bluuebunny/crossref_metadata_2025 huggingface dataset:
Complete Draft Genome Sequence of Cutibacterium (Propionibacterium) acnes Type Strain ATCC6919
Authors: Tang Hui-Jing , Si Kai-Wei , Zhang Xiao , Zhu He-Ling , Zheng Wen-Liang , Zhang Xi-Bao , Liang Jing-Yao , Ruan Jian-Bo
Published: May 2020

Objectives:

The wide use of antibiotics for acne is the main cause of drug-resistant Cutibacterium acnes. However, the complete genetic sequence reference of C. acnes has not yet been reported. Herein, we report the complete genetic sequence of Cutibacterium acnes type strain ATCC6919.

Methods:

Whole-genome sequencing of Cutibacterium acnes ATCC6919 was performed using both the Illumina Hiseq4000 and PacBio RSII single-molecule real-time sequencing platforms. The generated sequence reads were de novo assembled using the HGAP3 protocol of single-molecule real-time analysis v.2.3.0 software. The draft genome was annotated and further analyzed by various bioinformatics tools.

Results:

The total genome length of Cutibacterium acnes ATCC6919 was 2,495,001 bp (60.02% G + C content), with 2,450 coding sequences including 2,358 proteins, 45 tRNAs, 9 rRNAs, and 1 sRNA. The Comprehensive Antibiotic Resistance Database showed that the gene (thy A) found in ATCC6919 was associated with resistance to aminosalicylic acid. Antimicrobial susceptibility testing showed that this isolate was not sensitive to metronidazole and sulfamethoxazole, but was sensitive to all other tested antimicrobials (erythromycin, azithromycin, clarithromycin, tetracycline, minocycline, trimethoprim, levofloxacin, ceftriaxone, and doxycycline).

Conclusion:

This study reports the complete genome sequence of Cutibacterium acnes ATCC6919, which provides a valuable reference for comparative analysis based on the genomic characteristics and resistance gene diversity of Cutibacterium acnes.
Trends in Work-Related Musculoskeletal Disorders From the 2002 to 2014 General Social Survey, Quality of Work Life Supplement
Authors: Dick Robert B. , Lowe Brian D. , Lu Ming-Lun , Krieg Edward F.
Published: May 2020

Objective:

To update trends in prevalence of back and upper limb musculoskeletal symptoms and risk factors from the 2014 Quality of Work Life (QWL) Survey.

Methods:

Quadrennial QWL Surveys, 2002 to 2014 (withN = 1455, 1537, 1019, and 1124 in 2002, 2006, 2010, and 2014 surveys respectively) were analyzed for reports of back pain and pain in arms.

Results:

In the fourth analysis of this survey, 12-year trends continue to show a decline in back pain and pain in arms. Key physical (heavy lifting, hand movements, very hard physical effort) and psychosocial/work organizational factors (low supervisor support, work is always stressful, not enough time to get work done) remain associated with back and arm pain, with the physical risk factors showing the strongest associations.

Conclusion:

Physical exposure risk factors continue to be strongly associated with low back and arm pain and should be the focus of intervention strategies.
Working Conditions and Mental Health Status Related With Occupational Injury of Korean Outdoor Workers
Authors: Lee Wanhyung , Lee Junhyeong , Kim Ui-Jin , Yoon Jin-Ha , Choi Won-Jun , Ham Seunghon , Chung Eun Kyo , Kang Seong-Kyu
Published: May 2020

Objective:

This study investigated the working conditions and mental health status linked to occupational injury among Korean outdoor workers.

Methods:

Socioeconomic and occupational characteristics were collected using self-reported questionnaires from 26,468 paid workers selected using the 5th Korean Working Conditions Survey. The relationships among mental health issues, occupational injury, and working outdoors were estimated by logistic regression.

Results:

Outdoor workers were relatively older with lower educational levels and income, worked longer, and had greater exposure to occupational hazards, higher occupational injury rate, significantly higher risk of sleep disturbances, and higher occupational injury rates due to sleep disturbances than non-outdoor workers.

Conclusions:

There was a significant relationship among working outdoors, sleep quality, and mental health-related issues due to exposure to occupational hazards. Specific occupational health and safety strategies are needed to protect the mental health of outdoor workers.
Study of the Correlation Between Multiple Chemical Sensitivity and Personality Using the Quick Environmental Exposure Sensitivity Inventory Questionnaire and the Temperament and Character Inventory
Authors: Lu Xi , Hisada Aya , Anai Akane , Nakashita Chihiro , Masuda Shota , Fujiwara Yuki , Kunugita Naoki , Katoh Takahiko
Published: May 2020

Objective:

We conducted an analysis using the Quick Environmental Exposure Sensitivity Inventory to examine the correlation between multiple chemical sensitivity (MCS) and personality traits by using temperament and character inventory, and environmental exposures.

Methods:

An anonymous questionnaire was distributed to 667 employees working at an IT manufacturing plant in Japan. Variables including chemically sensitive population (CSP), personality, and environmental chemical exposure were individually evaluated using U-test, chi-squared test, and correlation analyses. We also did covariance structure analysis to build a structural equation model.

Results:

There was little direct impact of temperament on the CSP, while there was a significant impact of character on the CSP. Women were more likely to exhibit symptoms of CSP.

Conclusion:

MCS is correlated with personality, impacted more by character acquired later in life than innate temperament. There were sex differences in the incidence of MCS.
Early High-Risk Opioid Prescribing Practices and Long-Term Disability Among Injured Workers in Washington State, 2002 to 2013
Authors: Haight John R. , Sears Jeanne M. , Fulton-Kehoe Deborah , Wickizer Thomas M. , Franklin Gary M.
Published: May 2020

Objective:

To estimate associations between early high-risk opioid prescribing practices and long-term work-related disability.

Methods:

Washington State Fund injured workers with at least one opioid prescription filled within 6 weeks after injury (2002 to 2013) were included (N = 83,150). Associations between early high-risk opioid prescribing (longer duration, higher dosage, concurrent sedatives), and time lost from work, total permanent disability, and a surrogate measure for Social Security disability benefits were tested. Measures of early hospitalization, body part, and nature of injury were included to address confounding by indication concerns, along with sensitivity analyses controlling for injury severity.

Results:

In adjusted logistic models, early high-risk opioid prescribing was associated with roughly three times the odds of each outcome.

Conclusion:

Exposure to high-risk opioid prescribing within 90 days of injury was significantly and substantially associated with long-term temporary and permanent disability.
Association Between Presenteeism/Absenteeism and Well-being Among Korean Workers
Authors: Jeong Wonjeong , Kim Yun Kyung , Oh Sarah Soyeon , Yoon Jin-Ha , Park Eun-Cheol
Published: May 2020

Objective:

Absenteeism and presenteeism refer to loss in productivity related to sick leave and illness, respectively, which affect physical and mental health. We examined the association between presenteeism/absenteeism and level of well-being among Korean workers.

Methods:

We analyzed data from 44,019 participants who completed the 2017 Korean Working Conditions Survey. The World Health Organization Well-Being Index (WHO-5) was used to screen the well-being level. We examined the association between presenteeism/absenteeism and level of well-being using multiple linear regression.

Results:

WHO-5 scores were lower among workers who experienced presenteeism or absenteeism than those who experienced neither (presenteeism: β = −1.011, P < 0.0001, absenteeism: β = −0.403, P < 0.0001).

Conclusion:

Presenteeism and absenteeism were associated with lower level of well-being. We suggest that their management is important for maintaining the health of Koreans.
The Impact of Challenge and Hindrance Demands on Burnout, Work Engagement, and Presenteeism. A Cross-Sectional Study Using the Job Demands–Resources Model
Authors: Vinod Nair Anjali , McGregor Alisha , Caputi Peter
Published: May 2020

Objective:

The present study used the Job Demands–Resources (JD-R) model to understand how perceiving job demands as a hindrance or a challenge can influence an individual's exhaustion and motivation and its effect on presenteeism.

Method:

A sample of 171 working Australians was used to test the relationships between job demands and job resources with presenteeism via burnout and work engagement.

Findings:

The results suggested that challenge demands were positively related to burnout and work engagement, while hindrance demands were positively related to burnout and negatively related to work engagement. Most direct and indirect pathways predicted in earlier work incorporating the JD-R model to understand presenteeism were replicated.

Conclusion:

Future research on larger nation-wide samples is needed to further explore the differentiating effects of job demands on presenteeism via burnout and work engagement.
Associations Between the Breakroom Built Environment, Worker Health Habits, and Worker Health Outcomes: A Pilot Study Among Public Transit Rail Operators
Authors: Jones Nathan M. , McDonnell Meghan , Sparer-Fine Emily , Rosner Bernard , Dennerlein Jack T. , Kales Stefanos , Messerlian Carmen
Published: May 2020

Objective:

To investigate the association between the breakroom built environment and worker health outcomes.

Methods:

We conducted this study in a mass transit organization (rail). We collected a user-reported breakroom quality score (worker survey), a worksite health promotion score (validated audit tool), and self-reported worker health outcomes (survey).

Results:

Among the 12 breakrooms audited and 127 rail operators surveyed, the average worksite health promotion score was 9.1 (out of 15) and the average user-reported breakroom quality was 3.1 (out of 7). After multivariable regression, breakrooms with higher worksite health promotion scores and user-reported breakroom quality were associated with lower odds of depression and fewer medical disability days.

Conclusions:

This cross-sectional study demonstrates an association between the quality of the breakroom built environment and worker health, specifically depression and medical disability days.
Longitudinal Assessment of Health Symptoms in Relation to Neurotoxicant Exposures in 1991 Gulf War Veterans
Authors: Yee Megan K. , Zundel Clara G. , Maule Alexis L. , Heeren Timothy , Proctor Susan P. , Sullivan Kimberly A. , Krengel Maxine H.
Published: May 2020

Objective:

This analysis examined the relationship between Gulf War (GW) exposures and health symptoms reported in three time periods over 20 years in Ft. Devens Cohort veterans.

Methods:

Repeated logistic regression models examined the association of exposures and health symptoms over time. Models included baseline age, active duty status, post-traumatic stress disorder status, sex, and time since deployment as covariates.

Results:

Exposure to tent heaters was associated with increased odds of crying easily and muscle twitching. Exposure to pyridostigmine bromide (PB) pills was associated with increased odds of depression and fatigue. Exposure to the Khamisiyah sarin plume was associated with increased odds of trouble concentrating and crying easily.

Conclusion:

This longitudinal analysis demonstrated an association between neurotoxicant exposures and increased odds of cognitive/mood, fatigue, and neurological symptoms. In addition, most symptoms increased over time since deployment regardless of exposure.
Follow-Up of Occupational Health Issues and Measures Taken in Fukushima Daiichi Nuclear Power Plant Where Decommissioning Work Has Continued Over 6 Years Since 2014
Authors: Mori Koji , Tateishi Seiichiro , Kubo Tatsuhiko , Kobayashi Yuichi , Hiraoka Ko , Kawashita Futoshi , Hayashi Takeshi , Kobashi Masaki , Kiyomoto Yoshifumi , Fukai Kota , Tahara Hiroyuki , Okazaki Ryuji , Ogami Akira , Igari Kazuyuki , Suzuki Katsunori , Kikuchi Hiroshi , Yoshikawa Toru , Mori Takahiro , Ito Ryotaro , Sakai Kazuhiro
Published: May 2020

Objectives:

To follow up arising occupational health (OH) issues, measures taken, and their performances in the Fukushima Daiichi Nuclear Power Plant since 2014, and thus share experiences and extend the contribution of OH to long-term decommissioning work and preparation for future disasters.

Methods:

Necessary information from official reports and through the OH-related activities involved was collected and analyzed.

Results:

The issues were categorized into establishment of the OH management system, three individual issues, and others. During the 6 years until end 2019, the OH management system has been strengthened and OH measures have been enriched gradually by visualizing the broader picture, even though some resistance and problems have been encountered.

Conclusions:

Improvement in the autonomy of contractors and their ability to respond to environmental changes is necessary.
Prevalence of Burnout in Occupational and Environmental Medicine Physicians in the United States
Authors: Green-McKenzie Judith , Somasundaram Parvathi , Lawler Timothy , O’Hara Edward , Shofer Frances S.
Published: May 2020

Objective:

To determine prevalence and key drivers of burnout in Occupational and Environmental Medicine physicians in the United States.

Methods:

A nationwide survey of Occupational Medicine physicians was conducted using the Qualtrics® platform. Burnout, measured by the Maslach Burnout Inventory®, Social Support, and Job Satisfaction were assessed.

Results:

The response rate was 46%, the overall burnout prevalence 38%, and most respondents were men (69%). The mean age and mean years in practice were 56 years and 20 years respectively. Physicians working in government/military (48%) and private medical center group settings (46%) were significantly more likely to report burnout, with consultants (15%) reporting the lowest rate.

Conclusions:

Although the overall burnout prevalence is lower in Occupational Medicine physicians compared with most specialties, the rate varies significantly by practice setting (15% to 48%) affirming the impact of organizational factors.
Nephrotoxicity/renal failure after therapy with 90Yttrium- and 177Lutetium-radiolabeled somatostatin analogs in different types of neuroendocrine tumors: a systematic review
Authors: Stolniceanu Cati Raluca , Nistor Ionut , Bilha Stefana Catalina , Constantin Volovat , Simona Volovat , Matovic Milovan , Stefanescu Cipriana , Covic Adrian
Published: May 2020

Background/objective

Data regarding the nephrotoxicity of the peptide receptor radionuclide therapy (PRRT) with 90Yttrium- and 177Lutetium-radiolabeled somatostatin analogs (RSA) are inconclusive. We aimed to evaluate the short- and long-term nephrotoxicity following PRRT usage in patients with all types of neuroendocrine tumors (NETs).

Methods

A systematic review of observational studies reporting data about nephrotoxicity after treatment with 90Yttrium and 177Lutetium RSA was performed. Data on serum creatinine, creatinine clearance, glomerular filtration rate (GFR) and need for renal replacement therapy were compiled. We included patients with progressive, inoperable symptomatic G1, G2 and G3 different types of NETs. After searching in three electronic databases PubMed, Scopus and the Cochrane Library, from 1 January 1978 to November 2018, data were extracted and summarized using a random-effects model.

Results

The final analysis included 34 studies, comprising 5386 participants, enrolling patients with G1, G2, G3 NETs and a follow-up from 12 up to 191 months. Compared with renal function before treatment, measured/estimated glomerular filtration rate (m/eGFR) values changed after PRRT, with a mean annual decrease following PRRT between 2 and 4 mL/min/1.73 m2 suggesting different grades of nephrotoxicity after PRRT. When compared, 90Y-RSA and the 90Y-RSA-177Lu-RSA combination are associated with a higher m/eGFR decline compared to 177Lu-RSA alone.

Conclusions

PRRT can be followed by potentially serious long-term nephrotoxicity, despite kidney protection. The use of the quantified renal function combined with a long follow-up period and personalized dosimetry-based PRRT can reduce nephrotoxicity, in order to use the whole PRRT potential in the management of NETs.
Evaluating the Dietary Intakes of Energy, Macronutrients, Sugar, Fiber, and Micronutrients in Children With Celiac Disease
Authors: Ting Alison , Katz Tamarah , Sutherland Rosie , Liu Victoria , Tong Chai Wei , Gao Yajuan , Lemberg Daniel A. , Krishnan Usha , Gupta Nitin , Coffey Michael J. , Ooi Chee Yee
Published: May 2020

Objectives:

Children with celiac disease (CD) follow a lifelong gluten‐free diet. This restrictive diet may be associated with nutritional compromise. Our objectives were, therefore, to evaluate the dietary composition (energy, macronutrients and micronutrients, and fiber) in children with CD compared with healthy controls (HC) and relationship between dietary composition and socioeconomic status.

Methods:

This cross‐sectional, case‐control study recruited children with CD ages 2 to 18 years and HC matched for age, sex, and socioeconomic status. Clinical, sociodemographic, and dietary information were collected. A false discovery rate correction was applied to the P‐value for multiple comparisons (q‐value).

Results:

Sixty‐five CD children were matched with 65 HC (mean [SD] age: 10.2 [3.6] vs 10.1 [3.7] years, P = 0.96). Compared with HC, CD children had higher intakes of energy (2413.2 [489.9] vs 2190.8 (593.5) kcal/day, P = 0.02), total fat (818.1 ± 180.9 vs 714.3 ± 212.2 kcal/day, q = 0.018), and subtypes of fat (saturated, polyunsaturated, and monounsaturated). There were no differences in other macronutrients, sugar, micronutrients, or fiber between CD and HC, and no difference in dietary intake among CD between socioeconomic disadvantage versus advantage. Children with CD had lower weight z‐scores (−0.06 [1.05] vs 0.47 [0.96], P = 0.003) and body mass index (BMI) z‐scores (−0.02 [0.88] vs 0.41 [1.09], P = 0.02) than HC.

Conclusions:

Children with CD had higher calorie and fat intake compared with HC. Despite this, CD children had lower weight and BMI z‐scores compared with HC.
Pediatric Recurrent Intentional Foreign Body Ingestion
Authors: Low Kapalu Christina M. , Ibrahimi Nadia , Mentrikoski Janelle M. , Attard Thomas
Published: May 2020

Although foreign body ingestion (FBI) is a common pediatric referral concern, intentional or recurrent FBI (RFBI) in youth is poorly defined. In adults, several subgroups of patients with psychiatric comorbidities account for a large portion of FBIs. A similar classification system and corresponding management recommendations are yet to be outlined in pediatrics. We report 3 patients with RFBI: a 16‐year‐old, African American boy with 22 admissions and 27 endoscopic procedures for FBI removal; a 4‐year‐old, African American boy with autism spectrum disorder admitted twice after delayed presentation of ingestion of magnets; and a 15‐year‐old Caucasian girl with a complex mental health history who presented twice after intentional ingestion to self‐harm. We also present a literature review of pediatric RFBI. Patients with RFBI require a nuanced, multidisciplinary management approach to address acute concerns and reduce subsequent ingestion. A behavioral taxonomy and treatment considerations are presented.
Intestinal Inflammation Alters the Expression of Hepatic Bile Acid Receptors Causing Liver Impairment
Authors: Negroni Anna , Fiaschini Noemi , Palone Francesca , Vitali Roberta , Colantoni Eleonora , Laudadio Ilaria , Oliva Salvatore , Aloi Marina , Cucchiara Salvatore , Stronati Laura
Published: May 2020

Objectives:

The gut‐liver axis has been recently investigated in depth in relation to intestinal and hepatic diseases. Key actors are bile acid (BA) receptors, as farnesoid‐X‐receptor (FXR), pregnane‐X‐receptor (PXR), and G‐protein‐coupled‐receptor (GPCR; TGR5), that control a broad range of metabolic processes as well as inflammation and fibrosis. The present study aims to investigate the impact of intestinal inflammation on liver health with a focus on FXR, PXR, and TGR5 expression. The strategy to improve liver health by reducing gut inflammation is also considered. Modulation of BA receptors in the inflamed colonic tissues of inflammatory bowel disease (IBD) pediatric patients is analyzed.

Methods:

A dextran sodium sulphate (DSS) colitis animal model was built. Co‐cultures with Caco2 and HepG2 cell lines were set up. Modulation of BA receptors in biopsies of IBD pediatric patients was assessed by real‐time PCR and immunohistochemistry.

Results:

Histology showed inflammatory cell infiltration in the liver of DSS mice, where FXR and PXR were significantly decreased and oxidative stress was increased. Exposure of Caco2 to inflammatory stimuli resulted in the reduction of BA receptor expression in HepG2. Caco2 treatment with dipotassium glycyrrhizate (DPG) reduced these effects on liver cells. Inflamed colon of patients showed altered FXR, PXR, and TGR5 expression.

Conclusions:

This study strongly suggests that gut inflammation affects hepatic cells by altering BA receptor levels as well as increasing the production of pro‐inflammatory cytokines and oxidative stress. Hence, reducing gut inflammation is needed not only to improve the intestinal disease but also to protect the liver.
NASPGHAN Nutrition University (N2U)
Authors: Larson‐Nath Catherine , Goday Praveen S. , Fiechtner Lauren , Mangalat Nisha , Schwartz Sally , Scheimann Ann , Sentongo Timothy , Turner Justine M. ,   NASPGHAN Committee on Nutrition
Published: May 2020

The North American Society of Pediatric Gastroenterology, Hepatology, and Nutrition (NASPGHAN) developed NASPGHAN Nutrition University (N2U) in 2012 to improve nutrition education for pediatric gastroenterology providers. A total of 543 providers (physicians, registered dietitians, and advanced practice nurses) have applied to N2U and 285 have attended this 2‐day course. We used survey methodology to compare attendees to applicants who did not attend. Course attendees reported more confidence than nonattendees in the nutritional management of patients with short bowel syndrome, feeding disorders, and gastrointestinal allergies, even though they were seen at similar frequency in both groups. Eighty‐eight percent of attendees disseminated the information they learned at N2U through venues such as grand rounds or guideline/policy development. These results demonstrate the benefit of N2U in enhancing nutrition education for pediatric gastroenterology practitioners.
Sharing Roles and Control in Pediatric Low Risk Febrile Neutropenia: A Multicenter Focus Group Discussion Study Involving Patients, Parents, and Health Care Professionals
Authors: Morgan Jessica E. , Phillips Robert S. , Stewart Lesley A. , Atkin Karl
Published: May 2020

Introduction:

Reducing treatment intensity for pediatric low risk febrile neutropenia may improve quality of life, and reduce hospital-acquired infections and costs. Key stakeholders’ attitudes toward early discharge regimens are unknown. This study explored perceptions of reduced therapy regimens in the United Kingdom.

Materials and Methods:

Three study sites were purposively selected for their approaches to risk stratification, treatment protocols, shared care networks, and geographical spread of patients. Patients aged 13 to 18 years, parents of children of all ages and health care professionals participated in focus group discussions. A constant comparison analysis was used.

Results:

Thirty-two participants spoke of their different roles in managing febrile neutropenia and how these would change if reduced therapy regimens were implemented, how mutual trust would need to be strengthened and responsibility redistributed. Having identified a need for discretion and a desire for individualized care, negotiation within a spectrum of control allows achievement of the potential for realized discretion. Nonattendance exemplifies when control is different and families use their assessments of risk and sense of mutual trust, along with previous experiences, to make decisions.

Conclusions:

The significance of shared decision making in improving patient experience through sharing risks, developing mutual trust, and negotiating control to achieve individualized treatment cannot be underestimated.
Fusion 68Ga–Prostate-Specific Membrane Antigen PET/MRI on Postoperative Surveillance of Juvenile Nasal Angiofibroma
Authors: Sakthivel Pirabu , Thakar Alok , Arunraj Sreedharan Thankarajan , Bhalla Ashu Seith , Kumar Rakesh
Published: May 2020

Prostate-specific membrane antigen (PSMA) is expressed universally in juvenile nasopharyngeal angiofibroma (JNA). As contrast enhancement of postoperative scar is common with contrast-enhanced MRI (CEMRI), diagnosis of residual/recurrent JNA remains perplexing. Prostate-specific membrane antigen PET targets only the neovasculature and may aid in resolving this dilemma. Positive contrast enhancement on CEMRI was noted in a patient after 30 years of initial surgery, simulating recurrence. However, there was no abnormal uptake in PSMA scan, which was confirmed by biopsy as postoperative fibrosis. 68Ga-PSMA PET/MRI fusion may be an easy and novel technique to aid in differentiating residual/recurrent disease from surgical site reparative tissue.
Low ADC in CNS Lymphoma
Authors: Pyatigorskaya Nadya , Galanaud Damien , Dormont Didier , Soussain Carole , Kas Aurelie
Published: May 2020

Patients with primary central nervous system lymphomas (PCNSLs) present with nonspecific clinical symptoms, which makes correct imaging evaluation essential for diagnostic and therapeutic management. In this work, we examined an 81-year-old man with recently discovered PCNSL using 18F-FDG PET/MRI, and we were able to differentiate between 2 lesions—PCNSL lymphoma extension and a recent ischemia. Our work shows that ischemia should be considered as a differential diagnosis for lymphoma progression. Although 18F-FDG PET or MRI alone cannot always give unambiguous solution, PET/MRI can greatly improve the diagnosis accuracy and help decide on the appropriate patient management.
Chest Computed Tomography Manifestation of Coronavirus Disease 2019 (COVID-19) in Patients With Cardiothoracic Conditions
Authors: Salehi Sana , Abedi Aidin , Radmard Amir Reza , Sorouri Majid , Gholamrezanezhad Ali
Published: May 2020

The coronavirus disease 2019 (COVID-19) pandemic is a serious public health concern, with an exponentially growing number of patients worldwide. Computed tomography (CT) has been suggested as a highly sensitive modality for the diagnosis of pulmonary involvement in the early stages of COVID-19. The typical features of COVID-19 in chest CT include bilateral, peripheral, and multifocal ground-glass opacities with or without superimposed consolidations. Patients with underlying medical conditions are at higher risks of complications and mortality. The diagnosis of COVID-19 on the basis of the imaging features may be more challenging in patients with preexisting cardiothoracic conditions, such as chronic obstructive pulmonary disease, interstitial lung disease, cardiovascular disease, and malignancies with cardiothoracic involvement. The extensive pulmonary involvement in some of these pathologies may obscure the typical manifestation of COVID-19, whereas other preexisting pathologies may resemble the atypical or rare CT manifestations of this viral pneumonia. Thus, understanding the specific CT manifestations in these special subgroups is essential for a prompt diagnosis.
Diagnostic Performance of Chest X-Ray for COVID-19 Pneumonia During the SARS-CoV-2 Pandemic in Lombardy, Italy
Authors: Schiaffino Simone , Tritella Stefania , Cozzi Andrea , Carriero Serena , Blandi Lorenzo , Ferraris Laurenzia , Sardanelli Francesco
Published: May 2020

Chest x-ray (CXR) can play a role in diagnosing patients with suspected severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, but only few small-scale studies are available. We assessed the diagnostic performance of CXR in consecutive patients presenting at the emergency room at the Policlinico San Donato, Milan, Italy from February 24 to April 8, 2020 for suspected SARS-CoV-2 infection. The results of CXR were classified as positive or negative according to the original prospective radiologic reports. To overcome the limitations of reverse transcriptase-polymerase chain reaction (RT-PCR) swab, especially oscillating sensitivity, we added the information obtained from phone calls to discharged patients with negative initial RT-PCR. Thus, we included 535 patients with concomitant CXR and RT-PCR on admission (aged 65±17 y; 340 males, 195 females), resulting in 408 RT-PCR positive and 127 negative patients at the composite reference standard. Original CXR reports showed an 89.0% sensitivity (95% confidence intervals [CI], 85.5%-91.8%), 60.6% specificity (95% CI, 51.6%-69.2%), 87.9% positive predictive value (95% CI, 84.4%-90.9%), and 63.1% negative predictive value (95% CI, 53.9%-71.7%). The adoption of CXR alongside RT-PCR to triage patients with suspected SARS-CoV-2 infection could foster a safe and efficient workflow, counteracting possible false negative RT-PCR results.
The Surgical Approach to Abdominal Sacrocolpopexy and Concurrent Hysterectomy: Trends for the Past Decade
Authors: Winkelman William D. , Modest Anna M. , Richardson Monica L.
Published: May 2020

Objective

The aim of the study was to understand the surgical trends and 30-day complications of patients undergoing an abdominal sacrocolpopexy with a concurrent hysterectomy.

Methods

This is a retrospective cohort study of surgical cases from the American College of Surgeons National Surgical Quality Improvement Program from 2010 to 2017 who underwent an abdominal sacrocolpopexy and a concurrent hysterectomy.

Results

There were 9327 surgical cases of an abdominal sacrocolpopexy with a concurrent hysterectomy of which 7772 (83.3%) were minimally invasive and 1555 (16.7%) were through a laparotomy. The proportion of patients undergoing a laparotomy decreased by 2.4% per year from 2010 to 2018 (R
2 = 0.77). Among minimally invasive procedures, 4359 (46.7%) involved a concurrent supracervical hysterectomy and 4968 (53.3%) involved a concurrent total hysterectomy. Among minimally invasive procedures, patients who had a concurrent supracervical hysterectomy both had a longer operative time and were more likely to be admitted at least 2 days postoperatively compared with those who had a concurrent total hysterectomy (P < 0.001 for both).

Conclusions

Patients undergoing an abdominal sacrocolpopexy and concurrent hysterectomy are increasingly likely to undergo surgery in a minimally invasive approach. The Food and Drug Administration safety communication on electric power morcellation did not impact this trend. Although complication rates are low, regardless of the type of concurrent hysterectomy, some complications, such as blood transfusions and surgical site infections, seem to be highest for those undergoing a concurrent total hysterectomy despite the fact that a concurrent supracervical hysterectomy may be associated with a longer operative time and longer hospital admission.
Open tracheostomy for COVID-19–positive patients: A method to minimize aerosolization and reduce risk of exposure
Authors: Prabhakaran Kartik , Malcom Ryan , Choi James , Chudner Alexandra , Moscatello Augustine , Panzica Peter , Latifi Rifat , Rhee Peter
Published: May 2020

BACKGROUND

The COVID-19 virus is highly contagious, and thus there is a potential of infecting operating staff when operating on these patients. This case series describes a method of performing open tracheostomy for COVID-19 patients while minimizing potential aerosolization of the virus using typically available equipment and supplies.

METHODS

This is a case series of 18 patients who were COVID-19–positive and underwent open tracheostomy in the operating room under a negative pressure plastic hood created using readily available equipment and supplies. Patients had to be intubated for at least 14 days, be convalescing from their cytokine storm, and deemed to survive for at least 14 more days. Other indications for tracheostomy were altered mental status, severe deconditioning, respiratory failure and failed extubation attempts.

RESULTS

There were 14 men and 4 women with severe SARS-CoV2 infection requiring long-term intubation since March 23 or later. The mean age was 61.7 years, body mass index was 32.6, and the pretracheostomy ventilator day was 20.4 days. The indications for tracheostomy were altered mental status, severe deconditioning and continued respiratory with hypoxia. Failed extubation attempt rate was 16.7% and hemodialysis rate was 38.9%. All patients were hemodynamically stable, without any evidence of accelerating cytokine storm. To date there was one minor bleeding due to postoperative therapeutic anticoagulation.

CONCLUSION

This report describes a method of performing open tracheostomy with minimal aerosolization using readily available equipment and supplies in most hospitals.

LEVEL OF EVIDENCE

Therapeutic/care management, Level V.
Effect of cold storage and 1-methylcyclopropene treatment on fruit
storage potential of ‘Summer Prince’ and ‘Summer
King’ apples
Authors: Yoo Jingi , Kang In-Kyu
Published: May 2020

The purpose of this study was to investigate the effects of cold storage and
1-methylcyclopropene (1-MCP) treatment on fruit quality and storage potential of
‘Summer Prince’ and ‘Summer King’ apples. The fruits
were treated with 1-MCP at a concentration of 1 μL/L for 18 h immediately
after harvest, and stored for up to 6 months under cold storage (0°C).
The fruit quality during cold storage showed that the loss of flesh firmness of
untreated fruits was remained at 70 N for ‘Summer Prince’ apple up
to 4 months and 60 N for ‘Summer King’ apple up to 2 months, and
reduced down than those results after that. In 1-MCP treatment, both cultivars
maintained flesh firmness over 70N even after 6 months of storage. Titratable
acidity of untreated fruits decreased to 0.32% (‘Summer
Prince’) and 0.31% (‘Summer King’) for up to 3
months, but 1-MCP-treated fruits still remained at 0.33% and 0.30%
for up to 4 months of storage. Internal ethylene concentration (IEC) of
untreated fruits was increased after one month in both cultivars, but IEC of
1-MCP-treated fruits was significantly lower than that of untreated fruits. Skin
greasiness did not occur at all. Fruit weight loss and peel color variables (L*,
a*, b*) tended to a little increase during cold storage. In case of
‘Summer Prince’ apples, 1-MCP-treated fruits exhibited a reduced
weight loss and delayed change in redness (a*). Therefore, this study suggested
that the storage potential of ‘Summer Prince’ and ‘Summer
King’ apples at cold storage was estimated at 3 and 2 months,
respectively, but this potential would increase for up to 4 months with 1-MCP
treatment in both cultivars.
Effect of relative humidity on the microbial and physicochemical
characteristics of ‘Samnamul’ (Aruncus dioicus
var. kamtschaticus) during storage
Authors: Kim Ah-Na , Lee Kyo-Yeon , Kang Jin Yong , Rahman Muhammad Shafiur , Heo Ho Jin , Choi Sung-Gil
Published: May 2020

The effect of relative humidity (11–96%) on the numbers of microorganisms,
color values, total phenolic contents, antioxidant activities, and oxidative
enzyme activities of ‘Samnamul’ (Aruncus dioicus
var. kamtschaticus) was examined during storage at 10°C.
It was found that an increase in the relative humidity led to increases in the
number of aerobic bacteria, yeast, and mold during storage, while the samples
stored at a higher relative humidity exhibited lower L and b values, in addition
to higher a values, thereby indicating progressive browning. Furthermore, the
total phenolic contents and antioxidant activities decreased upon increasing the
relative humidity during storage at 10°C, and storage at a higher
relative humidity resulted in increases in the oxidative enzyme activities
(e.g., polyphenol oxidase and peroxidase activities) over 4 weeks. The obtained
result therefore indicate that the low oxidative enzyme activities of samples
stored at a low relative humidity restrict enzymatic oxidation and browning,
thereby maintaining the sample color and nutritional quality. As a result,
storage at a lower relative humidity is considerably effective for extending the
shelf life of ‘Samnamul’.
Comparison of the shelf-life of commercial salad lettuces based on
packaging types
Authors: Chang Min-Sun , Kim Jeong-Hee , Lee Jung-Soo , Park Mehea , Chang Eun-Ha , Hong Yoonpyo
Published: May 2020

A comparison of the shelf-life of various lettuces (i.e., Ezabel, Butterhead,
Pagero, mini Romaine, Caipira and red leaf lettuce) during storage was carried
out based on different packaging types. More specifically, the Butterhead
lettuce sample was packaged in a polyethylene terephthalate (PET) tray, while
the Ezabel, Pagero, mini Romaine, Caipira and red leaf lettuce samples were
packaged in polypropylene (PP) film. Changes in the sample weight loss,
respiration rate, chlorophyll content, and visual quality were then investigated
during storage at 10°C. The Ezabel and Caipira samples exhibited the
highest weight loss, whereas the Butterhead sample showed the lowest weight
loss. Among the various lettuce samples, the chlorophyll content of the mini
Romaine lettuce was the highest. In addition, the freshness of the Butterhead
lettuce sample was maintained during 18 days at 10°C, compared to 12 d
for the Ezabel, Pagero, mini Romaine, and Caipira samples. These results
therefore suggest that tray packaging was effective in maintaining the lettuce
quality, while packaging in a PP resulted in leaf softening and discoloration.
Larger leaf areas also resulted in longer shelf-life. The development of an
optimal packaging for lettuce to ensure that freshness is maintained during
storage is therefore necessary.
The Estimated Time-Varying Reproduction Numbers during the Ongoing Pandemic of the Coronavirus Disease 2019 (COVID-19) in 12 Selected Countries outside China
Authors: Hu Fu-Chang
Published: May 2020

Background: How can we anticipate the progression of the ongoing pandemic of the coronavirus disease 2019 (COVID-19)? As a measure of transmissibility, we aimed to estimate concurrently the time-varying reproduction number, R0(t), over time during the COVID-19 pandemic for each of the following 12 heavily-attacked countries: Singapore, South Korea, Japan, Iran, Italy, Spain, Germany, France, Belgium, United Kingdom, the United States of America, and South Africa.
Methods: We downloaded the publicly available COVID-19 pandemic data from the WHO COVID-19 Dashboard website (https://covid19.who.int/) for the duration of January 11, 2020 and May 1, 2020. Then, we specified two plausible distributions of serial interval to apply the novel estimation method implemented in the incidence and EpiEstim packages to the data of daily new confirmed cases for robustly estimating R0(t) in the R software.
Results: We plotted the epidemic curves of daily new confirmed cases for the 12 selected countries. A clear peak of the epidemic curve appeared in 10 of the 12 selected countries at various time points, and then the epidemic curve declined gradually. However, the United States of America and South Africa happened to have two or more peaks and their epidemic curves either reached a plateau or still climbed up. Almost all curves of the estimated R0(t) monotonically went down to be less than or close to 1.0 up to April 30, 2020 except Singapore, South Korea, Japan, Iran, and South Africa, of which the curves surprisingly went up and down at various time periods during the COVID-19 pandemic. Finally, the United States of America and South Africa were the two countries with the approximate R0(t) ≥ 1.0 at the end of April, and thus they were now facing the harshest battles against the coronavirus among the 12 selected countries. By contrast, Spain, Germany, and France with smaller values of the estimated R0(t) were relatively better than the other 9 countries.
Conclusion: Seeing the estimated R0(t) going downhill speedily is more informative than looking for the drops in the daily number of new confirmed cases during an ongoing epidemic of infectious disease. We urge public health authorities and scientists to estimate R0(t) routinely during an epidemic of infectious disease and to report R0(t) daily to the public until the end of the epidemic.
Outbreak of Kawasaki disease in children during COVID-19 pandemic: a prospective observational study in Paris, France
Authors: Toubiana Julie , Poirault Clement , Corsia Alice , Bajolle Fanny , Fourgeaud Jacques , Angoulvant Francois , Debray Agathe , Basmaci Romain , Salvador Elodie , Biscardi Sandra , Frange Pierre , Chalumeau Martin , Casanova Jean-Laurent , Cohen Jeremie F , Allali Slimane
Published: May 2020

Background: Acute clinical manifestations of SARS-CoV-2 infection are less frequent and less severe in children than in adults. However, recent observations raised concerns about potential post-viral severe inflammatory reactions in children infected with SARS-CoV-2.
Methods: We describe an outbreak of cases of Kawasaki disease (KD) admitted between April 27 and May 7, 2020, in the general paediatrics department of a university hospital in Paris, France. All children prospectively underwent nasopharyngeal swabs for SARS-CoV-2 RT-PCR, SARS-CoV-2 IgG serology testing, and echocardiography. The number of admissions for KD during the study period was compared to that observed since January 1, 2018, based on discharge codes, using Poisson regression.
Results: A total of 17 children were admitted for KD over an 11-day period, in contrast with a mean of 1.0 case per 2-week period over 2018-2019 (Poisson incidence rate ratio: 13.2 [95% confidence interval: 7.3-24.1], p <0.001). Their median age was 7.5 (range, 3.7-16.6) years, and 59% of patients originated from sub-Saharan Africa or Caribbean islands. Eleven patients presented with KD shock syndrome (KDSS) requiring intensive care support, and 12 had myocarditis. All children had marked gastrointestinal symptoms at the early stage of illness and high levels of inflammatory markers. Fourteen patients (82%) had evidence of recent SARS-CoV-2 infection (positive RT-PCR 7/17, positive IgG antibody detection 14/16). All patients received immunoglobulins and some received corticosteroids (5/17). The clinical outcome was favourable in all patients. Moderate coronary artery dilations were detected in 5 cases (29%) during hospitalisation.
Conclusions: The ongoing outbreak of KD in the Paris might be related to SARS-CoV2, and shows an unusually high proportion of children with gastrointestinal involvement, KDSS and African ancestry.
Cross-sectional IgM and IgG profiles in SARS-CoV-2 infection
Authors: Ozturk Tugba , Howell Christina , Benameur Karima , Ramonell Richard P , Cashman Kevin , Pirmohammed Shama , Bassit Leda , Roback John , Marconi Vince C , Schinazi Raymond F , Wharton Whitney , Lee F. Eun-Hyung , Hu William T
Published: May 2020

Background: Accurate serological assays can improve the early diagnosis of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, but few studies have compared performance characteristics between assays in symptomatic and recovered patients.
Methods: We recruited 32 patients who had 2019 coronavirus disease (COVID-19; 18 hospitalized and actively symptomatic, 14 recovered mild cases), and measured levels of IgM (against the full-length S1 or the highly homologous SARS-CoV E protein) and IgG (against S1 receptor binding domain [RBD]). We performed the same analysis in 103 pre-2020 healthy adult control (HC) participants and 13 participants who had negative molecular testing for SARS-CoV-2.
Results: Anti-S1-RBD IgG levels were very elevated within days of symptom onset for hospitalized patients (median 2.04 optical density [OD], vs. 0.12 in HC). People who recovered from milder COVID-19 only reached similar IgG levels 28 days after symptom onset. IgM levels were elevated early in both groups (median 1.91 and 2.12 vs. 1.14 OD in HC for anti-S1 IgM, 2.23 and 2.26 vs 1.52 in HC for anti-E IgM), with downward trends in hospitalized cases having longer disease duration. The combination of the two IgM levels showed similar sensitivity for COVID-19 as IgG but greater specificity, and identified 4/10 people (vs. 3/10 by IgG) with prior symptoms and negative molecular testing to have had COVID-19.
Conclusions: Disease severity and timing both influence levels of IgM and IgG against SARS-CoV-2, with IgG better for early detection of severe cases but IgM more suited for early detection of milder cases.
A dynamic model for Covid-19 in Brazil
Authors: Filho Rubens Lichtenthäler , Lichtenthäler Daniel Gomes
Published: May 2020

1

A dynamic model for the current coronavirus outbreak is presented. The most important parameters are identified which determine the number of cases progression. Results of a numerical simulation are compared with existing data of the number of COVID-19 cases and deaths in Sao Paulo and Brazil. On the basis of these results we display the effect of social distancing measures taken so far, which flattened the infection curve. A simple three steps procedure is proposed to predict changes in the evolution of the epidemics and we discuss the importance of serological representative surveys to relate the epidemic time to the real time. A criteria to start relaxing social distance measures is suggested.