bluuebunny/crossref_metadata_2025 huggingface dataset:
Measurement of Mobility and Physical Function in Patients Hospitalized With Hip Fracture: A Systematic Review of Instruments and Their Measurement Properties
Authors: Rix Alana , Lawrence Drew , Raper Eleanor , Calthorpe Sara , Holland Anne E , Kimmel Lara A
Published: October 2022

Objective

Hip fractures are common and significantly impact mobility and physical function. Measurement of patient progress post hip fracture in the acute hospital setting is important to monitor early recovery and outcomes. The objective of this systematic review was to assess the measurement properties (reliability, validity, responsiveness), interpretability, and clinical utility of instruments used to measure mobility and physical function in patients with hip fracture in the acute hospital setting.

Methods

Three databases (MEDLINE, Embase, and CINAHL) were searched. Studies reporting direct clinician assessment instruments to measure mobility or physical function in patients with hip fracture were included. Data were extracted by 2 reviewers, and the quality of each study was determined using the COnsensus-based Standards for the selection of health Measurement INstruments risk of bias checklist.

Results

Sixty-eight studies were included with 19 measurement instruments identified. The most frequently used instruments were the Timed “Up & Go” Test (TUG) (19 studies), Barthel Index (BI) (18 studies), Cumulated Ambulation Score (CAS) (18 studies), and Functional Independence Measure (FIM) (14 studies). All 4 of these instruments demonstrated good predictive validity (clinical outcomes and mortality) and responsiveness over time (effect sizes 0.63–2.79). The BI and CAS also had good reliability (intraclass correlation coefficient [ICC] >0.70). Floor effects were demonstrated for the TUG, CAS, and FIM (16%–60% of patients). The TUG, CAS, and BI all had good clinical utility.

Conclusion

Depending on the context (use by treating clinicians, research, benchmarking), 1 or a combination of the BI, CAS, and TUG provide robust measurement of mobility and physical function for patients with hip fracture in the acute hospital setting.

Impact

This study identified 3 instruments suitable for measuring mobility and physical function in hospitalized patients following hip fracture. This provides clinicians with tools to measure patient progress and benchmark across sites to improve patient outcomes.
Postoperative/postdischarge nausea and vomiting: evidence-based prevention and treatment
Authors: Schlesinger Tobias , Weibel Stephanie , Kranke Peter
Published: October 2022

Purpose of review

Postoperative/postdischarge nausea and vomiting (PONV/PDNV) remains a relevant issue in perioperative care. Especially in outpatient surgery, PONV can prevent discharge or lead to unplanned readmission.

Recent findings

Evidence on prophylaxis and treatment of PONV is growing, but implementation remains poor.

A liberal, universal PONV management is now endorsed by the guidelines. Specific evidence concerning prevention and (at-home) treatment of PDNV is still scarce.
The Ideal Threshold of Hemoglobin A1C in Diabetic Patients Undergoing Elective Lumbar Decompression Surgery
Authors: Gupta Rishabh , Chanbour Hani , Roth Steven G. , O’Brien Alex , Davidson Claudia , Devin Clinton J. , Stephens Byron F. , Abtahi Amir M. , Zuckerman Scott L.
Published: October 2022

Study Design:

Retrospective cohort study.

Objective:

To evaluate the association of Hemoglobin A1C (HbA1c) with surgical site infection (SSI) and patient-reported outcomes (PROs), and to identify optimal HbA1c thresholds to minimize the risk of SSI and maximize PROs.

Summary of Background Data:

Diabetes mellitus has been associated with worsened outcomes following spine surgery. HbA1c, a surrogate of glycemic control, is an important assessment tool in diabetic patients.

Methods:

A single-center, retrospective cohort study using prospectively collected data was undertaken. Diabetic patients undergoing elective lumbar decompression surgery between October 2010 and May 2021 were included. HbA1c, demographics, comorbidities, and perioperative data were collected. Primary outcomes included: 1) SSI, and 2) PROs, including the Numeric Rating Scale (NRS)-back/leg pain and Oswestry Disability Index (ODI). Secondary outcomes included: complications, readmissions, and reoperations within 90-days postoperatively. The minimum clinically important difference (MCID) was set at a 30% improvement from baseline PROs.

Results:

Of 1819 patients who underwent lumbar decompression surgery, 368 patients had diabetes mellitus, and 177 had a documented preoperative HbA1c value. Of patients with available HbA1c values, the mean age was 62.5±12.3, the mean HbA1c value was 7.2±1.5%, and SSI occurred in 3 (1.7%) patients only, which prevented further analysis of SSI and HbA1c. A significant association was seen with a higher HbA1c and failure to achieve NRS-Back pain MCID30 [Odds ratio(OR)=0.53, 95% confidence interval(CI) 0.42–0.78;P=0.001] and ODI MCID30 (OR=0.58, 95%CI 0.44–0.77;P=0.001), but not NRS-Leg pain MCID30 (OR=1.29, 95%CI 0.86–1.93;P=0.208). ROC-curve analysis and Youden’s index revealed an HbA1c threshold of 7.8 for NRS-Back pain MCID30 (AUC=0.65,P<0.001) and 7.5 for ODI MCID30 (AUC=0.65,P=0.001).

Conclusions:

In diabetic patients undergoing elective lumbar decompression surgery, HbA1c levels above 7.8 and 7.5 were associated with less improvement of NRS-Back and ODI scores at 12-months postoperatively, respectively. To optimize PROs, We recommend a preoperative HbA1c of 7.5 or below for diabetic patients undergoing elective lumbar decompression surgery.
Association Between Tracheostomy and Functional, Neuropsychological, and Healthcare Utilization Outcomes in the RECOVER Cohort
Authors: Mehta Sangeeta , Brondani Anita , Tomlinson George , Chu Leslie , Burns Stacey , Matte Andrea , Cameron Jill I. , Friedrich Jan O. , Rudkowski Jill , Robles Priscila , Skrobik Yoanna , Herridge Margaret , Adhikari Neill K. J. ,   for the Canadian RECOVER Program Investigators and the Canadian Critical Care Trials Group (CCCTG)
Published: October 2022

OBJECTIVES:

Tracheostomy is commonly performed in critically ill patients requiring prolonged mechanical ventilation (MV). We evaluated the outcomes of tracheostomy in patients who received greater than or equal to 1 week MV and were followed for 1 year.

DESIGN:

In this secondary analysis of a prospective observational study, we compared outcomes in tracheostomy versus nontracheostomy patients. Outcomes post ICU included Functional Independence Measure (FIM) subscales, 6-Minute Walk Test (6MWT), Short Form 36 (SF36), Medical Research Council (MRC) Scale, pulmonary function tests (PFTs), Impact of Event Scale (IES), Beck Depression Inventory-II (BDI-II), and vital status and disposition.

SETTING:

Nine University affiliated ICUs in Canada.

PATIENTS:

Medical/surgical patients requiring MV for 7 or more days who were enrolled in the Towards RECOVER Study.

MEASUREMENTS AND MAIN RESULTS:

Of 398 ICU survivors, 193 (48.5%) received tracheostomy, on median ICU day 14 (interquartile range [IQR], 8–0 d). Patients with tracheostomy were older, had similar severity of illness, had longer MV duration and ICU and hospital stays, and had higher risk of ICU readmission (odds ratio [OR], 1.9; 95% CI, 1.0–3.2) and hospital mortality (OR, 2.6; 95% CI, 1.1–6.1), but not 1-year mortality (hazard ratio, 1.41; 95% CI, 0.88–1.2). Over 1 year, tracheostomy patients had lower FIM-Total (7.7 points; 95% CI, 2.2–13.2); SF36, IES, and BDI-II were similar. From 3 months, tracheostomy patients had 12% lower 6MWT (p = 0.0008) and lower MRC score (3.4 points; p = 0.006). Most PFTs were 5–8% lower in the tracheostomy group. Tracheostomy patients had similar specialist visits (rate ratio, 0.63; 95% CI, 0.28–2.4) and hospital readmissions (OR, 0.82; 95% CI, 0.54–1.3) but were less likely to be at home at hospital discharge and 1 year.

CONCLUSIONS:

Patients who received tracheostomy had more ICU and hospital care and higher hospital mortality compared with patients who did not receive a tracheostomy. In 1 year follow-up, tracheostomy patients required a higher daily burden of care, expressed by FIM.
Benefits of international trauma rotation in South Africa: comparison with a trauma center in Tokyo
Authors: Nagao Tsuyoshi , Nakahara Shinji , Fujita Takashi , Sakamoto Tetsuya , Steyn Elmin
Published: October 2022

International rotations have been an option for young surgeons who face difficulties in obtaining sufficient trauma training in their own countries. One of the authors attended training in trauma surgery in South Africa for 6 months, where there are many trauma caseloads, and could experience the number of emergency operations equivalent to approximately 5 years in Japan. The rotation allows trainees to expose clinical practices intensively and to learn principles and theories of care under experienced academic surgeons. On the other hand, they could contribute to the host hospital as part of the workforce and by assisting young surgical residents. the development of a more systematic and formalized framework for staff exchange between developed and developing countries will provide mutual benefits to both sides.
Association between duration of return of spontaneous circulation and outcomes after out-of-hospital cardiac arrest
Authors: Lian Huixin , Xia Andong , Qin Xinyan , Tian Sijia , Kang Xuqin , Zhang Luxi , Niu Shengmei , Qin Fei , Zhang Jinjun
Published: October 2022

Background

Return of spontaneous circulation (ROSC) is a core outcome element of cardiopulmonary resuscitation (CPR); however, the definition or criterion of ROSC is disputed and varies in resuscitation for out-of-hospital cardiac arrest (OHCA).

Methods

This was a retrospective study of 126 patients with OHCA who achieved ROSC between January and December 2020. The probability of survival after OHCA related to CPR and ROSC duration was analyzed using the probability density function and empirical cumulative density functions.

Results

There were no significant differences between ROSC sustained until emergency department arrival and that sustained for at least 20 minutes in terms of the 24-hour survival rate (31.3% [31/99] vs. 35.7% [10/30]; P = 0.84), 30-day survival rate (23.2% [23/99] vs. 25.0% [7/30]; P = 0.99), or survival at 30 days with cerebral performance category (CPC) 1 and 2 (18.2% [18/99] vs. 10.7% [3/30]; P = 0.44). The Kolmogorov-Smirnov test values from the empirical cumulative density functions with ROSC sustained until hospital arrival and that sustained for at least 20 minutes were 0.44, 0.20, and 0.24 for CPC 1 or 2, CPC 3 or 4, and CPC 5, respectively.

Conclusion

Return of spontaneous circulation is a core outcome element of CPR. It should be defined as sustained for at least 20 minutes or until arrival at the emergency department and as a basic standard for evaluating resuscitation success after OHCA.
Reasons Primary Care Practices Chose Patient Experience Surveys During Patient-Centered Medical Home Transformation
Authors: Quigley Denise D. , Qureshi Nabeel , Hays Ron D.
Published: October 2022

Patient-centered medical home takes years to attain. Fifteen-to-eighteen percent of US primary care practices in 2008-2017 sought or maintained patient-centered medical home recognition. We conducted interviews with a stratified-random sample of 105 of these practices to determine why patient experience surveys were chosen. Fifty-one were using a Consumer Assessment of Healthcare Providers and Systems survey and 53 administering another patient survey. The 3 most common reasons were (1) to compare performance against other practices, which requires systematically collected data across large numbers of practices (ie, the Consumer Assessment of Healthcare Providers and Systems survey), (2) participation in an external patient-centered medical home program, and (3) survey administration cost. Leaders invested in a second patient survey for quality improvement needs.
Facial microbial flora in bearded versus nonbearded men in the operating room setting: A single-center cross-sectional STROBE-compliant observational study
Authors: El Edelbi Mostapha , Hassanieh Joelle , Malaeb Nancy , Abou Fayad Antoine , Jaafar Rola F. , Sleiman Ahmad , Abedelrahim Abdelkader , Kanafani Zeina , Matar Ghassan M. , Zaghal Ahmad
Published: October 2022

Beards are controversial in the operating room setting because of the possible retention and shedding of pathogens. Surgical site infection poses a significant burden on healthcare systems. All male healthcare workers who entered the operating room were approached to participate in the study. Four facial swab samples were anonymously collected and a hygiene practice questionnaire was administered. Sample A was taken from the upper and lower lips, sample B from cheeks, and samples C and D were collected by 20 and 40 cm shedding below the face. Colony-forming units (CFUs) and minimum inhibitory concentrations (MICs) of meropenem resistance were determined for samples A and B. Random samples from A, B, C, and D, in addition to meropenem-resistant isolates were cultured with chlorohexidine. Sixty-one bearded and 19 nonbearded healthcare workers participated in the study. 98% were positive for bacterial growth with CFU ranging between 30 × 104 and 200 × 106 CFU/mL. Bacterial growth was significantly higher in bearded participants (P < .05). Eighteen (27.1%) isolates were resistant to meropenem; of these which 14 (77.8%) were from bearded participants, this was not statistically significant. Chlorohexidine was effective in inhibiting the growth of all strains including the meropenem-resistant isolates. Bearded men in the operating room had a significantly higher facial bacterial load. Larger-scale resistance studies are needed to address facial bacterial resistance among healthcare workers in the operating room.

This study aimed to estimate the facial microbial load and identify strains and antimicrobial resistance profiles in bearded versus nonbearded male healthcare workers in the operating room of a tertiary hospital in the Middle East.
Trend and prediction of citations on the topic of neuromuscular junctions in 100 top-cited articles since 2001 using a temporal bar graph: A bibliometric analysis
Authors: Wu Jian-Wei , Yan Yu-Hua , Chien Tsair-Wei , Chou Willy
Published: October 2022

Background:

A neuromuscular junction (NMJ) (or myoneural junction) is a chemical synapse between a motor neuron (MN) and a muscle fiber. Although numerous articles have been published, no such analyses on trend or prediction of citations in NMJ were characterized using the temporal bar graph (TBG). This study is to identify the most dominant entities in the 100 top-cited articles in NMJ (T100MNJ for short) since 2001; to verify the improved TBG that is viable for trend analysis; and to investigate whether medical subject headings (MeSH terms) can be used to predict article citations.

Methods:

We downloaded T100MNJ from the PubMed database by searching the string (“NMJ” [MeSH Major Topic] AND (“2001” [Date - Modification]: “2021” [Date - Modification])) and matching citations to each article. Cluster analysis of citations was performed to select the most cited entities (e.g., authors, research institutes, affiliated countries, journals, and MeSH terms) in T100MNJ using social network analysis. The trend analysis was displayed using TBG with two major features of burst spot and trend development. Next, we examined the MeSH prediction effect on article citations using its correlation coefficients (CC) when the mean citations in MeSH terms were collected in 100 top-cited articles related to NMJ (T100NMJs).

Results:

The most dominant entities (i.e., country, journal, MesH term, and article in T100NMJ) in citations were the US (with impact factor [IF] = 142.2 = 10237/72), neuron (with IF = 151.3 = 3630/24), metabolism (with IF = 133.02), and article authored by Wagh et al from Germany in 2006 (with 342 citing articles). The improved TBG was demonstrated to highlight the citation evolution using burst spots, trend development, and line-chart plots. MeSH terms were evident in the prediction power on the number of article citations (CC = 0.40, t = 4.34).

Conclusion:

Two major breakthroughs were made by developing the improved TBG applied to bibliographical studies and the prediction of article citations using the impact factor of MeSH terms in T100NMJ. These visualizations of improved TBG and scatter plots in trend, and prediction analyses are recommended for future academic pursuits and applications in other disciplines.
Analysis of surgical outcomes in 102 patients with renal cell carcinoma with venous tumor thrombus: A retrospective observational single-center study
Authors: Horynecka Zuzanna , Jabłońska Beata , Kurek Adam , Lekstan Andrzej , Piaszczyński Michał , Mrowiec Sławomir , Oczkowicz Grzegorz , Król Robert
Published: October 2022

The aim of the study was to assess short- and long-term results following radical nephrectomy with renal vein and inferior vena cava thrombectomy in patients with renal cell cancer with venous thrombus and to investigate impact of various demographical, clinical and histological factors on overall survival (OS). The medical records of 102 adult patients with renal cell cancer with venous thrombus admitted for surgery in Department of General, Vascular and Transplant Surgery from 2012 to 2019 were retrospectively analyzed. The tumor was more frequently located on the right side compared to the left one (55 vs. 47). According to Neves Zincke classification, the levels of venous thrombus were as follows: 1 to 48 (47%), 2 to 47 (46%), 3 to 6 (6%), and 4 to 1 (1%). Postoperative complications were noted in 16 (15.7%) patients. One (3%) patient (Neves Zincke 2) died of intraoperative pulmonary embolism during hospitalization. Clear cell carcinoma was the most common pathological type reported in 92 (90.2%) patients. Thirty nine (38.2%) patients were alive at the time of last follow-up. The median OS was 21.50 (0–101.17) months. The 1-year OS was 75.5%. Significantly better OS (median 38.03 months) was noted in patients with RCC Neves Zincke 1 compared to OS (median 14.79 months) in patients with Neves Zincke 2-4 VT (P = .008). Higher tumor staging (T3 vs. T4) (P = .038), nodal staging (N0 vs. N1) (P = .0008), Fuhrman histological grading (G1-2 vs. G3-4) (P = .033) were associated with a shorter OS. Patients with renal cell cancer with venous thrombus, with an acceptable perioperative risk, should be treated surgically, because radical nephrectomy with thrombectomy performed in a high volume surgical center is a safe procedure. Neves Zincke 2-4 venous thrombus, higher tumor and nodal staging, as well higher Fuhrman histological grading are associated with a shorter OS.
Real-world study of trastuzumab and pertuzumab combined with chemotherapy in neoadjuvant treatment for patients with HER2-positive breast cancer
Authors: Ma Xiangmin , Zhang Xiangmei , Zhou Xinping , Ren Xiaofei , Ma Xindi , Zhang Weifang , Yang Ruiling , Song Tao , Liu Yunjiang
Published: October 2022

Clinical trials have shown that trastuzumab (H) and pertuzumab (P) combined with chemotherapy as neoadjuvant therapy increased pathological complete response (pCR) rate of patients with human epidermal growth factor receptor 2 (HER2)-positive breast cancer. However, date in China in the real world are currently limited.

Clinical data from patients with HER2-positive breast cancer who received HP combined with chemotherapy as neoadjuvant therapy at 2 institutions from March 2019 to February 2022 were retrospectively analyzed. Adverse reactions were evaluated using CTCAE version 5.0. The primary endpoint was total pathologic complete response (tpCR; ypT0/isypN0), and the secondary endpoints were breast pathologic complete response (bpCR; ypT0/is) and axillary pathologic complete response (apCR; ypN0). Factors influencing tpCR were also analyzed.

A total of 302 patients were included in the analysis, of which 145 were treated with H + P + taxane + carboplatin (TcbHP), 94 with H + P + taxane (THP) and 63 with sequential anthracycline and cyclophosphamide, followed by H + P + taxane (AC-THP). The overall tpCR rate was 64.9%, and those of TcbHP, THP, and AC-THP were 73.1%, 52.1%, and 65.1%, respectively. The tpCR rate of the hormone receptor (HR) negative group (80.3%) was higher than that of the HR positive group (52.1%). The overall bpCR rate was 73.5% and the apCR rate was 75.8%. In the univariate analysis, HR, HER2 status and treatment regimen were related factors that affected tpCR. In the multivariate analysis, HR, HER2 status and treatment regimen were independent predictors of tpCR (P < .001, P < .001 and P = .009). The levels 3 and 4 toxicities rates of TcbHP were slightly higher than those of THP and AC-THP.

HP combined with chemotherapy has achieved a high pCR rate. The TcbHP regimen had the highest pCR. HR-negative tumors demonstrated a higher pCR. HR, HER2 status and treatment regimen were independent predictors of tpCR. The adverse reactions are controllable.
Probiotics and rifaximin for the prevention of travelers’ diarrhea: A systematic review and network meta-analysis
Authors: Fan Hao , Gao Lei , Yin Zidan , Ye Sheng , Zhao Hua , Peng Qi
Published: October 2022

Background:

Probiotics and rifaximin are treatments for gut microbiota dysbiosis in patients with traveler’s diarrhea (TD), and they both proved beneficial for the prevention of TD. However, comparative effectiveness research between them has not been performed. A systematic review and network meta-analysis are to be performed to clarify which of them is more effective in the prevention of TD.

Methods:

Literature concerning the effectiveness of probiotics or rifaximin in the prevention of TD was searched in Medline, Embase, the Cochrane Central Register of Controlled Trials, and clinical registries for randomized controlled trials (RCTs) from inception of these databases to November 30, 2021 without any language restrictions. The primary efficacy outcome was the incidence of TD, and the safety outcome was the incidence of adverse events. The effect size of probiotics was measured by using relative ratio (RR), and the network meta-analysis was performed by using a frequentist approach and a random-effect model.

Results:

Totally 17 RCTs after screening 1119 retrieved records were included in analysis and 9 RCTs were with low risk of bias. Compared with placebo, both probiotics and rifaximin were associated with lower incidence of TD (probiotics, RR 0.85, 95% CI 0.76–0.95; rifaximin, RR 0.47, 95% CI 0.35–0.63), and rifaximin was more effective than probiotics (RR 0.56, 95% CI 0.4–0.78). Further analysis showed that sodium butyrate, rifaximin and L. acidophilus + L. bulgaricus + Bifido.bifidum + Strept. Thermophilus were the three most effective treatments for TD.

Conclusions:

Both rifaximin and probiotics are superior over placebo, and rifaximin has better treatment effect than probiotics in reducing the incidence of TD. Different types of probiotics have heterogeneous treatment effects.
Intestinal infectious diseases increase the risk of psychiatric disorders: A nationwide population-based cohort study
Authors: Yu Chia-Peng , Lin Iau-Jin , Wang Bing-Long , Tsao Chang-Huei , Huang Shi-Hao , Huang Yao-Ching , Sun Chien-An , Chung Chi-Hsiang , Hu Je-Ming , Chien Wu-Chien
Published: October 2022

Intestinal infectious diseases (IIDs) are among the most common diseases and are prevalent worldwide. IIDs are also one of the major disease groups with the highest incidence worldwide, especially among children and older adults. We observed a higher probability of IIDs in patients from the psychiatric department of Tri-Service General Hospital. Therefore, our objective was to investigate if there is an association between IIDs and the risk of developing psychiatric disorders. This nationwide population-based study used the database of the National Health Insurance (NHI) program in Taiwan. The study included 150,995 patients from 2000 to 2015, comprising 30,199 patients with IIDs as the study group and 120,796 patients without IIDs as the control group. Cox proportional hazards regression analysis was performed to calculate the hazard ratio of psychiatric disorders during the 16-year follow-up. Of the patients with IIDs, 4022 (13.32%) developed psychiatric disorders compared to 8119 (6.72%) who did not (P < .001). The adjusted hazard ratio (aHR) for overall psychiatric disorders in the study group was 2.724 (95% confidence interval [CI]: 2.482–2.976; P < .001). More specifically, the study group had a higher risk of developing a psychiatric disorder, including sleep disorders, depression, anxiety, bipolar disorder, post-traumatic stress disorder (PTSD)/acute stress disorder (ASD), schizophrenia, mental retardation (MR), substance abuse, and other psychiatric disorders. Furthermore, refractory IIDs (seeking medical attention for IIDs 3 or more times) increased the risk (aHR: 3.918; 95% CI: 3.569–4.280; P < .001) of developing psychiatric disorders. There was an association between IIDs and the increased risk of developing psychiatric disorders. The novel role of etiological factors in the development of psychiatric disorders deserves more attention, and the control of pathogens that cause IIDs is of urgent public health importance.
Population-Level Provider Compliance With Provincial Treatment Guidelines for the Management of Gonorrhea in Adolescents and Adults in Alberta, Canada; 2000 to 2019
Authors: Ugarte-Torres Alejandra , Diaz Pallares Carolina , Niruban John S. , Smyczek Petra , Gratrix Jennifer , Strong David , Singh Ameeta E.
Published: October 2022

Background

Appropriate antimicrobial therapy is one of the essential strategies in the global control of gonorrhea. We sought to determine the provider compliance with provincial treatment guidelines for gonococcal infections in Alberta, Canada, and to identify characteristics associated with provider noncompliance.

Methods

A retrospective population-based analysis of gonorrhea treatment from January 1, 2000, to December 31, 2019, using data extracted from a communicable disease database was performed. Prevalence ratios were calculated for provider compliance to treatment guidelines of patient, infection, and treating provider characteristics.

Results

We identified a total of 42,875 cases of gonorrhea, 58.3% were men, 40.3% were White, 28.2% were First Nations, and 16% were “unknown ethnicity.” Most cases were treated by family physicians (43.4%), sexually transmitted infection (STI) clinics (31.9%) and urgent care centers/hospitals (10%). Overall, there was 80.3% provider compliance with treatment guidelines. Provider compliance to treatment guidelines had the highest rates of compliance when treatment was provided by STI nurses in correctional facilities, STI clinics, and treatment of men having sex with men (94.7%, 91.7%, and 87.5%, respectively). Provider compliance to treatment guidelines was lowest when treating women (75.5%), pregnancy status (68.4), individuals of “unknown race/ethnicity” (74.8%), and those treated in urgent care centers and emergency department (66.7%).

Conclusions

Delivery of STI care by nurse-led models had the highest level of compliance with treatment guidelines. Our study informs areas for targeted interventions to improve the uptake of treatment guidelines, including the provision of treatment in urgent care centers and among women.
Primary Intrasellar Amyloidoma
Authors: Xu Yongqiang , Zhang Haitao , Liu Pengfei
Published: October 2022

Amyloidomas of the nervous system are rare in clinical practice and rarely reported in the literature. Primary intrasellar amyloidomas are even rarer. We encountered a 39-year-old male patient, whose chief complaint was headache and who had been hospitalized for 10 days. The patient did not have any past medical history. Preoperative computed tomography and magnetic resonance were nevertheless performed to exclude the possibility of pituitary apoplexy or Rathke cleft cyst. Due to the progressive worsening of his headache, a neuroendoscopic transsphenoidal tumor resection was carried out. During surgery it was found that the tumor exhibited a yellow crystalline substance with an inadequate blood supply and no obvious encapsulation. The tumor was completely resected under endoscopy, the amyloidoma was confirmed by postoperative pathological results, and no pituitary adenoma was found. The patient’s headache resolved after surgery, and after a 1-year follow-up, the tumor had not recurred.
ICTV Virus Taxonomy Profile: Sedoreoviridae 2022
Authors: Matthijnssens Jelle , Attoui Houssam , Bányai Krisztián , Brussaard Corina P. D. , Danthi Pranav , del Vas Mariana , Dermody Terence S. , Duncan Roy , Fāng (方勤) Qín , Johne Reimar , Mertens Peter P. C. , Mohd Jaafar Fauziah , Patton John T. , Sasaya (笹谷孝英) Takahide , Suzuki (鈴木信弘) Nobuhiro , Wei (魏太云) Taiyun
Published: October 2022

Sedoreoviridae is a large family of icosahedral viruses that are usually regarded as non-enveloped with segmented (10–12 linear segments) dsRNA genomes of 18–26 kbp. Sedoreovirids have a broad host range, infecting mammals, birds, crustaceans, arthropods, algae and plants. Some of them have important pathogenic potential for humans (e.g. rotavirus A), livestock (e.g. bluetongue virus) and plants (e.g. rice dwarf virus). This is a summary of the ICTV Report on the family Sedoreoviridae, which is available at ictv.global/report/sedoreoviridae.
Characterization of Mayaro virus (strain BeAn343102) biology in vertebrate and invertebrate cellular backgrounds
Authors: Pujhari Sujit , Brustolin Marco , Heu Chan C. , Smithwick Ronald , Larrosa Mireia , Hafenstein Susan , Rasgon Jason L.
Published: October 2022

Mayaro virus (MAYV) is an emerging New World alphavirus (genusAlphavirus, familyTogaviridae) that causes acute multiphasic febrile illness, skin rash, polyarthritis and occasional severe clinical phenotypes. The virus lifecycle alternates between invertebrate and vertebrate hosts. Here we characterize the replication features, cell entry, lifecycle and virus-related cell pathology of MAYV using vertebrate and invertebratein vitromodels. Electron-dense clathrin-coated pits in infected cells and reduced viral production in the presence of dynasore, ammonium chloride and bafilomycin indicate that viral entry occurs through pH-dependent endocytosis. Increase in FITC-dextran uptake (an indicator of macropinocytosis) in MAYV-infected cells, and dose-dependent infection inhibition by 5-(N-ethyl-N-isopropyl) amiloride (a macropinocytosis inhibitor), indicated that macropinocytosis is an additional entry mechanism of MAYV in vertebrate cells. Acutely infected vertebrate and invertebrate cells formed cytoplasmic or membrane-associated extracytoplasmic replication complexes. Mosquito cells showed modified hybrid cytoplasmic vesicles that supported virus replication, nucleocapsid production and maturation. Mature virus particles were released from cells by both exocytosis and budding from the cell membrane. MAYV replication was cytopathic and associated with induction of apoptosis by the intrinsic pathway, and later by the extrinsic pathway in infected vertebrate cells. Given that MAYV is expanding its geographical existence as a potential public health problem, this study lays the foundation for biological understanding that will be valuable for therapeutic and preventive interventions.
Signaling pathways involved in the repression of root nitrate uptake by nitrate inArabidopsis thaliana
Authors: Chaput Valentin , Li Jianfu , Séré David , Tillard Pascal , Fizames Cécile , Moyano Tomas , Zuo Kaijing , Martin Antoine , Gutiérrez Rodrigo A. , Gojon Alain , Lejay Laurence
Published: October 2022

InArabidopsis thaliana, root high-affinity nitrate (NO3-) uptake depends mainly on NRT2.1, 2.4 and 2.5, which are repressed by high NO3-supply at the transcript level. ForNRT2.1, this regulation is due to the action of (i) feedback downregulation by N metabolites and (ii) repression by NO3-itself mediated by the transceptor NRT1.1(NPF6.3). However, forNRT2.4andNRT2.5the signaling pathway(s) remain unknown along with the molecular elements involved. Here we show that unlikeNRT2.1, NRT2.4andNRT2.5are not induced in a NO3-reductase mutant but are strongly upregulated following replacement of NO3-by ammonium (NH4+) as the N source. Moreover, increasing NO3-concentration in a mixed nutrient solution with constant NH4+concentration results in a gradual repression ofNRT2.4andNRT2.5, which is suppressed in anrt1.1mutant. This indicates thatNRT2.4andNRT2.5are subjected to repression by NRT1.1-mediated NO3-sensing, and not to feedback repression by reduced N metabolites. We further show that key regulators of NRT2s transporters, such as HHO1, HRS1, PP2C, LBD39, BT1 and BT2, are also regulated by NRT1.1-mediated NO3-sensing, and that several are involved in NO3-repression ofNRT2.1, 2.4and2.5. Finally, we provide evidence that it is the phosphorylated form of NRT1.1 at the T101 residue, which is most active in triggering the NRT1.1-mediated NO3-regulation of all these genes. Altogether, these data led to propose a regulatory model for high-affinity NO3-uptake inArabidopsis, highlighting several NO3-transduction cascades downstream the phosphorylated form of the NRT1.1 transceptor.

One sentence summary

Characterisation and identification of molecular elements involved in the signaling pathways repressing NRT2s transporters and root nitrate uptake in response to nitrate.
High nucleotide diversity accompanies differential DNA methylation in naturally diverging populations
Authors: Ord James , Gossmann Toni I. , Adrian-Kalchhauser Irene
Published: October 2022

Epigenetic mechanisms such as DNA methylation (DNAme) are thought to comprise an invaluable adaptive toolkit in the early stages of local adaptation, especially when genetic diversity is constrained. However, the link between genetic diversity and DNAme has been scarcely examined in natural populations, despite its potential to shed light on the evolutionary forces acting on methylation state. Here, we analysed reduced-representation bisulfite sequencing and whole genome pool-seq data from marine and freshwater stickleback populations to examine the relationship between DNAme variation (between- and within-population), and nucleotide diversity in the context of freshwater adaptation. We find that sites that are differentially methylated between populations have higher underlying standing genetic variation, with diversity higher among sites that gained methylation in freshwater than those that lost it. Strikingly, while nucleotide diversity is generally lower in the freshwater population as expected from a population bottleneck, this is not the case for sites which lost methylation which instead have elevated nucleotide diversity in freshwater compared to marine. Subsequently, we show that nucleotide diversity is higher among sites with ancestrally variable methylation and also positively correlates with the sensitivity to environmentally induced methylation change. Both suggest that as selection on the control of methylation state becomes relaxed, so too does selection against mutations at the sites themselves. Increased epigenetic variance in a population is therefore likely to precede genetic diversification.
Development and validation of a type 2 diabetes machine learning classification model for EHR-based diagnostics and clinical decision support
Authors: Glanz Victor , Dudenkov Vladimir , Velikorodny Alexey
Published: October 2022

Background

Undiagnosed type 2 diabetes continues to represent a significant challenge for all national healthcare systems. Although diagnostic criteria and laboratory screening procedures are well-established, clinical tests have limitations, and in many cases, diagnosis confirmation and more accurate interpretation of the test results are required. Machine learning methods, when applied to clinical outcome risk prediction, demonstrate great effectiveness, as they recognize specific patterns in data dynamics and thus can be used for the identification of at-risk cases where diabetes and complications can be delayed or even prevented. The aim of this study was to develop a type 2 diabetes machine learning model capable of efficient early identification of diabetes presence based on the results of common laboratory tests.

Methods

Real-world medical data from electronic medical records were subjected to a multistage processing, including feature selection, missing values imputation. The machine learning algorithms adopted in this study were XGBoost, multilayer perceptron, ridge classifier, ridge classifier with polynomial features, bootstrap aggregating, dynamic ensemble selection, stacked generalization. An external dataset was analyzed via the same workflow to validate the initial results. The study was designed in accordance with the TRIPOD statement.

Results

We have developed a machine learning classification model for type 2 diabetes that possesses several important advantages over conventional clinical methods (specifically, FINDRISC, ADA risk score). Performance metrics for the diabetes diagnostic model were 0.96 AUC, 92% specificity, and 89% sensitivity (mean values).

Conclusions

The study results potentially have major clinical implication and provide a contribution to the field of conventional diabetes risk assessment tools. Being specifically trained on real-world laboratory data and based on satisfactory external validation results, the present diagnostic type 2 diabetes model demonstrates high generalizability and can serve as a medical decision support and health monitoring tool.
Progressive spread of chromosomal inversions blends the role of colonization and evolution in a parallel Galápagos beetle radiation
Authors: Vangestel Carl , De Corte Zoë , Van Belleghem Steven M. , Vandekerckhove Matthias , Gharbi Karim , Hendrickx Frederik
Published: October 2022

Archipelago island fauna include some of the most compelling examples of parallel adaptation to ecological gradients. However, despite the insuslar nature of these systems, the possibility that repeated instances of within-island divergence resulted from independent (in situ) evolutionary rather than repeated colonization events remains most often unclear. Here, we investigated the genomic underpinning of a progressive adaptive radiation of caterpillar-hunter beetles (Calosoma) in the low- and highland habitats from the Galápagos. TheseCalosomabeetles have evolved only partially reduced wings in the highland of the youngest islands but evolved to distinct short-winged species in the highland of the oldest islands. In support of independent evolutionary events, the extent of genome-wide divergence between long-winged lowland and short-winged highland populations decreased towards younger islands. However, in support of repeated colonization events, adaptation to highland habitats was driven by repeated selection of alleles that are shared across all highland species and populations. These alleles comprised extensive chromosomal inversions whose origin was traced back to an initial high-lowland divergence event on the oldest island. Moreover, we found evidence that after this initial divergence event, highland alleles spread to younger islands through dispersal of highland individuals as well as dispersal of lowland individuals that were polymorphic at adaptive loci, both providing the opportunity for the establishment of highland populations on the younger islands. These findings highlight the importance of an old divergence in driving repeated adaptation to ecological gradients. Complex histories of colonization and introgression may thus result in a mixed contribution of inter-island dispersal and within-island evolution in shaping parallel species communities on islands.
Computational constraints on the associative recall of spatial scenes
Authors: Ryom Kwang Il , Stendardi Debora , Ciaramelli Elisa , Treves Alessandro
Published: October 2022

We consider a model of associative storage and retrieval of compositional memories in an extended cortical network. Our model network is comprised of Potts units, which represent patches of cortex, interacting through long-range connections. The critical assumption is that a memory is composed of a limited number of items, each of which has a pre-established representation: storing a new memory only involves acquiring the connections, if novel, among the participating items. The model is shown to have a much lower storage capacity than when it stores simple unitary representations. It is also shown that an input from the hippocampus facilitates associative retrieval. When it is absent, it is advantageous to cue rare rather than frequent items. The implications of these results for emerging trends in empirical research are discussed.
Cohort Profile: The Danish National Cohort Study of Effectiveness and Safety of SARS-CoV-2 vaccines (ENFORCE)
Authors: Stærke Nina Breinholt , Reekie Joanne , Johansen Isik S. , Nielsen Henrik , Benfield Thomas , Wiese Lothar , Søgaard Ole Schmeltz , Tolstrup Martin , Iversen Kasper Karmark , Tarp Britta , Larsen Fredrikke Dam , Larsen Lykke , Lindvig Susan Olaf , Holden Inge Kristine , Iversen Mette Brouw , Knudsen Lene Surland , Fogh Kamille , Jakobsen Marie Louise , Traytel Anna , Østergaard Lars , Lundgren Jens ,   the ENFORCE Study Group
Published: October 2022

Purpose

The ENFORCE cohort is a national Danish prospective cohort of adults who received a Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine as part of the Danish National SARS-CoV-2 vaccination program. It was designed to investigate the long-term effectiveness, safety and durability of SARS-CoV-2 vaccines used in Denmark.

Participants

A total of 6943 adults scheduled to receive a SARS-CoV-2 vaccine in the Danish COVID-19 Vaccination Program were enrolled in the study prior to their first vaccination. Participants will be followed for a total of two years with five predetermined follow-up visits and additional visits in relation to any booster vaccination. Serology measurements are performed after each study visit. T-cell immunity is evaluated at each study visit for a subgroup of 699 participants. Safety information is collected from participants at visits following each vaccination. Data on hospital admissions, diagnoses, deaths and SARS-CoV-2 polymerase chain reaction (PCR) results are collected from national registries throughout the study period. The median age of participants was 64 years (IQR 53-75), 56.6% were females and 23% were individuals with an increased risk of a serious course of COVID-19. A total of 340 (4.9%) participants tested positive for SARS-CoV-2 spike IgG at baseline.

Findings to date

Results have been published on risk factors for humoral hyporesponsiveness and non-durable response to SARS-CoV-2 vaccination, the risk of breakthrough infections at different levels of SARS-CoV-2 spike IgG by viral variant, and on the antibody neutralizing capacity against different SARS-CoV-2 variants following primary and booster vaccinations.

Future plans

The ENFORCE cohort will continuously generate studies investigating immunological response, effectiveness, safety and durability of the SARS-CoV-2 vaccines.

Registration

clinicaltrials.govidentifier:NCT04760132.

Strengths and limitations

- The ENFORCE study combines repeated detailed SARS-CoV-2 specific immunological measurements prior to, and throughout the course of SARS-CoV-2 vaccination, with register-based follow-up of safety data and microbiological test results.

- The ENFORCE cohort includes a large proportion of elderly participants and participants with concomitant diseases.

- The three vaccine groups display a high degree of variation in demographic factors and distribution across risk groups, due to the prioritization of specific vaccines to risk groups during the primary roll out of the SARS-CoV-2 vaccination program.
Proteomics of resilience to Alzheimer’s disease identifies brain regional soluble Aβ levels, actin filament processes, and response to injury
Authors: Huang Zhi , Merrihew Gennifer E. , Larson Eric B. , Park Jea , Plubell Deanna , Fox Edward J. , Montine Kathleen S. , Keene C. Dirk , Zou James Y. , MacCoss Michael J. , Montine Thomas J.
Published: October 2022

Resilience to Alzheimer’s disease (RAD) is an uncommon combination of high disease burden without dementia that may provide critical insights into limiting the clinical impact of this incurable disease. In this study, we used mass spectrometry-based proteomics to quantify regional protein differences that characterize RAD. Starting with over 700 brain donations, we identified 43 extensively annotated research participants who met stringent inclusion exclusion criteria and analyzed matched isocortical regions, hippocampus, and caudate nucleus. Differential expression analysis of 7,115 soluble proteins identified lower isocortical and hippocampal soluble Aβ peptide levels as a significant feature of RAD. Protein co-expression analysis revealed a group of 181 densely-interacting proteins significantly associated with RAD that were enriched for actin filament-based process, cellular detoxification, and wound healing in isocortex and hippocampus. We further support our findings using data from 689 human isocortical samples from four independent external cohorts that were the closest approximations of our clinico-pathologic groups. The molecular basis of RAD, a widely replicated state in older adults for which there is no experimental model, likely holds important insights into therapeutic interventions for Alzheimer’s disease.
Scaling patterns of body plans differ among squirrel ecotypes
Authors: Linden Tate J. , Burtner Abigail E. , Rickman Johannah , McFeely Annika , Santana Sharlene E. , Law Chris J.
Published: October 2022

Body size is often hypothesized to facilitate or constrain morphological diversity in the cranial, appendicular, and axial skeletons. However, how overall body shape scales with body size (i.e., body shape allometry) and whether these scaling patterns differ between ecological groups remains poorly investigated. Here, we test whether and how the relationships between body shape, body size, and limb lengths differ among species with different locomotory specializations, and describe the underlying morphological components that contribute to body shape variation among squirrel (Sciuridae) ecotypes. We quantified the body size and shape of 87 squirrel species from osteological specimens held at museum collections. Using phylogenetic comparative methods on these data, we found that 1) body shape and its underlying morphological components scale allometrically with body size, but these allometric patterns differ among squirrel ecotypes; 2) only ground squirrels exhibit a relationship between forelimb length and body shape, where more elongate species exhibit relatively shorter forelimbs; and 3) the relative length of the ribs and elongation or shortening of the thoracic region contributes the most to body shape variation across squirrels. Overall, our work contributes to the growing understanding of mammalian body shape evolution and how it is influenced by body size and locomotor ecology, in this case from robust subterranean to gracile gliding squirrels.