bluuebunny/crossref_metadata_2025 huggingface dataset:
Efficacy and safety of rituximab in the treatment of membranous nephropathy
Authors: Lu WanJun , Gong ShuHao , Li Juan , Luo HongWen , Wang Ying
Published: April 2020

Background and objectives:

Rituximab (RTX) is considered to be a promising drug for curing membranous nephropathy. However, the efficacy and safety of RTX in treating membranous nephropathy remain uncertain. This meta-analysis aimed to investigate the efficacy and safety of RTX in patients with membranous nephropathy.

Methods:

A literature search was performed using Pubmed, Embase, OVID, and Cochrane Library and randomized controlled trials (RCTs) case-controls and cohort studies published till 30 July 2019 were assessed. The studies assessing the efficacy and safety of RTX in patients with membranous nephropathy were included.

Results:

Eight relevant trials involving 542 patients were included in the meta-analysis. It was found that RTX did not significantly improve serum albumin levels and e-GFR when compared with the control group (including cyclosporine and cyclophosphamide, chlorambucil, prednisone, non-immunosuppressive anti-proteinuria treatment), serum albumin levels (OR = 0.31, 95%CI–0.12–0.74, P = .15), e-GFR (OR = –1.49, 95%CI–17.14–14.17, P = .85). However, RTX did reduce the serum creatinine (OR = –0.01, 95%CI–0.36–0.34, P = .95) and urinary protein (OR = –2.39, 95%CI –7.30 –2.53, P = .34) levels. Also, in comparison to the control group, RTX did improve the total remission rate (OR = 1.63, 95%CI 0.48–5.54, P = .43), achieve a higher rate of complete remission (OR = 2.54, 95%CI 1.65–3.90, P < .01) and also reduced the amount of M-type phospholipase A2 receptor-Antibody depletion in patients (OR = 5.59, 95%CI 1.81–17.2, P = .003). RTX-related adverse events were mostly mild (most infusion-related reactions) in nature and serious adverse events were rare.

Conclusion:

RTX proved to be efficient, well-tolerated and a safe drug in the treatment of membranous nephropathy. Most patients reach complete remission during the follow-up period, and relapse is rare. RTX may turn out to be promising in membranous nephropathy patients.
Meandering pulmonary veins
Authors: Lee Miji , Jeon Kyung Nyeo , Park Mi Jung , Bae Kyungsoo
Published: April 2020

Rationale:

Meandering pulmonary vein is a rare congenital pulmonary vascular anomaly. It presents unilateral single pulmonary vein that takes a circuitous route in the lung and drains normally into the left atrium. Most cases of meandering pulmonary vein have been reported to be right-sided. A few of them coincided with features of scimitar syndrome.

Patient concerns:

A 71-year-old woman and a 20-year-old man presented with incidentally found abnormal findings on chest radiographs.

Diagnosis:

Through multi-detector chest computed tomography, the 71-year-old woman was diagnosed as left-sided meandering pulmonary vein without any other anomalies while the 20-year-old man was diagnosed as having right-sided meandering pulmonary vein with features of scimitar syndrome.

Interventions:

Specific intervention was not performed for either patient.

Outcomes:

These patients were reassured and discharged. They are doing well without any respiratory symptoms.

Lessons:

Meandering pulmonary veins can occur on the left side and coincide with features of scimitar syndrome. Multi-detector computed tomography with 3D reconstruction allows clear depiction of vascular connections and associated anomalies, obviating the need for invasive procedures.
Fine-needle aspiration with rapid parathyroid hormone assay to identify parathyroid gland in thyroidectomy
Authors: Zou Xian , Shi Longshun , Zhu Guohua , Zhu Liguo , Bao Jiandong , Fan Jun , Hu Yonghong , Zhou Bin , Lv Zhongwei
Published: April 2020

To determine the levels of parathyroid hormone (PTH) in the fluids of various tissues for identification of parathyroid glands during thyroidectomy.

Our study comprised 31 patients with thyroid cancer who underwent lobectomy with central compartment dissection at our hospital from October 2014 to February 2015. A total of 186 tissue samples, including 28 from parathyroid glands and 158 from non-parathyroid tissues, were obtained during the operations. Tissue fluids were collected via fine-needle aspiration to measure PTH levels; the tissue was punctured 3 times with a 26-gauge syringe needle and washed with 0.5 mL normal saline. Tissues were also prepared for pathological examination.

PTH concentrations were significantly higher in parathyroid tissues than non-parathyroid tissues. None of the patients had irremediable parathyroid dysfunction after surgical resection.

Use of fine-needle aspiration for quantification of PTH levels in tissue fluids rapidly, safely, and effectively identifies the parathyroid glands during thyroidectomy.
Recurrence of pigmented villonodular synovitis of the knee
Authors: Fang Yushun , Zhang Qingsong
Published: April 2020

Rationale:

Pigmented villonodular synovitis is a rare disease which may involve any joints. It has localized and diffuse forms, and the latter is more aggressive with a higher recurrence rate. Different treatments are applied to each form of the disease, but there is no standard surgical procedure or any consensus on whether adjuvant therapy should be used. Many factors may lead to recurrence of the disease; however, there is no reliable way to predict the recurrence.

Patient concerns:

A 21-year-old female patient presented with a one-year history of progressive pain of the right knee.

Diagnoses:

Pigmented villonodular synovitis.

Interventions:

We performed an anterior approach arthroscopic synovectomy and a posterior approach open synovectomy in the popliteal fossa, but the patient declined to take radiotherapy as a post-surgical adjuvant therapy. Then, she received a repeat arthroscopic synovectomy 20 months later because of the recurrent lesions, and a radiotherapy was performed 6 weeks after the second surgery.

Outcomes:

There were no abnormal signs in the right knee on magnetic resonance imaging scanning 6 months after the second surgery. The range of motion of her right knee was normal.

Lessons:

Pigmented villonodular synovitis is a rare disease which may involve any joints. Surgical resection plus adjuvant therapy is recommended for patients with risk factors of recurrence.
Antenatal administration of hepatitis B immunoglobulin and hepatitis B vaccine to prevent mother to child transmission in hepatitis B virus surface antigen positive pregnant women
Authors: Chen Zhe , Zeng Min , Liu Dan , Wu Lin , Zhang Lingli
Published: April 2020

Background:

This study aims at evaluating the benefits and harms of hepatitis B immune globulin (HBIG) and hepatitis B vaccine (HBVac) in preventing mother to child transmission in HBV surface antigen (HBsAg) positive pregnant women during antenatal period.

Methods:

Seven electronic databases including PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure (CNKI), WanFang Database, Chinese Biomedical Literature Database (CBM), VIP Database for Chinese Technical Periodicals (VIP), and 3 clinical trial registry platforms were searched from inception date to December 2017. Only randomized controlled trials (RCTs) were included in this study. The Cochrane risk of bias tool was applied to assessing the risk of bias. The outcomes were analyzed by Review Manager 5.3 software.

Results:

Sixteen RCTs involving 2440 HBsAg positive pregnant women were included in the meta-analysis. Compared with placebo group, HBIG and HBVac group had a significant decrease in the number of newborns who were HBsAg positive (relative risks [RR]: 0.2, 95% confidence interval [CI] [0.18, 0.40], P < .00001) and HBV-DNA positive (RR: 0.25, 95% CI [0.09, 0.71], P = .010), and had a significant increase in the number of anti-HBs positive newborns (RR: 3.95, 95% CI [3.11, 5.00], P < .00001). After 1-year follow up, the number of HBsAg positive newborns continued to decline (RR: 0.09, 95% CI [0.04, 0.20], P < .00001) and the number of anti-HBs positive newborns continued to increase in HBIG and HBVac group (RR: 1.30, 95% CI [1.22, 1.38], P < .00001). Compared with HBIG group, HBIG and HBVac group had no significant difference in the number of HBsAg positive newborns (RR: 1.68, 95% CI [0.66, 4.30], P = .28), and had a significant decrease in the number of HBsAg positive newborns (RR: 0.31, 95% CI [0.12, 0.84], P = .02). Additionally, only 1 study reported 2 swelling cases, 4 studies were reported no adverse events, and 11 studies were not report adverse reaction.

Conclusions:

HBIG and HBVac could be an effective alternative for HBsAg positive pregnant women to prevent mother to child transmission. However, due to the limitations of the study, the long-term efficacy and safety of HBIG and HBVac still need long-term and high-quality research to confirm.
Jejuno-jejunal intussusception caused by a percutaneous endoscopic gastrojejunostomy tube in a pediatric patient: A case report
Authors: Kakiuchi Toshihiko , Nakayama Aiko , Nojiri Junichi , Yamanouchi Takeshi , Matsuo Muneaki
Published: April 2020

Rationale:

Although percutaneous endoscopic gastrojejunostomy (PEG-J) tubes are believed to reduce the side effect of aspiration, cautious catheter management is required. Intussusception is a serious complication of these tubes.

Patient concerns:

A 7-year-old boy bedridden with hypoxic encephalopathy owing to drowning at the age of 1 year was admitted our hospital with urinary retention for 1 month. At the age of 4 years, a PEG-J tube was inserted. Concomitant with hyperaldosteronemia, an intestinal intussusception from the duodenum to the jejunum was observed via computed tomography (CT). The patient's condition worsened dramatically; gastrointestinal perforation was suspected, and laparotomy was performed.

Diagnosis:

Jejuno-jejunal intussusception.

Interventions:

Open surgery was performed to release the intussusception. By assessing the reduced intestinal tract, the intussusception starting from a 50 cm portion from the Treitz ligament had been extended to 100 cm from the Treitz ligament. The oral side jejunum was dilated. No evidence of intestinal perforation or strangulated ileus was observed, and the intussusception was manually remediable.

Outcomes:

Preoperative CT examination showed intussusception from the duodenum to the jejunum. Laparotomy showed intussusception on the anal side of the Treitz ligament. With regard to the CT findings associated with the progression of intussusception to the duodenal site, as a result of the telescope phenomenon extending to the duodenum due to the relaxation of the Treitz ligament through repeated intussusception, it was considered that CT examination revealed intussusception extending from the jejunum to the duodenum of oral side. After 3 postoperative weeks, the patient was finally able to return home.

Lessons:

If the ileus is observed during the insertion of a PEG-J, clinicians should consider the possibility of intussusception even in the duodenum.
Update on in-vivo preclinical research models in adrenocortical carcinoma
Authors: Kar Adwitiya , Wierman Margaret E. , Kiseljak-Vassiliades Katja
Published: April 2020

Purpose of review

The aim of this review is to summarize recent advances on development of in vivo preclinical models of adrenocortical carcinoma (ACC).

Recent findings

Significant progress has been achieved in the underlying molecular mechanisms of adrenocortical tumorigenesis over the last decade, and recent comprehensive profiling analysis of ACC tumors identified several genetic and molecular drivers of this disease. Therapeutic breakthroughs, however, have been limited because of the lack of preclinical models recapitulating the molecular features and heterogeneity of the tumors. Recent publications on genetically engineered mouse models and development of patient-derived ACC xenografts in both nude mice and humanized mice now provide researchers with novel tools to explore therapeutic targets in the context of heterogeneity and tumor microenvironment in human ACC.

We review current in-vivo models of ACC and discuss potential therapeutic opportunities that have emerged from these studies.
Organ allocation in the age of the algorithm: avoiding futile transplantation – utility in allocation
Authors: Faitot Francois , Michard Baptiste , Artzner Thierry
Published: April 2020

Purpose of review

This review describes and questions the evolution of allocation systems from local team decisions in the 20th century to patient-oriented allocation using complex algorithm predicting transplant benefit.

Recent findings

The opening years of the 2000s have seen the implementation of prioritization scores aiming at increasing transparency and reducing waitlist mortality. The 2010s have underlined the necessity of drawing the upper limits of how sick a patient can be while still ensuring acceptable survival. More complex algorithms evaluating transplant benefit have been implemented in allocation systems to take this issue into account.

Allocation algorithms are becoming more and more complex, integrating numerous parameters from both donor and recipient to achieve optimal matching. The limitations of implementing these complex algorithms are represented by the evermoving waiting list demography, geographic disparities between recipients and donors, team policy adaptation to rule changes, and implicit biases within the transplant community. Survival as the only metric by which to define benefit may be seen as restrictive; quality of life may be a fruitful measure for better defining benefit in organ transplantation in the future.
Normothermic machine perfusion of donor-lungs ex-vivo: promoting clinical adoption
Authors: Gilmour Jenny , Griffiths Chelsea , Pither Tom , Scott William E. , Fisher Andrew J.
Published: April 2020

Purpose of review

Lung transplantation offers the only realistic therapeutic option for patients with end-stage lung disease. However, this is impacted by a shortfall in availability of suitable donor-lungs. Normothermic machine perfusion of donor-lungs outside the donor body also known as ex-vivo lung perfusion (EVLP) offers a potential solution through objective assessment, reconditioning and treatment of donor-lungs initially deemed unsuitable for use. This review discusses key advances and challenges in the wider clinical adoption of this technology.

Recent findings

This review will summarize key research within the following areas: recent clinical trials utilizing EVLP, logistical challenges, EVLP protocol innovations, novel assessment methods and current research into therapeutic modulation of lung function during EVLP.

Normothermic machine perfusion of donor-lungs ex-vivo offers a promising platform to assess and modulate donor-lung quality prior to transplantation. Consensus on how and when to best utilize EVLP is yet to be reached, meaning that widespread clinical adoption of the technology has not yet become a reality. Further work is needed on agreed indications, perfusion protocols and organization of services before becoming a regularly used procedure prior to lung transplantation.
How Nurse Scientists Can Stay Productive and on Track During the Pandemic
Authors: Bruner Deborah W.
Published: April 2020

On March 11, 2020, with the declaration of a global pandemic by the World Health Organization, an unplanned slowdown of academic research activities has taken place. Although this is not an ideal situation for nurse scientists, it presents a number of unique opportunities for researchers to shift their focus in the short term, which may actually lead to more productivity in the long term. This commentary explores ways nurse scientists can stay on track without derailing their plans for career advancement under unprecedented circumstances.
The Effect of Simulated Central Field Loss on Street-crossing Decision-Making in Young Adult Pedestrians
Authors: Almutleb Essam S. , Hassan Shirin E.
Published: April 2020

SIGNIFICANCE

This study explored the street-crossing decision-making performance of young normally sighted subjects with simulated central field loss (CFL). The results suggest that using eccentric viewing enables a person to make safe and reliable street-crossing decisions.

PURPOSE

This study tested the hypothesis that, as the diameter of an experimentally induced central scotoma increases, the accuracy and reliability of street-crossing decisions worsen.

METHODS

Street-crossing decisions were measured in 20 young subjects aged between 23 and 31 years while monocularly viewing a nonsignalized, one-way street for different vehicular arrival times. Using a 5-point rating scale, subjects judged whether they could cross the street before vehicular arrival with habitual vision and simulated CFL with eccentric viewing. The CFL was induced using soft contact lenses with different central opaque diameters. Using receiver operating characteristic curve analysis, we obtained subjects' accuracy (amount of time in seconds where subjects either overestimated or underestimated vehicular arrival time relative to their actual crossing time) and reliability (how quickly subjects transitioned from judging insufficient to sufficient time to cross relative to their actual crossing time).

RESULTS

The centrally opaque contact lenses induced central scotomata with a mean (standard deviation) diameter of 17.12° (5.83°). No significant difference in street-crossing accuracy (P = .35) or reliability (P = .09) was found between the normal, habitual vision and simulated CFL conditions. No statistically significant correlations were found between scotoma diameter and the accuracy and reliability of subjects' street-crossing decisions (P = .83 and P = .95, respectively).

CONCLUSIONS

The findings of this study suggest that adopting eccentric viewing enables a person to successfully mitigate the negative effects of an absolute central scotoma on the accuracy and reliability of their street-crossing decisions.
Outcomes of Children With Cystic Fibrosis Admitted to PICUs*
Authors: Smith Michael A. , McGarry Meghan E. , Ly Ngoc P. , Zinter Matt S.
Published: April 2020

Objectives:

Data on outcomes of children with cystic fibrosis admitted to PICUs are limited and outdated. Prior studies cite PICU mortality rates ranging from 37.5% to 100%. Given the advances made in cystic fibrosis care, we expect outcomes for these patients to have changed significantly since last studied. We provide an updated report on PICU mortality and the factors associated with death among critically ill children with cystic fibrosis.

Design:

Retrospective multicenter cohort analysis utilizing data from the Virtual Pediatric Systems database.

Setting:

Data were collected from 135 PICUs from January 1, 2009, to June 20, 2018.

Patients:

One-thousand six-hundred thirty-three children with cystic fibrosis accounting for 2,893 PICU admissions were studied.

Interventions:

None.

Measurements and Main Results:

The primary outcome was mortality during PICU admission. Predictors included demographics, anthropometrics, diagnoses, clinical characteristics, and critical care interventions. Odds ratios of mortality were calculated in univariate and multivariable analyses to assess differences in mortality associated with predictor variables. Generalized estimating equation models were used to account for multiple admissions per patient. The overall PICU mortality rate was 6.6%. Factors associated with increased odds of mortality included hemoptysis/pulmonary hemorrhage, pneumothorax, gastrointestinal bleeding, bacterial/fungal infections, lower body mass index/malnutrition, and need for noninvasive or invasive respiratory support. Intubation/mechanical ventilation occurred in 26.4% of the 2,893 admissions and was associated with a 19.1% mortality rate. Of the nonsurvivors, 20.7% died without receiving mechanical ventilation.

Conclusions:

The mortality rate during PICU admissions for patients with cystic fibrosis is lower than has been reported in prior studies, both in the overall cohort and in the subset requiring invasive mechanical ventilation. These data provide updated insight into the prognosis for cystic fibrosis patients requiring critical care.
HIV Self-Testing Programs to Men Who Have Sex With Men Delivered by Social Media Key Opinion Leaders and Community-Based Organizations are Both Effective and Complementary: A National Pragmatic Study in China
Authors: Zhang Wenran , Hu Qinghai , Tang Weiming , Jin Xia , Mao Xiang , Lu Tianyi , Gao Yangyang , Chu Zhenxing , Dong Willa , Bao Yugang , Shang Hong , Xu Junjie
Published: April 2020

Background:

Social media key opinion leaders (SMKOLs) and community-based organizations (CBOs) are 2 leading delivery strategies for HIV self-testing (HIVST). This study compared respondent characteristics, linkage to care, antiretroviral treatment, and cost of HIVST among men who have sex with men (MSM) recruited via SMKOLs and CBOs in China.

Methods:

Between January and December 2018, SMKOLs distributed HIVST advertisements to MSM through WeChat public platforms; simultaneously, CBOs distributed HIVST program messages to local MSM. All participants were required to pay a deposit to apply for the HIVST kit and had their deposit refunded after completing an online survey and uploading HIVST results. Trained staff provided HIV referral services by telephone and WeChat.

Results:

One thousand seven hundred forty-three [63.0% (1743/2766)] and 1023 [37.0% (1023/2766)] individuals met criteria via SMKOLs and CBOs, respectively. MSM reached by SMKOLs had a lower HIV seropositive rate [2.1% (33/1561) vs. 12.5% (100/803)] and higher proportion received antiretroviral treatment [94.4% (31/33) vs. 29.0% (29/100)] compared with CBO-recruited MSM (all P < 0.05). The average number of HIVST respondents recruited by each investigator in SMKOL-strategy was higher than that of CBO-strategy (290 vs. 49). The SMKOLs had lower cost of per person tested (USD 13.18 vs. USD 101.21) and per newly identified HIV infection case (USD 632.66 vs. USD 812.70).

Conclusions:

SMKOLs have lower cost of per person tested, whereas CBOs can reach MSM subpopulations with higher HIV seropositive rates. Both recruitment methods are efficient and should be used as complementary HIVST delivery strategies to address low HIV testing coverage among Chinese MSM.
Unraveling Haemophilus influenzae virulence mechanisms enable discovery of new targets for antimicrobials and vaccines
Authors: Langereis Jeroen D. , de Jonge Marien I.
Published: April 2020

Purpose of review

The human upper respiratory tract is colonized with a variety of bacterial microorganisms including Haemophilus influenzae. The species H. influenzae consists of typeable and nontypeable H. influenzae (NTHi) variants. Typeable H. influenzae are subdivided into types a through f, based on the polysaccharide capsule, whereas the NTHi strains do not express a polysaccharide capsule. In this review, we highlight the current advances in the field of H. influenzae, with the focus on bacterial virulence mechanisms that facilitate bacterial colonization and disease, particularly for NTHi.

Recent findings

In the past decade, it has become apparent that NTHi has the ability to cause invasive infections. Recently, a number of adhesins have been shown to be crucial for bacterial colonization and invasion and these proteins were investigated as vaccine antigens. Although NTHi lacks a polysaccharide capsule, it expresses lipooligosaccharide that contribute to adhesion and evasion of complement-mediated killing, both contributing to bacterial virulence, which could potentially be targeted by novel antimicrobial drugs or vaccines.

The unraveling of H. influenzae virulence mechanisms resulted in the identification of promising targets for novel antimicrobials and vaccine antigens aiming to prevent or treat both typeable and nontypeable H. influenzae infections.
The biological basis of chronic fatigue: neuroinflammation and innate immunity
Authors: Omdal Roald
Published: April 2020

Purpose of review

Chronic fatigue is common in cancer, neurodegenerative, and chronic inflammatory diseases and is regarded by many patients as their absolutely worst problem. Lately, fatigue is increasingly understood to have a genetic and molecular basis.

Recent findings

Biologically, fatigue occurs as part of the sickness behavior response, a complex and automated behavior triggered by the activation of innate immunity and neuroinflammation. IL-1β causes neuronal activation in the brain and subsequent fatigue. In addition to proinflammatory molecules, potential partners in the complex brain signaling of fatigue include downregulatory mechanisms for inflammation and cellular stress responses and the neuropeptide hypocretin-1. These mechanisms all become constantly activated in chronic conditions. Genetic studies indicate that fatigue may have evolved to enhance survival during infection and injury.

Fatigue is a major clinical problem. Finding the right treatment is challenging, as no specific options exist and only a few of the mechanisms contributing to fatigue are known. Because fatigue is generated in the brain, further studies should focus on proteomics and specific candidate proteins in cerebrospinal fluid. Studies on genetic variants, gene activation, and epigenetics are also required.
Clinicopathological Correlates: Chronic Arsenic Toxicity Causing Bilateral Symmetric Progressive Optic Neuropathy
Authors: Freund Paul , Al-Shafai Laila , Mankovskii Gabriella , Howarth David , Margolin Edward
Published: April 2020

A 70 year-old man presented with insidiously progressing central visual acuity loss in both eyes over several years. Objectively the only abnormality identified on the exam was questionable granularity in the fovea in each eye. Extensive work up which included neuro-imaging, screening blood work for toxic and nutritional causes of optic neuropathy as well as electroretinogram and fluorescein angiography to rule out subtle maculopathy was all unrevealing. When vision continued to deteriorate over the next several years investigations were repeated and again did not yield any positive results. Levels of heavy metals were then obtained after further progression of visual loss, revealing very high levels of arsenic. Subsequent investigations revealed that patient has been spending almost every weekend for the past 28 years alone at a remote country cottage where the sole supply of water was from the local well. He also recalled that 1.5 months after purchasing the cottage he developed hemorrhagic colitis requiring partial colectomy. The specimen from colectomy was located and total reflection x-ray fluorescence testing performed in a specialized lab revealed greatly increased level of arsenic particle in the colonic biopsy from 28 years ago. This case is a reminder that heavy metal toxicity should be considered in a differential diagnosis of patients with bilateral symmetric optic neuropathy.
Machine-learning approaches to substance-abuse research: emerging trends and their implications
Authors: Barenholtz Elan , Fitzgerald Nicole D. , Hahn William Edward
Published: April 2020

Purpose of review

To provide an accessible overview of some of the most recent trends in the application of machine learning to the field of substance use disorders and their implications for future research and practice.

Recent findings

Machine-learning (ML) techniques have recently been applied to substance use disorder (SUD) data for multiple predictive applications including detecting current abuse, assessing future risk and predicting treatment success. These models cover a wide range of machine-learning techniques and data types including physiological measures, longitudinal surveys, treatment outcomes, national surveys, medical records and social media.

The application of machine-learning models to substance use disorder data shows significant promise, with some use cases and data types showing high predictive accuracy, particularly for models of physiological and behavioral measures for predicting current substance use, portending potential clinical diagnostic applications; however, these results are uneven, with some models performing poorly or at chance, a limitation likely reflecting insufficient data and/or weak validation methods. The field will likely benefit from larger and more multimodal datasets, greater standardization of data recording and rigorous testing protocols as well as greater use of modern deep neural network models applied to multimodal unstructured datasets.
Bibliometric Analysis of Manuscript Characteristics that Influence Citations: A Comparison of Six Major Family Medicine Journals
Authors: Paracha Hamza , Johal Amit , Tiwana Maida , Hafeez Dawood M , Jalal Sabeena , Rehman Ateeq , Hussain Syed Asim , Khosa Faisal
Published: April 2020

Objective

The premise of our study was to investigate the characteristics of family medicine (FM) manuscripts that influence citation rate, capturing features of manuscript construction that are discrete from the study design.

Design

We conducted a cross-sectional study of published articles (n = 199), from January to June 2008, from 6 major FM journals with the highest impact factor. Annals of Family Medicine (IF = 1.864), British Journal of General Practice (1.104), Journal of American Board of Family Medicine (1.015), Family Practice (0.976), Family Medicine (0.936), and BMC Family Practice (0.815). Citation counts for these articles were retrieved using Web of Science filter on SCImago and 25 article characteristics were tabulated manually. We then predicted the citation rate by performing univariate analysis, spearman rank-order correlation, and multiple regression model on the collected variables.

Results

Using spearman rank-order correlation, we found the following variables to have significant positive correlation with citations: number of references (rs and p-value, 0.31 and 0.001 respectively), total words (0.36, 0.001), number of pages (0.33, 0.001), abstract word count (0.17, 0.010) and abstract character count (0.16, 0.010). In a multivariate linear regression model: number of references (p-value = 0.010, R2 = 0.06) and multi-institutional (p-value = 0.050, R2 = 0.01) had a significant effect on citation rates.

Conclusion

Editors and authors of FM can enhance the impact of their journals and articles by utilizing this bibliometric study when assembling their manuscript.
Supportive Care for Patient with Respiratory Diseases: An Umbrella Review
Authors: Luo Xufei , Lv Meng , Wang Xiaoqing , Long Xin , Ren Mengjuan , Zhang Xianzhuo , Liu Yunlan , Li Weiguo , Zhou Qi , Ma Yanfang , Fukuoka Toshio , Ahn Hyeong Sik , Lee Myeong Soo , Luo Zhengxiu , Liu Enmei , Wang Xiaohui , Chen Yaolong
Published: April 2020

Background

Supportive treatment is an important and effective part of the management for patients with life-threatening diseases. This study aims to identify and evaluate the forms of supportive care for patients with respiratory diseases.

Methods

An umbrella review of supportive care for patient respiratory diseases was undertaken. We comprehensively searched the following databases: Medline, EMBASE, Web of Science, CNKI (China National Knowledge Infrastructure), Wanfang Data and CBM (SinoMed) from their inception to 31 March 2020, and other sources to identify systematic reviews and meta-analyses related to supportive treatments for patient with respiratory diseases including COVID-19, SARS, MERS and influenza. We assessed the methodological quality using the AMSTAR score and the quality of the evidence for the primary outcomes of each included systematic review and meta-analysis.

Results

We included 18 systematic reviews and meta-analyses in this study. Most studies focused on the respiratory and circulatory support. Ten studies were of high methodological quality, five studies of medium quality, and three studies of low quality. According to four studies extracorporeal membrane oxygenation did not reduce mortality in adults (OR/RR ranging from 0.71 to 1.28), but two studies reported significantly lower mortality in patients receiving venovenous extracorporeal membrane oxygenation than in the control group (OR/RR ranging from 0.38 to 0.73). Besides, monitoring of vital signs and increasing the number of medical staff may also reduce the mortality in patients with respiratory diseases.

Conclusions

Our overview suggests that supportive care may reduce the mortality of patients with respiratory diseases to some extent. However, the quality of evidence for the primary outcomes in the included studies was low to moderate. Further systematic reviews and meta-analyses are needed to address the evidence gap regarding the supportive care for SARS, MERS and COVID-19.
Modeling Exit Strategies from COVID-19 Lockdown with a Focus on Antibody Tests
Authors: German Reinhard , Djanatliev Anatoli , Maile Lisa , Bazan Peter , Hackstein Holger
Published: April 2020

Abstract

This paper presents two epidemiological models that have been developed in order to study the disease dynamics of the COVID-19 pandemic and exit strategies from the lockdown which has been imposed on many countries world-wide. A strategy is needed such that both the health system is not overloaded letting people die in an uncontrolled way and also such that the majority of people can get back their social contacts as soon as possible. We investigate the potential effects of a combination of measures such as continuation of hygienic constraints after leaving lockdown, isolation of infectious persons, repeated and adaptive short-term contact reductions and also large-scale use of antibody tests in order to know who can be assumed to be immune and participate at public life without constraints. We apply two commonly used modeling approaches: extended SEIR models formulated both as System Dynamics and Agent-Based Simulation, in order to get insight into the disease dynamics of a complete country like Germany and also into more detailed behavior of smaller regions. We confirm the findings of other models that without intervention the consequences of the pandemic can be catastrophic and we extend such findings with effective strategies to overcome the challenge. Based on the modeling assumptions it can be expected that repeated short-term contact reductions will be necessary in the next years to avoid overload of the health system and that on the other side herd immunity can be achieved and antibody tests are an effective way to mitigate the contact reductions for many.
Epidemic Landscape and Forecasting of SARS-CoV-2 in India
Authors: Rajendrakumar Aravind Lathika , Narayanan Nair Anand Thakarakkattil , Nangia Charvi , Chourasia Prabhal Kumar , Chourasia Mehul Kumar , Ghouse Syed Mohammed , Nair Anu Sasidharan , Nair Arun B , Koya Shaffi Fazaludeen
Published: April 2020

BACKGROUND

India was one of the countries to institute strict measures for SARS-CoV-2 control in early phase. Since, then, the epidemic growth trajectory was slow before registering an explosion of cases due to local cluster transmissions.

METHODS

We estimated growth rate and doubling time of SARS-CoV-2 for India and high burden states using crowd sourced time series data. Further, we also estimated Basic Reproductive Number (R0) and time dependent reproductive number (Rt) using serial intervals from the data. We compared the R0 estimated from five different methods and R0 from SB was further used in analysis. We modified standard SIR models to SIRD model to accommodate deaths using R0 with the Sequential Bayesian method (SBM) for simulation in SIRD models.

RESULTS

On an average, 2.8 individuals were infected by an index case. The mean serial interval was 3.9 days. The R0 estimated from different methods ranged from 1.43 to 1.85. The mean time to recovery was 14 ± 5.3 days. Daily epidemic growth rate of India was 0.16 [95%CI; 0.14, 0.17] with a doubling time of 4.30 days [95%CI; 3.96, 4.70]. From the SIRD model, it can be deduced that the peak of SARS-CoV-2 in India will be around mid-July to early August 2020 with around 12.5% of population likely to be infected at the peak time.

CONCLUSIONS

The pattern of spread of SARS-CoV-2 in India is suggestive of community transmission. There is a need to increase fund for infectious disease research and epidemiologic studies. All the current gains may be reversed rapidly if air travel and social mixing resumes rapidly. For the time being, these must be resumed only in a phased manner, and should be back to normal levels only after we are prepared to deal with the disease with efficient tools like vaccine or a medicine.
Fatigue in perinatal stroke is associated with resting-state functional connectivity
Authors: Wrightson J.G , Carlson H.L , Condliffe E.G , Kirton A
Published: April 2020

Fatigue is prevalent in youth with perinatal stroke, but the causes are unclear. Predictive coding models of adult post-stroke fatigue suggest that fatigue may arise from dysfunction in predictive processing networks. To date, the association between fatigue and neural network connectivity in youth with perinatal stroke has not been examined. The present study examined the association between fatigue and the functional connectivity of predictive processing neural networks, measured using resting-state functional magnetic resonance imaging, in individuals with perinatal stroke. Participants who reported experiencing fatigue had weaker functional connectivity between the non-lesioned middle frontal and supramarginal gyri and between the non-lesioned intracalcarine cortex and the lesioned paracingulate cortex. In contrast, participants reporting fatigue had stronger functional connectivity between the lesioned inferior temporal gyrus and non-lesioned insula. These results suggest that fatigue in youth with hemiparetic cerebral palsy caused by perinatal stroke is associated with the functional connectivity of hubs previously associated with predictive processing and fatigue. These results suggest potential cortical and behavioral targets for the treatment of fatigue in individuals with perinatal stroke.
Ability of Fabric Facemasks Materials to Filter Ultrafine Particles at Coughing Velocity
Authors: O’Kelly Eugenia , Pirog Sophia , Ward James , Clarkson P. John
Published: April 2020

Objectives

We examined the ability of fabrics which might be used to create homemade face masks to filter out ultrafine (0.1μm and smaller in diameter) particles at the velocity of adult human coughing.

Method

Twenty commonly available fabrics and materials were evaluated for their ability to reduce air concentrations of ultrafine particles at a face velocity of 16.5 m/s. Further assessment was made on the filtration ability of select fabrics while damp and of fabric combinations which might be used to construct homemade masks.

Results

Single fabric layers blocked a range of ultrafine particles. When fabrics were layered, significantly more ultrafine particles were filtered. Nonwoven fusible interfacing significantly increased filtration.

Conclusions

The current coronavirus pandemic has left many communities without access N95 facemasks. Our findings suggest that face masks made from layered common fabric can help filter ultrafine particles and provide some protection for the wearer when commercial facemasks are unavailable.

STRENGHTS AND LIMITATIONS OF THIS STUDY

Tested a large number of potential facemask materials, including materials currently in common use such as Lycra which have not been previously tested

Evaluated filtration efficiency at coughing velocities, more closely mimicking use-case of masks worn for community protection than previous studies

Assess the data from prior published work and current study, creating a picture of Filtration Efficiency and the impact of velocity

Did not discriminate between pathogenic and non-pathogenic particles

Breathing resistance was estimated based on qualitative feedback
Transformation of the Tanzania Medical Store Department through Global Fund support: lessons learned from the field
Authors: Githendu Patrick , Morrison Linden , Silaa Rosemary , Pothapregada Sai , Asiimwe Sarah , Idris Rafiu , Peterson Tatjana , Davidson Emma , Lesego Abaleng , Mwale Neema , Mwakalobo Sako , Bwanakunu Laurean , Achoki Tom
Published: April 2020

Background

The Tanzania government sought support from The Global Fund to Fight AIDs, Tuberculosis and Malaria (Global Fund) to reform its Medical Stores Department (MSD), with the aim of improving performance. Our study aimed to assess the impact of the reforms and document the lessons learned.

Methods

We applied quantitative and qualitative research methods to assess the impact of the reforms. The quantitative part entailed a review of operational and financial data covering the period before and after the implementation of the reforms. We applied interrupted time series analysis to determine the change in average availability of essential health commodities at health zones. Qualitative data was collected through 41 key informant interviews. Participants were identified through stakeholder mapping, purposive and snowballing sampling techniques, and responses were analyzed through thematic content analysis.

Results

Availability of essential health commodities increased significantly by 12.6% (95%CI, 9.6-15.6), after the reforms and continued to increase on a monthly basis by 0.2% (95%CI, 0.0-0.3) relative to the preintervention trend. Sales increased by 56.6% while the cost of goods sold increased by 88.6% between 2014/15 and 2017/18. Surplus income increased by 56.4% between 2014/15 and 2017/18, with reductions in rent and fuel expenditure. There was consensus among participants that the reforms, were instrumental in improving performance of MSD.

Conclusion

Many positive results were realized through the reforms at MSD. However, despite the progress, there were risks such as the increasing government receivable that could jeopardize the gains. Multi-stakeholder efforts are necessary, to sustain the progress and expand public health.
Supramolecular Organization Predicts Protein Nanoparticle Delivery to Neutrophils for Acute Lung Inflammation Diagnosis and Treatment
Authors: Myerson Jacob W. , Patel Priyal N. , Habibi Nahal , Walsh Landis R. , Lee Yi-Wei , Luther David C. , Ferguson Laura T. , Zaleski Michael H. , Zamora Marco E. , Marcos-Contreras Oscar A. , Glassman Patrick M. , Johnston Ian , Hood Elizabeth D. , Shuvaeva Tea , Gregory Jason V. , Kiseleva Raisa Y. , Nong Jia , Rubey Kathryn M. , Greineder Colin F. , Mitragotri Samir , Worthen George S. , Rotello Vincent M. , Lahann Joerg , Muzykantov Vladimir R. , Brenner Jacob S.
Published: April 2020

Acute lung inflammation has severe morbidity, as seen in COVID-19 patients. Lung inflammation is accompanied or led by massive accumulation of neutrophils in pulmonary capillaries (“margination”). We sought to identify nanostructural properties that predispose nanoparticles to accumulate in pulmonary marginated neutrophils, and therefore to target severely inflamed lungs. We designed a library of nanoparticles and conducted anin vivoscreen of biodistributions in naive mice and mice treated with lipopolysaccharides. We found that supramolecular organization of protein in nanoparticles predicts uptake in inflamed lungs. Specifically, nanoparticles with agglutinated protein (NAPs) efficiently home to pulmonary neutrophils, while protein nanoparticles with symmetric structure (e.g.viral capsids) are ignored by pulmonary neutrophils. We validated this finding by engineering protein-conjugated liposomes that recapitulate NAP targeting to neutrophils in inflamed lungs. We show that NAPs can diagnose acute lung injury in SPECT imaging and that NAP-like liposomes can mitigate neutrophil extravasation and pulmonary edema arising in lung inflammation. Finally, we demonstrate that ischemicex vivohuman lungs selectively take up NAPs, illustrating translational potential. This work demonstrates that structure-dependent interactions with neutrophils can dramatically alter the biodistribution of nanoparticles, and NAPs have significant potential in detecting and treating respiratory conditions arising from injury or infections.
Estimation of Tunisia COVID-19 infected cases based on mortality rate
Authors: Abdeljaoued-Tej Ines , Dhenain Marc
Published: April 2020

Estimating the number of people affected by COVID-19 is crucial in deciding which public health policies to follow. The authorities in different countries carry out mortality counts. We propose that the mortality reported in each country can be used to create an index of the number of actual cases at a given time. The specificity of whether or not deaths are rapid or not by COVID-19 also affects the number of actual cases. The number of days between the declaration of illness and death varies between 12 and 18 days. For a delay of 18 days, and using an estimated mortality rate of 2%, the number of cases in April 2020 in Tunisia would be5 580people. The pessimistic scenario predicts22 320infected people, and the most optimistic predicts 744 (which is the number of reported cases on April12, 2020). Modeling the occurrence of COVID-19 cases is critical to assess the impact of policies to prevent the spread of the virus.
The socio-economic determinants of the coronavirus disease (COVID-19) pandemic
Authors: Stojkoski Viktor , Utkovski Zoran , Jolakoski Petar , Tevdovski Dragan , Kocarev Ljupco
Published: April 2020

The magnitude of the coronavirus disease (COVID-19) pandemic has an enormous impact on the social life and the economic activities in almost every country in the world. Besides the biological and epidemiological factors, a multitude of social and economic criteria also govern the extent of the coronavirus disease spread in the population. Consequently, there is an active debate regarding the critical socio-economic determinants that contribute to the resulting pandemic. In this paper, we contribute towards the resolution of the debate by leveraging Bayesian model averaging techniques and country level data to investigate the potential of 35 determinants, describing a diverse set of socio-economic characteristics, in explaining the coronavirus pandemic outcome.