b2/BNT162b2, n=8) were also tested for VNA against VOC B.1.617.2 (delta) in the cVNT. The strength of IgG binding to separate SARS-CoV-2 antigens was measured by avidity.

Results

After the first vaccination, prevalence of IgG directed against (trimeric) SARS-CoV-2 spike (S)-protein and its receptor-binding domain (RBD) varied from 55-95 % (AZD1222) to 100% (BNT162b2), depending on the vaccine used and the SARS-CoV-2 antigen used. The booster vaccination resulted in 100 percent seroconversion and appearance of highly avid IgG as well as VNA against VOC B.1.1.7. The results of the anti-SARS-CoV-2 IgG tests showed an excellent correlation to the VNA titres against this VOC. The agreement of cVNT and sVNT results was good. However, the sVNT seems to overestimate non and weak B.1.1.7-neutralising titres. The mean anti-SARS-CoV-2 IgG and B.1.1.7-neutralising titres were significantly higher after heterologous vaccination compared to the homologous AZD1222 scheme. If VOC B.1.617.2 was used as antigen, significantly lower mean VNAs were measured in the cVNT, and three (33.3%) vector vaccine recipients had a VNA titre <1:10.

Conclusions

The heterologous SARS-CoV-2 vaccination leads to a strong antibody response with anti-SARS-CoV-2 IgG and VNA titres at a level comparable to that of a homologous BNT162b2 vaccination scheme. Irrespectively of the chosen immunisation regime, highly avid IgG antibodies can be detected just two weeks after the second vaccine dose indicating the development of a robust humoral immunity. The observed reduction in the VNA titre against VOC B.1.617.2 is remarkable and may be attributed to a partial immune escape of the delta variant.