bluuebunny/crossref_metadata_2025 huggingface dataset:
Daily pain catastrophizing predicts less physical activity and more sedentary behavior in older adults with osteoarthritis
Authors: Zhaoyang Ruixue , Martire Lynn M. , Darnall Beth D.
Published: June 2020

Musculoskeletal disorders such as knee osteoarthritis (OA) are the primary cause of chronic pain in older adults. Recommended self-management strategies for knee OA include staying physically active in the face of pain, but many patients avoid activities they are capable of doing. The overall purpose of this study was to examine the extent to which daily pain catastrophizing, a maladaptive coping strategy, could influence OA patients' physical activity and sedentary behavior. The current study used data from 143 older knee OA patients who completed electronic daily diaries for 22 days and wore an accelerometer to capture physical activity and sedentary behavior. At the beginning of each day, patients reported their pain catastrophizing regarding the day ahead. Results from multilevel models demonstrated that on mornings when patients catastrophized more than usual about their pain in the day ahead, they spent more time in sedentary behavior and engaged in fewer minutes of moderate to vigorous physical activity that day. Cross-day lagged analyses further showed that the effect of morning pain catastrophizing on subsequent sedentary behavior extended to the next day. More time spent in sedentary behavior, in turn, contributed to greater pain catastrophizing the next morning. These findings support the mechanistic role of daily pain catastrophizing in the avoidance of physical activity for older OA patients, and suggest that effective interventions for pain catastrophizing may also reduce sedentary behavior and enhance physical activity, with longer-term benefits for pain management, physical function, and overall health.
Assessing Cochlear Implant Insertion Angle From an Intraoperative X-ray Using a Rotating 3D Helical Scala Tympani Model
Authors: Giardina Christopher K. , Canfarotta Michael W. , Thompson Nicholas J. , Fitzpatrick Douglas C. , Hodge Sarah E. , Baker Jenna , O’Connell Brendan P.
Published: June 2020

Background:

Angular insertion depth (AID) of the electrode array provides valuable information regarding intracochlear positioning, which can be used to predict outcomes and optimize performance. While computed tomography (CT) offers high-resolution imaging, there is a need to develop technology to accurately determine AID from intraoperative x-rays acquired at unknown angles.

Methods:

An algorithm was developed using a three-dimensional model of the scala tympani to estimate AID from an x-ray acquired at an unknown angle. The model is manipulated over the x-ray until the projection angle is inferred and the location of the round window and individual electrode contacts are identified. Validation of the algorithm involved 1) assessing accuracy with deviation from cochlear view by comparing AID determined with simulated x-rays to those determined with CT in a temporal bone model, and 2) assessing reproducibility in the clinical setting, by comparing intra- and inter-rater reliability with intraoperative x-ray in cochlear implant (CI) recipients, which were subsequently compared to AID determined with postoperative CT.

Results:

Estimates of AID from x-rays were generally within 10 degrees of CT regardless of deviation from cochlear view. Excluding two outliers with poor imaging quality, the intraclass correlation coefficients for intra- and inter-rater reliability were excellent (0.991 and 0.980, respectively).

Conclusion:

With intraoperative x-rays of sufficient quality, the helical scala tympani model can be used to accurately and reliably determine AID without the need to specify a preferred image angle. The application can therefore be used in most CI recipients when a postoperative CT is not available.
Nimodipine and Steroid Combination Therapy for Idiopathic Sudden Sensorineural Hearing Loss
Authors: Han Jae Joon , Jung Jae Yeup , Park Kye Hoon , Lee Ho Yun , Lee Byung Don , Choi Seong Jun , Lee Chi Kyou
Published: June 2020

Objective:

To evaluate the treatment outcomes of nimodipine and steroid combination therapy for idiopathic sudden sensorineural hearing loss (ISSNHL).

Study Design:

Retrospective case review.

Setting:

Tertiary referral center.

Patients:

Seventy-eight patients who were diagnosed with ISSNHL were divided into two group based on the treatment strategies used: steroid+nimodipine (SN, n = 36) and steroid only (SO, n = 42) groups. Based on the level of hearing loss before treatment, subgroup analysis (<90 dB HL, SN-S versus SO-S groups; ≥90 dB HL, SN-P versus SO-P groups) was performed.

Interventions:

Nimodipine+dexamethasone versus dexamethasone alone.

Main Outcome Measures:

Hearing thresholds and complete/partial recovery rate after treatment.

Results:

Hearing thresholds after treatment were not significantly different between the SN and SO groups (46.8 ± 29.4 versus 54.8 ± 27.6 dB HL, p = 0.218). However, the complete recovery rate was significantly higher in the SN group than in the SO group (41.7% versus 16.8%, p = 0.014). In subgroup analysis, the complete recovery rate was significantly higher in the SN-S group than in the SO-S group (60.9% versus 19.2%, p = 0.003), whereas the difference between the SN-P and SO-P groups was not significant (7.7% versus 12.5%, p = 0.672). The cumulative incidence of complete recovery was significantly higher in SN-S group than in the SO-S group (p = 0.005); the mean recovery time was 4.4 weeks (95% confidence interval [CI], 2.8–6.1) in the SN-S group and 8.8 weeks (95% CI, 7.0–10.5) in the SO-S group.

Conclusions:

The results of this study suggest that nimodipine and steroid combination therapy for ISSNHL results in a higher complete recovery rate than steroid alone in patients with moderate to severe hearing loss.
Vestibular Evoked Myogenic Potential (VEMP) Test-retest Reliability in Children
Authors: Fuemmeler Elizabeth , Rodriguez Amanda I. , Thomas Megan , Creutz Tom , Fitzpatrick Denis , Janky Kristen L.
Published: June 2020

Objective:

Vestibular evoked myogenic potentials (VEMPs) are short-latency muscle potentials measured from the neck (cervical VEMP; cVEMP) or under the eyes (ocular VEMP; oVEMP), which provide information regarding function of the saccule and utricle, respectively. VEMPs are reliable when performed in adults; however, reliability of VEMPs in children is unknown. Therefore, the purpose of the study was to determine the test-retest reliability of c- and oVEMP testing in normal control children.

Study Design:

Prospective.

Setting:

Hospital.

Patients:

Ten adults, 14 adolescent children and 13 young children with normal hearing.

Interventions:

c- and oVEMP testing were completed across two test sessions in response to air-conduction 500 Hz tone-burst and impulse hammer stimuli. Additionally, oVEMP was completed using eyes-open and eyes-closed conditions.

Main Outcome Measures:

Intraclass correlation coefficients were calculated to determine the reliability of c- and oVEMP outcomes.

Results:

When using air-conduction stimuli, c- and oVEMP amplitudes are reliable across test sessions in normal control children and adults. With impulse hammer stimuli, cVEMP amplitudes showed high reliability; however, oVEMP amplitudes showed low reliability in both eyes-open and eyes-closed conditions. Comparison between eyes-open and eyes-closed oVEMP conditions revealed shorter latencies and higher peak-to-peak amplitudes in the eyes-open condition.

Conclusions:

In this small cohort of normal control children, cVEMPs are reliable using air-conduction and impulse hammer stimuli and oVEMPs are reliable using air-conduction stimuli in the eyes-open condition. oVEMP in eyes-closed conditions were less reliable compared with eyes-open conditions and resulted in a large number of absent responses.
Can You Hear Me Now? The Impact of Hearing Loss on Patient Health Literacy
Authors: Tolisano Anthony M. , Fang Lilly B. , Isaacson Brandon , Kutz Joe Walter , Hunter Jacob B.
Published: June 2020

Objective:

To elucidate the impact of hearing loss on patient health literacy.

Study Design:

Prospective, cross-sectional study.

Setting:

Academic otology practice at a university hospital.

Patients:

Consecutive, adult, English-speaking patients.

Main Outcome Measures:

Inadequate health literacy, defined as a composite score of less than or equal to nine on the brief health literacy screen (BHLS), was compared with patient hearing data utilizing the American Academy of Otolaryngology–Head and Neck Surgery (AAO-HNS) hearing classification. Secondary outcome measures included comparisons of inadequate BHLS scores according to patient demographic and clinical information.

Results:

There were 300 consecutive adult (>18 years old) patients evaluated with the BHLS at a university otology practice between February and March 2019. The median patient age was 60-years (range, 18–91 yr), a slight majority (160, 53.3%) were women, and most patients were White (241, 86.7%) and non-Hispanic (260, 91.6%). Overall, 9.7% of patients were found to have inadequate health literacy. Men had higher rates of inadequate health literacy as compared with women (13.6% versus 6.3%, odds ratio [OR] = 2.35, 95% confidence interval [CI] 1.06–5.25). Audiometric data was available for 284 (95%) patients, of which 235 (82.7%) had class A or B hearing and 49 (17.3%) had class C or D hearing. Patients with Class C or D hearing had a lower median composite BHLS score compared with patients with Class A or B hearing (11.6 versus 13.6, p < 0.0001) and an increased rate of inadequate health literacy (28.6% versus 4.7%, OR = 8.15, 95% CI 3.42–19.37). Increased age, female sex, and better hearing were independent predictors of higher BHLS scores on multivariable analysis.

Conclusions:

Hearing loss is an independent risk factor for inadequate health literacy. Providers should be aware of this risk and consider implementing strategies to improve counseling for this at-risk group of patients.
A Structural Analysis of Tympanic Compartments of the Middle Ear in Patients With Down's Syndrome: A Temporal Bone Study
Authors: Nogaki Taketoshi , Paparella Michael M. , Cureoglu Sebahattin
Published: June 2020

Hypothesis: There may be findings peculiar to the temporal bones of children with Down's syndrome (DS). The purpose of this study is to investigate the temporal bone histopathology of the children with DS.

Background: Otitis media with effusion is a highly prevalent condition with DS. Knowledge of the volume of the tympanic compartments and the area of the tympanic isthmus might be important to find out the pathogenesis of highly prevalent otitis media with effusion in those patients.

Methods:

We compared the volume of the epitympanum, mesotympanum, and the areas of the tympanic isthmus and tympanic orifice of eustachian tube in temporal bones from patients with DS. We also investigated the eustachian tube histopathologically.

Results:

The mean volume of the epitympanum and the mesotympanum was significantly smaller in the DS group than the control group. We found no significant difference in the mean diameter of the protympanic opening and tympanic orifice between the two groups. The mean narrowest area of the aerated and bony tympanic isthmus also was not significantly different between the two groups. An immature development of eustachian tube and cartilage was seen. We found mesenchyme remaining at the epitympanum and/or mesotympanum in all specimens in the DS group, and in five specimens in the control group.

Conclusion:

In the presence of the small middle ear, poorly developed eustachian tube, and tensor muscle, a vicious circle occurs, making otitis media with effusion difficult to resolve.
Intraoperative Observational Real-time Electrocochleography as a Predictor of Hearing Loss After Cochlear Implantation: 3 and 12 Month Outcomes
Authors: O’Leary Stephen , Briggs Robert , Gerard Jean-Marc , Iseli Claire , Wei Benjamin P.C. , Tari Sylvia , Rousset Alex , Bester Christo
Published: June 2020

Objective:

A decrease in intracochlear electrocochleographic (ECochG) amplitude during cochlear implantation has been associated with poorer postoperative hearing preservation in several short-term studies. Here, we relate the stability of ECochG during surgery to hearing preservation at 3- and 12-months.

Methods:

Patients with hearing ≤80-dB HL at 500 Hz were implanted with a slim-straight electrode array. ECochG responses to short, high-intensity, 500-Hz pure tones of alternating polarity were recorded continuously from the apical-most electrode during implantation. No feedback was provided to the surgeon. ECochG amplitude was derived from the difference response, and implantations classified by the presence (“ECochG drop”) or absence (“no drop”) of a ≥30% reduction in ECochG amplitude during insertion. Residual hearing (relative and absolute) was reported against the ECochG class.

Results:

ECochG was recorded from 109 patients. Of these, interpretable ECochG signals were recorded from 95. Sixty-six of 95 patients had an ECochG drop during implantation. Patients with an ECochG drop had poorer preoperative hearing above 1000 Hz. Hearing preservation (in decibels, relative to preoperative levels and functionally) was significantly poorer at 250-, 500-, and 1000-Hz at 3 months in patients exhibiting an ECochG drop. Twelve-month outcomes were available from 85 patients, with significantly poorer functional hearing, and greater relative and absolute hearing loss from 250 to 1000 Hz, when an ECochG drop had been encountered.

Conclusion:

Patients exhibiting ECochG drops during implantation had significantly poorer hearing preservation 12 months later. These observational outcomes support the future development of surgical interventions responsive to real-time intracochlear ECochG. Early intervention to an ECochG drop could potentially lead to prolonged improvements in hearing preservation.
A novel method: can stapedial acoustic reflex have a role in the diagnosis of minimal hepatic encephalopathy?
Authors: Yazici Alper , Emre Yildirim Abdullah , Konduk BuğraTolga , Aytaç İsmail , Barutçu Sezgin
Published: June 2020

Objective

Stapedial acoustic reflex is an easily accessible and applicable test which is also valuable for the clinical conditions which affect the various locations of the central nervous system. Searching the diagnostic value of stapedial acoustic reflex at minimal hepatic encephalopathy is the aim of this research.

Methods

Diagnosis of minimal hepatic encephalopathy was conducted by mini-mental state and critical flickered frequency tests. Minimal hepatic encephalopathy diagnosed patients were established in the first group. Cirrhosis (without minimal hepatic encephalopathy or overt hepatic encephalopathy) diagnosed patients were created the control group. The stapedial acoustic reflex test was applied for minimal hepatic encephalopathy and the control group by audiologists in a soundproof room.

Results

In total, 221 patients were screened and 97 patients meet the inclusion criterions. Out of 97 patients, 52 were the minimal hepatic encephalopathy patients and the remaining patients were the control group. Acoustic reflex tests battery includes the evaluation of two pathways called ipsilateral and contralateral. Ipsilateral way test results were found positive in all minimal hepatic encephalopathy patients and 95% positive in the control group. Contralateral acoustic reflex test results were found 36% positive in minimal hepatic encephalopathy patients and 95% positive in the control group, respectively. A comparison of ipsilateral and contralateral acoustic reflex test results was displayed a statistical significance.

Conclusion

Stapedial acoustic reflex test results of cirrhosis patients may cover additional parameters for the diagnosis of minimal hepatic encephalopathy.
Increased rates of spinal fusion surgery in patients with hereditary hemochromatosis: a five-year propensity matched cohort analysis
Authors: Kesler Alex M. , Kröner Paul T. , Wijarnpreecha Karn , Palmer William C.
Published: June 2020

Object

Spinal arthropathy is associated with hereditary hemochromatosis and has been linked to calcium pyrophosphate dehydrate crystal deposition (CPPD) which resembles ankylosing spondylitis on radiograph, yet lacks clinical findings of inflammatory spinal arthritis. The aim of our study was to assess the use of spinal surgery and its outcomes in the US inpatient population with hereditary hemochromatosis from 2012 to 2016 by using the US Nationwide Inpatient Sample (NIS) database.

Methods

The observational retrospective cohort study uses the NIS 2012 to 2016. All patients with hereditary hemochromatosis were included using International Classification of Diseases 9th and 10th revisions, Clinical Modification codes. The cohort was stratified according to having undergone spinal surgery and substratified by the type of surgery. The primary outcome was determining the use of spinal surgery in patients with hereditary hemochromatosis. Secondary outcomes were determining length of hospital stay and total hospital charges and costs.

Results

A total of 39 780 patients with hereditary hemochromatosis were identified and propensity matched to nonhereditary hemochromatosis controls. The mean patient age was 61 years, and 65% were females. For the primary outcome patients with hereditary hemochromatosis underwent significantly more spinal fusion surgery compared to patients without hereditary hemochromatosis odds of 2.13 (P = 0.05). While there was no difference in mean LOS, or costs, patients with hereditary hemochromatosis had higher hospital charges.

Conclusion

Hereditary hemochromatosis is associated with higher odds of spinal fusion. It is a major complication not improved by phlebotomy, and there are currently no therapies to prevent this joint disease.
A 7-Year-Old Boy With Recurring Episodes of Abdominal Pain
Authors: Noble Jennifer , Ledrick David
Published: June 2020

Recurrent abdominal pain is a relatively common complaint in children who present to the emergency department. The etiology is often thought to be psychogenic, with an underlying organic cause present in less than 10% of patients. Intermittent ureteropelvic junction obstruction is usually not considered in the differential diagnosis of recurrent acute abdominal pain in children, which can cause a significant delay in diagnosis. In this condition, intermittent obstruction of the flow of urine from the renal pelvis to the proximal ureter occurs, which causes intermittent acute colicky abdominal pain and vomiting. This acute event, often referred to as a Dietl's crisis, either subsides after several hours or prompts a visit to the emergency department. Management often focuses on the identification of psychosocial issues or constipation, and routine abdominal imaging is not a common practice. The frequency of these events over time and the duration of each acute event are 2 components that factor into determining the loss of function in the affected kidney. The purpose of this case report is to increase awareness of intermittent ureteropelvic junction obstruction as a cause of recurring episodes of acute abdominal pain in children. Emphasis in this case report is on Dietl's crisis, how it presents, and how it is diagnosed and managed.
Outcomes Among HIV-Positive Patients Hospitalized With COVID-19
Authors: Karmen-Tuohy Savannah , Carlucci Philip M. , Zervou Fainareti N. , Zacharioudakis Ioannis M. , Rebick Gabriel , Klein Elizabeth , Reich Jenna , Jones Simon , Rahimian Joseph
Published: June 2020

Background:

SARS-CoV-2 infection continues to cause significant morbidity and mortality worldwide. Preliminary data on SARS-CoV-2 infection suggest that some immunocompromised hosts experience worse outcomes. We performed a retrospective matched cohort study to characterize outcomes in HIV-positive patients with SARS-CoV-2 infection.

Methods:

Leveraging data collected from electronic medical records for all patients hospitalized at NYU Langone Health with COVID-19 between March 2, 2020, and April 23, 2020, we matched 21 HIV-positive patients with 42 non-HIV patients using a greedy nearest-neighbor algorithm. Admission characteristics, laboratory test results, and hospital outcomes were recorded and compared between the 2 groups.

Results:

Although there was a trend toward increased rates of intensive care unit admission, mechanical ventilation, and mortality in HIV-positive patients, these differences were not statistically significant. Rates for these outcomes in our cohort are similar to those previously published for all patients hospitalized with COVID-19. HIV-positive patients had significantly higher admission and peak C-reactive protein values. Other inflammatory markers did not differ significantly between groups, although HIV-positive patients tended to have higher peak values during their clinical course. Three HIV-positive patients had superimposed bacterial pneumonia with positive sputum cultures, and all 3 patients died during hospitalization. There was no difference in frequency of thrombotic events or myocardial infarction between these groups.

Conclusions:

This study provides evidence that HIV coinfection does not significantly impact presentation, hospital course, or outcomes of patients infected with SARS-CoV-2, when compared with matched non-HIV patients. A larger study is required to determine whether the trends we observed apply to all HIV-positive patients.
Magnesium sulfate ameliorates sepsis-induced diaphragm dysfunction in rats via inhibiting HMGB1/TLR4/NF-κB pathway
Authors: Jiang Jihong , Chen Qi , Chen Xia , Li Jinbao , Li Shitong , Yang Bin
Published: June 2020

Background

Diaphragm dysfunction could be induced by sepsis with subsequent ventilatory pump failure that is associated with local infiltration of inflammatory factors in the diaphragm. It has been shown that the administration of anticonvulsant agent, magnesium sulfate (MgSO4) could decrease systematic inflammatory response. We recently reported that MgSO4 could inhibit macrophages high mobility group box 1 (HMGB1) secretion that confirms its anti-inflammatory properties. Toll-like receptor 4 (TLR4)/nuclear factor-kappa B (NF-κB) signal pathway appears to be involved in the pathology of septic experimental animal’s inflammatory response and involve in the pathogenic mechanisms of sepsis-induced diaphragm dysfunction. Thus, in this study, we are aiming to explore whether MgSO4 could ameliorate sepsis-induced diaphragm dysfunction via TLR4/NF-κB pathway in a rodent model with controlled mechanical ventilation (CMV) and subsequent septic challenge.

Methods

Rats were randomly assigned into (1) control group: having an identical laparotomy but without ligation or puncture in the cecum; (2) CLP group: cecal ligation and puncture (CLP) with continuous saline infusion; (3) CLP + MgSO4 group: CLP with continuous MgSO4 administration; and (4) MgSO4 group: a sham surgery with MgSO4 administration. After surgery, all rats were submitted to CMV for 18 h. After completion of the study protocol, blood inflammatory cytokine/chemokine was detected by ELISA, as well as diaphragm contractility, TLR4, NF-κB (p65), phospho-NF-κB (p65) and HMGB1 protein expression.

Results

The level of inflammatory cytokine/chemokine includes interleukin-6, monocyte chemoattractant protein-1 (MCP-1), macrophage inflammatory protein-2 (MIP-2) and HMGB1 in blood were significantly increased at 18-h post-CLP compared with the control group. We found that rats in the CLP group had substantial diaphragm dysfunction with a distinct downshift of the force–frequency curve. Furthermore, expression of HMGB1, TLR4, NF-κB (p65) and phospho-NF-κB (p65) in diaphragm were significantly increased in the CLP group. In contrast, MgSO4 attenuated the septic inflammation reaction in diaphragm and serum and preserved diaphragm function.

Conclusion

MgSO4 protects against sepsis-induced diaphragm dysfunction. This may be associated with its anti-inflammatory effect on HMGB1/TLR4/NF-κB signal pathway
Monocyte chemotactic protein-1-induced protein 1 contributes to neuronal injury following hypoxic-ischemia in the neonatal mouse brain
Authors: Naik Radheya Y. , Foster Dawson , Bray Phillip , Chang Yingzi , Han Byung Hee
Published: June 2020

Neuroinflammation has been implicated in neurodegenerative diseases and acute brain injuries such as stroke. Monocyte chemotactic protein-1-induced protein-1 (Mcpip1) is a multifunction protein known to have pro-apoptotic or anti-apoptotic actions depending on the nature of experimental settings. However, its role in brain damage after asphyxia in the developing brain has not been studied. We, therefore, explored the role of Mcpip1 in brain injury after hypoxic-ischemia in neonatal mice. At postnatal day 7, Mcpip1-deficient and wild type mice underwent a carotid artery ligation and exposure to hypoxia (8% oxygen). After hypoxic-ischemic insult, we determined the time-course of apoptotic cell death and the expression levels of genes encoding proinflammatory factors. The impact of Mcpip1 on long-term brain damage was assessed 1 week post-hypoxic-ischemia by cresyl violet staining. We found caspase-3 activity was significantly increased in the ipsilateral brain tissues within 12–24 h after hypoxic-ischemia. There was a marked increase in the levels of mRNA transcripts encoding Mcpip1, TNFα, and CCL2 in the ipsilateral brain tissues 6–48 h after hypoxic-ischemia. We found hypoxic-ischemia-induced caspase-3 activity and the levels of the proinflammatory genes were attenuated in Mcpip1-knockout mice compared to wild type mice. Histological assessment revealed that hypoxic-ischemia-induced brain tissue loss was significantly attenuated in the hippocampus of Mcpip1-knockout mice than that of wild type mice (9.0 ± 5.6% vs. 33.9 ± 11.0%, P < 0.05). Our data suggest that Mcpip1 contributes to acute and delayed brain damage, in part, via regulation of neuroinflammation after hypoxic-ischemic insult in the developing mouse brain.
Local tomography and the role of the complex numbers in quantum mechanics
Authors: Niestegge Gerd
Published: June 2020

Various reconstructions of finite-dimensional quantum mechanics result in a formally real Jordan algebraAand a last step remains to conclude thatAis the self-adjoint part of a C*-algebra. Using a quantum logical setting, it is shown that this can be achieved by postulating that there is a locally tomographic model for a composite system consisting of two copies of the same system. Local tomography is a feature of classical probability theory and quantum mechanics; it means that state tomography for a multipartite system can be performed by simultaneous measurements in all subsystems. The quantum logical definition of local tomography is sufficient, but it is less restrictive than the prevalent definition in the literature and involves some subtleties concerning the so-called spin factors.
Risk factors and protective factors of mental health during COVID-19 outbreak and lockdown in adult Indian population- A cross-sectional study
Authors: Saikarthik Jayakumar , Saraswathi Ilango , Siva Thirusangu
Published: June 2020

Background

The novel Corona virus has derailed the entire world and various steps have been taken by the health authorities to tackle this pandemic. Nationwide lockdown has been imposed to control the spread of COVID-19 outbreak in India, which could have psychological impact on the population.

Aim

Our study aims to study the effect of the COVID-19 outbreak & subsequent lockdown on mental health status of adult Indian population along with identifying the high-risk groups.

Methodology

An online survey was conducted during 3rd phase of lockdown gathering details about sociodemographic variables, practice of precautionary measures, awareness and concerns regarding COVID-19 and mental health status of the participants through DASS21 questionnaire from 873 adults.

Results

The prevalence of depression, anxiety and stress were 18.56%, 25.66%, and 21.99% respectively including higher number of participants with mild depression (15.1%) and stress (14.5%) and moderate anxiety (16.3%). Female gender, age <25 years, unemployment, self-business, employed in private sector, lack of formal education, larger household size, parenthood (>2 kids) were associated with increased likelihood of negative mental health. Confidence in physician’s ability to diagnose COVID-19 infection, decreased self-perceived likelihood of contracting COVID-19, lesser frequency of checking for information on COVID-19 and satisfaction of information received were protective against negative mental health.

Conclusion

This landmark study identified the protective and risk factors of mental health during COVID-19 pandemic, to help authorities and mental health workers to strategize and deliver interventional methods to maintain psychosocial wellbeing of the population.
Limited genetic parallels underlie convergent evolution of quantitative pattern variation in mimetic butterflies
Authors: Bainbridge Hannah E. , Brien Melanie N. , Morochz Carlos , Salazar Patricio A. , Rastas Pasi , Nadeau Nicola J.
Published: June 2020

Mimetic systems allow us to address the question of whether the same genes control similar phenotypes in different species. Although widespread parallels have been found for major effect loci, much less is known about genes that control quantitative trait variation. In this study, we identify and compare the loci that control subtle changes in the size and shape of forewing pattern elements in twoHeliconiusbutterfly co-mimics. We use quantitative trait locus (QTL) analysis with a multivariate phenotyping approach to map the variation in red pattern elements across the whole forewing surface ofHeliconius eratoandHeliconius melpomene. These results are compared to a QTL analysis of univariate trait changes, and show that our resolution for identifying small effect loci is improved with the multivariate approach. QTL likely corresponding to the known patterning geneoptixwere found in both species but otherwise, a remarkably low level of genetic parallelism was found. This lack of similarity indicates that the genetic basis of convergent traits may not be as predictable as assumed from studies that focus solely on Mendelian traits.
Does Gender or Religion Contribute to the Risk of COVID-19 in Hospital Doctors in the UK?
Authors: Daga Sunil , Jafferbhoy Sadaf , Menon Geeta , Ali Mansoor , Chakravorty Subarna , Ghani Saqib , Burney Amir , Bamrah JS , Mehta Ramesh , Chakravorty Indranil
Published: June 2020

The novel coronavirus pandemic is posing significant challenges to healthcare workers (HCWs) in adjusting to redeployed clinical settings and enhanced risk to their own health. Studies suggest a variable impact of COVID-19 based on factors such as age, gender, comorbidities and ethnicity. Workplace measures such as personal protective equipment (PPE), social distancing (SD) and avoidance of exposure for the vulnerable, mitigate this risk. This online questionnaire-based study explored the impact of gender and religion in addition to workplace measures associated with risk of COVID-19 in hospital doctors in acute and mental health institutions in the UK.

The survey had 1206 responses, majority (94%) from BAME backgrounds. A quarter of the respondents had either confirmed or suspected COVID-19, a similar proportion reported inadequate PPE and 2/3 could not comply with SD. One third reported being reprimanded in relation to PPE or avoidance of risk. In univariate analysis, age over 50 years, being female, Muslim and inability to avoid exposure in the workplace was associated with risk of COVID-19. On multivariate analysis, inadequate PPE remained an independent predictor with a twofold (OR 2.29, (CI - 1.22-4.33), p=0.01) risk of COVID-19.

This study demonstrates that PPE, SD and workplace measures to mitigate risk remain important for reducing risk of COVID-19 in hospital doctors. Gender and religion did not appear to be independent determinants. It is imperative that employers consolidate risk reduction measures and foster a culture of safety to encourage employees to voice any safety concerns. (240 words)
Genome-wide analyses of behavioural traits biased by misreports and longitudinal changes
Authors: Xue Angli , Jiang Longda , Zhu Zhihong , Wray Naomi R. , Visscher Peter M. , Zeng Jian , Yang Jian
Published: June 2020

Genome-wide association studies (GWAS) have discovered numerous genetic variants associated with human behavioural traits. However, behavioural traits are subject to misreports and longitudinal changes (MLC) which can cause biases in GWAS and follow-up analyses. Here, we demonstrate that individuals with higher disease burden in the UK Biobank (n =455,607) are more likely to misreport or reduce their alcohol consumption (AC) levels, and propose a correction procedure to mitigate the MLC-induced biases. The AC GWAS signals removed by the MLC corrections are enriched in metabolic/cardiovascular traits. Almost all the previously reported negative estimates of genetic correlations between AC and common diseases become positive/non-significant after the MLC corrections. We also observe MLC biases for smoking and physical activities in the UK Biobank. Our findings provide a plausible explanation of the controversy about the effects of AC on health outcomes and a caution for future analyses of self-reported behavioural traits in biobank data.
Trace, Quarantine, Test, Isolate and Treat: A Kerala Model of Covid-19 Response
Authors: Sulaiman KM , Muhammad T , A P Rishad Muhammad , Afsal K
Published: June 2020

Kerala reported the first three cases of coronavirus in India in late January. Kerala, one of the India’s most densely populated states, which makes its success in fighting the Covid-19 all the more commendable. Moreover, an estimated 17% of its 35 million population employed or lives elsewhere, more than 1 million tourists visit each year, and hundreds of students study abroad, including in China. All of this mobility makes the state more vulnerable to contagious outbreaks. What is the strategy behind the success story? This paper compares the situation of COVID-19 pandemic in major states and Kerala by the different phase of lockdown, and also highlights Kerala’s fight against the pandemic. We used publicly available data from https://www.covid19india.org/ and Covid-19 Daily Bulletin (Jan 31-May 31), Directorate of Health Services, Kerala (https://dashboard.kerala.gov.in/). We calculate the phase-wise period prevalence rate (PPR) and the case fatality rate (CFR) of the last phase. Compared to other major states, Kerala showed better response in preventing pandemic. The equation for the Kerala’s success has been simple, prioritized testing, widespread contact tracing, and promoting social distance. They also imposed uncompromising controls, were supported by an excellent healthcare system, government accountability, transparency, public trust, civil rights and importantly the decentralized governance and strong grass-root level institutions. The “proactive” measures taken by Kerala such as early detection of cases and extensive social support measures can be a “model for India and the world”.
Polyclonal epitope cartography reveals the temporal dynamics and diversity of human antibody responses to H5N1 vaccination
Authors: Han Julianna , Schmitz Aaron J. , Richey Sara T. , Dai Ya-Nan , Turner Hannah L. , Mohammed Bassem M. , Fremont Daved H. , Ellebedy Ali H. , Ward Andrew B.
Published: June 2020

Novel influenza A virus (IAV) strains elicit recall immune responses to conserved epitopes, making them favorable antigenic choices for universal influenza virus vaccines. Evaluating these immunogens requires a thorough understanding of the antigenic sites targeted by the polyclonal antibody (pAb) response, which single particle electron microscopy (EM) can sensitively detect. Here, we employed EM polyclonal epitope mapping (EMPEM) to extensively characterize the pAb response to hemagglutinin (HA) after H5N1 immunization in humans. Cross-reactive pAbs originating from memory B cells immediately bound the stem of HA and persisted for over a year post vaccination. In contrast,de novopAb responses to multiple sites on the head of HA, which targeted previously determined key neutralizing sites on H5 HA, expanded after the second immunization and waned quickly. Thus, EMPEM provides a robust tool for comprehensively tracking the specificity and durability of immune responses elicited by novel universal influenza vaccine candidates.
Comparative Survival Analysis of Immunomodulatory Therapy for COVID-19 ‘Cytokine Storm’: A Retrospective Observational Cohort Study
Authors: Narain Sonali , Stefanov Dimitre G. , Chau Alice S. , Weber Andrew G. , Marder Galina , Kaplan Blanka , Malhotra Prashant , Bloom Ona , Liu Audrey , Lesser Martin L. , Hajizadeh Negin ,   Northwell COVID-19 Research Consortium
Published: June 2020

Background

Cytokine storm is a marker of COVID-19 illness severity and increased mortality. Immunomodulatory treatments have been repurposed to improve mortality outcomes.

Methods

We conducted a retrospective analysis of electronic health records across the Northwell Health system. COVID-19 patients hospitalized between March 1, 2020 and April 15, 2020, were included. Cytokine storm was defined by inflammatory markers: ferritin >700ng/mL, C-reactive protein >30mg/dL, or lactate dehydrogenase >300U/L. Patients were subdivided into six groups -no immunomodulatory treatment (standard of care) and five groups that received either corticosteroids, anti-interleukin 6 (IL-6) antibody (tocilizumab) or anti-IL-1 therapy (anakinra) alone or in combination with corticosteroids. The primary outcome was hospital mortality.

Results

There were 3,098 patients who met inclusion criteria. The most common comorbidities were hypertension (40-56%), diabetes (32-43%) and cardiovascular disease (2-15%). Patients most frequently met criteria with high lactate dehydrogenase (74.8%) alone, or in combination, followed by ferritin (71.4%) and C-reactive protein (9.4%). More than 80% of patients had an elevated D-dimer. Patients treated with a combination of tocilizumab and corticosteroids (Hazard Ratio [HR]: 0.459, 95% Confidence Interval [CI]: 0.295-0.714; p<0.0001) or corticosteroids alone (HR: 0.696, 95% CI: 0.512-0.946; p=0.01) had improved hospital survival compared to standard of care. Corticosteroids and tocilizumab was associated with increased survival when compared to corticosteroids and anakinra (HR: 0.612, 95% CI: 0.391-0.958; p-value=0.02).

Conclusions

When compared to standard of care, corticosteroid and tocilizumab used in combination, or corticosteroids alone, was associated with reduced hospital mortality for patients with COVID-19 cytokine storm.
PERSONAL PROTECTIVE EQUIPMENT (PPE) USING IN ANTALYA 112 EMERGENCY AMBULANCE SERVICES DURING OUTBREAK
Authors: Gulsen Mehmet Fatih , Kurt Münevver , Kaleli Isil , Ulasti Ayhan
Published: June 2020

Abstract

A new type of Coronavirus (SARS-CoV-2) was identified on January 7th, 2020, and the disease was named COVID-19 caused by this virus. The first confirmed COVID-19 (+) case in Antalya was detected on March 14th, 2020 and transferred by an Antalya 112 emergency ambulance to hospital.

Using of Personal Protective Equipment (PPE) in ambulance work standards against COVID-19, was recommended by global health authorities. The aim of this descriptive, retrospective and cross-sectional study which is conducted between the dates of March 14th, 2020 – May 31st, 2020, is to evaluate the level of PPE usage, the risk analysis results of Antalya 112 ambulance teams during outbreak. There were 5344 possible and 787 confirmed COVID-19 (+) positive ambulance cases between the dates of study conducted. The majority of these cases were male (62%) and over the age of 65 (47%). The majority of cases were result in “transferred to healthcare facilities” (75.48%). The total 2361 ambulance team workers were taken to risk analysis measurements in terms of COVID-19. The majority of ambulance team members were assessed with no risk available. The ambulance team members who are assessed with no risk available, has preferred to use Level-4 PPE (N95/FPP-Goggle/face protection-Gloves-Apron/coverall) mostly (84.50%) during ambulance transfers. Using mask on patient and the level of PPE usage showed negative correlation with risk level of Healthcare Workers (HCWs). There have been detected only 2 HCWs diagnosed with COVID-19 with Computed Tomography. The follow-up procedures of two HCWs has been finalized, and both of them cured. The studies about easy-to-use, high-tech PPE with maximum protection, are recommended for further studies.
The King’s College London Coronavirus Health and Experiences of Colleagues at King’s Study (KCL CHECK) protocol paper: a platform for study of the effects of coronavirus pandemic on staff and postgraduate students
Authors: Davis Katrina A.S. , Stevelink Sharon A.M. , Al-Chalabi Ammar , Bergin-Cartwright Gabriella , Bhundia Rupa , Burdett Howard , Carr Ewan , Lavelle Grace , Leightley Daniel , Middleton Candice , Nicholson Timothy , O’Neill Lucy , Polling Catherine , Ruane Aoife , Wickersham Alice , Hotopf Matthew , Razavi Reza
Published: June 2020

Introduction

We will use an occupational sample to study the impact of COVID-19 on current staff and postgraduate research students at a large UK university. The cohort study will address some of the key questions about COVID-19 for the international community, while also providing feedback to the employer and educator.

Methods and analysis

Participants were recruited via email to their University email address. Administrative records were available to compare the composition of volunteer participants to underlying staff and postgraduate student populations of the University. The study comprises a baseline survey, longitudinal follow-up surveys and a viral antibody study. Baseline information was collected in April 2020 including demographics, working situation, current stresses and worries, mental health and neurological symptoms. Personal experiences of COVID-19, indirect experiences and attitudes towards the pandemic were queried, as well as satisfaction with communication and support at work. Longitudinal surveys will assess changes in COVID-19 exposure and mental health. A viral antibody detection component is being planned and will also be longitudinal in nature.

Ethics and dissemination

Ethical approval has been gained from KCL’s Psychiatry, Nursing and Midwifery Research Ethics Committee (HR-19/20-18247). Participants were provided with information and agreed to a series of consent statements before enrolment. Data are kept on secure servers with access to personally identifiable information limited. Researchers may apply to have access to pseudonymised data. Findings will be disseminated internally to the University and participants, and externally through scientific publications.
Multimodal FDG-PET and EEG assessment improves diagnosis and prognostication of disorders of consciousness
Authors: Hermann Bertrand , Stender Johan , Habert Marie-Odile , Kas Aurélie , Denis-Valente Mélanie , Raimondo Federico , Pérez Pauline , Rohaut Benjamin , Sitt Jacobo Diego , Naccache Lionel
Published: June 2020

The complex diagnosis of disorders of consciousness (DoC) diagnosis increasingly relies on brain-imaging techniques for their ability to detect residual signs of consciousness in otherwise unresponsive patients. However, few of these techniques have been validated on external datasets. Here, we show that the FDG-PET glucose metabolic index of the best preserved hemisphere has robust in-sample and out-sample performances to diagnose DoC, slightly outperforming EEG-based classification. We further show that a multimodal assessment combining both FDG-PET and EEG not only improved diagnostic performances, but also allowed to identify covert cognition and to predict 6-month responsiveness in initially unresponsive patients. Lastly, we show that DoC heterogeneity reflects a sum of regional cortical metabolic differences, and their corresponding behavioral patterns, rather than a binary contrast between conscious and unconscious states. In total, we show that FDG-PET and EEG provide complementary information on DoC physiopathology and that their combination improves DoC diagnosis and prognostication.
A Counterfactual Graphical Model Reveals Economic and Sociodemographic Variables as Key Determinants of Country-Wise COVID-19 Burden
Authors: Sethi Tavpritesh , Kedia Saurabh , Awasthi Raghav , Lodha Rakesh , Ahuja Vineet
Published: June 2020

Importance

Insights into the country-wise differences in COVID-19 burden can impact the policies being developed to control disease spread.

Objective

Present study evaluated the possible socio-economic and health related factors (and their temporal consistency) determining the disease burden of COVID-19.

Design

A retrospective analysis for identifying associations of COVID-19 burden.

Setting

Data on COVID-19 statistics (number of cases, tests and deaths per million) was extracted from the website https://www.worldometers.info/coronavirus/ on 10th April and 12th May. Variables obtained to estimate the possible determinants for COVID-19 burden included economic-gross domestic product; socio-demographic-Sustainable Development Goals, SDGs indicators related to health systems, percentage Chinese diaspora; and COVID-19 trajectory-date of first case in each country, days between first reported case and 10th April, days between 100th and 1000th case, and government response stringency index (GRSI).

Main outcomes and Measures

COVID-19 burden was modeled using economic and socio-demographic determinants. Consistency of inferences for two time points at three levels of increasing statistical rigor using (i) Spearman correlations, (ii) Bayesian probabilistic graphical model, and (iii) counterfactual impact was evaluated.

Results

Countries’ economy (reflected by GDP), mainly through the testing rates, was the major and temporally consistent determinant of COVID-19 burden in the model. Reproduction number of COVID-19 was lower where mortality due to water, sanitation, and hygiene (WaSH) was higher, thus strengthening the hygiene hypothesis. There was no association between vaccination status or tuberculosis incidence and COVID burden, refuting the claims over BCG vaccination as a possible factor against COVID-19 trajectory.

Conclusion and Relevance

Countries’ economy, through testing power, was the major determinant of COVID-19 burden. There was weak evidence for hygiene hypothesis as a protective factor against COVID-19.
Common genetic associations between age-related diseases
Authors: Dönertaş Handan Melike , Fabian Daniel K. , Valenzuela Matías Fuentealba , Partridge Linda , Thornton Janet M.
Published: June 2020

Age is a common risk factor in many diseases, but the molecular basis for this relationship is elusive. In this study we identified 4 disease clusters from 116 diseases in the UK Biobank data, defined by their age-of-onset profiles, and found that diseases with the same onset profile are genetically more similar, suggesting a common etiology. This similarity was not explained by disease categories, co-occurrences or disease cause-effect relationships. Two of the four disease clusters had an increased risk of occurrence from age 20 and 40 years respectively. They both showed an association with known aging-related genes, yet differed in functional enrichment and evolutionary profiles. We tested mutation accumulation and antagonistic pleiotropy theories of aging and found support for both. We also identified drug candidates for repurposing to target multiple age-dependent diseases with the potential to improve healthspan and alleviate multimorbidity and polypharmacy in the elderly.